Smart Women Smart Choices Workbook

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College women enrolled in the Smart Women Smart Choice program were mailed a personal workbook that guided them to change their behavior in order to reduce their risk related to dangerous drinking.

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Smart Women Smart Choices Workbook

  1. 1. SM WORKBOOK
  2. 2. Sheran McNiff, Program Educator Email: AEPP@state.health.mn.us. Fax: 651-215-9988 Private toll free Phone: 1-888-702-9971 Website: www.iPartySmarter.com Minnesota Department of Health Minnesota Department of Health 85 E. 7th Place, Suite 220 P.O. Box 64882 St. Paul, MN 55164-0882 Monday-Friday, 9 am - 4 pm. Leave your name, number, and recommend a time you may be reached within the next couple days. Keep the program educator handy when you need her.
  3. 3. Welcome to the Smart Women Smart Choices Workbook Congratulations for taking the time to take better care of you. If you’re thinking you might be ready for a change, this workbook is right for you. Don’t be discouraged by its size! You can move through it quickly and you can always work through it in stages. Here are a couple of things to keep in mind as you proceed: The program educator can assist you at any point in the • program. You can reach her Monday-Friday, 9-4 pm. Her contact information is printed on the bottom of each page and inside the front cover of this workbook. Because we’d like to support your journey, the program educator will contact • you in the next month and again in four months. She will check on your progress and address your questions or concerns. When the educator follows up with you at these points, you will have the opportunity to earn a Target gift card! About the Smart Women Smart Choices Program The Minnesota Department of Health sponsors this free educational program for women. Women have the power to make The primary goals of the program are to: good decisions • decrease risky drinking and about their • enhance effective use of birth control, including health and safety. condoms. The program focuses on helping women explore their alcohol and birth control use, including condoms, because women’s decisions about these two behaviors can have serious immediate and life-long consequences. This workbook provides a series of steps to explore your drinking and birth control use. You decide if and how to change based on your individual circumstances and preferences. Need Help? Call….1-888-702-9971 -1-
  4. 4. Before Starting the Workbook Before starting the exercises in the workbook, be sure to do the following: Read Your Personal Feedback from the educator About the Resource Directory and More Included with the workbook are several other items to assist you on your change journey. Resource Directory: Finding Help to Change This directory provides a wealth of resources to assist you in your change effort. When you are ready to create your change plans in Step 2 of the workbook, review the directory to contact the resources that will assist you. Many of the websites included in the directory also can be found on the program website at iPartySmarter.com. A Closer Look Booklet This booklet provides additional information on a variety of the topics related to your change efforts. We encourage you to read them as you proceed with the steps of change. Need Help? Call….1-888-702-9971 -2-
  5. 5. Table of Contents Page What’s Your Party Style? 4 Reasons to Change 6 Step 1: Making a Decision to Change 11 Birth Control 12 Drinking 14 Step 2: Planning to Change 19 Birth Control 20 Drinking 30 Step 3: Handling the Challenges of Change 43 Glossary of Terms 47 Attachments Resource Directory: Finding Help to Change A Closer Look Booklet Need Help? Call….1-888-702-9971 -3-
  6. 6. What’s Your Party Style? Your party style can make all the difference between having fun or having regrets. This activity can help you determine whether or not your party style is setting you up for a good time or some real problems. For each question, choose the response that best describes how often you experience each of the following situations. Never Not Sometimes Often Very Often Often 1. After you’ve been drinking or partying, do 1 2 3 4 5 your friends tell you about something you said or did that you don’t remember or you are embarrassed to hear? 2. Do you find yourself ending up having sex 1 2 3 4 5 with a person you would never consider as a partner when you are sober? 3. Do you have sex without using birth control 1 2 3 4 5 or condoms? 4. When you have sex with a new partner do 1 2 3 4 5 you forget or choose not to use a condom? 5. After you’ve had sex with a new partner 1 2 3 4 5 without using a condom, do you skip getting tested for Sexually Transmitted Infections (STIs)? 6. Do you worry about being taken advantage of 1 2 3 4 5 or hurt by someone when you’re drinking? Add up your points in each column: Add up your total points: Need Help? Call….1-888-702-9971 -4-
  7. 7. Your Party Style Score Now read the description that corresponds to your total score. Your Your Party Style Score 1-6 Less Dangerous points Your party style is most likely keeping you out of harm’s way. However, to ensure that you keep yourself safe, consider making a few changes. This workbook can help you do that. 7-18 Somewhat Dangerous points Your party style is sometimes putting you in harm’s way. To keep yourself safe, you need to consider making some changes. This workbook can help you do that. 19-30 Most Dangerous points Your party style definitely is putting you in harm’s way - often. To keep yourself safe, you need to consider making some serious changes. This workbook can help you do that. How did you do? The results of the Party Style activity aren’t scientific and they aren’t an indictment of your behaviors. However, they can help you think about whether you need to make a change in your party practices. Keep reading to learn more. Need Help? Call….1-888-702-9971 -5-
  8. 8. Reasons to Change
  9. 9. Reasons to Change Making decisions is a natural part of life. However, before making a decision to change, it’s good to make sure it’s an informed choice. So let’s review some of the risks related to drinking and sex that might be really good reasons to make a change. Drinking and Sex: A Dangerous Brew You’ve probably already discovered that sex and drinking often go together. The mix can create some unique hazards for women. Some women drink to get a “buzz” to help them relax and feel more sociable with When it comes to drinking others. As alcohol relaxes inhibitions, it also alcohol, men and women are impairs a woman’s thinking and judgment, making NOT created equal. The her more vulnerable to risky behaviors and impact of two drinks on a situations. Because too much alcohol impairs a man is roughly equivalent to woman’s judgment, memory, and balance, making one drink on a woman. her more vulnerable to a wide range of dangers, it can be considered “risky” or “dangerous drinking”. Center on Addiction and Substance Abuse. 2006 It’s the impact of drinking on your thinking and behaviors that can lead to trouble. You need to know that if you drink like the boys, you’re subjecting yourself to twice the effects from the same amount of alcohol. What is Dangerous Drinking? Experts suggest that women who drink more than 3 standard* drinks in a 2-hour period (even occasionally) or more than 7 standard drinks per week are more likely to experience serious problems with relationships, school, work, safety, health, money and the law. National Institute on Alcohol Abuse and Alcoholism. (2005) Alcohol a women’s health issue. NIAAA. (1990) Alcohol use and abuse: Where do the numbers come from? Alcohol Alert. No. 7. * See the standard drink definition and chart in the glossary at the back of the workbook. Need Help? Call….1-888-702-9971 -6-
