Sap County Coordination Update s5

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Sap County Coordination Update s5

SAP COUNTY COORDINATION UPDATE March, 2015

Prepared by: PA Network for Student Assistance Services (PNSAS) www.sap.state.pa.us

PENNSYLVANIA NETWORK FOR STUDENT ASSISTANCE SERVICES INTERAGENCY UPDATE

SAP Parent/Guardian Brochure Template An important aspect of SAP is parent/guardian involvement. PNSAS is offering schools a new template to use in developing their own personalized brochure. Your team may already have a brochure and choose not to use this one, but we encourage you to take this opportunity to update it. The template is not meant to be printed as is, but rather customized by adding your SAP team's name, team members, and contact information. You may wish to change it as appropriate for the age group you serve by adding or removing observable behaviors. In addition, you may want to customize it based on your team's process. Access the template here. If you would like to discuss this further, feel free to contact your regional coordinator.

Liaison Webinar Available for Viewing The Pennsylvania Network for Student Assistance held a free on-line professional development opportunity for SAP liaisons February 17, 2015. Sherry Peters, from the National Technical Assistance Center for Children's Mental Health, was our speaker on “Addressing at Risk Behaviors: Could Trauma Be a Factor?” Sherry’s previous work experience was with the Pennsylvania Department of Human Services, Children’s Bureau where she was an active partner in the development and furtherance of SAP in Pennsylvania. The recording of this presentation, along with the PowerPoint and handouts, will soon be available on the SAP website at www.sap.state.pa.us. We would like to thank Chester County Intermediate Unit for hosting this webinar.

SAP BACK TO BASICS

Student Assistance Program (SAP) and School-wide Positive Behavior Intervention and Support (SWPBIS) Your School has come on board and is implementing SWPBIS and your SAP Team is a vital component of your school system, NOW What?

Can the SAP team be used as a SWPBIS team? How can we work together? Yes! SAP complements SWPBIS by addressing the needs of all students in the building from day one of SWPBS implementation, through the implementation of all three tiers. Student Assistance also complements SWPBIS in that SAP has a self- referral component where students can request help when they need it and not have to wait to be identified. SAP core teams are perfectly suited to play a vital role with any of the SWPBIS tier teams.

In today’s school environment with high expectations around academics and with limited time, having separate teams is not always a cost effective use of a school’s resources. With 30 years of implementation of Student Assistance (SAP), it’s fair to say that collaboration and coordination is again the focus of what SAP can do when your school is implementing SWPBIS.

In September 2011, The Commonwealth SAP Interagency Committee developed a guidance document for SAP teams to use when considering utilizing their SAP team for the core team required in SWPBIS or at a minimum, as a collaborative 1 support process within the SWPBIS framework. These documents, as well as other resources are located on the SAP website at www.sap.state.pa.us under “Additional Resources”. Currently we are in the process of gathering information from schools implementing SWPBIS in order to update this document. In the meantime, here are some helpful tips and strategies to use as you discuss SAP and SWPBIS. There are additional suggestions located in the guidance document.

Practical tips 1) Contact your Regional SAP Coordinator for technical assistance (see map on the SAP website). 2) Download the guidance document off the SAP website. 3) Discuss whether you want to combine teams or have separate teams. 4) Reach out to a neighboring school who also is implementing SWPBIS and ask about their approach. 5) Remember that SAP is mandatory and the functions of SAP need to be met regardless if the teams are combined or not.

Strategies for determining if combining SAP and SWPBS team is best for your school district - Have the SAP Team members list out their roles and responsibilities. - Have the SWPBS Team members list out their roles and responsibilities. - Compare lists of roles and responsibilities of both teams for similarities and action plan if needed. - List pros and cons of utilizing the existing SAP team. - Complete the working smarter exercise (see attachment A 6 in the guidance document). - Discuss the feasibility of combining or having two separate teams.

Considerations for teams that have decided to combine teams - Assure that the team will have enough time to complete all their assigned tasks. - Cross train your team members in SAP and SWPBS. - Re-write the roles and responsibilities of the combined/new team members. - Develop procedures for obtaining written parental permission where applicable. - Develop procedures for involvement of your SAP liaison. - Develop procedures for reporting of SAP and SWPBS data and its analysis.

