Commentaries Risk for Unintended Pregnancy and Child bearing Among Educable Mentally Handicapped Adolescents Susan R. Levy, Cydne Perhats, Myra Nash Johnson
T
hough pregnancy and birth rates among all adult women have declined steadily, the birth rate among adolescents decreased only slightly during the past decade. It remains frighteningly stable, or may be increasing, for the youngest and most at-risk age groups.'-3Among at-risk groups receiving limited attention in studies of early and unintended teen pregnancy are adolescents with developmental disabilities. For all young teens, unintended pregnancy and subsequent parental responsibilities can strain social, physical, and emotional resources already challenged significantly during the complex developmental period of adolescence. Many risk factors associated with early childbearing may be further exacerbated by developmental delays in these adolescents, placing them at even greater risk. Thus, further generations at risk are being created by not developing effective prevention strategies that schools and communities can implement to meet the special needs of these teens. One study' of pregnant females served by the San Diego Adolescent Pregnancy and Parenting Program (SANDAPP) revealed low intellectual ability or functioning was a serious risk factor for adolescent pregnancy. Results from SANDAPP indicate special education teens became mothers in disproportionate numbers and dropped out of school at earlier ages than nonspecial education teens. Twenty percent of pregnant teens in the study population were enrolled in special education classes, yet only 10% of all students in the San Diego school district typically attend such classes (n = 135; mean age = 16). In addition, the mean dropout age for special education teens was one year younger than that of their non-special education peers (age 14 vs. age 15). Through working with the Children and Adolescent Pregnancy Project (CAPP), it became apparent over time that approximately one-third of all presenting students were identified as educable mentally handicapped (EMH). CAPP, an ongoing, school-based intervention program, addresses intellectual functioning as a risk factor for pregnancy because of the large number of Susan R. Levy, PhD, FASHA, CHES, Associate Director of School/ Adolescent Research; and Cydne Perhats, MPH. Research Specialist, Prevention Research Center, M / C 275, The University of Illinois at Chicago, 850 W. Jackson Blvd., Suite 400, Chicago, IL 60607; and Myra Nash Johnson, ACS W, (former Director, Arts of Living Institute). Executive Director, Westside Health Partnership, 3829 W. Ogden Ave., Chicago, IL 60623. This article was submitted July 22, 1991. and revised and accepted for publication January 27, 1992.
EMH females presenting themselves at intake and through referral. CAPP was initiated to meet the service needs of this highly vulnerable population. Few programs target the very young pregnant teen. Few programs have been evaluated over time and none integrated a sizable EMH pregnant teen population as part of the intervention.5 The history of CAPP is linked directly to the observation of a dramatic change in the age and developmental status of the pregnant females enrolling in the program or referred for services during the 1980s.
PROGRAM DESCRIPTION CAPP began as a three-year (1983-1985) demonstration model developed by the Arts of Living Institute (ALI), which was established as an alternative school for pregnant teens in 1973. ALI now serves between 900 and 1,200 females each year. CAPP was established within ALI in response to increasing numbers of elementary school-age (ESA, ages 11-15) and educable mentally handicapped (ages 1 1-19) pregnant adolescents who required developmentally appropriate programs and services to meet their special needs. Most of these students were Black (91 Vo) or Hispanic (7%) teens from families living at or below the poverty level. Approximately one-half of CAPP participants resided in five Chicago communities identified by the Chicago Dept. of Health as high risk for poor pregnancy outcomes. The demonstration program promoted an 18-month follow-up with the females after delivery of their babies to maintain the health of infants and mothers, to prevent subsequent pregnancies, and to encourage completion of high school. It offered an extensive core of developmentally appropriate educational, health, and social services to Chicago's youngest mothers, within a single setting. CAPP staff also coordinated direct care through a comprehensive network of' public and private service agencies located in or near the client's neighborhood. The caseworker often was the first and only link to the service delivery system for these teens. The EMH Client
Though two other alternative schools in Chicago offer educational programs for pregnant teens,,CAPP is the only program that addresses the EMH pregnant mother. Teens with IQs of 60 to 79 are identified as EMH by the Chicago Board of Education. These teens are higher-level functioning students with the potential
~~
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April 1992, Vol. 62, No. 4
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to learn to read and write and to achieve a degree of selfcare and independence. EMH students enrolled in CAPP attend special education classes as well as other CAPP services. The decision to include the EMH population in the same program as the younger pregnant teens was based on the developmental similarity of the two groups. EMH students generally were three years behind grade level and, though most were older than age 15, they were at a similar cognitive developmental stage as the younger pregnant teens. Special Concerns More than 50% of the females in CAPP reported
