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Health Promotion: Sexual Health of Delaware’s Teenagers

Stephanie Charney

Department of Nursing, Delaware Technical Community College

NUR330-501 Population and Community Health

Dr. Karen Wagamon

April 7th, 2024

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Health Promotion: Sexual Health of Delaware’s Teenagers

Adolescence is a critical period marked by significant physical, emotional, and social

changes, making teenage sexual health a topic of major importance. While mental health and

obesity are prominent concerns, sexual health stands out due to its profound impact on teenagers’

well-being and future trajectories. Martinez and Abma (2020) highlight concerning statistics,

revealing that a notable proportion of teenagers engage in sexual intercourse by age 19. This

underscores the need for comprehensive sexual education and accessible reproductive health

services. Despite advancements in sexual health education and contraception availability,

challenges persist, including disparities in access to care, societal norms, and cultural influences.

Unwanted pregnancies among teenagers pose significant risks to physical and emotional

well-being, strain familial relationships and support networks, and impose economic costs on

society. Teenage mothers face higher risks of pregnancy complications, educational disruptions,

and mental health issues (Aldam et al., 2019). Families supporting teenage parents may

experience financial strain and emotional stress, leading to conflicts and breakdowns in

communication (Smith et al., 2018). Moreover, unintended pregnancies among teenagers incur

substantial economic costs, including healthcare expenses, social welfare programs, and lost

productivity (Guttmacher Institute, 2021). These economic burdens perpetuate intergenerational

cycles of poverty and disadvantage, hindering the well-being and opportunities of affected

individuals and families.

To address these challenges, comprehensive interventions are necessary. This includes

prioritizing sexual health promotion efforts, ensuring equitable access to sexual health resources,

and providing support and resources to teenage parents and their families. By empowering

teenagers to make informed decisions about their sexual health and addressing the root causes of
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unintended pregnancies, we can break the cycle of intergenerational poverty and disadvantage,

fostering healthier communities for generations to come.

There is a prevailing need across Delaware, particularly in low-income communities, for

comprehensive sexual education. Only 68.8% of high school students in Delaware report

receiving formal instruction on contraception methods during sexual education classes,

according to the Youth Risk Behavior Survey (Delaware Division of Public Health, 2021).

Limited access to evidence-based sexual education perpetuates knowledge gaps and contributes

to risky sexual behaviors among teenagers, exacerbating the burden of STIs and unintended

pregnancies (Corcoran, 2020). Addressing these multifaceted challenges requires comprehensive

interventions that prioritize access to sexual health resources, culturally sensitive healthcare

services, and evidence-based sexual education.

As implied, teenage sexual health is a complex and multifaceted issue with far-reaching

implications for individuals, families, and society as a whole. By investing in comprehensive

sexual education, accessible reproductive health services, and support systems for teenage

parents, we can promote the well-being and future prospects of adolescents while mitigating the

broader societal impacts of unwanted pregnancies. Addressing the root causes of unintended

pregnancies is crucial for breaking the intergenerational cycle of poverty, alleviating the

economic costs incurred by healthcare expenses and lost productivity, strengthening familial

relationships and support networks, and safeguarding the physical and emotional well-being of

both teenage mothers and their children. It is imperative that we prioritize teenage sexual health

as a vital component of comprehensive adolescent health initiatives, ensuring that all young

people have the resources and support they need to thrive.

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The Role of Nurses in Promoting Sexual Health among Teenagers in Delaware

Nurses in Delaware play a crucial role in enhancing the sexual health outcomes of

teenagers by providing comprehensive sexual education, STI prevention and management,

contraceptive counseling, and creating supportive environments for open dialogue. Despite the

state's efforts, a significant gap remains in sexual education accessibility, with only 48% of high

schools in Delaware mandating comprehensive sexual education (SIECUS, 2024). Nurses, with

their expertise and approachability, can bridge this gap by offering accurate and age-appropriate

sexual education in various settings, including schools, community centers, and healthcare

facilities.

In the realm of STI prevention and management, Delaware has witnessed increasing rates

of STIs among teenagers in recent years (Leonard, 2024). Nurses stand at the forefront of

providing counseling, testing, and treatment for STIs, advocating preventive measures such as

condom use and regular screenings. Moreover, nurses play a pivotal role in offering

contraceptive counseling and services to teenagers, empowering them to make informed choices

about their sexual health. By providing a range of contraceptive options and respecting teenagers'

autonomy and confidentiality, nurses ensure that teenagers have access to essential resources for

preventing unintended pregnancies.

