Adolescent Pregnancy Prevention Programs Research Articles

Association of service facilities and amenities with adolescent birth rates in Mexican cities

BackgroundThe association of the built environment and the structural availability of services/amenities with adolescent birth rates (ABR) has been overlooked in Latin America. We investigated the association of the availability, and changes in the availability, of services/amenities with ABR in 92 Mexican cities.MethodsWe estimated ABR using data on live birth registration linked to municipality of residence at the time of birth from 2008–2017. The number of services/amenities were obtained from the National Statistical Directory of Economic Units in 2010, 2015, and 2020 and grouped as follows: education, health care, pharmacies, recreation, and on- and off-premises alcohol outlets. Data were linearly interpolated to obtain yearly estimates. We estimated densities per square km by municipality. We fitted negative binomial hybrid models, including a random intercept for municipality and city, and adjusted for other social environment variables.ResultsAfter adjustment a 1-unit increase in the density of recreation facilities, pharmacies, and off-premises alcohol outlets within municipalities was associated with a 5%, 4% and 12% decrease in ABR, respectively. Municipalities with higher density of education, recreational and health care facilities had a lower ABR; in contrast, municipalities with a higher density of on-premises alcohol experienced a higher ABR.ConclusionOur findings highlight the importance of economic drivers and the need to invest in infrastructure, such as pharmacies, medical facilities, schools, and recreation areas and limit the availability of alcohol outlets to increase the impact of current adolescent pregnancy prevention programs.

Sexual health educational intervention in medical students.

The National Autonomous University of Mexico Faculty of Medicine created the Adolescent Pregnancy Prevention Program, which is aimed at students. To determine the sexual-reproductive health profile of medical students through a diagnostic questionnaire and of those who participated in an educational intervention on sexuality (three modules). First-year undergraduate students, schoolyear 2017-2018, participated. Students were considered to be trained when they took at least one module. The questionnaire was answered by 1157 students, 21.9 % participated in at least one module, 43.1% had initiated sexual activity and 25 % received the educational intervention. Not having used a condom in their last intercourse was identified in 20 %, and a high prevalence of intercourse under the influence of alcohol was observed. It is important for specific sexuality competences to be promoted among those who will be doctors in the future.

Strategies for recruiting, training, and retaining educators for adolescent pregnancy prevention programs: Insights from organization leaders and educators.

This paper provides insights into how 17 community-based organizations (CBOs) recruited, trained, and retained educators in pregnancy prevention program implementations for underserved adolescents in different areas of the United States. The paper also highlights problems and potential solutions associated with these practices. The study adopted a qualitative descriptive framework. We conducted 41 interviews with leaders and educators of CBOs and conducted qualitative content analysis of the interview data integrating deductive and inductive coding approaches. We found that a commonly emphasized recruitment and selection challenge was finding qualified candidates for short-term project-based employment. Interviewees highlighted limitations of curriculum training in preparing novice educators for program implementation and shared their strategies to overcome these limitations. Post-onboarding professional development opportunities were available for long-term educators, but not for short-term project-based educators. Educators reported receiving sufficient support from their organizations and coworkers to perform their jobs and maintain their well-being. Although none of the educators desired to leave their roles, they shared potential reasons for turnover, such as project-based employment and a desire to explore different career paths. We align the study findings with best practices proposed in the adolescent health education and human resources literatures and present a set of recommendations. Researchers interested in adolescent pregnancy prevention program implementation and organizations that plan to implement programs can benefit from the findings and recommendations presented in this article.

Meta-analysis of Federally Funded Adolescent Pregnancy Prevention Program Evaluations.