Suggestions to follow when NOT combining SAP and SWPBS teams - Develop a plan that will ensure communication and prevent redundancy between the teams. -Develop clearly written guidelines as to the specific roles and responsibilities of each team. Include guidance for team members who sit on both teams around roles and confidentiality. - Develop procedures that clearly outline the types of referrals that will be made to each team. - Develop a protocol and procedures to inform school staff about the types of referrals they should make to each team. - Develop procedures for sharing of data that is collected on students who may be discussed at both the SAP and SWPBS team meetings. - Develop procedures for contacting parents when student is addressed by both teams.

Remember tip one: Contact your Regional SAP Coordinator for technical assistance. Please note, that these strategies and practical tips are only a few suggestions, more information is listed in the guidance document. More Information on SWPBIS can also be found on the PAPBS website at www.PAPBS.org.

RESOURCES

Project Beacon Spring Retreats Project Beacon East – 10-12 April @ Camp Victory, Millville, PA (Columbia Co.) Project Beacon West – 1-3 May @ YMCA Camp Soles, Rockwood, PA (Somerset Co.) Project Beacon Registration is now open.

2 Project Beacon is a free weekend retreat for children of current service members and veterans. The weekends will be filled with fun, consisting of group games, a climbing wall and zip line, arts and crafts, paddle boats, fishing, archery and of course bonfires! This camp is open to children with or without disabilities/special needs. Check in will be at 6 pm on Friday and checkout will be at 1 pm on Sunday. Campers will be accepted via first come, first served basis. In order to be accepted campers must complete and submit a registration packet. If you have any questions, please contact Liz Bunting or Shane Gemmill at 717-741-3891 or [email protected].

U.S. Department of Education Releases Human Trafficking in America's Schools Guide Trafficking of children or the sale of children is modern slavery. It involves exploiting a child for the purpose of forced labor, commercial sex, or both. An estimated 1.2 million children are trafficked each year worldwide, and the problem is dire right here in America. Schools can and should be safe havens for students, and even more so for students whose lives are otherwise characterized by instability and lack of safety or security. School personnel are uniquely well positioned to identify and report suspected abuse and connect students to services- actions that can prevent trafficking and even save lives. Everyone who is part of the school community- administrators, teachers, bus drivers, maintenance personnel, food service staff, resource officers, and other school community members-has the potential to be an advocate for child victims of human trafficking, but we must learn the indicators of the crime, its warning signs, and how to respond when a student is an apparent victim. Human Trafficking in America's Schools is a guide for school staff that includes information about risk factors, recruitment, and how to identify trafficking; what to do if you suspect trafficking, including sample school protocols and policies; and other resources and potential partnership opportunities. For more information and to download a copy of the guide, visit http://safesupportivelearning.ed.gov/human- trafficking-americas-schools.

Early Relationship Skills Prevent Teen Dating Violence February was Teen Dating Violence Awareness and Prevention Month—a time to promote healthy relationship skills to preteen and teens. Healthy and respectful behaviors can prevent teen dating violence. What You Need To Know -About 10% of high school students report being hit, slammed into something, or injured on purpose by a boyfriend or girlfriend in year before CDC survey. -Dating violence can be prevented when teens, families, organizations, and communities implement effective prevention strategies together. Dating Matters gives tips for preventing dating violence early and creating a safer future for young people

Safe Supportive Learning Environments Archived Webinars The National Center on Safe Supportive Learning Environments (NCSSLE) hosts webinars on a range of topics related to improving conditions for learning (e.g., preventing disruptive behaviors such as bullying, harassment, and violence and substance abuse). Go here to see archived webinars including several on dating violence.

Parents as Partners: A Suicide Prevention Guide for Parents Created by Suicide Awareness Voices of Education (SAVE), Parents as Partners: A Suicide Prevention Guide for Parents is a nine-page booklet that contains useful information for parents who are concerned that their children may be at risk for suicide. The booklet includes:  Information about depression, its symptoms, and its causes.  Information about the warning signs of suicide.  Recommendations for how to address possible suicide risk in your children.  Recommendations for sources of additional information. Parents as Partners: A Suicide Prevention Guide for Parents was developed by the staff of SAVE. SAVE’s mission is to prevent suicide through public awareness and education, eliminate stigma, and serve as a resource for those touched by suicide.