Beyond education and clinical services, nurses cultivate a supportive and non-judgmental

environment for teenagers to discuss sexual health concerns. Adolescents often face barriers to

seeking information or care related to sexual health due to stigma or embarrassment. Nurses

alleviate these barriers by providing a safe space for teenagers to ask questions, express

concerns, and access resources without fear of judgment. By connecting with teenagers
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holistically, nurses foster trust and facilitate meaningful conversations that empower teenagers to

prioritize their sexual health and well-being.

In essence, nurses are instrumental in promoting teenage sexual health in Delaware.

Through their multifaceted roles as educators, counselors, advocates, and allies, nurses

contribute significantly to the overall well-being of adolescents in the state. However, sustained

efforts are needed to ensure that all teenagers have equitable access to high-quality sexual health

services and education, ultimately empowering them to make informed decisions and lead

healthier lives.

SMART Goals

Goal 1: Increase Access to Affordable Sexual Health Services

At the heart of addressing sexual health disparities in Delaware lies the imperative to

enhance access to affordable healthcare services. To achieve this, partnerships will be established

with local healthcare providers and community clinics to offer low-cost or sliding-scale fee

sexual health services, encompassing STI testing, contraception counseling, and reproductive

healthcare. Over the next 12 months, the objective is to increase the number of individuals

accessing sexual health services by 20% within targeted low-income communities. This goal is

not only achievable by leveraging existing healthcare infrastructure and collaborating with

community partners but is also realistic given the prevalence of healthcare facilities and clinics

within Delaware. Implementation of partnership agreements and fee structures will commence

within the next three months, with progress tracked towards the 20% increase in service

utilization over the subsequent 12 months.

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In relation to the SMART goal of expanding access to affordable sexual health services,

nurses would serve as pivotal figures in various capacities. Firstly, they would collaborate

closely with healthcare providers and community clinics to establish and promote low-cost

sexual health services. Through their clinical expertise and understanding of community needs,

nurses would contribute to innovative solutions to address barriers to care. They would also

serve as advocates for policies supporting affordable healthcare access, engaging in legislative

advocacy and community organizing to address social determinants of health. Overall, nurses

would play a critical role in achieving the SMART goal by promoting equitable access to sexual

health resources and improving health outcomes for all individuals.

Goal 2: Enhance Telehealth Services for Rural Communities

Expanding telehealth services represents a critical avenue for addressing the unique

challenges faced by individuals residing in rural communities, particularly in Southern Delaware.

This goal entails the inclusion of virtual consultations for sexual health concerns, STI testing,

and contraceptive counseling in telehealth offerings. Over the next six months, the objective is to

increase the utilization of telehealth services for sexual health consultations by 30% among

residents of rural communities within Southern Delaware. Achieving this goal is feasible through

investment in telehealth infrastructure, provider training on telemedicine platforms, and

advancements in technology and broadband availability in rural areas. The timely

implementation of the expansion of telehealth services, beginning within the next three months,

will be accompanied by monitoring of utilization rates over the subsequent six months to track

progress towards the 30% increase target.

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In alignment with the SMART goal of enhancing telehealth services for rural

communities, nurses take on multifaceted roles to ensure equitable access to high-quality

healthcare. Firstly, they lead the implementation of telehealth programs within healthcare

facilities and community organizations serving rural populations. Collaborating with various

organizations, nurses can lead telehealth implementation and raise awareness of its benefits

among both patients and healthcare professionals.

Furthermore, nurses will serve as telehealth coordinators, facilitating virtual consultations

and coordinating patient care seamlessly. They triage inquiries, schedule appointments, and

provide necessary support, leveraging their clinical judgment and communication skills to

address patient needs effectively. Additionally, nurses offer tailored telehealth education to

empower patients in navigating virtual healthcare platforms and accessing necessary services

remotely. They also advocate for policy changes to enhance telehealth infrastructure and

reimbursement mechanisms in rural areas, collaborating with upper management to identify and

overcome barriers to telehealth adoption. Through their leadership, advocacy, and

patient-centered care approach, nurses play a vital role in improving healthcare access and

outcomes for rural communities, contributing to the realization of SMART goals for healthcare

equity and inclusivity.

Goal 3: Strengthen Comprehensive Sexual Education in Schools

Education plays a pivotal role in shaping attitudes and behaviors towards sexual health,

particularly among adolescents. Collaborative efforts with school districts will focus on

implementing evidence-based and culturally sensitive sexual education curricula in schools

serving low-income and minority populations. The aim is to increase the percentage of schools
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offering comprehensive sexual education programs by 50% within targeted low-income

communities over the next academic year. Achieving this goal involves providing training and

resources to educators, engaging with school administrators, and advocating for the integration

of comprehensive sexual education into existing curricula. With commitment from educators and

administrators and the availability of evidence-based resources, the goal is realistic and aligned

with the commitment to promoting student well-being. Implementation will commence at the

start of the next academic year, with progress monitored over the subsequent 12 months towards

achieving the 50% increase in program implementation.