  10. 10. Feeling Sexy but Not Very Smart Although alcohol can decrease sexual inhibitions and make you feel sexier, it acts as a central nervous system depressant, affecting your judgment and decision making that would normally keep you out of harm’s way. A woman drinking alcohol while she is sexually active and not using contraception*, including condoms, puts herself at risk in many ways. Reducing your drinking to safer Unwanted Sex—Alcohol decreases your levels and/or improving your inhibitions, allowing you to engage in sexual effective use of birth control can activity you wouldn’t do when you are significantly reduce your risks. sober, or allowing encounters for which you may not have given consent. In the past several years, many national studies of college student drinking report that college men and women are taking significant risks when they drink. Sex under the influence—More than 100,000 students are too intoxicated to • know whether they consented to sexual intercourse. NIAAA, 2002 Unprotected sex—400,000 students have sex without using any protection • from STIs or unintended pregnancy. NIAAA, 2002 Sexually Transmitted Infections—Women who use alcohol are more likely to have more sexual partners, more casual sexual partners, and higher rates of STIs and HIV/AIDs than women who don’t drink. They tend to use contraception, including condoms less often. CASA, 2006 There are over 25 different organisms causing STIs, but young women are • hit hardest by chlamydia. Studies have found that women have a three times higher rate of the infection than men. CDC, 2004 The long-term consequences of untreated disease for women are much more • severe than for men. Untreated chlamydia infection can result in infertility. CDC, 2004 Even if you use birth control*, you are not protected from STIs, unless you also use a condom. Latex, polyurethane or plastic condoms are the only birth control method that prevents STIs, including HIV/AIDS. *Birth control includes an array of methods—pills, ring, patch shots, condom, etc. Need Help? Call….1-888-702-9971 -7-
  11. 11. Unintended Pregnancy— In the United States, women report that nearly half their pregnancies are unintended which may result in problems for both a woman and her child. Eighty-five percent of all sexually active women can expect to become • pregnant at least once in the course of a year, if they are not using any form of contraception. Hatcher, R.A. et al., 2004 About 50 % of unintended pregnancies occur among couples who were using a • contraceptive method in the month the woman became pregnant. Either the method did not work properly or the couple did not use it consistently or correctly. Guttmacher Institute, 2006 Unplanned pregnancy can interrupt the achievement of personal goals and • trigger economic hardship, child abuse, partner relationship difficulties, depression and substance use in women. Naimi, Lipscomb, Brewer, 2003 Other Negative Consequences Deterioration in your academic performance or achieving your personal goals— About 25 % of college students report academic problems caused by alcohol use including: • Earning lower grades, • Doing poorly on exams or papers, and • Missing class and falling behind. NIAAA, 2002 Impact on your closest relationships— Maybe your friends have said you’re different (maybe not very nice) when you drink and now you worry about hurting the people you care about. Although alcohol can help calm some people down, it can make others irritable. Drinking can complicate your life, adding more stress. Alcohol can lower inhibitions, affecting how a woman expresses her feelings, resulting in her saying or doing things that she may regret. Cunradi, Caetano & Schafer, 2002 Need Help? Call….1-888-702-9971 -8-
  12. 12. Sexual Assault and Violence—Numerous studies on college campuses have associated drinking with violence to women. A national study of college women from 119 colleges and universities found • that roughly one in 20 (4.7%) women reported being raped. Nearly three quarters (72%) of the victims experienced rape while • intoxicated. Mohler-Kuo, Dowdall, Koss, Wechsler, 2004 One study found that alcohol is one of the most significant contributors to • sexual aggression among male college students. NIAAA, 2002 Accidents—Drinking too much can affect your perception, balance, and decision- making abilities resulting in falls, car accidents, and assault. Research shows that people with a blood alcohol level of .03 or higher lack coordination, which can lead to injuries and falls. For example, if a 140-pound woman drinks 3 beers in 2 hours, she would have a BAC of .03. She is impaired at this level and puts herself at risk for possible injury. NIAAA, 1989 Money troubles and tangles with the law can occur if you spend too much money on drinking or you drive while under the influence. Not paying the rent on time can really mess up your life. So can driving under the influence and getting a DWI on your record. Fetal Alcohol Spectrum Disorders—If you are not aware you have become pregnant and continue to drink, you risk having a child with Fetal Alcohol Syndrome (FAS) and other alcohol-related disorders. These disorders range from mild learning and behavior problems to growth deficiencies and severe mental and physical impairment. This range of problems is called fetal alcohol spectrum disorders (FASD). FASD Center for Excellence, 2005 Making a change in your drinking and/or birth control and condom use could help you avoid many of these problems. If you’d like to learn more about any of these topics, check out A Closer Look Booklet included with this workbook. Need Help? Call….1-888-702-9971 -9-
  13. 13. References Center on Addiction and Substance Abuse. 2006. Women under the influence. Baltimore: John Hopkins University Press. Centers for Disease Control and Prevention. 2004. Trends in reportable sexually transmitted diseases in the United States. (online) www.cdc.gov/std/stats/trends2004.htm Centers for Disease Control and Prevention. 2004. Pelvic inflammatory disease - CDC Fact sheet. (online) www.cdc.gov/std/PID/STDFact-PID.htm#howget Cooper, M. L. 2005. Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Department of Psychology, University of Missouri-Columbia, Columbia, Missouri. (online) www.collegedrinkingprevention.gov/media/Journal/101- Cooper.pdf Cunradi, S. C., Caetano, R., and Schafer, J. 2002. Alcohol-related problems, drug-use, and male intimate partner violence severity among U.S. couples. Alcoholism: Clinical and Experimental Research, 26: 493. FASD Center for Excellence. 2005. The language of fetal alcohol spectrum disorders. (online) http://fascenter.samhsa.gov/documents/WYNKLanguageFASD2.pdf Guttmacher Institute. 2006. Contraception counts: Minnesota. (online) http://www.guttmacher.org/pubs/state_data/states/minnesota.html Hatcher, R.A. et al. Contraceptive technology. New York: Ardent Media. 2004. Mohler-Kuo M. Dowdall G.W. Koss M. Wechsler H. 2004. Correlates of rape while intoxicated in a national sample of college women. Journal of Studies on Alcohol. 2004; 65(1): 37-45. Naimi, T.S. Lipscomb, L.E. Brewer R.D. et al. 2003. Binge drinking in the preconception period and the risk of unintended pregnancy: implications for women and their children. Pediatrics Vol. 111 No. 5, pp. 1136-1141. National Institute on Alcohol Abuse and Alcoholism. 2002. A snapshot of annual high-risk college drinking consequences. (online) www.collegedrinkingprevention.gov/StatsSummaries/snapshot.aspx National Institute on Alcohol Abuse and Alcoholism. 1989. Alcohol and trauma. Alcohol Alert. No. 3. (online) http://www.niaaa.nih.gov/Publications/AlcoholAlerts/default.htm Need Help? Call….1-888-702-9971 -10-
