Pregnancy Prevention Initiative Research Articles

Abstinence-only education and teen pregnancy rates: why we need comprehensive sex education in the U.S.

The United States ranks first among developed nations in rates of both teenage pregnancy and sexually transmitted diseases. In an effort to reduce these rates, the U.S. government has funded abstinence-only sex education programs for more than a decade. However, a public controversy remains over whether this investment has been successful and whether these programs should be continued. Using the most recent national data (2005) from all U.S. states with information on sex education laws or policies (N = 48), we show that increasing emphasis on abstinence education is positively correlated with teenage pregnancy and birth rates. This trend remains significant after accounting for socioeconomic status, teen educational attainment, ethnic composition of the teen population, and availability of Medicaid waivers for family planning services in each state. These data show clearly that abstinence-only education as a state policy is ineffective in preventing teenage pregnancy and may actually be contributing to the high teenage pregnancy rates in the U.S. In alignment with the new evidence-based Teen Pregnancy Prevention Initiative and the Precaution Adoption Process Model advocated by the National Institutes of Health, we propose the integration of comprehensive sex and STD education into the biology curriculum in middle and high school science classes and a parallel social studies curriculum that addresses risk-aversion behaviors and planning for the future.

The impact of body image and Afrocentric appearance on sexual refusal self-efficacy in early adolescent African American girls

Research examining the association between body image and sexual risk-taking has been mostly limited to clinical and/or White female samples. It is unclear whether body image plays a role in sexual risk-taking among African American early adolescent females. Moreover, research has neglected to consider body image within a cultural and ethnic framework. A positive sense of Afrocentric appearance may influence, either positively or negatively, sexual attitudes and behaviors among African American early adolescent girls. The purpose of this study, conducted with 156 urban African American early adolescent females, was to examine the relationships among body image, Afrocentric appearance, and sexual refusal self-efficacy. Results found no significant association between body image and sexual refusal self-efficacy. However, structural equation modeling found that a positive sense of Afrocentric appearance significantly predicted increased sexual refusal self-efficacy. Implications of this study in regard to culturally-based teenage pregnancy prevention and education initiatives are discussed.

The Role of Policy Advocacy in Assuring Comprehensive Family Life Education in California

As part of their 10-year $60 million Teenage Pregnancy Prevention Initiative, The California Wellness Foundation funded 18 state and local organizations to conduct policy advocacy to strengthen teen pregnancy prevention policies. This article describes how some of these grantees accomplished noteworthy goals, including the passage of the California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act (SB71), the prevention of the state's pursuit of federal "abstinence-only-until-marriage" funding, and the passage of a local school district FLE policy. Grantee progress is presented through a five-stage policy change framework: Institutional Capacity and Leadership Building, Policy Issue Recognition, Policy Prioritization, Policy Adoption, and Policy Maintenance. Implications are shared for advocates, policy makers, and funders who are developing initiatives aimed at improving the health of adolescents.

Native Teen Voices: Adolescent Pregnancy Prevention Recommendations

Purpose American Indian adolescent pregnancy rates are high, yet little is known about how Native youth view primary pregnancy prevention. The aim was to identify pregnancy prevention strategies from the perspectives of both male and female urban Native youth to inform program development. Methods Native Teen Voices (NTV) was a community-based participatory action research study in Minneapolis and St. Paul, Minnesota. Twenty focus groups were held with 148 Native youth who had never been involved in a pregnancy. Groups were stratified by age (13–15 and 16–18 years) and sex. Participants were asked what they would do to prevent adolescent pregnancy if they were in charge of programs for Native youth. Content analyses were used to identify and categorize the range and types of participants’ recommendations within and across the age and sex cohorts. Results Participants in all cohorts emphasized the following themes: show the consequences of adolescent pregnancy; enhance and develop more pregnancy prevention programs for Native youth in schools and community-based organizations; improve access to contraceptives; discuss teen pregnancy with Native youth; and use key messages and media to reach Native youth. Conclusions Native youth perceived limited access to comprehensive pregnancy prevention education, community-based programs and contraceptives. They suggested a variety of venues and mechanisms to address gaps in sexual health services and emphasized enhancing school-based resources and involving knowledgeable Native peers and elders in school and community-based adolescent pregnancy prevention initiatives. A few recommendations varied by age and sex, consistent with differences in cognitive and emotional development.

The Program Plan Index: an evaluation tool for assessing the quality of adolescent pregnancy prevention program plans.

