Epidemiology Paper Epidemiology Paper Many issues are at the forefront of public health, but prevention is still the topic most discussed by health professionals. This will always be the way to break the cycle of diseases and many other health-related problems. Using the epidemiology triangle and the basics of epidemiology teenage pregnancy will be examined. This issue is still the number one preventable problem in the United States because it is not a disease, it does not “accidentally” transmit to one person to the other, and it will continue to cause problems for the young parents.
The definition of epidemiology is something that took a very long time and is often misunderstood. A CDC scientist found this to be true and also found that he too was perplexed about the true definition. He went to Emory University and was asking passer-by what they though epidemiology was. The medical student said “the worst taught course in medical school” the next person said “the science of making the obvious obscure” (CDC, 2004). The answers revealed that even people who should know what epidemiology was do not so the CDC made a web page specifically designed to make the definition less “obscure. “A less entertaining, but more conventional, definition of epidemiology is “the study of the distribution and determinants of health-related states in specified populations, and the application of this study to control health problems” (CDC, 2004, para. 10). A more simple definition is obtained by looking at the difference between a health care provider and an epidemiologist. A health care provider looks at the individual who has a disease or problem and does tests to determine the best treatment and cause.
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The epidemiologist looks at the entire population to eventually intervene to end the health problem and prevent it from happening (CDC, 2004). This is where teenage pregnancy fits in with public health. The epidemiology triangle is a tool often used as a guide for prevention although teenage pregnancy can often cause some problems when applying this. The epidemiology triangle is a visual tool that can help determine what part of a disease or health-related issue can stop it from happening.
The triangle has three sides one representing the susceptible person or host, the other representing the causative agent, and the other representing the environment. This can be used, but often the problem is more complex than this. “To explain disease and disability caused by multiple factors, McMahon and Pugh developed the concept of web of causation” (McEwen, 2002, p. 114). This can be used to look at teenage pregnancy because this is a problem that is caused by multiple factors. The problem of teenage pregnancy is attributable to a complex interaction between a number of causative and contributing factors including lack of knowledge about sexuality and pregnancy prevention, lack of easily accessible contraception, peer pressure to engage in sex, low self-esteem, social patterns that encourage early motherhood, and use of alcohol or other drugs” (McEwen, 2002, p. 114). Although it is complex to why teens engage in sexual activity given all the issues it is often simple to come up with a solution, education!
Looking at the multiple variables alerts the health care professional to engage teens in many activities to properly educate them. Interventions need to include building self-esteem; role playing on how to say no; educating parents on how to properly supervise activities; information in understandable terms on contraception and how pregnancy occurs (McEwen, 2002). When examining teenage pregnancy there are two types of epidemiology methods that are used. “Descriptive epidemiology considers the amount and distribution of disease within a population by person, place, and time.
This is used primarily to describe patterns of disease rather than considering or speculating on the cause” (McEwen, 2002, p. 122). The other type of epidemiology is analytical. This investigates the “why” of the disease. It uses analytical tools such as studies to find a relationship between two factors that lead to its development (McEwen, 2002). Pregnancy prevention uses both types of epidemiology. The descriptive methods are used to determine the patterns and the analytical method is used to figure out the items that cause it to occur.
The analytical method is used more often because the causative factors of pregnancy in adolescents are often needed in the “approach with a level of complexity usually not found in descriptive epidemiology” (Szklo & Nieto, 2007, p. 4). Looking at the statistics of teenage pregnancy is something very interesting because one may be surprised to know what the patterns are in their state. Although certain states have lower rates it is still a problem causing issues for the United States. “The United States as the highest rates of teenage pregnancy and teen births in the western industrialized world. Teen pregnancy costs the United States at least seven billion dollars annually” (Pregnant teen help website, 2011, para. 1). This is interesting because a prevention program would cost significantly less than the billions of dollars spent taking care of teenage mothers and their children. Although teenage pregnancy rates have fallen in recent years the contributing factors of teenage pregnancy may mean there will be a trend upward in the upcoming years.
Some of these contributing factors are living in poverty, lack of access to or poor use of contraception, growing up in a single-parent home, and parents with low levels of education (Centers for disease control and prevention, 2010, para. 3). These factors, given the economy in recent years may increase, thus increasing the number of teen pregnancies. Health care professionals need to recognize the factors that may eventually increase the number of teen pregnancies even though their state may not be one of the leading numbers of teenage pregnancy.
This is the main principle of prevention. The three levels of prevention can be applied to pregnancy prevention. “Primary prevention consists mainly of activities to keep people healthy before onset of disease” (Stanhope & Lancaster, 2008, p. 907). The “disease” in the case of pregnancy is more of a state of being than a disease but can be applied the same. The beginning of this level of prevention will begin with assessment of risk behavior and intervention of education on how to avoid pregnancy, mostly though behavior (Stanhope & Lancaster, 2008).