Beginning in 2010, the U.S. Department of Health and Human Services (HHS) sponsored numerous studies testing the effectiveness of Adolescent Pregnancy Prevention programs on youths' risky sexual behaviors. This article presents results from a meta-analysis of such studies completed between 2015 and 2019 and provided to us by HHS. Studies were eligible for inclusion if they used an experimental/quasi-experimental design, included a comparison condition, assigned at least 10 study participants to each condition, and measured and reported at least one outcome related to sexual behavior or consequences. Data were extracted using a standardized coding protocol and outcomes were coded as, or transformed to, log odds ratio effect sizes for analysis and then transformed to odds ratio effect sizes for presentation in the text. All outcomes were coded such that log odds ratios greater than zero (odds ratios greater than 1) indicate beneficial effects (e.g., reductions in risky sexual behavior). A total of 52 studies met the inclusion criteria. Across 7 outcome types, pooled effects were generally small, the direction of effects was mixed, and none achieved statistical significance: recent pregnancy (OR = 1.30, 95% CI [1.00, 1.68]), ever had sex (OR = 1.07, 95% CI [0.99, 1.15]), recent sexual activity (OR = 0.95, 95% CI [0.84, 1.09]), recent unprotected sexual activity (OR = 1.05, 95% CI [0.96, 1.16]), ever pregnant (OR = 1.21, 95% CI [0.51, 2.89]), number of sexual partners (OR = 1.08, 95% CI = [0.28, 4.22]), and proportion of recent sexual experiences that were unprotected (OR = 0.74, 95% CI = [0.43, 1.31]). Moderator analyses pooling across all 7 outcome types indicated minor differences in program effectiveness between program settings, with those delivered in classroom settings being the least effective (b = - 0.17, 95% CI [- 0.33, - 0.01]). These findings do not lend meaningful support for the overall effectiveness of this group of pregnancy prevention programs. However, because the meta-analysis sample only included programs recently funded by HHS, these findings may have limited generalizability to programs funded by other entities or implemented in other countries.

Spatial distribution and factors associated with adolescent pregnancy in Nigeria: a multi-level analysis

BackgroundAdolescent pregnancy is a global public health and social phenomenon. However, the prevalence of adolescent pregnancy varies between and within countries. This study, therefore, sought to investigate the spatial distribution and factors associated with adolescent pregnancy in Nigeria.MethodsUsing data from the women’s recode file, a sample of 9448 adolescents aged 15-19 were considered as the sample size for this study. We employed a multilevel and spatial analyses to ascertain the factors associated with adolescent pregnancy and its spatial clustering.ResultsThe spatial distribution of adolescent pregnancy in Nigeria ranges from 0 to 66.67%. A high proportion of adolescent pregnancy was located in the Northern parts of Nigeria. The likelihood of adolescent pregnancy in Nigeria was high among those who had sexual debut between 15 to 19 years [aOR = 1.49; 95%(CI = 1.16-1.92)], those who were currently married [aOR = 67.00; 95%(CI = 41.27-108.76)], and adolescents whose ethnicity were Igbo [aOR = 3.73; 95%(CI = 1.04-13.30)], while adolescents who were currently working [aOR = 0.69; 95%(CI = 0.55-0.88)] were less likely to have adolescent pregnancy.ConclusionA high proportion of adolescent pregnancy was located in the Northern parts of Nigeria. In addition, age at sexual debut, educational level, marital status, ethnicity, and working status were associated with adolescent pregnancy. Therefore, it is vital to take cognizant of these factors in designing adolescent pregnancy prevention programs or strengthening existing efforts in Nigeria.

Community service learning in the teen outreach program in non-metropolitan florida high schools

ABSTRACT Engagement of adolescents with their communities has been associated with lower rates of adolescent pregnancy. The purpose of this study was to qualitatively analyze Community Service Learning activities in the Teen Outreach Program (TOP) on a variety of dimensions. Data analyzed included CSL records submitted by TOP facilitators during the 2014–2015 school year implementation of TOP in non-metropolitan high schools in a Southeastern US state. CSL records included quantitative components such as type of projects, hours, and student participation. Qualitative data included thematic analysis of open-ended responses to questions regarding stages of CSL. A majority of projects were indirect service, indicating that students did not engage with the community. This study contributes to the literature by analyzing how CSL functions within an implementation of TOP, emphasizing the inclusion of civic participation activities in adolescent pregnancy prevention programs.