To assess process, impacts, and outcomes among 45 distinct county teen pregnancy prevention initiatives, several standardized data collection procedures, instruments, and protocols were developed including the Program Plan Index (PPI). The PPI was developed to determine if program plans met legislative requirements and were consistent with best practices in public health program planning and teen pregnancy prevention. Analysis of proposals from 45 counties revealed that 12 county plans were evaluated as deficient, 14 as low, 14 as acceptable, 4 as good, and 1 as excellent. Explanations for overall performance included the following: criteria used to develop the PPI based on an in-depth understanding of best practices, variations in the criteria for county request for proposals, lack of prevention expertise at the local level, and minimal time for grantees to draw down funds. Statewide efforts to improve funded community-based teen pregnancy prevention planning, implementation, and empowerment evaluation efforts are ongoing.

Factors Affecting Yukon Teen Pregnancy Decline in the Mid and Late 1990s

Teen pregnancy has declined throughout North America in the 1990s. In Yukon Territory, Canada, teen pregnancy was almost 40% lower than in the early 1990s. This rate of decline is significantly greater than most recently reported national rates of teen pregnancy decline in Canada and United States. Identifying possible causes of the Yukon decline may help policy makers and program managers plan and implement teen pregnancy prevention strategies.Data on Yukon teen pregnancy prevention initiatives were collected numerous discussions and interviews with through Yukon service providers, teens and the general public between 1994 and 2001. Analysis of data demonstrates that multiple new initiatives spanning many sectors were implemented in the mid and late 1990s that could have contributed to the decline in Yukon teen pregnancy.A multi-dimensional approach to teen pregnancy prevention that included researching and evaluating family planning programs and policies before, during, and after implementation, increasing access to longer-acting hormonal contraceptives, providing continuing family planning medical education to health care providers and other youth service providers, subsidization of contraceptives, delivery of innovative family planning mass media campaigns, and delivery of ongoing sexual health education programs may have significantly contributed to the decline in Yukon teen pregnancy. Collaboration among service providers across many service sectors (clinical, public health, education First Nations, government communication and policy, grassroots) facilitated coordination of the multidimensional approach.

The Development of Programs for Pregnant and Parenting Teens

ABSTRACT The impact of early pregnancy and parenting on adolescents is well documented, with its negative effects on achieving adequate education, job skills training, gainful employment and economic independence duly recognized. While current interest and resources focus on abstinence only programs as major pregnancy prevention initiatives, we are increasingly failing those young women who have chosen early parenthood as a life option. This article will describe the efforts of a large urban hospital to provide hospital-based comprehensive services to pregnant and parenting teens to reduce the negative consequences to them and their children, and to help them to become effective parents and lead healthy, productive lives.

Analyzing the Contribution of Community Change to Population Health Outcomes in an Adolescent Pregnancy Prevention Initiative

Analyzing the Contribution of Community Change to Population Health Outcomes in an Adolescent Pregnancy Prevention Initiative

Analyzing the contribution of community change to population health outcomes in an adolescent pregnancy prevention initiative.

Few evaluations of community initiatives have established a link between intermediate outcomes, such as community or systems change, and more distant population-level health outcomes (e.g., estimated rates of employment or adolescent pregnancy). This article describes an analysis of the contribution of community changes facilitated by a community health initiative to prevent adolescent pregnancy to the population-level outcome of birth rates for teens. The authors examine a hypothesis that this link might be expected when community changes are of greater amount, intensity, duration, and exposure. The results showed reductions in birth rates in Target Area A, where there was a greater concentration of community changes and a slight increase where there were far fewer changes. This report provides a method for describing empirically the contribution of environmental change to more distant population-level outcomes.

Analyzing the Contribution of Community Change to Population Health Outcomes in an Adolescent Pregnancy Prevention Initiative

Analyzing the Contribution of Community Change to Population Health Outcomes in an Adolescent Pregnancy Prevention Initiative

Education Now and Babies Later (ENABL): Life History Of a Campaign to Postpone Sexual Involvement

Education Now and Babies Later (ENABL), a statewide adolescent pregnancy prevention initiative, was inaugurated in California in June 1992. Developed by the state's Office of Family Planning, ENABL utilized a five-session intervention curriculum, Postponing Sexual Involvement (PSI), targeted at delaying the onset of sexual activity among youths aged 12-14. Schoolwide and community-based activities, along with a statewide media and public relations campaign, reinforced the intervention's message. Data collected from nearly 9,000 surveys, 75 individual interviews and 50 focus groups indicated that youths, parents and community representatives supported the initiative and endorsed its message, although most recommended changes to the curriculum. However, because no impact on sexual behavior could be demonstrated, the campaign was abruptly terminated in February 1996, despite recommendations that the program be retained and improved.