problems such as sexual or physical abuse, early maternal deprivation, environmental deprivation, foster care placement, and chronic transience of family members in and out of the home. In addition, 32% of CAPP’s fathers were four or more years older than the females they were “dating.” Developmentally speaking, such gaps may represent as much as twice the age difference in the number of years of chronological separation between an EMH adolescent female and her partner. In one case, a male age 40 impregnated an EMH female age 15. While this case clearly would be labeled sexual exploitation, the more common cases where an EMH female age 15 “dates” a male age 19 also should be viewed as such. Recent Developments
Funding recently was obtained to evaluate data collected on clients who presented at CAPP from 1983-1985. During this period, CAPP served 98 EMH and 228 ESA pregnant females, representing approximately 22% to 25 9’0 of all pregnant teens younger than age 15 who gave birth in Chicago during those three years. Though ALI primarily serves the south and west geographic regions of the city, students referred from schools in those neighborhoods are similar to other young, primarily Black pregnant teens from high-risk communities. Client outcomes were determined for four major indicators commonly used to evaluate teen pregnancy programs: low birthweight ( 2,500 grams/5.5 pounds), infant mortality, repeat pregnancy, and dropping out of school. Both ESA and EMH pregnant teens enrolled in CAPP during the three-year period had lower than expected rates on all four outcome measures compared to rates predicted by either local Chicago or national statistics. The fact that no significant differences were found between ESA and EMH clients on these four outcome measures may speak to the appropriateness of serving these two at-risk groups in a combined program. If comparisons were made to actual neighborhoods where most of the females live, the figures would show an even greater disparity from the expected outcomes. A cause-and-effect relationship between program support and client outcomes such as school retention and avoiding a repeat pregnancy cannot be inferred from evaluation of present program variables. For example, during the three-year period for which CAPP clients were followed, only 30% of mothers reported they were not attending or had not completed school. In contrast, the dropout rate for Chicago high schools through the end of the senior year is 45% for all stu-
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152
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dents and 70% for pregnant teem6 It is difficult to attribute the observed school retention rate of CAPP participants to any one factor. Though staying in school may delay early childbearing, no single outcome is predictive of any other. Their interrelationship probably differs among individual females, their particular circumstances, and their ability to cope with the challenges and demands placed on them at a given time. Furthermore, since some CAPP clients still were younger than age 16 at the end of the evaluation, it was not possible to accurately assess dropout rates for this population. Long-term outcomes could not be determined without following clients through high school. Most EMH teens were older, however, and program data suggest they may be at increased risk of dropping out in earlier grades. School attendance was 15% lower among EMH students when compared with ESA students at the same grade level. Consistency of these findings with those from SANDAPP at least raises serious concerns about the risk of school failure among EMH pregnant teens. While CAPP found that approximately one-third of its clients were identified as EMH, the actual Chicago population figures for EMH females who are pregnant is unknown. Apparently, no other programs have specifically integrated a sizable EMH population as part of an intervention with pregnant teens. Without additional data, it cannot be determined if the EMH/ESA composition of the CAPP caseload represents the population at large. Further studies need to be conducted to determine if increased risk of unintended pregnancy and associated school failure exists among EMH adolescents. CONCLUSION Results from the CAPP evaluation and the SANDAPP study imply that a greater number of mentally handicapped adolescents may become pregnant and drop out of school at earlier ages than in the general teen population. Lack of developmentally appropriate information and opportunities for social learning experiences deprive EMH individuals of their right to knowledge and healthy sexual expression, making them increasingly vulnerable to sexual exploitation and unintended pregnancy. Because the largest number of mildly and moderately retarded individuals can be reached in the school setting, school-based pregnancy prevention efforts should be targeted to this group. School-based clinics that offer comprehensive health services have been successful in reducing the number of pregnancies, increasing contraceptive use, facilitating access to early prenatal care and general health care, and keeping young mothers in school.’J CAPP data suggest it is appropriate and effective to serve the needs of the EMH pregnant female with the same intensive, long-term, integrated programs as benefits the very young pregnant adolescent. These programs and other school-based models could be expanded to address the needs of the special learner through adoption of developmentally appropriate human sexuality education classes. These classes should cover health and human sexuality, decision-making, self-protection, social skills development, and self-efficacy.