3 Objectives: Parents who read the brochure will have: 1. Increased knowledge about depression and its relationship to suicide. 2. Increased awareness of the symptoms of mental illness. 3. Increased awareness of effective treatments for mental illness. 4. Increased knowledge of warning signs for suicide. 5. Increased knowledge of additional resources related to suicide prevention. Implementation Essentials:  When possible, those who distribute the brochure should be aware of local helping resources, including crisis support lines and clinical services. Cost of the booklet is $3.50. Go here to order and to view additional resources.

When Teens Talk of Suicide: What You Need to Know It can be difficult for parents to differentiate between teenagers' normal expressions of negative feelings, and signs of suicidal risk. Gene Beresin and Steve Schlozman, child and adolescent psychiatrists at Massachusetts General Hospital, explain that alarming comments and behavior don't always indicate imminent danger: "Sometimes kids say something. Sometimes they post a frightening array of hopeless lyrics on Facebook. And most of the time - and this is important - kids don't do anything to hurt themselves. Morbid lyrics and even suicidal sentiments are surprisingly common in adolescence." However, they strongly encourage following up on such behaviors by talking directly with teens to learn more about their condition, and by consulting with mental health professionals. Research shows that asking young people directly about their possible suicidal feelings does not increase suicide risk but instead provides relief. In this article, the two doctors also provide specific suggestions for how to approach such a conversation. Read the article here.

Bullying Prevention: 2015 Resource Guide In the 2013 Youth Risk Behavior Survey (YRBS), 20 percent of students reported being bullied on school property and 15 percent reported being electronically bullied in the 12 months preceding the survey. Victimized youth are at increased risk for depression, anxiety, sleep difficulties, and poor school adjustment. Youth who bully others are at increased risk for substance use, academic problems, and violence later in adolescence and adulthood. Compared to youth who only bully, or who are only victims, bully-victims suffer the most serious consequences and are at greater risk for both mental health and behavior problems. This resource guide provides links to organizations, programs, publications, and resources focused on bullying prevention. It is divided into seven sections: (1) Organizations and Websites; (2) Data, Definitions, and Research; (3) Programs, Campaigns, and Toolkits; (4) Policies, Laws, and Legislation; (5) Publications and Resources; (6) At-Risk Populations; and (7) Bullying and Co-Occurring Issues. Each item in this resource guide includes a short description and a link to the resource itself. Learn more and access the CSN Resource Guide .

Executive Function: What is it and Why Does It Matter? Executive function is the capacity to control one’s behavior and direct it toward longer-term goals. Because it is so important, Search Institute has prepared a new research brief that explains the concept in clear and actionable terms. The brief, Strengthening Executive Function in Children: Tips for Parents and Practitioners, compares the role of executive function in the brain to that of an air traffic controller who must coordinate the landing schedules of multiple planes, ensuring that everyone reaches the ground safely. This new research brief describes how adults can easily do many things to promote the growth of executive function in children by keeping in mind the acronym SOAR:  Support imagination  Offer choices within limits  Assist reflection  Raise activity levels To find out more about SOAR strategies and what parents can do to nurture executive function skills in children, download a free copy of Search Institute’s latest research brief and view a brief video on executive function here. 4 2013 Fatality Data Now Available in WISQARS The Web-based Injury Statistics Query and Reporting System (WISQARS) is an interactive, online database that provides fatal and nonfatal injury data from a variety of sources. Users can search, sort, and view the injury data and create reports, charts, maps, and slides. The Centers for Disease Control has just updated WISQARS to include 2013 data in the following modules: Fatal Injury Reports, Leading Causes of Death, and Years of Potential Life Lost.

Resources on Marijuana Use, Consequences, Available Data, and Prevention Strategies Need to update your knowledge regarding marijuana use and consequences as well as prevention strategies? Listed below are resources containing a variety of current information on marijuana use, consequences, available data, and prevention strategies:  Resources from the Addiction Technology Transfer Center Network (ATTC) http://attcnetwork.org/marijuana/index.aspx The Marijuana Lit page includes resources such as webinars, videos and infographics.  Resources from SAMSHA’s Center for the Application of Prevention Technologies (CAPT) http://captus.samhsa.gov/access-resources/new-suite-capt-tools-target-youth-marijuana-use Risk and Protective Factors Associated with Youth Marijuana Use, offering a summary of research findings on factors associated with youth marijuana use. Strategies and Interventions to Prevent Youth Marijuana: An At-a-Glance Resource Tool, providing brief summaries of the strategies and associated interventions. Prevention Programs that Address Youth Marijuana Use, presenting detailed descriptions of substance abuse prevention strategies and associated interventions that have been evaluated to determine their effects on marijuana outcomes. Preventing Youth Marijuana Use: An Annotated Bibliography, providing abstracts for the resources presented throughout the suite. Youth Marijuana Use: Consumption, Consequence, and Risk and Protective Factor Data Resources , offering prevention practitioners a comprehensive listing of available data resources and surveys developed by and for a range of federal agencies.