  14. 14. Step 1: Making a Decision to Change Birth Control Drinking
  15. 15. Making a Decision to Change Making decisions can be difficult: Should I change my major and risk spending another year in school or • should I stick with the one I have? Should I stay in this unhappy relationship or should I risk being on my • own? Of course making a decision would be easy if there were only one choice. But often we have at least two options and, most of the time there are pros and cons for each. On the next few pages, you will work through several exercises to help you to think through the pros and cons of your drinking and your contraception use and ultimately make a decision about whether or not to change your behavior. We’ll begin with looking at your use of birth control, including condoms. Remember, you can contact the program educator at any point in the program. You can reach her Monday-Friday, 9-4 pm. Her contact information is printed on the bottom of each page and inside front cover of this workbook. Need Help? Call….1-888-702-9971 -11-
  16. 16. Using Birth Control, Including Condoms For each of the following grids, list as many good things you can think of about using birth control (BC), including condoms, to protect yourself from pregnancy and sexually transmitted infections (STIs). Then list the bad things you can think of about using BC, including condoms. Assign a weight to each item in terms of their importance to you. • Add up the total weight at the bottom of each grid. • A couple of examples are provided to get you started. • What are the GOOD things and the BAD things about using birth control (BC), including condoms? 1 = important 2 = more important 3 = most important GOOD THINGS BAD THINGS Weight Weight 1-3 1-3 about using BC, Condoms about using BC, Condoms I don’t worry about getting BC can be expensive. pregnant. I don’t worry about getting an STI. I may have to discuss BC with my partner and that might be uncomfortable. Total weight Total weight Need Help? Call….1-888-702-9971 -12-
  17. 17. For each of the following grids, list as many good and bad things you can think of about changing your use of birth control (BC), including condoms. Assign a weight to each item in terms of their importance to you. • Add up the total weight at the bottom of each grid. • A couple of examples are provided for you to get you started. • What are the GOOD and BAD things ABOUT CHANGING my birth control (BC) use, including condoms? 1 = important 2 = more important 3 = most important GOOD THINGS BAD THINGS Weight Weight 1-3 1-3 about changing my use about changing my use of BC, Condoms of BC, Condoms If I drink, I won’t have to plan for I might have to go to a clinic or my sex in order to prevent pregnancy. doctor to get a new BC method. Another BC method might cost My partner and I will have to learn less. how to use condoms. Total weight Total weight Need Help? Call….1-888-702-9971 -13-
  18. 18. Drinking Now think about your drinking. For each of the following grids, list as many good and bad things you can think of about drinking. Assign a weight to each item in terms of their importance to you. • Add up the total weight at the bottom of each grid. • A couple of examples are provided to get you started. • What are the GOOD and BAD THINGS about drinking? 1 = important 2 = more important 3 = most important BAD THINGS GOOD THINGS Weight Weight 1-3 1-3 about drinking about drinking I worry about having unwanted sex I feel more sociable. when I’ve been drinking. I worry about getting an STI when I feel more attractive and sexy. I have been drinking. Total weight Total weight Need Help? Call….1-888-702-9971 -14-
  19. 19. Now complete the grids for the good and bad things about changing your drinking. Assign a weight to each item in terms of their importance to you. • Add up the total weight at the bottom of each grid. • A couple of examples are provided to get you started. • What are the GOOD and BAD THINGS about changing your drinking? 1 = important 2 = more important 3 = most important BAD THINGS GOOD THINGS Weight Weight 1-3 1-3 about changing my drinking about changing my drinking I’ll feel inhibited and Less worry about having unwanted uncomfortable with people I don’t sex. know. My drinking friends will feel bad if Less worry about getting hurt or I don’t drink with them as much. taken advantage by someone. Total weight Total weight Need Help? Call….1-888-702-9971 -15-
  20. 20. Weighing the Pros and Cons Go back to the grids you completed about your birth control and condom use and your drinking. Now write in the total weight of each grid in the boxes below. The Good vs. The Bad Things About BC, Condoms & Drinking My BC & My Drinking Condom Use (Total weight) (Total weight) Good things about Bad things about Which did you score highest for? Check the one for which you scored more bad than good about making a change. _____My Birth Control and Condom use ____My Drinking The Good vs. The Bad Things About Changing My BC & My Drinking Condom Use (Total weight) (Total weight) Good things about changing Bad things about changing Which did you score highest for? Check the one for which you scored more good than bad about making a change. ______My Birth Control and Condom Use ____My Drinking Need Help? Call….1-888-702-9971 -16-
  21. 21. The results of this activity may help you gauge what you might gain or lose from changing your drinking and/or BC and condom use. As you look at the results, keep in mind that what matters is how the checks weigh up in favor for or against making a change in either your drinking or birth control, including condom use. Are you thinking there are more benefits to making a change in one area more than the other? Only you can make that determination. It’s about taking the first step in taking better care of you. Personal Reflection: Your Use of BC & Condoms How comfortable are you with your use of birth control, including condoms? • What are your reasons for using your current birth control method, including • condoms? What concerns do you have about your use of birth control, including condoms? • What are your thoughts about changing your use of birth control, including • condoms? Avoiding sex is the only 100% sure way to avoid Personal Reflection: Your Drinking getting pregnant or getting an STI. Choosing How comfortable are you with your drinking? • not to drink will reduce the possibility of getting into unsafe situations or engaging in risky What are your reasons for drinking? • behaviors. Need Help? Call….1-888-702-9971 -17-
  22. 22. What concerns do you have about your drinking? • What are your thoughts about changing your drinking? • So, what’s the smart thing to do? As you think about your situation and whether or not to make any changes, remember it’s ok to take a few steps back to give yourself time to figure out what is best for you. You may have felt pressured to become involved in sex and drinking before • you were really comfortable doing so. It’s smart to decide to take a break until you feel ready to handle or avoid the risks and responsibilities of having sex or drinking. Or, maybe you’ve already experienced negative events related to drinking. • It’s smart to stop drinking to learn more about protecting yourself when you drink and have sex. That way, you can make better decisions in the future. Of course, if you’re ready to make a change, it’s smart to make a plan to do so by reflecting on your use of birth control, including condoms and your drinking. Need Help? Call….1-888-702-9971 -18-