While the CAPP experience points to the need for adolescent pregnancy programs that address special requirements of EMH pregnant teens, prevention and protection represent the ideal method of reducing risks in this population. Developmentally disabled youth need to be educated about inappropriate touching of all kinds by adults, including family members, and to learn to differentiate between positive and exploitative touching. Both the child and the parent need to know selfprotective practices that can be learned to avoid harmful situations. In addition, service providers who educate and care for disabled youth must be thoroughly screened. Finally, because these individuals are at a similar level of development as their younger peers, special protective services should be required for this population regardless of age, such as changing the age of statutory rape laws to age 21 for adolescents with developmental disabilities. The “Just Say No” approach cannot be an effective method of self-protection for these adolescents. Results from this evaluation raise disturbing questions; questions that will remain unanswered without further research into the risks of unintended pregnancy and childbearing for adolescents with developmental disabilities. Findings from the CAPP evaluation proved inconclusive in part because local and national data on rates of unintended pregnancy and childbearing in the EMH population are not available. To address these issues at the national level, a critical need exists to compile data on teen pregnancy and birth rates according to developmental criteria. As professionals concerned with
the physical, emotional, and intellectual well-being of children and adolescents, the essential service needs of this frequently neglected population demand attention and further research from all disciplines working in the fields of maternal and child health, adolescent development, and mental retardation. Progress can be achieved through greater awareness and collaboration in research and program development aimed at achieving mutually shared goals and ideals for the child with developmental H delays. References I . Advance report of final natality statistics, 1988.Monthly Viral Star Rep. 1990;39(4). 2. Moore KA. Facts At A Glance. Washington, DC: Child Trends Inc; 1990. 3. Mulchahey KM. Adolescent pregnancy: Prevalence, health and psychosocial risks. In: Story M, ed. Nutrition Management of the Pregnant Adolescent. Washington, DC: National Clearinghouse; 1990;l-7. 4. Kleinfeld LA, Young RL. Risk of pregnancy and dropping out of school among special education adolescents. J Sch Health. 1989;59(8):359-361. 5 . Interventions for pregnant and parenting adolescents. In: Hayes CE, ed. Risking the Future: Adolescent sexuality, pregnancy, ond childbearing. Washington, DC: National Academy of Sciences; 1987:189-230. 6. The Bottom Line: Chicago’s failing schools and how to save them. Chicago, 111: Designs for Change research report no I ; 1985. 7. Kirby D. Comprehensive school-based health clinics: A growing movement to improve adolescent health and reduce teen-age pregnancy. J Sch Health. 1986;56(7):289-291. 8. Dryfoos JG. School-based health clinics: A new approach to preventing adolescent pregnancy? Fam Plann Perspecl. 1985;17(2): 70-75.
Job Opportunities HEALTH EDUCATORS: The Missouri Dept. of Health, Bureau of Health Promotion, is currently recruiting for approximately 14 health educator positions. HEALTH EDUCATOR 111 two positions - Duties include developing statewide health education and health promotion programs and supervising implementation in one or more district areas. The positions are located in the departmental central office (Columbia) and the Central District (Jefferson City). Four years experience in community or worksite health promotion, or comprehensive school health education; and a master’s degree in health education are required. Credentialing as a Certified Health Education Specialist is recommended. Salary $23,940 - $32,004. HEALTH EDUCATOR II two positions - Duties include overseeing and coordinating health education and health promotion programs for a large multi-county or district area. The positions are located in the departmental central office (Columbia) and the Eastern (St. Louis) Health District. Two years of professional experience in community or worksite health promotion, or comprehensive school health education: and graduation from an accredited four-year college or university with major specialization in health education are required. A master’s degree in health education is preferred. Credentialing as a Certified Health Education Specialist is recommended. Salary $21,228 - $28,224. HEALTH EDUCATOR I 10 posltlons - Health Educator I positions will be located in various county health departments statewide. Duties include developing and implementing health education and health promotion programs for a multi-county area.