So like mentioned above, if there are risk factors that a client has including a single parent home, the nurse can be aware that he or she may be more likely to become pregnant at a young age and provide he or she with the most appropriate interventions and education. Education at this stage of prevention can be methods to prevent from becoming pregnant including use of contraceptive pills, condoms, etc. These interventions can help reduce the client’s risk of getting pregnant.
This may also be education that is provided, not only to the person who may get pregnant (female), but to the person who can get someone pregnant (male). Secondary education is a little more difficult when looking at teenage pregnancy. “Secondary prevention includes screening for diseases to ensure their early identification, treatment, and follow up” (Stanhope & Lancaster, 2008, p. 910). So when looking at teenage pregnancy “secondary prevention focuses on preventing teen parents from having subsequent births” (“National campaign,” 2002, p. 3). The Young Parents Network is a secondary prevention program that is impressive in preventing second births while at the same time providing prevention methods at all levels. This program not only focuses on the young mother but also contributes the secondary education of the young fathers, an area often left out of these programs. “Young Parents Network recognizes the importance of a father in the family and the impact that fathers have upon their children” (Young parents network, 2011, para. 1).
Tertiary prevention can also include prevention of getting pregnant again but also can be viewed as the support for the young parents after the pregnancy has occurred. This could be viewed as a secondary or primary prevention measure. “Tertiary prevention efforts may include prevention of additional adolescent pregnancies, support of positive parent-infant interaction, support groups for adolescent parents, and programs that support adolescents while they pursue educational goals” (Lundy & Jones, 2009, p. 697). This is another impressive aspect of the Young Parents Network.
They do all of these intervention methods including primary prevention also. Home visits with the young parents allow open communication and often provide the parents with a close support system. The nurse will make sure that they have a plan for education in the future and assist him or her with finding other community resources that he or she may be unaware of. They also provide parenting classes for the father and the mother and offer childcare during these classes so that he or she may attend. This can improve self-esteem that can also show significant hope for prevention of future pregnancies.
Jean Watson’s caring theory can be applied to the prevention methods mentioned above and also help the nurse to develop a positive influential relationship with the client to provide the best care. This relationship can be the best tool in being a positive role model in an adolescent’s life and preventing pregnancy. Interventions that can relate to this theory are based on the relationship that must be formed for a young parent or teenager to trust what an adult is educating them about teenage pregnancy prevention.
This must be done in order for “the nurse to enter into and stay within the other’s frame of reference for connecting with the inner life world of meaning and spirit of the other; together they join in a mutual search for meaning and wholeness of being” (Watson caring science institute, 2011, para. 5). While examining the workings of the Young Parents Network the nurses did just that when establishing the relationship and coming up with interventions that will work with each client. For example, the promotion of self esteem and sense of self is aided by offering the participant rewards for attending classes and achieving milestones.
These rewards can be used to purchase items at a “store” that provides them with needed items such as diapers and clothes. This promotes an individual’s self-worth and provides them with a sense of accomplishment that is often missing. Caring moments are another way that interventions can be used to reinforce Jean Watson’s Theory when preventing pregnancy. “A caring occasion occurs whenever the nurse and another come together with their unique life histories and phenomenal fields in a human-to-human transaction” (Watson caring science institute, 2011, para. ). Using spokespersons for prevention and the primary level the nurse can connect with the client by providing the client with his or her own story or one that can connect with him or her. Teens often lack the connection between their lives and that of adults. This intervention of providing them with stories like their own can be a source of inspiration and motivation to either prevent pregnancy or prevent another from occurring. Teenage pregnancy will be a forever discussed topic that will have its ups and downs.
Using the epidemiology triangle and epidemiology methods the health care professional in the community or public health realm can help stop its increase. The principles of prevention can be used combined with epidemiology to ensure that the best methods are being used by public health professionals. Examining the trends in the population and the occurrences in specific states can further direct the nurse to come up with the best strategies to make the United States lower the startling standing in teenage pregnancy. References
CDC. (2004). www. cdc. gov/excite/classroom/intro_epi. htm Centers for disease control and prevention. (2010). www. cdc. gov/features/dsTeenPregnancy/ Lundy, K. S. , & Jones, S. (2009). Community health nursing caring for the public’s health (2nd ed. ). Sadbury, MA: Jones and Bartlett Publishers. McEwen, M. (2002). Community-based nursing an introduction (2nd ed. ). St. Louis, MO: Saunders. Pregnant teen help website. (2011). www. pregnantteenhelp. org/statistics/teen-pregnancy-statistics/ Stanhope, M. , & Lancaster, J. (2008).
Public health nursing population centered health care in the community (7th ed. ). St. Louis, MO: Mosby Elsevier. Szklo, M. , & Nieto, J. (2007). Epidemiology beyond the basics (2nd ed. ). Sadbury, MA: Jones & Bartlett Learning. The national campaign to prevent teen pregnancy. (2002). Retrieved from www. thenationalcampaign. org/resources/pdf/pubs/ReadyResII_Final. pdf Watson caring science institute. (2011). www. watsoncaringscience. org Young parents network. (2011). www. youngparentsnetwork. org/what_we_offer/father. html