TRAINING OPPORTUNITIES

Youth Mental Health First Aid Training The Pennsylvania Department of Education, Bureau of Special Education is pleased to announce the following training dates: PaTTAN King of Prussia - March 6, 2015 (8:00 am - 5:00 pm) PaTTAN Pittsburgh - April 22 & 23, 2015 (9:00 am - 1:30 pm - both days) PaTTAN Harrisburg - May 5 & 6, 2015 (9:00 am - 1:30 pm - both days) Youth mental health first aid is an 8 hour training designed to teach people methods of assisting a young person who may be in the early stages of developing a mental health problem or in a mental crisis. This training event is being offered to school and/or agency teams to ensure ample support is available to students. Suggested team members are listed below. Prior to the training, teams will be required to watch an introductory webinar. Information pertaining to the recorded webinar will be provided upon registration. Target Audience: School and/or agency teams which may include: educators, administrators, social services staff and volunteers, substance abuse professionals, social workers, school psychologists, guidance counselors, counselors, family members, college/university leaders, nurses, physician assistants, primary care workers, & policymakers Please register online at PaTTAN. For questions regarding registration, contact: King of Prussia - Delores Lawson, [email protected] 800-441-3215 x7216 Pittsburgh - Kristen Olszyk, [email protected] 412-826-6848 Harrisburg - Wendy Weary, [email protected] 717-901-2273

5 Third Thursdays Bullying Prevention Series Continues Mark your calendars for these upcoming Third Thursdays Bullying Prevention dates: March 19, 2015: Cultivating Empathy for Healthy Relationships and Collaborative Programs April 16, 2015: Fostering Cultural Competence: Using Children’s Literature to Talk about Difficult Issues in K-12 Classrooms May 21, 2015: Bullying in Sports: The Injuries We Don’t See For more information go here.

The Center for Schools and Communities is offering two new training courses for educators and helping professionals: Cultivating Empathy for Healthy Relationships and Collaborative Classrooms This training opportunity will challenge you to examine your own empathy skills and offer several practical and engaging activities and discussions you can have with your students to help develop empathy and perspective- taking and to cultivate an atmosphere characterized by kindness, respect and collaboration. The training is 9AM-4PM at the Center for Schools and Communities in Camp Hill, PA. Cost is $129 per person; lunch on your own. Pre-registration required. This training has been aligned with PA Core Standards, Academic Standards for Career Education and Work and Standards for Student Interpersonal Skills. This six-hour course is eligible for Act 48 and/or NASW credit. Event dates: Wednesday, March 18, 2015 Tuesday, May 19, 2015 Register Online Full course description Download the flyer

Mindset, Grit and Optimism: Promoting Skills that Lead to Academic Tenacity Research shows us that non-cognitive factors such as mindset, students' beliefs about their intelligence and abilities, their habits of self-control and their reactions to everyday setbacks can have a far greater impact than IQ on both academic and long-term success. Come learn relatively simple educational and psychological interventions that target these factors and can transform students' experiences and achievements in school and in life. This six-hour course is eligible for Act 48 and/or NASW credit. The training is 9AM-4PM at the Center for Schools and Communities in Camp Hill, PA. Cost is $129 per person; lunch on your own. Pre-registration required. Event date: Thursday, May 7, 2015 Register Online Full course description Download the flyer

2015 STAR-Center Conference "Understanding Adversity and Helping Youth to Overcome it" Friday, May 1, 2015 The William Pitt Union (University of Pittsburgh Campus) 3959 Fifth Avenue Pittsburgh, PA 15260 Read the full conference brochure and access the registration form here.