-
-
-
Individuals will be employees of a county health department. Graduation from an accredited four-year college or university with a bachelor’s degree with major specialization in health education or a master’s degree in health education is required. Credentialing as a Certified Health Education Specialist is recommended. Salary $18,192 - $23,940. Review of positions will begin immediately. The search will remain open until all positions are filled. The Missouri Dept. of Health is an Equal Opportunity/Affirmative Action Employer. Quallfled applicants should send a resume and transcrlpts to: Nancy Miller, MEd, CHES, Chief, Bureau of Health Promotion, Missouri Dept. of Health, 201 Business Loop 70 West, Columbia, MO 65203; 314/876-3250, FAX 314/443-3592.
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THE WEKEELA CAMPS a co-ed camp in Canton, Maine, seeks Registered Nurses, June 21 - August 22, 1992. Excellent facilities. Outstanding staff, top compensation, private rooms, informal, caring atmosphere. Contact: Eric or Lauren Scoblionko, 130 S. Merkle Road, Columbus, OH 43209 (614) 235-3177.
-
HEALTH EDUCATION Teach in M S and BS degree programs. Seek individual with ability in the preparation of grants and contracts proposals. Assistant Professor; Tenure-track appointment; doctorate in health education. Contact Dr. Arvil Burks, Chair, Dept. of Health Education, University of Central Arkansas, Box 5016U, Conway, AR 72032. UCA is an EOE/AA institution.
Journal of School Health
April 1992, Vol. 62, No. 4
153
T
hough pregnancy and birth rates among all adult women have declined steadily, the birth rate among adolescents decreased only slightly during the past decade. It remains frighteningly stable, or may be increasing, for the youngest and most at-risk age groups.'-3Among at-risk groups receiving limited attention in studies of early and unintended teen pregnancy are adolescents with developmental disabilities. For all young teens, unintended pregnancy and subsequent parental responsibilities can strain social, physical, and emotional resources already challenged significantly during the complex developmental period of adolescence. Many risk factors associated with early childbearing may be further exacerbated by developmental delays in these adolescents, placing them at even greater risk. Thus, further generations at risk are being created by not developing effective prevention strategies that schools and communities can implement to meet the special needs of these teens. One study' of pregnant females served by the San Diego Adolescent Pregnancy and Parenting Program (SANDAPP) revealed low intellectual ability or functioning was a serious risk factor for adolescent pregnancy. Results from SANDAPP indicate special education teens became mothers in disproportionate numbers and dropped out of school at earlier ages than nonspecial education teens. Twenty percent of pregnant teens in the study population were enrolled in special education classes, yet only 10% of all students in the San Diego school district typically attend such classes (n = 135; mean age = 16). In addition, the mean dropout age for special education teens was one year younger than that of their non-special education peers (age 14 vs. age 15). Through working with the Children and Adolescent Pregnancy Project (CAPP), it became apparent over time that approximately one-third of all presenting students were identified as educable mentally handicapped (EMH). CAPP, an ongoing, school-based intervention program, addresses intellectual functioning as a risk factor for pregnancy because of the large number of Susan R. Levy, PhD, FASHA, CHES, Associate Director of School/ Adolescent Research; and Cydne Perhats, MPH. Research Specialist, Prevention Research Center, M / C 275, The University of Illinois at Chicago, 850 W. Jackson Blvd., Suite 400, Chicago, IL 60607; and Myra Nash Johnson, ACS W, (former Director, Arts of Living Institute). Executive Director, Westside Health Partnership, 3829 W. Ogden Ave., Chicago, IL 60623. This article was submitted July 22, 1991. and revised and accepted for publication January 27, 1992.