In line with the SMART goal of enhancing comprehensive sexual education in schools,

nurses take on pivotal roles in ensuring students receive inclusive and accurate information about

sexual health. Initially, they collaborate with school leaders and educators to design

evidence-based curricula tailored to the needs of diverse student populations, particularly those

from low-income and minority backgrounds. Utilizing their clinical expertise and understanding

of adolescent development, nurses work alongside stakeholders to ensure that the programs are

culturally sensitive, age-appropriate, and aligned with educational standards.

Additionally, nurses provide crucial support by training school nurses and educators to

deliver comprehensive sexual education effectively. Through workshops and resources, they

equip staff with the skills and knowledge needed to foster safe and supportive learning

environments where students can openly discuss sexual health topics. Nurses also advocate for

policies mandating comprehensive sexual education and allocate resources for teacher training

and program evaluation, collaborating with policymakers and advocacy groups to prioritize

teenage sexual health.

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Furthermore, nurses engage with parents and communities to build support for

comprehensive sexual education initiatives and dispel misconceptions surrounding the topic. By

facilitating workshops and outreach events, they empower parents to have open conversations

with their children about sexual health and foster collaboration between schools and families.

Nurses play a crucial role in promoting sexual health literacy and well-being among adolescents,

contributing to the achievement of SMART goals for comprehensive sexual education.

Health Promotion Plan: Improving Sexual Health in Teens in Delaware

The health promotion plan outlined here is designed to address and improve sexual health

outcomes among teenagers in Delaware. It encompasses a multi-faceted approach aimed at

increasing access to affordable sexual health services, enhancing telehealth options for rural

communities, and strengthening sexual education programs in schools serving low-income and

minority populations. Through the deployment of mobile sexual health clinics, telemedicine

consultations, and collaboration with healthcare providers and community organizations, the plan

seeks to overcome barriers to accessing comprehensive sexual health care. By empowering teens

with knowledge, resources, and support, the goal is to promote healthier behaviors and reduce

the prevalence of sexually transmitted infections and unintended pregnancies. Through

collaboration and innovation, this plan endeavors to make meaningful strides in promoting

sexual health equity for all teens in Delaware.

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Goals and Objectives

1. Increase Access to Affordable Sexual Health Services: By the end of the year, increase

the utilization of affordable sexual health services by 20% among low-income

populations in Delaware.

2. Enhance Telehealth Services for Rural Communities: Within six months, expand

telehealth services to reach 30% of individuals in rural communities in Southern

Delaware.

3. Strengthen Comprehensive Sexual Education in Schools: Within the next academic year,

increase the implementation of comprehensive sexual education programs by 50% in

schools serving low-income and minority populations.

Interventions

Increase Access to Affordable Sexual Health Services

1. Establish Mobile Sexual Health Clinics: Deploy mobile clinics to underserved

communities, providing low-cost services.

2. Implement Telemedicine Consultations for Sexual Health: Offer remote consultations for

STI testing and contraception counseling.

3. Collaborate with Planned Parenthood and Local Health Departments: Partner with

existing healthcare providers to offer affordable sexual health services.

Enhance Telehealth Services for Rural Communities:

1. Telehealth Education and Outreach Campaigns: Conduct campaigns to raise awareness

about telehealth services in rural areas.

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2. Provide Telehealth Training for Healthcare Providers: Train providers on delivering

high-quality care via telemedicine platforms.

3. Partner with Community Health Centers and State Telehealth Programs: Collaborate to

expand telehealth services in rural communities.

Strengthen Comprehensive Sexual Education in Schools:

1. Support Curriculum Development and Implementation: Assist schools in developing and

implementing evidence-based sexual education curricula.

2. Facilitate Parent and Community Engagement Events: Host workshops and forums to

involve parents and community stakeholders in sexual health education.

3. Access Resources from National Organizations: Seek guidance and resources from

organizations such as Advocates for Youth and SIECUS to enhance sexual education

efforts.

Resources

In Delaware, several pre-existing resources contribute to the groundwork for

implementing the proposed health promotion plan aimed at improving sexual health among

teens. The Delaware Division of Public Health (DPH) plays a crucial role in providing sexual

health services and education across the state. According to the Delaware Department of Health

and Social Services (DHSS), DPH operates clinics that offer confidential sexual health services,

including STI testing and contraception, which can serve as essential partners in expanding

access to affordable sexual health services (Delaware Health and Social Services, n.d.).

