Evelyn Kappeler Director HHS Office of Adolescent Health

Office of Adolescent Health What Are the Primary Federal Activities related to preventing preterm birth?

Evelyn KappelerDirector, Office of Adolescent HealthOffice of the Assistant Secretary for Health U.S. Department of Health and Human Services

Secretarys Advisory Committee on Infant MortalityAugust 10, 2015 12AgendaOverview of OAH Introduction to OAH Programs and ActivitiesNational, Evidence-based Teen Pregnancy Prevention ProgramPregnancy Assistance Fund ProgramQ and A

Q & A

2HHS Office of Adolescent Health (OAH)Vision - To Advance Best Practices to Improve the Health and Well-being of Americas Adolescents Key ActivitiesCoordinate adolescent health initiatives across HHSConvener of Adolescent Health: Think, Act, Grow (TAG)Administer and support Teenage Pregnancy Prevention (TPP) ProgramPregnancy Assistance Fund (PAF) National Resource CentersTPP, Pregnancy Assistance and HIV/AIDS Prevention Among AdolescentsSeveral National TPP Evaluations3 3OASH Organizational ChartSylvia Mathews BurwellSecretaryRegional HealthAdministratorsRegions I-X

Office of Assistant SecretaryNational Vaccine Program Office

Executive Officer

Office of the Surgeon General

Office of Disease Prevention and Health Promotion

Office of Population Affairs

Office on Womens Health

President's Council on Fitness Sports and Nutrition

Office of Research Integrity

Office of HIV/AIDS and Infectious Disease Policy

Office of Minority Health

Office of Commissioned Corps Force ManagementDeputy AssistantSecretary for Health

Office of CommunicationsDirector

Office of Adolescent Health

Office for HumanResearch Protections

Assistant SecretaryKaren B. DeSalvo, MD, MPH, MSc

4 4Tier 1 Replication of program models proven effective through rigorous evaluation

Tier 2 Demonstration programs to develop and test additional models and innovative strategies

TPP Program Support Programmatic Training & Technical AssistanceMedical Accuracy ReviewPerformance MeasuresEvaluation Training & Technical AssistanceStaffing and Overhead

OAH Teen Pregnancy Prevention Program5 581 New TPP Grantees (July 1, 2015 June 30, 2020)Serving close to 300,000 youth each year and 1.2 million youth over five-years across 38 States and the Marshall Islands

Capacity Building to Support Evidence-Based TPP Programs (1A) 8 granteesBuilding capacity in communities with high teen birth rates (47.7 112 per 1,000); focus on reaching youth in foster care and juvenile detention, homeless youth, and young parents

Replicating Evidence-Based TPP Programs to Scale (1B) 50 granteesImplementing evidence-based TPP programs to scale in multiple settings in communities with especially high teen birth rates (40 - 136.1 per 1,000)Focusing on engaging the entire community and ensuring a well coordinated approach

Supporting Early Innovation to Prevent Teen Pregnancy (2A) 2 granteesSupporting technology-based innovations and programmatic-based innovationsHosting a national competition to select innovators who will receive funding and support

Rigorous Evaluation of New or Innovative Approaches (2B) 21 granteesEvaluating new interventions designed to fill gaps in the current evidence-based for TPP, including interventions for males (5), Latino youth (1), American Indian youth (1), youth in foster care (2), incarcerated youth (1), LGBTQ youth (2), clinic-based interventions (4), intervention for families and caregivers (1), technology-based interventions (3), and new school and community-based interventions (6).

More information available at http://www.hhs.gov/ash/oah/oah-initiatives/tpp_program/cohorts-2015-2020.html Overview of New TPP Grantees6 6 Pregnancy Assistance FundPatient Protection and Affordable Care Act (Public Law 111-148) sections 10211- 10214

Authorizes $25 million for each of fiscal years 2010 through 2019

Authorizes the Secretary of HHS to establish and administer a Pregnancy Assistance Fund to award competitive grants to States and Tribes to assist pregnant and parenting teens and women

7 . 7 Pregnancy Assistance FundPurposeProvide expectant and parenting teens, women, fathers and their families with:

A seamless network of services to help them complete high school or post secondary degrees

Gain access to health care, child care, family housing, and other critical supports

Improve services for pregnant women who are victims of domestic violence, sexual violence, sexual assault, and staking

8 The PAF program emphasizes health, education, and social services to provide a comprehensive supportive network for expectant and parenting teens, women, fathers, and their families.

Assist participants in getting access to necessary services whether health care, child care, prenatal care, or housing as examples.

89Funding Categories1.Providing support for expectant and parenting students in Institutions of Higher Education (IHE)

2.Providing support for expectant and parenting teens, women, fathers, and their families in high schools and community service centers

3.Improving services for pregnant women who are victims of domestic violence, sexual violence, sexual assault, and stalking

4.Increasing public awareness and education of services available for expectant and parenting teens, women, fathers, and their families

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10Pregnancy Assistance FundProgram activities emphasize health, education, and social services for expectant and parenting teens, women, fathers, and their families

All services provided in categories 1, 2, and 3 should be evidence-based or evidence-informed and culturally and linguistically appropriate11

PAF grantees use a range of approaches which include a mix of

Home Visiting Academic Support Group-based support Referrals Health care services Child care Fatherhood programs Job training

The PAF can play a role in assisting in the prevention of pre-term births in that grantees are expected to provide a range of services, either directly or through referrals, and act as a major source of assistance with health care needs.

Spacing births is strategy to prevent preterm births. We know that the interval between first and second pregnancy strongly impacts preterm birth risk. Currently, nearly 1 in 5 births to teens, ages 1519, are repeat births. American Indian and Alaskan Natives, Hispanics, and black teens are about 1.5 times more likely to have a repeat teen birth, compared to white teens. Infants born from a repeat teen birth are often born too small or too soon, which can lead to more health problems for the baby.

We see the PAF program as an opportunity to education expectant and parenting young women (and men) about preconception and interconception care. And, one of the priorities of PAF grantees is the prevention and timing of a second a pregnancy.

It is also in opportunity to teach pregnant and parenting young families about the important of healthy behaviors while pregnant and before pregnancy.

1112Pregnancy Assistance FundDisseminate information about the availability of and eligibility for health coverage under federal and state programs, such as:MedicaidChildrens Health Insurance ProgramHealth Insurance MarketplacesProvide application assistance and enrollment in these services for expectant and parenting students and their children.Demonstrate collaboration among relevant State agencies and leverage other resources or links to existing support services 13Key HighlightsCollection of a common set of performance measureshttp://www.hhs.gov/ash/oah/oah-initiatives/tpp_program/program-guidance/Assets/2014-paf-performancemeasures.pdfGrantee level evaluation and plans for Federal evaluation

Development of a sustainability planhttp://www.hhs.gov/ash/oah/oah-initiatives/paf/training/sustainability.html

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