EMH females presenting themselves at intake and through referral. CAPP was initiated to meet the service needs of this highly vulnerable population. Few programs target the very young pregnant teen. Few programs have been evaluated over time and none integrated a sizable EMH pregnant teen population as part of the intervention.5 The history of CAPP is linked directly to the observation of a dramatic change in the age and developmental status of the pregnant females enrolling in the program or referred for services during the 1980s.
PROGRAM DESCRIPTION CAPP began as a three-year (1983-1985) demonstration model developed by the Arts of Living Institute (ALI), which was established as an alternative school for pregnant teens in 1973. ALI now serves between 900 and 1,200 females each year. CAPP was established within ALI in response to increasing numbers of elementary school-age (ESA, ages 11-15) and educable mentally handicapped (ages 1 1-19) pregnant adolescents who required developmentally appropriate programs and services to meet their special needs. Most of these students were Black (91 Vo) or Hispanic (7%) teens from families living at or below the poverty level. Approximately one-half of CAPP participants resided in five Chicago communities identified by the Chicago Dept. of Health as high risk for poor pregnancy outcomes. The demonstration program promoted an 18-month follow-up with the females after delivery of their babies to maintain the health of infants and mothers, to prevent subsequent pregnancies, and to encourage completion of high school. It offered an extensive core of developmentally appropriate educational, health, and social services to Chicago's youngest mothers, within a single setting. CAPP staff also coordinated direct care through a comprehensive network of' public and private service agencies located in or near the client's neighborhood. The caseworker often was the first and only link to the service delivery system for these teens. The EMH Client
Though two other alternative schools in Chicago offer educational programs for pregnant teens,,CAPP is the only program that addresses the EMH pregnant mother. Teens with IQs of 60 to 79 are identified as EMH by the Chicago Board of Education. These teens are higher-level functioning students with the potential
~~
Journal of School Health
April 1992, Vol. 62, No. 4
151
to learn to read and write and to achieve a degree of selfcare and independence. EMH students enrolled in CAPP attend special education classes as well as other CAPP services. The decision to include the EMH population in the same program as the younger pregnant teens was based on the developmental similarity of the two groups. EMH students generally were three years behind grade level and, though most were older than age 15, they were at a similar cognitive developmental stage as the younger pregnant teens. Special Concerns More than 50% of the females in CAPP reported
problems such as sexual or physical abuse, early maternal deprivation, environmental deprivation, foster care placement, and chronic transience of family members in and out of the home. In addition, 32% of CAPP’s fathers were four or more years older than the females they were “dating.” Developmentally speaking, such gaps may represent as much as twice the age difference in the number of years of chronological separation between an EMH adolescent female and her partner. In one case, a male age 40 impregnated an EMH female age 15. While this case clearly would be labeled sexual exploitation, the more common cases where an EMH female age 15 “dates” a male age 19 also should be viewed as such. Recent Developments
Funding recently was obtained to evaluate data collected on clients who presented at CAPP from 1983-1985. During this period, CAPP served 98 EMH and 228 ESA pregnant females, representing approximately 22% to 25 9’0 of all pregnant teens younger than age 15 who gave birth in Chicago during those three years. Though ALI primarily serves the south and west geographic regions of the city, students referred from schools in those neighborhoods are similar to other young, primarily Black pregnant teens from high-risk communities. Client outcomes were determined for four major indicators commonly used to evaluate teen pregnancy programs: low birthweight ( 2,500 grams/5.5 pounds), infant mortality, repeat pregnancy, and dropping out of school. Both ESA and EMH pregnant teens enrolled in CAPP during the three-year period had lower than expected rates on all four outcome measures compared to rates predicted by either local Chicago or national statistics. The fact that no significant differences were found between ESA and EMH clients on these four outcome measures may speak to the appropriateness of serving these two at-risk groups in a combined program. If comparisons were made to actual neighborhoods where most of the females live, the figures would show an even greater disparity from the expected outcomes. A cause-and-effect relationship between program support and client outcomes such as school retention and avoiding a repeat pregnancy cannot be inferred from evaluation of present program variables. For example, during the three-year period for which CAPP clients were followed, only 30% of mothers reported they were not attending or had not completed school. In contrast, the dropout rate for Chicago high schools through the end of the senior year is 45% for all stu-