  23. 23. Step 2: Planning to Change Stop and think back to the previous pages of the workbook. What problems might make you consider working to change your birth control and condom use or your drinking? By now it might be clear which of these behaviors you’re going to change, but maybe it’s not. In any case, continue to make your way through the workbook. In this section, you’ll think about what influences your decisions about alcohol and birth control. You’ll identify strategies to avoid or better handle trying situations and you’ll create a plan to set your course for change. Need Help? Call….1-888-702-9971 - 19 -
  24. 24. Step 2: Planning to Change My Use of Birth Control
  25. 25. How Confident Am I About Using Birth Control, Including Condoms? Discovering what is interfering with your birth control (BC), including condom use, can help you think ahead and plan to handle these situations. The questions below will help you analyze when, where, and why you don’t use contraception or condoms. Choose the response that best describes the feelings of confidence you have in each situation according to the following scale: 1 2 3 4 5 Not at all confident Not very confident Moderately Very confident Extremely confident confident Right now, I am confident that I would effectively use birth control, including condoms: How Confident am I? Not at Not Moderately Very Extremely SITUATION all Very If I experience side effects from the BC. 1 2 3 4 5 If I’m using BC but don’t have condoms 1 2 3 4 5 with me. If the BC control and condoms are too 1 2 3 4 much trouble to use. If my partner says he doesn’t want to use 1 2 3 4 5 BC or condoms. When I want sex with a new partner or I 1 2 3 4 5 am getting back together with a former partner for the first time. If I ‘m drinking or using other drugs. 1 2 3 4 5 If I feel ashamed or confused about 1 2 3 4 5 having sex. If I’m too short on time or money to get 1 2 3 4 5 the supplies I need. If I feel my parents or friends will 1 2 3 4 5 disapprove of my having a sexual relationship. When I am too caught up in the heat of 1 2 3 4 5 the moment to talk about using BC or condoms with my partner. If I feel it is wrong for me to plan to 1 2 3 4 5 have sex. If my partner gets upset or angry. 1 2 3 4 5 Need Help? Call….1-888-702-9971 - 20 -
  26. 26. Other situations or factors that might influence my use of birth control or condoms include: Discoveries about My Birth Control & Condom Use Now go back and look at your responses. How do you feel about your birth control and condom use? • Under what circumstances are you most likely NOT going to use birth • control or to use it ineffectively? Under what circumstances are you most likely NOT going to use condoms? • Need Help? Call….1-888-702-9971 - 21 -
  27. 27. What I Can Do to Improve My Use of Birth Control, Including Condoms First, read through and think about the reasons for ineffectively using birth control (BC) or condoms* in the left hand column. Then list all the other reasons you can think for not using BC. Then list all the coping strategies you can think of that could help you deal with the situation. Think about what you learned in the last activity and select the strategies that might work best for you. If you aren’t sure about how to handle a situation, read the handout: “Protecting Yourself from Unplanned Pregnancy and STIs” in A Closer Look Booklet. What I Can Do to Improve My Birth Control and Condom Use? Reasons for Ineffective Use Possible Coping Strategies of BC, Condoms If the BC and condoms are too Switch to pills, patch, ring or shots so I much trouble to use, I can… don’t have to deal with BC right before sex. When I experience side effects from my BC control method, I can… If I’m using BC control but don’t have condoms with me, I can…. If I want sex with a new partner or I am getting back together with a former partner for the first time, I can… When my partner says he doesn’t want to use BC or condoms, I can… When I’m too short on time or money to get the supplies I need, I can… When I feel others disapprove of my having a sexual relationship, or I feel ashamed or confused about having sex, I can… *Note: Even if you effectively use birth control to prevent pregnancy, you are not protected from STIs unless you also use a condom. Condoms are the only BC method that prevents STIs and HIV. Birth control includes an array of methods—pills, ring, patch, shots, condom, etc. Need Help? Call….1-888-702-9971 - 22 -
  28. 28. What I Can Do to Improve My Birth Control and Condom Use? Reasons for Ineffective Use of Possible Coping Strategies BC, Condoms When I know I will be drinking or using drugs and will likely have sex, I can… When I am too caught up in the heat of the moment to talk about using BC or condoms with my partner. To avoid this, I can… If my partner gets upset or angry with me about using BC or condoms, I can… Need Help? Call….1-888-702-9971 - 23 -
  29. 29. Am I Ready to Change My Use of Birth Control, Including Condoms? You’ve spent some time reflecting on your current birth control and condom use. The following exercise will help you assess your desire to change that behavior. 1. On the following line, make a slash at the point that shows how important it is for you to change your use of birth control, including condoms. 0 1 2 3 4 5 Definitely Definitely not important important 2. On the following line, make a slash at the point that shows how confident you are that you can change your use of birth control, including condoms. 0 1 2 3 4 5 Not at all confident Very confident 3. Circle the number that shows how ready you are to change your use of birth control, including condoms. 0= Not at all ready to change my use of birth control and condoms 1= Thinking about changing my use of birth control and condoms 2= Planning and making a commitment to change my birth control and condoms 3= Actively using birth control and condoms each and every time I have intercourse 4= No need to reevaluate my birth control, including condom use 4. At this time, what are you thinking about changing your birth control, including condom use? Need Help? Call….1-888-702-9971 - 24 -
  30. 30. Making A Plan to Change Congratulations if you’ve decided to change your birth control, including condom use. Making a plan is your personal road map to change. If you need more information or help to write your plan, here’s some tips: Revisit the exercises you have completed so far in the workbook. Go to A Closer Look Booklet included with this workbook. Read the information on the following topics: Tips for Changing Your Birth Control Use • Protecting Yourself from STIs and Unplanned Pregnancy • Writing My Plan to Change • Refer to the Resource Directory: Finding Help to Change to select places to get more information and assistance if you need it. Contact the program educator if you get stuck at anytime. Writing Your Plan to Change: Birth Control Setting My Goal: Birth Control & Condom Use First, think about your current use of birth control and condoms. Where would you like to go from here? Then review the possible options for change below and choose a goal that is doable for you. If you can think of other options, write them down. If you don’t like these options and need help, refer to the information about STIs and BC methods included in A Closer Look Booklet. Need Help? Call….1-888-702-9971 - 25 -