Additionally, Planned Parenthood of Delaware is another key resource that already offers

comprehensive sexual health services, including education, counseling, and medical care,
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making them valuable collaborators in the effort to increase access to affordable sexual health

services (Planned Parenthood of Delaware, n.d.). These preexisting resources provide a solid

foundation for partnerships and collaboration, facilitating the successful implementation of the

proposed interventions to address the sexual health needs of teens in Delaware.

Evaluation

The quantitative evaluation plan for the health promotion initiative in Delaware will

comprehensively assess the effectiveness of the interventions aimed at improving sexual health

among teens. Utilization rates for sexual health services and telehealth consultations will be

closely monitored to gauge the extent to which low-income populations are accessing affordable

sexual health services and telehealth consultations. Additionally, the percentage of individuals in

rural communities accessing telehealth services will be tracked to evaluate the impact of efforts

to enhance telehealth services in Southern Delaware. Progress towards strengthening sexual

education in schools serving low-income and minority populations will be measured through

implementation rates of comprehensive sexual education programs. Furthermore, changes in

knowledge, attitudes, and behaviors related to sexual health among target populations will be

assessed through pre- and post-intervention surveys, interviews, and focus groups. By

systematically tracking these quantitative indicators, the evaluation plan will provide valuable

insights into the impact of the health promotion initiatives, informing future programmatic

decisions and resource allocation.

In addition to the quantitative evaluation measures, gathering qualitative data through

patient satisfaction surveys, interviews, and focus groups will provide valuable insights into the

effectiveness and impact of the health promotion interventions on the target population.
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Feedback from patients and stakeholders will offer perspectives on the accessibility, quality, and

appropriateness of sexual health services and educational programs. Moreover, soliciting input

from healthcare providers, educators, and community leaders involved in program

implementation will help identify strengths, challenges, and areas for improvement. Additionally,

conducting surveys or town hall meetings to gauge community perceptions of sexual health

initiatives will ensure that the interventions align with the needs and preferences of the

communities they serve. By implementing these interventions and conducting thorough

evaluations, stakeholders can work towards achieving the SMART goals outlined and promote

sexual health equity among teens in Delaware. This comprehensive approach to evaluation will

enable ongoing refinement and optimization of the health promotion plan to better meet the

needs of the target population and drive meaningful change in sexual health outcomes.

Conclusion

The health promotion plan outlined offers a comprehensive strategy to improve sexual

health outcomes among teens in Delaware. By focusing on increasing access to affordable sexual

health services, enhancing telehealth options for rural communities, and strengthening sexual

education in schools, the plan aims to address disparities and promote equity. Through

evidence-based interventions and thorough evaluation, we can track progress and ensure that the

plan effectively meets the needs of our teen population. Collaboration among healthcare

providers, educators, community leaders, and national organizations will be crucial for success.

By remaining committed to implementation, evaluation, and adaptation, we can work towards

achieving our goals and fostering a healthier future for all teens in the state.
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References

Aldam, S. F. S., Keliat, B. A., Wardani, I. Y., Sulistiowati, N. M. D., & Florensa, M. V. A.

(2019). Risk factors of mental health in adolescents: emotional, behavioral, family, and

peer relationship problems. Comprehensive Child and Adolescent Nursing, 42(sup1),

284-290.

Corcoran, J. L. (2020). Understanding Adolescent Sexual Health Through Exploration of Their

Perceptions, Behaviors, and Beliefs (Doctoral dissertation, The University of Alabama at

Birmingham).

Delaware Division of Public Health. (2021). Delaware Health Statistics Center. Retrieved from

https://www.dhss.delaware.gov/dhss/dph/hp/hpstats.html

Delaware Health and Social Services. (n.d.). Teen Pregnancy Prevention. State of Delaware.

https://dhss.delaware.gov/dhss/dph/chca/dphahtpp01.html

Guttmacher Institute. (2019). Unintended pregnancy in the United States. Guttmacher.

https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states

Leonard, N. (2024). Syphilis cases are rising sharply in Pa., N.J. and Del., new federal data

shows. WHYY. https://whyy.org/articles/syphilis-delaware-valley-rising/

Martinez, G., & Abma, J. C. (2020). Sexual activity and contraceptive use among teenagers aged

15-19 in the United States, 2015-2017.

Planned Parenthood. (n.d.). About us.

https://www.plannedparenthood.org/planned-parenthood-delaware/who-we-are

SIECUS. (2024). Delaware State Profile. SIECUS.

https://siecus.org/state_profile/delaware-state-profile-23/
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Smith, C., Strohschein, L., & Crosnoe, R. (2018). Family histories and teen pregnancy in the

United States and Canada. Journal of Marriage and Family, 80(5), 1244-1258.