-
152
Journal of School Health
April 1992, Vol. 62, No. 4
dents and 70% for pregnant teem6 It is difficult to attribute the observed school retention rate of CAPP participants to any one factor. Though staying in school may delay early childbearing, no single outcome is predictive of any other. Their interrelationship probably differs among individual females, their particular circumstances, and their ability to cope with the challenges and demands placed on them at a given time. Furthermore, since some CAPP clients still were younger than age 16 at the end of the evaluation, it was not possible to accurately assess dropout rates for this population. Long-term outcomes could not be determined without following clients through high school. Most EMH teens were older, however, and program data suggest they may be at increased risk of dropping out in earlier grades. School attendance was 15% lower among EMH students when compared with ESA students at the same grade level. Consistency of these findings with those from SANDAPP at least raises serious concerns about the risk of school failure among EMH pregnant teens. While CAPP found that approximately one-third of its clients were identified as EMH, the actual Chicago population figures for EMH females who are pregnant is unknown. Apparently, no other programs have specifically integrated a sizable EMH population as part of an intervention with pregnant teens. Without additional data, it cannot be determined if the EMH/ESA composition of the CAPP caseload represents the population at large. Further studies need to be conducted to determine if increased risk of unintended pregnancy and associated school failure exists among EMH adolescents. CONCLUSION Results from the CAPP evaluation and the SANDAPP study imply that a greater number of mentally handicapped adolescents may become pregnant and drop out of school at earlier ages than in the general teen population. Lack of developmentally appropriate information and opportunities for social learning experiences deprive EMH individuals of their right to knowledge and healthy sexual expression, making them increasingly vulnerable to sexual exploitation and unintended pregnancy. Because the largest number of mildly and moderately retarded individuals can be reached in the school setting, school-based pregnancy prevention efforts should be targeted to this group. School-based clinics that offer comprehensive health services have been successful in reducing the number of pregnancies, increasing contraceptive use, facilitating access to early prenatal care and general health care, and keeping young mothers in school.’J CAPP data suggest it is appropriate and effective to serve the needs of the EMH pregnant female with the same intensive, long-term, integrated programs as benefits the very young pregnant adolescent. These programs and other school-based models could be expanded to address the needs of the special learner through adoption of developmentally appropriate human sexuality education classes. These classes should cover health and human sexuality, decision-making, self-protection, social skills development, and self-efficacy.
While the CAPP experience points to the need for adolescent pregnancy programs that address special requirements of EMH pregnant teens, prevention and protection represent the ideal method of reducing risks in this population. Developmentally disabled youth need to be educated about inappropriate touching of all kinds by adults, including family members, and to learn to differentiate between positive and exploitative touching. Both the child and the parent need to know selfprotective practices that can be learned to avoid harmful situations. In addition, service providers who educate and care for disabled youth must be thoroughly screened. Finally, because these individuals are at a similar level of development as their younger peers, special protective services should be required for this population regardless of age, such as changing the age of statutory rape laws to age 21 for adolescents with developmental disabilities. The “Just Say No” approach cannot be an effective method of self-protection for these adolescents. Results from this evaluation raise disturbing questions; questions that will remain unanswered without further research into the risks of unintended pregnancy and childbearing for adolescents with developmental disabilities. Findings from the CAPP evaluation proved inconclusive in part because local and national data on rates of unintended pregnancy and childbearing in the EMH population are not available. To address these issues at the national level, a critical need exists to compile data on teen pregnancy and birth rates according to developmental criteria. As professionals concerned with