Parents involvement and barriers of programme interventions to reduce adolescent pregnancy

Adolescent pregnancy is defined as a pregnancy between the ages of 13-19 years, adolescent pregnancy occurs around 25% of women worldwide, but this number continues to decline due to educational support, contraception and prevention strategies for adolescent pregnancy. Evidence shows that there were programme interventions to reduce adolescent pregnancy such as encouraging people to participate in comprehensive prevention of adolescent pregnancy programs and health campaign to avoid unsafe sexual relationships. This scoping review was aimed to map out available evidence related to the parents’ involvement and barriers of programme intervention to reduce adolescent pregnancy. This scoping review followed the framework of Arksey and O'Malley, which consists of identifying the review questions; look for relevant evidence; selecting relevant studies; maping the data; and medicate, conclude and report results. PRISMA flowchart was used to display the evidence search flow. The results of the review indicated that there were 12 included articles from the search process. This review emerged 3 themes: efforts to reduce adolescent pregnancy rates, support for adolescent reproductive health services, barriers to reproductive health services for adolescents. It is important encouragage people to participate in comprehensive adolescent pregnancy prevention programs in including provision of information about the dangers of adolescents’ pregnancy, reproductive health, and maintain positive relationship with the family.

Perfil de adolescentes gestantes e de seus recém-nascidos em município do sul do Brasil

OBJETIVO: descrever o perfil de adolescentes gestantes e de seus recém-nascidos em um município do sul do Brasil. MÉTODO: trata-se de um estudo transversal descritivo. A coleta de dados foi realizada com base nos dados das declarações de nascidos vivos do município entre os meses de janeiro a dezembro de 2018. Para avaliar a associação entre as variáveis numéricas, os testes da correlação linear de Pearson ou Spearman foram utilizados. O nível de significância adotado foi de 5% (p<0,05), utilizando-se medidas de tendência central de variabilidade, frequências absoluta e relativa. RESULTADOS: de 2.974 registros de nascimento, 445 eram de mães adolescentes, resultando num quantitativo de (15%) de gravidez na adolescência. A maioria das adolescentes possuía idade média de 17,5 anos, (62,5%) eram brancas, (92,8%) eram solteiras. Quanto à escolaridade, 61,6% com o ensino fundamental completo; e (87%) ocupação do lar. Observou-se associação estatisticamente significativa ntre o número de consultas de pré-natal e o peso ao nascer dos neonatos de maneira positiva para a idade das gestantes e contexto de vida. CONCLUSÕES: evidenciou-se um expressivo número de adolescentes gestantes, observando-se a necessidade da implementação de estratégias de planejamento familiar pelos programas de prevenção da gravidez na adolescência.

"Mom, I'm Pregnant": The Adolescent Pregnancy Reveal.

The pregnancy reveal is conventionally a celebratory occasion, but for a pregnant adolescent, sharing news of a pregnancy, particularly with parents, can be a daunting prospect. Nonetheless, given the importance of social support to pregnant and parenting adolescents' success, the pregnancy reveal is an important step toward making healthy pregnancy decisions. Drawing on data from 27 in-depth interviews with young parents in Texas who were peer educators in an adolescent pregnancy prevention program, we find that adolescents often delay telling parents about a pregnancy. The complex decision-making process they undergo as they consider how and from whom to seek help can be drawn out, sometimes well into the second trimester, potentially delaying prenatal care and other steps necessary for a healthy pregnancy. This finding suggests that the delay and its consequences warrant further research and may have implications for parents' and practitioners' conversations with adolescents about sexual and reproductive health.

