Assignment 2: Course Project—Plan to Address Health Issue

APPLICATIONS OF THE PRECEDE-PROCEED MODEL 10

Applications of the PRECEDE-PROCEED Model

PHE 6210 Health Promotion and Disease Prevention

Phyllis Ocran

Dr. Gayle Jones

May 2, 2017

UNPROTECTED INTERCOURSE AMONG TEENS

In recent times, when there are many infections due to unprotected intercourse, it is vital to understand the consequence of unprotected intercourse amongst teens. Unprotected sex amongst teens is bad news since it leads to increased dangerous and deadly infections like STIs and most important HIV. (Southern Nevada Health District, 2012). These are permanent and lifelong consequences that affect all teens. Furthermore, unprotected sex amongst teens is greatly influenced by drugs and can also lead to a teen pregnancy that is mostly unwanted (Southern Nevada Health District, 2012). It is a problem and a huge socio-economic implications as well as daunting stigmas especially when a teen contract STIs and HIV as well as unwanted/teen pregnancies.

Reasons Unprotected Intercourse amongst teens is problematic

There are a couple of vital reasons why unprotected intercourse among the teens is problematic (Southern Nevada Health District, 2012), according to recent statistics, teen pregnancy is at its all-time high as the prevalence is 24% per 1,000 women. The second reason unprotected intercourse amongst teens is a problem is exposure to STIs and HIV/AIDS as well as the stigmatization associsted with it. (Braly, Amuta, & McNeill, 2013). Furthermore, unprotected intercourse amongst the teens is expensive not only to the government agencies but also to the parents and teens (Braly et al, 2013). According to the Centers for Disease Control and Prevention (CDC) estimated that $15.9 billion is used to disease new cases of STDs annually. Furthermore, around $9 billion is used annually in teen pregnancy increasing the burden on taxpayers (Braly et al, 2013).

Identify one or two behavioral risk factors related to your selected health issue

The issue selected was unprotected intercourse among teens. There are various behavioral risk factors that cause teenagers to engage in unprotected intercourse. One of the behaviors is substance abuse. According to the McKinley Health Center at the University of Illinois, almost 50% of males and 41% of females confessed to having taken alcohol just before intercourse. 49% of the males and 38% of the females confessed to the alcohol having been the reason they had sex. 26% of the males and 36% of the females did not use protection during their sexual encounter when on drugs. This study shows that drugs such as alcohol can cause people to engage in the risky sexual behavior. Alcohol, for instance, affects the ventral striatum and the prefrontal cortex of the brain. These parts are tasked with the reward system and controlling impulsive behavior. One will, therefore, be more likely to engage in an impulsive sexual behavior when drunk. (Brown & Prinstein, 2011). Drugs, therefore, play a role in the likelihood of a person engaging in unprotected intercourse.

Identify the predisposing, reinforcing, and enabling factors for each selected behavioral risk factor.

Predisposing factors are the inherent factors in an individual that causes them to be more likely to engage in a certain behavior. It includes one’s attitudes, knowledge, beliefs, skills and personal preferences that cause them to undertake a specific behavior. Several predisposing factors can cause the behavioral risk factor, one of them is being brought up in an environment where there is substance abuse. If one has been raised in a home or neighborhood that tolerates drug and substance abuse, the individual is likely to engage in substance abuse. One’s attitude towards drug abuse and sexual behavior is another predisposition factor. One’s attitude and world view govern their perceptions of the world as well as our decisions. Therefore one’s attitudes toward drug abuse and sexual behavior will dictate whether they will engage in it.

The reinforcing factors are the rewards that one gets after engaging in a specific behavior. These rewards cause them to continue expressing the behavior. One such factor is the media. The media today glorifies risky habits such as sexual intercourse and drug abuse. Many of the songs that the young people listen today are filled with messages that promote such behavior. This inevitably causes the individuals to be more likely to engage in the behavior.

Acceptance from reference groups is also a reinforcing factor (Greenberg, Bruess & Oswalt, 2017). Teenagers love to get approval from their friends. If they relate to a group which practices drug abuse and they practice it as well, they will receive approval from their friends. This approval will encourage them to continue engaging in drug abuse which will put them at a higher risk of engaging in unprotected sex with other people.

An enabling factor is a factor that motivates one to adopt a behavior. It is the availability of resources that allows one to engage in a certain behavior. One enabling factor for teenagers to engage in drug abuse is the easy availability of the drugs. Teenagers who have easy accessibility to drugs will more likely engage in drug abuse and consequently risky sexual behavior.

Describe at least two examples of each factor as they relate to the behavior.

One predisposing factor is if one was raised in a home or neighborhood that condones drug abuse. The teenager will believe that drug abuse is acceptable and will practice it. Similarly, if the child was raised in a neighborhood that shuns drug abuse, they will not engage in drug abuse. Drug addiction or the tendency to engage in drug abuse has been linked to some genetically transferable genes. These genes make one more likely to engage in substance abuse (Greenberg et al., 2017). Therefore, if one’s parents had a history of drug abuse, one may have issues with drug abuse. Drug abuse in the teenager will, therefore, cause them to be more likely to engage in unprotected sex.

