How Tillamook County, Oregon Did it:

In 1990 the teen pregnancy rate in Tillamook county was 24 per 1,000 girls 10 - 17, worse than all but 5 of the state's 36 counties. Beginning that year, and continuing to the present, community leaders in Tillamook fashioned a community-wide strategy to change this condition. The strategy was simple: Get everyone - churches, public and private agencies, schools, health workers and families - to acknowledge the problem and commit themselves to doing whatever they can to change it. The controversial nature of the challenge was actually turned into an asset. The widely different views of leaders and the institutions they represented helped motivate the community to get involved.

Between 1990 and 1994, the teen pregnancy rate decreased to 7.1 per 1,000 girls 10 - 17, the best rate in the state. Tillamook county does not attribute this success to any particular service, but rather to the combined effects of the community efforts. These included:

- Schools: added self esteem and sexuality education to their curriculum

- Churches: worked at opening up communication channels with teens, taught refusal skills and promoted abstinence.

- County Health Department: With support from the County Commissioners, the department expanded clinic hours and changed policy to assure that any teen who called the health department for information or services would be seen within 48 hours (not two to three weeks previous practice)

- YMCA: sponsored a "teens at risk" program, providing recreation activities which kept teens busy and built self esteem.

- Community College: worked with teens through the Tillamook Teen Parent Program to prevent second unintended pregnancies.

- Commission on Children and Families: funded teen pregnancy prevention curriculum in the schools as well as counseling and support groups.

- The Tillamook County General Hospital, with other partners, opened "Healthy Families of Tillamook County," a home visiting and parenting program for all newborns.

Other partners included the Women's Crisis Center, the Tillamook Family Counseling Center, the Tillamook Bay Child Care Center, the Tillamook Bay Community College, and others.

According to the Health Department summary, Tillamook county "found that forming partnerships and working together toward a desired result can bring about astounding results. ... Their turn-around was an evolutionary process, with new partners bringing contributions forward at different times." Given a catalyst and a targeted focus on a desired result, the same process can occur in other communities.

Excerpt from "A Strategy Map for Results Based Budgeting," The Finance Project, September, 1996 (see Resources and References).