  31. 31. Protect yourself with a condom EVERY time you My Options for Changing My Birth have vaginal, anal, and oral sex. Control Use: Option 1: I plan to learn about and try another birth control method and use it correctly and faithfully every time I have sex. What method(s) might you try?________________________ Option 2: I plan to learn how to correctly use condoms and use them every time I have any type of sex that will expose me to STIs (even if I am using BC effectively). Option 3: I plan to keep a supply of condoms on hand and to carry them with me whenever I plan to drink. Option 4: I plan to avoid having sex. Other Options: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ _____________________________________________________________ My Goal(s) for Using Birth Control, including condoms: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Need Help? Call….1-888-702-9971 - 26 -
  32. 32. If you’d like to learn more about writing the rest of your plan, refer to the “Writing Your Plan to Change” information included in A Closer Look Booklet. Finding Help to Change Resources To Help Me Change My BC & Condom Use Resources: I will ask for help with: Rewarding Myself for Change Situation or reason I Strategy to handle My Reward when I’ve might not use effective this situation accomplished this step birth control and condoms Need Help? Call….1-888-702-9971 - 27 -
  33. 33. Committing Myself to Change You might find it helpful to complete and sign the following commitment to change statement. Committing Myself to Change: My Birth Control & Condom Use I ____________________commit myself to work on my change plan starting today_______through________ (4 months from today). I will reward myself for my successes, even the small ones. • If I have a setback, I will think about how this happened, what • I have learned, and decide how to better handle or avoid situations that are difficult for me. I will recommit myself to my change plan and keep trying • I will do my best because I respect and care about myself. • TIP: Once you’ve completed this plan, you might want to tear it out of this workbook and keep it where you can refer to it over the next 4 months. Good Luck! Need Help? Call….1-888-702-9971 - 28 -
  34. 34. Step 2: Changing My Drinking
  35. 35. A Special Note of Caution Smart Women Smart Choices is designed for women who might want to reduce their drinking, not for women who have serious problems with alcohol such as alcohol dependence or are pregnant or are planning a pregnancy. These women should not drink at all. Read these questions and answer YES or NO . . . • Do you have a strong urge to drink? • Do you sometimes decide not to drink but then drink anyway? • Do you keep drinking even though alcohol has caused some serious problems in your life? • Do you think about drinking a lot? • Do you ever have a drink in the morning to steady your nerves? If you answered YES to any of these questions, you might have a problem with alcohol that requires professional help. We urge you to check with your health care provider who can do an alcohol dependency evaluation and advise you about the best course of action. For more information and assistance call: First Call for Help: Dial 2-1-1 or phone 651-291-0211 SAMHSA’s Referral Helpline: 1-800-662-4357 For more information about alcohol use, addiction and assessment, go to Minnesota Department of Human Services—Chemical Health Division website http://www.dhs.state.mn.us/main/groups/disabilities/documents/pub/dhs_id_003460.hcsp Or Revisit the program website, iPartySmarter.com for more resources about drinking and pregnancy
  36. 36. How Confident Am I About My Drinking? Discovering the circumstances when you tend to drink too much can help you think ahead and avoid or act differently in those situations. The questions below will help you analyze when, where, and why you drink too much. Choose the response that best describes the feelings of confidence you have for each situation according to the following scale: 1 2 3 4 5 Not at all Not very Moderately Very confident Extremely confident confident confident confident Right now, I am confident I would be able to resist the urge to drink too much: How confident am I? SITUATION Not at Not Moderately Very Extremely all Very If I ‘m feeling frustrated, angry or 1 2 3 4 5 things are going badly for me. If I have trouble sleeping or if I 1 2 3 4 5 feel physically tense or jumpy. If things are going really well for 1 2 3 4 5 me and I feel like celebrating. If I am in a situation that reminds 1 2 3 4 5 me of how good if feels to drink or where I drank too much in the past. If I have an argument with my 1 2 3 4 5 significant other, my parents, or a friend. If my friends or my significant 1 2 3 4 5 other are pressuring me into drinking too much. If I ‘m enjoying myself at a party 1 2 3 4 5 and want to have even more fun. Need Help? Call….1-888-702-9971 - 29 -
  37. 37. Discoveries about My Drinking Now go back and look at your responses: What did you discover about your drinking? • Are there other situations or people that might influence your drinking? • What are they and how confident do you feel you would be able to resist drinking too much in that situation or with that person? In what situations is it hardest not to drink? • Can you think of anything that would make it easier to avoid drinking so • much? What is a Standard Drink? A Standard drink is defined as: A 12 oz. can or bottle of beer A 5 oz. glass of wine A 12 oz. can or bottle of wine cooler 1.5 oz. of liquor in a mixed drink or as a shot * See the standard drink chart included in the workbook glossary. Many alcoholic beverages are available in containers that hold several standard drinks. For example, one beer sold by the pint (16 oz.) at a bar is about one and a half standard drinks. Need Help? Call….1-888-702-9971 - 30 -
  38. 38. What I Can Do When I Am Tempted To Drink Too Much… First, read and think about the situations, which in the past have and in the future might influence you to drink too much. Then list all the other reasons you can think of that might influence your drinking. What other things can you do to handle situations where you may be tempted to drink too much? Now list all the things you can think of that could help you deal with the situation. Think about what you learned in the last activity and select the strategies that might work best for you. If you aren’t sure about how to handle a situation, read the handouts: “Smarter Drinking” and “Tips for Changing Your Drinking” in A Closer Look Booklet. Drinking Triggers Possible Coping Strategies When I am feeling down or Consider talking with a friend or counselor about tense, or frustrated or angry, my feelings. instead of drinking, I can… When I am in the mood for celebrating, instead of drinking, I can… When I’m asked to go somewhere where I would normally drink too much, I can… When I’ve had an argument with someone I care about, I can… When someone is pressuring me to drink a lot, I can… Need Help? Call….1-888-702-9971 - 31 -
  39. 39. What other reasons might influence your drinking? What other things can you do to handle situations where you may be tempted to drink too much? Drinking Triggers Possible Coping Strategies Need Help? Call….1-888-702-9971 -32-
  40. 40. Am I Ready to Change My Drinking? You’ve spent some time reflecting on your current alcohol use. The following exercise will help you assess your desire to change that behavior. 1. On the following line, make a slash at the point that shows how important it is for you to change your drinking. 0 1 2 3 4 5 Definitely Definitely not important important 2. On the following line, make a slash at the point that shows how confident you are that you can change your drinking. 0 1 2 3 4 5 Not at all confident Very confident 3. Circle the number that shows how ready you are to change your drinking. 0= Not at all ready to decrease my drinking 1= Thinking about decreasing my drinking 2= Planning and committed to decreasing my drinking 3= Actively decreasing my alcohol use. 4= No need to reevaluate my alcohol use. 4. At this time, what are you thinking about your drinking? If you aren’t planning to change your drinking, why not? Need Help? Call….1-888-702-9971 -33-