One’s attitude and belief affect whether they will engage in a specific behavior. If the teenager believes that drug abuse is acceptable, they are more likely to engage in this act than individuals who believe that drug abuse is unacceptable. Taking the example of children who have been raised in religious well-off homes, most of these children do not engage in drug abuse or early sexual encounters because they believe that it is wrong. However, those who have grown up in neighborhoods where the society accepts drug abuse are more likely to engage in drug abuse and early sexual encounters. The children adopt the societal norms while at a young age through observational learning. They believe that such behavior is appropriate and therefore engage in it. However, those who have grown up in a well-off religious home have grown up knowing that such actions are unacceptable and will be less likely to engage in them.

The reinforcing factors are the media and acceptance from reference groups. The media shows what is trending in the society. Today, the media is full of images and songs that glorify pre-marital sex and drug abuse. The teenagers are very vulnerable and can be influenced by these messages to engage in these risky habits. In the bid to be trendy as they undergo self-discovery, they may engage in drug abuse. This could cause them to engage in risky sexual behavior while intoxicated. Similarly, if the media shuns drug abuse, as seen in the many drug prevention campaigns, the teenagers will tend not to engage in drug abuse. Appreciation from their reference groups for engaging in drug abuse could cause them to believe that the behavior is acceptable and therefore engage in it even more. Acceptance from parents could lead them to not engage in drug abuse. If the parents do not support drug abuse, the teenager may seek approval by not engaging in drug abuse putting them at a lower risk of engaging in unprotected sex.

The enabling factor is the availability of drugs which encourages the abuse of drugs and alcohol as well. Underage drinking is illegal in the United States. However, the teenagers are still able to access alcohol since they convince adults to buy it for them. The availability of these drugs allows them to carry on with their drug abuse behavior (Gerstein, &Green, 2013). The teenagers from the low income areas are the most affected as there is much drug dealing in their neighborhoods allowing them to access a wide variety of these drugs. The drug dealers target teenagers in schools as their customers, and the gangs use drugs to lure teenagers into the gang activities. These children are therefore more likely to engage in drug abuse than the children in well-off neighborhoods where there is less prevalence of drug abuse and peddling.

Discuss the advantages and disadvantages of two different settings that can be used to address the health behavior in the targeted population.

This behavior can be addressed by various means. One of the ways is civic education. This is where the society is educated on the effects of drug abuse and the negative effects of unprotected sex among the teenagers. This knowledge will allow the society to take a proactive role and take up protective measures for the children such as parents communicating with them about sex and the society offering after-school programs for the children. These teens will be occupied and informed on the dangers of unprotected sex and drug abuse which will reduce the levels of unprotected sex among the teens in the society (Still, Sarwer & Blankenship, 2014).

This approach would especially be beneficial for children raised in poor neighborhoods where there is a lot of substance abuse as it will reshape their world view to understand that drug abuse is wrong and will put them at risk of unprotected sex. Also, once the society proactively works together to guide the children, they will not be affected by the environment they have grown up in but will be guided down the right path. The disadvantage is that it is very difficult to get community involvement in these areas. Most people are not learned in these areas, therefore, will not understand the grave importance of this initiative. The slacking off of the society will cause the collapse of the program, and the youth will continue engaging in the drug abuse.

Another way of addressing this is by having mandatory random drug tests in schools. Once the teenager is found to be positive, they are reported to the police and counseled. The advantage of this approach is that it will discourage the children from engaging in drug abuse as they will fear being discovered and reported to the schools. The lack of drug abuse will, therefore, lower the rate of unprotected sex among the students. While this approach may be effective, it could be disadvantageous in that these teens will find drugs that cannot be detected by tests and will continue with the practice. Examples of such drugs are LSD, Benadryl, and dextromethorphan, which are not easily detectable. These drugs may be even more dangerous and intoxicating, which will threaten their health while at the same time increase the rate of unprotected sex among this population. Furthermore, strict parenting by the society will cause the children to become more rebellious and therefore make them more likely to engage in unprotected sex.

References

Braly, V., Amuta, A., & McNeill, E. B. (2013). A Section of the PRECEDE–PROCEED Model and Its Application in Fictional Podunk, Texas: A Strategy for Preparing Future Health Education Specialists to Use Planning Models. Journal of Health Education Teaching Techniques, 2 (2);1–15.

Greenberg, J., Bruess, C. & Oswalt, S. (2017). Exploring the dimensions of human sexuality. Burlington, MA: Jones & Bartlett Learning.

Gerstein, D.R. & Green, L.W. (2003). National Research Council (US) Committee on Substance Abuse Prevention Research; Preventing Drug Abuse: What do we know? Washington (DC): National Academies Press (US);.2, Concepts of Prevention. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK234581/

Southern Nevada Health District. (2012). Teens face ‘real life’ consequences of unprotected sex. Retrieved from Southern Nevada Health District: https://www.southernnevadahealthdistrict.org/newsletter/enews/1103-teens.html

Still, C., Sarwer, D. & Blankenship, J. (2014). The ASMBS textbook of bariatric surgery. New York: Springer.