Key Informant Interview with Kristin Parnell, RN

We chose one of our key informants to be Kristin Parnell, a registered nurse at Cabarrus
Pediatric Clinic in concord. We asked her several questions about the main health concerns or
problems of adolescents in the area. She identified the main health concerns to be childhood
obesity, asthma, type II diabetes, eating disorders, autism, teen pregnancy and sexually
transmitted infections. The top two problems are childhood obesity and asthma. Mrs. Parnell
said from what she saw at her practice, she would estimate that 6 out of every 10 adolescents are
overweight or obese. Kristin stated that both problems seem to be on the rise from what she has
seen at the doctor’s office she works at.

I asked Kristin how the parents and children respond when told they are overweight or
obese. She replied that they are both open and most of the time already know that they are
overweight, however that does not mean they change their diet or exercise practices.
Interventions by the staff include education about eating healthy and instruction about the food
guide pyramid, formulating exercise plans and encouraging the kids to lose weight and stick with
the program. Only about half of the adolescents seem to comply and change their diet and
exercise habits.

In contrast, when the parents and children are told they have asthma, they are very
compliant with their medication regime. Some of the medications prescribed at the hospital
include an Albuterol inhaler and an Atrovent nebulizer. Some of the children are also on
Singulair which is a once daily medication for asthma.

I asked Kristin what the doctors and nurses felt important to talk with the adolescents
about when they came in for a visit. She said they talked with them about getting vaccines such
as Menactra, T-DAP, Gardisil, the seasonal flu vaccine and the H1N1 vaccine. They also talk
with each kid about their diet habits, eating healthy and exercising every day. If the adolescent is
over 16, the doctor asks the parents to step out of the room so the child will feel more
comfortable about discussing if they are engaging in sexual activity. They always ask if
adolescent if they have any questions for them and try to making them feel comfortable. They
also usually ask what the kids like to do for fun. Sports and video games are the top two
responses.
 Key Informant Interview with Candi Mizell, RN, BSN

After much distress over finding a second key informant interview, Candi Mizell, the
school nurse from Central Cabarrus High School, volunteered to answer a few questions
regarding the adolescent population. We chose questions regarding teen pregnancy as well as
sexually transmitted diseases. When asking about teen pregnancy being on the incline, nurse
Mizell stated that in this school year alone, the school has encountered an increase in the number
of pregnancies. She said that last year they had over twenty five pregnancies amongst the student
population. Unfortunately, she states that she only sees this rising in the future.

I asked the nurse about the prevalence regarding age, race, and culture and if she
encountered one more than the other. She stated that at Central Cabarrus, the population they see
teen pregnancy most often in is Hispanics (this year anyway). However, she said that the data
varies from year to year. She said that she personally she sees more Caucasian and African
Americans in her office seeking guidance on the pregnancy process, but receives information on
those who are pregnant throughout the school and the Hispanic population has been more
prevalent this year. As for a certain age group, she states that she sees students from the ages of
15-18.

A support system is often an important part of teen pregnancy. I asked nurse Mizell if the
majority of the adolescents had any type of support system. She informed me that fortunately for
the students, most of the families are supportive. During this school year, they have encountered
one family that has not been supportive. She told me that a lack of support often makes the
process extremely difficult for the student both mentally and physically. If this is the case, nurse
Mizell tries her best to act as the support system and get the student plugged in to support
programs such as Stepping Stones. When questioned about the outcome regarding students
staying in school, dropping out, or becoming homebound she responded that the majority remain
in school. She states that although it is not easy for them, Central Cabarrus does their best to
encourage graduation. She said one personal goal of hers is to encourage the students to stay in
school. She states that she tries to get them to look at the advantages and help them focus on their
future. They do however have those who choose to not stay in school. She makes every effort to
contact these students and encourage them. They have had students who are required to be on
bed rest and the students’ school work is sent to their home. Central Cabarrus tries to
accommodate the best they can.

I asked nurse Mizell which resources were utilized when a student finds out they are
pregnant. The school allows registered nurses from an organization known as Stepping Stones to
speak with the students if they wish. The program is through the Cabarrus County Health
Alliance program. She went on to say that anyone may utilize this resource as a part of the
pregnancy process.
 I also questioned nurse Mizell about the prevalence of sexually transmitted diseases
(STD). She stated that she has had a small increase in the number of students who are concerned
about having an STD. She said that she is sure more students have them around the school, but
do not wish to speak with her about it. She also admits that many students are probably not
aware of the seriousness of contracting an STD. She said they could be walking around each day
and be oblivious to the fact of having an STD. She encourages students about her open door
policy and assures that everything they tell her is confidential. She states that while she sees a
limited number of students questioning an STD, she sees that the problem is on the rise. When a
student is concerned, she informs them to seek medical attention and get tested at the local health
department. I asked what the students are doing in terms of sex education and she states they are
only educated on the process once in their four years of high school. She believes that if more
students were aware of the complications and the seriousness of the disease that safer sex would
be practiced.

I asked if parents must be involved in both teen pregnancy and STD situations and she
states that due to laws such as HIPAA the parent is not required to be notified. It is up to the
student as to whether or not to notify the parents. Nurse Mizell strongly encourages if the
students have a good relationship with the parents to use them as a support system.