Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Anne Ray

Committee Member

Dr. Mark Swanson

Committee Member

Dr. Caitlin Pope


Kentucky has the 6th highest rate of adolescent pregnancy in the United States and Harlan County ranks among the highest rates in the state. Adolescent pregnancy is a public health problem and costs taxpayers in the United States around $9.4 billion each year. Overall, there have been declines in adolescent pregnancy but the national average soars above those in other Western industrialized nations such as the United Kingdom. Implementing a comprehensive sexual health education program in a public school setting is an efficient strategy to reach numerous adolescents and influence sexual health knowledge and help to delay the initiation of sexual activity. To address this burden the Harlan County School System has decided to use the Get Real Framework on its evidence-based foundation. It will be implemented in a cohort of 6th grade students among three schools in Harlan County. Community Stakeholders will help with the implementation process. In the short-term we will measure teachers’ confidence and comfortability delivering the lessons, students’ knowledge of comprehensive sexual health and education, students’ knowledge of contraceptive use, and students’ knowledge of healthy relationships and responsible decision making regarding healthy relationships and contraceptive use. In the medium-term we will measure students’ use of contraceptives, students’ number of sexual partners, students’ participation in unhealthy relationships, and the initiation of sex. The long-term outcome is decreased rates of unintended adolescent pregnancy.

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Public Health Commons