  41. 41. My Circle of Support for Change When making a change, some of us need a little help from our friends. Think back to the situations you identified earlier in which you were tempted to drink too much. Then think about the people in your life who can best help you handle this situation. Identify and use support persons you TRUST like family, friends (not drinking buddies), spiritual guides, counselors or groups. Identify at least two support persons you can count on. Set up regular contact with your support persons through daily or weekly check-ins. This circle represents you and the people in your life whom you trust. First, write the tempting situation in which you might drink too much, and then name a support person and how they can help you. For example at a party, if you decide to drink, you and your best girlfriend can agree on a drinking limit before you party. Then hold each other accountable once you get there. Situation: Situation: ______________ ______________ Person: Person: ______________ ______________ What they can What they can ME do:_______________ do:_______________ _________________ _________________ Situation: Situation: ______________ ______________ Person: Person: . ______________ ______________ What they can What they can do:_______________ do:_______________ _________________ _________________ Adapted and used with permission from NCAST-AVENUW Programs. Adapted from Circle of Support, Promoting Maternal Mental Health During Pregnancy. Need Help? Call….1-888-702-9971 -34-
  42. 42. Making a Plan to Change Congratulations if you’ve decided to change your drinking. Making a plan can be your personal road map to change. If you need more information or help to write your plan, here’s some tips: Revisit the exercises you have completed so far in the workbook. Go to A Closer Look Booklet included with this workbook. Read the information on these topics: Writing Your Plan to Change • Tips for Changing Your Drinking • Refer to the Resource Directory: Finding Help to Change to select places to get more information and assistance if you need it. Contact the program educator if you get stuck at anytime. ` Need Help? Call….1-888-702-9971 -35-
  43. 43. Writing My Plan to Change: Drinking Setting My Goal for Drinking First, think about your current drinking habits as your starting point. Where would you like to go from here? Look at the options below and select or create your own goal that is doable for you. My Options for Changing My Drinking Are: Option 1: I plan to decrease my drinking: On the average day when I drink, I will drink no more than ______ drinks. • During the average week, I will drink no more than _______drinks. • I will never drink more than _______ drinks in any two-hour period. • *Note: See the recommended Drinking Limits for Women in the glossary. Option 2: I plan not to drink alcohol at all My Goals for Drinking Are: Have you decided on a goal and are you comfortable with it? Is it realistic and doable? Write it in the space below, if you’d like. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ If you’d like to learn more about writing the rest of this change plan, refer to the “Writing Your Plan to Change” information sheet included in A Closer Look Booklet. Need Help? Call….1-888-702-9971 -36-
  44. 44. My Circle of Support Be sure to list at least two people you can count on. People To Help Me Change My Drinking Person Situation What they can do: Finding Help to Change Resources To Help Me Change My Drinking Resources: I will ask for help with: Rewarding Myself for Change Trigger or situation when Strategy to handle My Reward when I’ve I might drink too much this situation accomplished this step Need Help? Call….1-888-702-9971 -37-
  45. 45. Committing to Change You might find it helpful to complete and sign the following Commitment to change statement. Committing Myself to Change: My Drinking I ____________________commit myself to work on my change plan starting today_______through________ (4 months from today). I will reward myself for my successes, even the small ones. • If I have a setback, I will think about how this happened, what • I have learned, and decide how to better handle or avoid situations that are difficult for me. I will recommit myself to my change plan and keep trying • I will do my best because I respect and care about myself. • TIP: Once you’ve completed this plan, you might want to tear it out of this workbook and keep it where you can refer to it over the next 4 months. Good Luck! Need Help? Call….1-888-702-9971 -38-
  46. 46. Step 3: Handling the Challenges of Change
  47. 47. Handling the Stress of Change When we are making an important life change, it’s common to experience stress and a variety of feelings. This will pass as you adapt to the changes. As you get more practiced at your new behaviors, such as resisting drinking too much or learning to use a new birth control method, you will begin to feel more confident and relaxed. If you aren’t sure how to cope with the stress of making a change, read the handout: “Stress: Coping with Change” in A Closer Look Booklet. Prepare Yourself for Set Backs or Slips Anyone who is brave enough to make a change will face “slips” a few times during the process. These are moments when you may find yourself repeating old habits, (forgetting to take a pill, not using a condom or drinking more than you planned) and getting off course from achieving your goals. It’s common to start thinking negative thoughts. You may even consider giving up or believe you’re a failure. It’s important to remind yourself that a “slip” is a temporary delay in your journey. Keeping a positive attitude is the surest way to get yourself back on course. Remember that this is the time to contact your support network to help you through this hump. Can you think of a time when you’ve committed yourself to a change but had a “slip” or even two? Perhaps you have been on a diet but somehow found yourself in front of the TV shoveling in ice cream or chips. What was your slip? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Need Help? Call….1-888-702-9971 - 39 -
  48. 48. How did you handle that slip? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ How might you handle a slip in your drinking, birth control or condom use? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ For each situation below, consider what you could do to help you avoid the slip in the future. Forgetting to take a condom with you before a party and then having sex • with someone you don’t know very well. Forgetting to take a pill, wearing your patch, or going to the clinic for your • shot when it’s due. Letting someone pressure you into sex when you really didn’t want it. • Letting someone pressure you to drink too much. • Other situations you worry might happen and how you might feel and what • you could do to avoid the slip in the future: Need Help? Call….1-888-702-9971 - 40 -