Examining the Effects of an Adolescent Pregnancy Prevention Program by Risk Profiles: A More Nuanced Approach to Program Evaluation

PurposeThe objective of the study was to examine whether latent class analysis (LCA) could (1) identify distinct subgroups of youth characterized by multiple risk and protective factors for early sexual initiation and (2) allow for a more nuanced assessment of the effects of a middle school program to prevent teen pregnancy/HIV/sexually transmitted infection. MethodsLCA was applied to data from the baseline (seventh grade) sample of 1,693 sexually inexperienced students participating in a randomized controlled trial of It's Your Game…Keep It Real in Harris County, Texas. Multilevel analysis was applied within subgroups defined by the latent classes to assess for potential differential program effects. ResultsLCA identified 3 distinct profiles of youth: family disruption, other language household, and frequent religious attendance. Multilevel analyses found differential effects of the program across these profiles with a significant and substantial reduction (30%) in initiation of vaginal sex by ninth grade for students in the family disruption profile only. ConclusionsApplication of LCA may hold promise for conducting more nuanced evaluations and refinements of behavior change interventions for youth.

Youth and provider perspectives of Wahine Talk: A holistic sexual health and pregnancy prevention program developed with and for homeless youth

Half of homeless youth experience pregnancy at some point during their adolescence. Few programs exist to address pregnancy prevention among homeless youth, particularly from a holistic health promotion framework. Wahine Talk, an innovative adolescent pregnancy prevention and sexual health program, helps to fill this gap. The current study is part of a larger examination of Wahine Talk's initial feasibility, appropriateness, and acceptability, exploring experiences of both homeless youth participants (n = 11) and an interdisciplinary team of providers (n = 4) in three focus groups (N = 3). Template Analysis of focus group data resulted in five main themes characterizing participant and provider experiences of the intervention: 1) basic needs services are foundational; 2) peer mentorship takes many forms; 3) group is good, but is not for everyone; 4) putting a person in the clinic; and 5) holistic sexual health promotion. Findings suggest that Wahine Talk is initially feasible to provide, appropriate for homeless young women, and acceptable as delivered. Implications for practice, policy, and research are discussed.

A Holistic Approach to Adolescent Pregnancy Prevention

An editorial presented which discusses the issue of teenage pregnancy prevention programs. It mentions the Adolescent Pregnancy Prevention (APP) Program which teaches and supports healthy sexual choices, the individual programs APP supports, and the need to promote such programs and disseminate the successes.

Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial

BackgroundEarly marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living.MethodsThe study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives.DiscussionWhile the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be considered seriously when evaluating whether such a program can justify the required investments in a setting with scarce resources. The economic evaluations outlined in this paper will generate valuable information that can be used to guide large-scale implementation of programs to address the problem of the high prevalence of adolescent childbirth and school drop-outs in similar settings.Trial registrationClinicalTrials.gov, NCT02709967. Registered on 2 March 2016. ISRCTN, ISRCTN12727868. Registered on 4 March 2016.

Incorporating Trauma-Informed Care Into School-Based Programs.

This article provides an overview of the rationale and process for incorporating trauma-informed approaches into US school-based programs, using school-based adolescent pregnancy prevention programs as an example. Research literature is reviewed on the prevalence and outcomes of childhood trauma, including the links between trauma and pregnancy. Information is then presented concerning the implementation of trauma-informed approaches in school settings, describing activities undertaken, barriers encountered, and outcomes achieved. Next, we describe the implications of this literature for school-based adolescent pregnancy prevention programs, outlining the reasons for including trauma-informed approaches in these programs, the prerequisites for doing so, and some examples of successful implementation. Many children in our country experience trauma, placing them at increased risk of multiple health concerns including adolescent pregnancy. In response to this situation, some schools have successfully incorporated trauma-informed approaches into adolescent pregnancy prevention programs, as well as other programming. Incorporating trauma-informed approaches into school settings, including school-based adolescent pregnancy prevention programs, is a viable and important way to address the multiple needs of traumatized children.