6 SAVE THE DATE

Commonwealth Prevention Alliance (CPA) 25th Annual Conference June 10- June 12, 2015 Nittany Lion Inn University Park, PA 16802 Click here for Save the Date Flyer and an outline of some conference highlights.

2016 Annual PASAP/PAMLE Conference February 28-March, 2016 Penn State Conference Center Hotel State College, PA 16803

FUNDING OPPORTUNITIES

Drug-Free Communities Support Program Grant The DFC Program was created by the Drug-Free Communities Act of 1997 (Public Law 105-20). The DFC Support Program has two goals: 1. Establish and strengthen collaboration among communities, public and private non-profit agencies; as well as federal, state, local, and tribal governments to support the efforts of community coalitions working to prevent and reduce substance use among youth*.

2. Reduce substance use among youth and, over time, reduce substance abuse among adults by addressing the factors in a community that increase the risk of substance abuse and promoting the factors that minimize the risk of substance abuse.

*For the purposes of this RFA, “youth” is defined as individuals 18 years of age and younger.

The goals of this program are to establish and strengthen collaboration among communities and public and private nonprofit agencies, and reduce substance use among youth and adults. The deadline to apply is March 18, 2015. To read more about this grant and eligibility requirements go here.

NEWS

Shake it Off? Not So Easy for People with Depression, New Brain Research Suggests Rejected by a person you like? Just "shake it off" and move on, as music star Taylor Swift says. But while that might work for many people, it may not be so easy for those with untreated depression, a new brain study finds. The pain of social rejection lasts longer for them -- and their brain cells release less of a natural pain and stress- reducing chemical called natural opioids, researchers report in the journal Molecular Psychiatry. The findings were made in depressed and non-depressed people using specialized brain-scanning technology and a simulated online dating scenario. The research sheds new light on how the brain's pain-response mechanism, called the opioid system, differs in people with depression. On the flip side, when someone they're interested in likes them back, depressed people do feel relatively better -- but only momentarily. This may also be explained by differences in their opioid system compared to non-depressed people, according to the new results. Further research could lead to a better understanding of how to boost the opioid response in depressed individuals to reduce the exaggerated effect of social stress, and to increase the benefits of positive social interactions. The researchers focused on the mu-opioid receptor system in the brain -- the same system that they have studied for years in relation to response to physical pain. During physical pain, our brains release opioids to dampen pain signals. 7 The new work shows that this same system is associated with an individual's ability to withstand social stress -- and to positively respond to positive social interactions, says senior author Jon-Kar Zubieta, M.D., Ph.D. "Social stressors are important factors that precipitate or worsen illnesses such as depression, anxiety and other neuropsychiatric conditions. This study examined mechanisms that are involved in the suppression of those stress responses," he says. "The findings suggest novel potential targets for medication development that directly or indirectly target these circuits and biological factors that affect variation between individuals in recovery from this otherwise chronic and disabling illness." Zubieta is a member of U-M's Molecular and Behavioral Neuroscience Institute, and the Phil F. Jenkins Research Professor of Depression in the Department of Psychiatry. The new findings have already prompted the team to plan follow-up studies to test individuals who are more sensitive to social stress and vulnerable to disorders such as social anxiety and depression, and to test ways of boosting the opioid response. Click here to read more about the study.

Stress Caused by Discrimination Linked to Mental Health Issues among Latino Teens Latino adolescents who experience discrimination-related stress are more likely to experience anxiety, depression, and issues with sleep, according to research led by NYU's Steinhardt School of Culture, Education, and Human Development. These mental health outcomes were more pronounced among Latino teens born in the U.S. to immigrant parents, as opposed to foreign-born teens. The longitudinal study, which appears online in the journal Child Development, suggests that first-generation immigrants and second-generation immigrants are affected differently by discrimination-related stress. Latinos are the largest and fastest growing ethnic minority in the U.S., making up 15 percent of the population. Research has shown that many young Latinos face discrimination in their daily lives. "Discrimination has been linked to a variety of mental health symptoms," said Selcuk Sirin, associate professor of applied psychology at NYU Steinhardt and the study's lead author. "Adolescence may be a particularly vulnerable time for discrimination, as forming one's cultural, ethnic, and racial identities are central during this developmental period." Sirin and his colleagues surveyed 173 Latino teens in New York City high schools during the teens' 10th, 11th, and 12th grade years. Both foreign-born (first-generation) immigrants and U.S.-born (second-generation) immigrants were included. "The finding may shed light on the 'immigrant paradox,' where second-generation immigrants fare worse than first- generation immigrants in a number of contexts, including mental health," said Sirin. "This may be because foreign-born immigrants are more in touch with aspects of Latino culture that serve a protective role, or because discrimination becomes more noticeable for later generations." The researchers concluded that the pattern of improving mental health over time demonstrates the psychological strength and resilience among Latino immigrants. However, those working with Latino immigrants should consider the damaging effects of discrimination on mental health, especially for U.S.-born youth. Read more here.