  49. 49. Tips for Handling Slips Think of making change one day at a time, achieving one step at a time. Remind yourself that it will get easier the more you practice your new skills or behaviors. Consider the following actions when you encounter a slip in your change process: Stop, look, and listen. Look to see how the slip is a warning signal. Review the situation leading up to the slip. Ask yourself the following questions. What events led up to the slip? Were there any early warning signals that preceded the lapse? What were they? How can I avoid or handle the situation in the future? Revise and carry out a response plan. Decide what your new actions steps will be and then immediately implement them. If you need help, seek support from someone you trust. Keep calm and think about the slip as an opportunity for learning. Look at the slip as a single event, something that can be avoided in the future. Remind yourself of your past successes, instead of focusing pessimistically on your current setbacks. Forgive yourself. Let go of harsh self-talk and unproductive feelings such as anger or shame. Keep the end goal visibly in front of you. Keep reminding yourself why it’s important to you to make the change. In addition, don’t forget to reward yourself for each step of change! Need Help? Call….1-888-702-9971 - 41 -
  50. 50. You’ve completed the workbook. Keep following your action plan(s), your personal road map to change. What’s Next? Here are a couple of things to keep in mind as you work your plan for change over the next four months: Feel free to ask the program educator to assist you. • You can reach her Monday-Friday, 9-4 pm. Her contact information is printed on the bottom of each page and inside the front cover of this workbook. Because we’d like to support your journey, the program educator will contact • you in the next month and again in four months. She will check on your progress and address your questions or concerns. Remember that when the educator follows up with you at these points, you • will have the opportunity to earn a Target gift card! Need Help? Call….1-888-702-9971 - 42 -
  51. 51. Glossary of Terms Alcohol Dependency or Alcoholism is a chronic, life long disease. Alcohol dependence is characterized by craving alcohol, inability to stop drinking, physical dependence (addiction) and tolerance to alcohol. Tolerance is the need to drink more and more to feel the same or experiencing fewer effects when drinking the usual amounts of alcohol. Dependent Drinkers are defined as those who are unable to control their alcohol use, have experienced repeated adverse consequences, are pre-occupied with alcohol use and have evidence of tolerance or withdrawal. Alcohol abuse and dependence are associated with repeated negative physical, psychological and social effects from alcohol. Source: Burge, S.K. and Schneider, F.D. 1999. Alcohol-related problems: recognition and intervention. American Academy of Family Physicians Vol. 59, No. 2. http://www.aafp.org/afp/990115ap/361.html 70k Alcohol Treatment varies depending on the type of drug (alcohol is a drug) and the characteristics of the individual. Treatment can include counseling, cognitive therapy, or psychotherapy, medications, or both. Counseling helps people learn how to cope with their drug cravings and ways to prevent and deal with relapse if it occurs. The best programs provide therapies and other services to meet individual’s needs and situations including their age, race, culture, sexual orientation, gender, pregnancy, parenting, housing and employment needs and physical and sexual abuse issues. Source: National Institute on Drug Abuse (NIDA) Principles of Drug Addiction Treatment: A Research Based Guide. February 8, 2005. Blood Alcohol Concentration (BAC) is a measure of how much alcohol is in someone's blood. It is the most accurate and measurable gauge of alcohol impairment. In Minnesota, when a person reaches .08 BAC, it is illegal to drive a vehicle. To reach a .08 BAC level, a 170-pound man would have to drink approximately four drinks in one hour on an empty stomach or a 137-pound woman would have to drink approximately three drinks in one hour on an empty stomach. When drivers reach .08 BAC, their critical driving skills, like judging distance and speed, steering, visual tracking, concentration, braking and staying in driving lanes are severely impaired. (Moskowitz, 2000) At a .08 BAC level, a person is 11 times more likely to be involved in a fatal crash than someone who has had nothing to drink. Sources: Keall M., Frith W., and Patterson T. 2004. The influence of alcohol, age and number of passengers on the nighttime risk of driver fatal injury in New Zealand. Accident Analysis and Prevention, 36. Zador P., Krawchuk S. and Voas R. Relative Risk of Fatal Crash Involvement by BAC, Age and Gender. 2000. DOT HS 809 050. Washington, DC: National Highway Traffic Safety Administration. Cited in Mothers Against Drunk Driving Issue Brief. 2006. (online) www.madd.org/madd_programs/7584 Need Help? Call….1-888-702-9971 - 43 -
  52. 52. Chemical Dependency Assessment or Evaluation includes an interview with a chemical dependency counselor where the individual’s chemical use is reviewed along with the impact on the individual’s daily life and relationships. The evaluation may also include a review of relevant medical, legal, mental health and previous treatment records, a physical and interviews with other people in the person’s life. The evaluation is used to address individual's unique needs and to create a treatment plan. Source: Minnesota Department of Human Services-Chemical Health Division. 2006. (online) www.dhs.state.mn.us/main/groups/disabilities/documents/pub/DHS_id_003460.hcs Dangerous Drinking is an alternative to the expert’s term “binge drinking” by college students. Students, who participated in research conducted at Rutgers University, preferred this term because it is nonjudgmental and corresponds with their concern about impaired judgment and the resultant negative consequences of drinking versus the experts’ focus on the quantity of drinking to define problem or risk drinking. Sources: Ledermen, L.C, Goodhart, F.W. and Latiman, L. 2003. A case against “binge” as the term of choice: convincing college students to personalize messages about dangerous drinking. Journal of Health Communication. Vol. 8. Minnesota Statute: Driving While Impaired.www.revisor.leg.state.mn.us/stats/169A/ Drinking Levels for Women For most women, moderate alcohol use--one drink a day--causes few if any problems.* According to the National Institute on Alcohol Abuse and Alcoholism, women can avoid negative health and social consequences if they drink at or below these levels: • No more than 7 drinks in any week • No more than 3 drinks in about a 2-hour period. *However, certain women should not drink at all. This includes women who: Are pregnant or trying to become pregnant; • Are planning to drive or engage in activities that require alertness and skill • (such as using high-speed machinery); Taking certain over-the-counter or prescription medications; • Have a medical condition that can be made worse by drinking; • Are recovering alcoholics; • Are younger than age 21. • Note: A number of factors influence how and to what extent alcohol affects an individual’s body and brain, including: • How much and how often a person drinks; Need Help? Call….1-888-702-9971 - 44 -