the physical, emotional, and intellectual well-being of children and adolescents, the essential service needs of this frequently neglected population demand attention and further research from all disciplines working in the fields of maternal and child health, adolescent development, and mental retardation. Progress can be achieved through greater awareness and collaboration in research and program development aimed at achieving mutually shared goals and ideals for the child with developmental H delays. References I . Advance report of final natality statistics, 1988.Monthly Viral Star Rep. 1990;39(4). 2. Moore KA. Facts At A Glance. Washington, DC: Child Trends Inc; 1990. 3. Mulchahey KM. Adolescent pregnancy: Prevalence, health and psychosocial risks. In: Story M, ed. Nutrition Management of the Pregnant Adolescent. Washington, DC: National Clearinghouse; 1990;l-7. 4. Kleinfeld LA, Young RL. Risk of pregnancy and dropping out of school among special education adolescents. J Sch Health. 1989;59(8):359-361. 5 . Interventions for pregnant and parenting adolescents. In: Hayes CE, ed. Risking the Future: Adolescent sexuality, pregnancy, ond childbearing. Washington, DC: National Academy of Sciences; 1987:189-230. 6. The Bottom Line: Chicago’s failing schools and how to save them. Chicago, 111: Designs for Change research report no I ; 1985. 7. Kirby D. Comprehensive school-based health clinics: A growing movement to improve adolescent health and reduce teen-age pregnancy. J Sch Health. 1986;56(7):289-291. 8. Dryfoos JG. School-based health clinics: A new approach to preventing adolescent pregnancy? Fam Plann Perspecl. 1985;17(2): 70-75.
Job Opportunities HEALTH EDUCATORS: The Missouri Dept. of Health, Bureau of Health Promotion, is currently recruiting for approximately 14 health educator positions. HEALTH EDUCATOR 111 two positions - Duties include developing statewide health education and health promotion programs and supervising implementation in one or more district areas. The positions are located in the departmental central office (Columbia) and the Central District (Jefferson City). Four years experience in community or worksite health promotion, or comprehensive school health education; and a master’s degree in health education are required. Credentialing as a Certified Health Education Specialist is recommended. Salary $23,940 - $32,004. HEALTH EDUCATOR II two positions - Duties include overseeing and coordinating health education and health promotion programs for a large multi-county or district area. The positions are located in the departmental central office (Columbia) and the Eastern (St. Louis) Health District. Two years of professional experience in community or worksite health promotion, or comprehensive school health education: and graduation from an accredited four-year college or university with major specialization in health education are required. A master’s degree in health education is preferred. Credentialing as a Certified Health Education Specialist is recommended. Salary $21,228 - $28,224. HEALTH EDUCATOR I 10 posltlons - Health Educator I positions will be located in various county health departments statewide. Duties include developing and implementing health education and health promotion programs for a multi-county area.
-
-
-
Individuals will be employees of a county health department. Graduation from an accredited four-year college or university with a bachelor’s degree with major specialization in health education or a master’s degree in health education is required. Credentialing as a Certified Health Education Specialist is recommended. Salary $18,192 - $23,940. Review of positions will begin immediately. The search will remain open until all positions are filled. The Missouri Dept. of Health is an Equal Opportunity/Affirmative Action Employer. Quallfled applicants should send a resume and transcrlpts to: Nancy Miller, MEd, CHES, Chief, Bureau of Health Promotion, Missouri Dept. of Health, 201 Business Loop 70 West, Columbia, MO 65203; 314/876-3250, FAX 314/443-3592.
-
THE WEKEELA CAMPS a co-ed camp in Canton, Maine, seeks Registered Nurses, June 21 - August 22, 1992. Excellent facilities. Outstanding staff, top compensation, private rooms, informal, caring atmosphere. Contact: Eric or Lauren Scoblionko, 130 S. Merkle Road, Columbus, OH 43209 (614) 235-3177.
-
HEALTH EDUCATION Teach in M S and BS degree programs. Seek individual with ability in the preparation of grants and contracts proposals. Assistant Professor; Tenure-track appointment; doctorate in health education. Contact Dr. Arvil Burks, Chair, Dept. of Health Education, University of Central Arkansas, Box 5016U, Conway, AR 72032. UCA is an EOE/AA institution.
Journal of School Health
April 1992, Vol. 62, No. 4
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