A Community Needs Index for Adolescent Pregnancy Prevention Program Planning: Application of Spatial Generalized Linear Mixed Models.

Objective The objective is to estimate community needs with respect to risky adolescent sexual behavior in a way that is risk-adjusted for multiple community factors. Methods Generalized linear mixed modeling was applied for estimating teen pregnancy and sexually transmitted disease (STD) incidence by postal ZIP code in New York State, in a way that adjusts for other community covariables and residual spatial autocorrelation. A community needs index was then obtained by summing the risk-adjusted estimates of pregnancy and STD cases. Results Poisson regression with a spatial random effect was chosen among competing modeling approaches. Both the risk-adjusted caseloads and rates were computed for ZIP codes, which allowed risk-based prioritization to help guide funding decisions for a comprehensive adolescent pregnancy prevention program. Conclusions This approach provides quantitative evidence of community needs with respect to risky adolescent sexual behavior, while adjusting for other community-level variables and stabilizing estimates in areas with small populations. Therefore, it was well accepted by the affected groups and proved valuable for program planning. This methodology may also prove valuable for follow up program evaluation. Current research is directed towards further improving the statistical modeling approach and applying to different health and behavioral outcomes, along with different predictor variables.

A Clustered Randomized Controlled Trial of the Positive Prevention PLUS Adolescent Pregnancy Prevention Program.

To determine the impact of Positive Prevention PLUS, a school-based adolescent pregnancy prevention program on delaying sexual intercourse, birth control use, and pregnancy. I randomly assigned a diverse sample of ninth grade students in 21 suburban public high schools in California into treatment (n = 2483) and control (n = 1784) groups that participated in a clustered randomized controlled trial. Between October 2013 and May 2014, participants completed baseline and 6-month follow-up surveys regarding sexual behavior and pregnancy. Participants in the treatment group were offered Positive Prevention PLUS, an 11-lesson adolescent pregnancy prevention program. The program had statistically significant impacts on delaying sexual intercourse and increasing the use of birth control. However, I detected no program effect on pregnancy rates at 6-month follow-up. The Positive Prevention PLUS program demonstrated positive impacts on adolescent sexual behavior. This suggests that programs that focus on having students practice risk reduction skills may delay sexual activity and increase birth control use.

Adolescent Pregnancy Prevention Programs and Research: A Time To Revisit Theory.

The authors argue that researchers and developers need to revisit the theory of planned behavior, social cognitive theory, and the social, psychological theories that are predictive of sexual behavior, and it mentions innovations and research involving adolescent pregnancy prevention programs in America. Funding from the U.S. Department of Health and Human Services' Office of Adolescent Health is examined, along with the efforts to reduce adolescent sexual risk behaviors.

Comprehensive Reporting of Adolescent Pregnancy Prevention Programs.

An introduction is presented in which the author discusses the special issue of the journal which examines the impacts of American adolescent pregnancy prevention programs on behavioral outcomes and funding by the U.S. Department of Health and Human Services' Office of Adolescent Health.

Replication Typology and Guidelines for Adolescent Pregnancy Prevention Initiatives.

An introduction is presented in which the authors discuss the supplemental issue of the journal which examines the replication typology and guidelines for adolescent pregnancy prevention programs in America, as well as the U.S. Department of Health and Human Services' Office of Adolescent Health.

The Promise of Technology to Advance Rigorous Evaluation of Adolescent Pregnancy Prevention Programs in American Indian and Alaska Native Tribal Communities.

The authors discusses the potential impact that technology might have on the process of evaluating the efficacy of adolescent pregnancy prevention programs in American Indian and Alaska Native (AI/AN) tribal communities as of 2016, and it mentions the challenges that are associated with implementing rigorous evaluation designs and research programs involving members of AI/AN tribes. Online interventions for AI/AN youth and adolescents are examined, along with e-mail and text messages.