  53. 53. The age at which a person first began drinking, and how long he or she has • been drinking; The person’s age, level of education, gender, genetic background, and family • history of alcoholism; Whether a person is at risk because of prenatal alcohol exposure; and • The person’s general health status and use of other medications or drugs. • Sources: Department of Health and Human Services and the Department of Agriculture. Dietary Guidelines for Americans 2005. Available online at: http://www.health.gov/dietaryguidelines/dga2005/document/.National Institute on Alcohol Abuse and Alcoholism. College Drinking: What is alcoholism? 9/23/2005 http://www.collegedrinkingprevention.gov/OtherAlcoholInformation/facts/q-a.aspx See also NIAAA Publications: Alcohol Alert No. 16: Moderate Drinking; Alcohol Alert No. 27: Alcohol-Medication Interactions; Alcohol Alert No 50: Fetal Alcohol Exposure and the Brain; and Alcohol Alert No. 52: Alcohol and Transportation Safety Driving While Intoxicated (DWI) In Minnesota, it is illegal to drive with a blood alcohol concentration (BAC) at or above .08%. Minnesota penalties for a first offense are 90 days revocation of the driver’s license, 90 days in jail and /or a $1,000 in fines. Additional penalties include a $680 reinstatement fee and completion of a DWI knowledge test to reinstate a drivers’ license. Each offense results in more severe penalties. Four DWI’s in a 10-year period can result in a felony conviction. Penalties for a felony DWI can be up to 7 years in prison and $14,000 in fines. Source: Minnesota Statute: Driving While Impaired. 2005. (online) www.revisor.leg.state.mn.us/stats/169A/ Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term describing the range of possible effects on a person whose mother drank alcohol during pregnancy. These effects can include physical, mental, behavioral, learning disabilities, or a combination of these, with possible lifelong implications. The term FASDs is not intended for use as a clinical diagnosis. Unlike people with FAS, those with FASDs do not show the identifying physical characteristics of FAS and, as a result, they often go undiagnosed. Source: Centers for Disease Control, 2005. (online) www.cdc.gov/ncbddd/fas/faqs.htm Fetal Alcohol Syndrome (FAS) is one of the leading known preventable causes of mental retardation and birth defects. FAS represents the severe end of a spectrum of effects that can occur when a woman drinks alcohol during pregnancy. Fetal death is the most extreme outcome. FAS is a medical diagnosis and is characterized by abnormal facial features, growth deficiency and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, Need Help? Call….1-888-702-9971 - 45 -
  54. 54. attention span, communication, vision, hearing, or a combination of these things. These problems often lead to difficulties in school and problems getting along with others. FAS is a permanent condition. It affects every aspect of an individual’s life and the lives of his or her family. However, FAS is 100% preventable—if a woman does not drink alcohol while she is pregnant. Source:(FASD) Centers for Disease Control, 2005. (online) www.cdc.gov/ncbddd/fas/faqs.htmFetal Alcohol Syndrome (FAS) Centers for Disease Control, 2005. www.cdc.gov/ncbddd/fas/faqs.htm “Risky” or “Problem” Drinking, also called alcohol misuse by experts, is drinking at levels that place individuals at risk for health, safety and social problems. quot;Riskyquot; drinking is defined as consuming more than 7 drinks per week or more than 3 drinks per occasion for women and more than 14 drinks per week or more than 5 drinks per occasion for men. The lower cut-point is used for women because women are generally of smaller stature than men and metabolize alcohol differently than men do. Sources: National Institute on Alcohol Abuse and Alcoholism. 2005. Alcohol a women’s health issue. NIAAA. (1990) Alcohol use and abuse: Where do the numbers come from? Alcohol Alert. No. 7. (online) ttp://pubs.niaaa.nih.gov/publications/aa07.htm Sexually Transmitted Infection (STI) An STI is an infection or disease passed from person to person through sexual contact. Two-thirds of all STIs occur in people 25 years of age or younger. Women suffer more frequent and more serious complications from STIs than men. Sources: American Social Health Association. 2002. Facts & answers about STIs. (online) www.ashaSTI.org/sitemap.cfm. National Women’s Health Information Center. Sexually transmitted infections: Overview.2005. (online)http://www.4woman.gov/faq/STIsgen.pdf A Standard drink is defined as: A 12 oz. can or bottle of beer A 5 oz. glass of wine A 12 oz. can or bottle of wine cooler 1.5 oz. of liquor in a mixed drink or as a shot Unsafe Sex is any behavior that increases the risks of negative consequences associated with sexual contact including HIV/AIDS, other sexually transmitted infections (STIs) and unplanned pregnancy. Unsafe sex may include: (1) Making poor decisions regarding sexual activities, including having multiple partners; having casual or unknown partners; and failure to discuss risk topics prior to intercourse and (2) Failure to take adequate protective measures, such as using condoms and effective birth control. Source: Cooper, M.L. Alcohol use and risky sexual behavior among college students and youth: evaluating the evidence. 2005. University of Missouri-Columbia, MO. (online) www.collegedrinkingprevention.gov/SupportingResearch/Journal/cooper.asp Need Help? Call….1-888-702-9971 - 46 -
  55. 55. Unintended Pregnancy is a pregnancy that is identified by the woman as either unwanted or mistimed at the time of conception. Eighty-five percent of all sexually active women can expect to become pregnant at least once in the course of a year, if they are not using any form of contraception. Half of the six million pregnancies that occur among American women each year are unintended. About 50 % of unintended pregnancies occur among couples who were using a contraceptive method in the month the woman became pregnant. Either the method did not work properly or the couple did not use it consistently or correctly. Sources :Hatcher, R.A. et al. Contraceptive technology. New York: Ardent Media. 2004. Guttmacher Institute, Contraception Counts: Minnesota. 2006. (online)www.guttmacher.org/pubs/state_data/states/minnesota.html Unwanted Sex, Sexual Assault, Date Rape, Sexual Abuse, is any type of sexual activity person does not agree to, including: inappropriate touching; vaginal, anal, or oral penetration; sexual intercourse that you say no to; rape; attempted rape and child molestation. Source: U.S. Department of Health and Human Services. 2005. (online) http://womenshealth.gov/violence/types/sexual.cfm Standard Drink Chart 1.5 oz. of spirits 12 oz. of beer 8-9 oz. of malt liquor (8.5 oz. 5 oz. of table 1.5 oz. (one jigger of 80-proof or wine cooler in a 12-oz. glass that, if full, wine of brandy gin, vodka, whiskey, would hold about 1.5 oz. (one etc.) shown straight in standard drinks of malt liquor) jigger) a highball glass,before adding mixer 8.5 oz. 5 oz. 1.5 oz. 12 oz. 1.5 oz. Note: People buy many of these drinks in containers that hold multiple standard drinks. For example, malt liquor is often sold in 16, 22, or 40 oz. containers that hold between two and five standard drinks, and table wine is typically sold in 25 oz. (750 ml.) bottles that hold five standard drinks. Source: Adapted from the National Institute on Alcohol Abuse and Alcoholism. 2005. (online) www.collegedrinkingprevention.gov/NIAAACollegeMaterials/trainingmanual/module_2.aspx Need Help? Call….1-888-702-9971 - 47 -
  56. 56. Acknowledgments The Minnesota Department of Health would like to thank the following people for their invaluable contributions to the development of this curriculum: Sheran McNiff Heidi Kammer Esther Maki Jennifer O’Brien Diane O ’ Connor Russell Herder Advertising Diane L. Morehouse Sherry Ceperich MaryJo Chippendale Mary Kate Weber Karen De Young Patricia Green Need Help? Call….1-888-702-9971 - 48 -
  57. 57. Community and Family Health / Maternal Child Health 85 E. 7th Place, Suite 220 P.O. Box 64882 St. Paul, MN 55164-0882 If you need this document in another format call: TDD/TTY 651-201-5797 or 1-888-702-9971 The Smart Women Smart Choices program and www.iPartySmarter.com website are created and managed by the Minnesota Department of Health with funds from the Department of Health and Human Services, Centers for Disease Control and Prevention. March 2007

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