Cyber Dating Abuse among Teens Using School-Based Health Centers Cyber dating abuse is common and associated with Adolescent Relationship Abuse (ARA) and sexual assault in an adolescent clinic-based sample. The associations of cyber dating abuse with sexual behavior and pregnancy risk behaviors suggest a need to integrate ARA education and harm reduction counseling into sexual health assessments in clinical settings. Access the full study from Pediatrics .

CDC Reports 58 Million Non-Smokers in the United States Exposed to Secondhand Smoke Although secondhand smoke exposure in the United States dropped by half between 1999 to 2000 and 2011 to 2012, one in four non-smokers, or 58 million people, are still exposed to smoke, according to a new Vital Signs report from the Centers for Disease Control and Prevention (CDC). Read more .

Study Teens Who Skimp On Sleep Now Have More Drinking Problems Later Sleep-deprived teenagers find it difficult to focus in class, and they're more likely get sick. They are also more likely to develop problems with alcohol later on, according to a study published Friday in the journal Alcoholism: Clinical & Experimental Research.

8 The study included teens who suffered from conditions like insomnia as well as those who simply weren't getting enough sleep. Teenagers ages 14 through 16 who had trouble falling or staying asleep were 47 percent more likely to binge drink than their well-rested peers. Sleep problems were linked to even more issues with alcohol later on. Teens who had trouble sleeping when the researchers first checked in with them were 14 percent more likely to drive drunk and 11 percent more likely to have interpersonal issues related to alcohol a year later. And five years after that — when everyone was college-aged or older — those who had sleep issues in high school were 10 percent more likely to drive drunk. About 45 percent of adolescents don't get the recommended eight to 10 hours a night, polls show. The findings are based on data collected from 6,500 adolescents who were part of the larger National Longitudinal Study of Adolescent Health, which began tracking a group of adolescents in the mid-90s. Read more here .

Study Says Alcohol Ads Make Kids and Teens More Likely to Drink New research published online in JAMA Pediatrics showed that teens receptive to alcohol ads on television such as while watching the notoriously-alcohol ad heavy Super Bowl, were more likely to drink. The study was conducted by pediatrician Dr. Susanne E. Tanski of the Geisel School of Medicine at the Children's Hospital at the Dartmouth- Hitchcock Medical Center and colleagues. Surveys using images of alcohol ads were given to 2,541 teens and young adults between the ages of 15 and 23 in 2011 and 2013. Almost 1,600 completed follow-up surveys. Those under the legal drinking age of 21 were only slightly less likely to see alcohol ads on television than those in the 21 to 23 age group. One in four people older than 21 reported seeing these ads. Those who remembered seeing the ads and liking them were more likely to begin drinking or to become binge drinkers if they had already begun drinking when they took the first survey. Among teens 15 to 17 in the study, 29 percent reported binge drinking and 17 percent reported hazardous or risky drinking, meaning that they met or exceeded a threshold score for alcohol use. Read more .

Rate of Substance Abuse High Among Pregnant Teens: Study Almost 60 percent of pregnant teens say they have used one or more substances in the past year, nearly double the rate of non-pregnant teens, researchers at the University of Texas at Austin have found. Use of these substances continues during pregnancy, especially among younger teens, the study found. More than one-third of all pregnant teens ages 12 to 14 said they used one or more substances in the previous month, the Austin American-Statesman reports. Pregnant teens were most likely to use alcohol (16 percent), followed by marijuana (14 percent) and other illicit drugs (5 percent). The findings are published in Addictive Behaviors. The researchers found pregnant teens were less likely to use drugs or alcohol once they moved into their second or third trimester. The study included data from 97,850 teen girls between ages 12 and 17. A total of 810 reported they were pregnant. For more information, click here.

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