Teen Pregnancy Prevention Research Articles

Sampling strategies for proportion and rate estimation in a spatially correlated population

Conventional sampling theory is widely used in environmental and health hazard assessment. However, spatial sampling techniques are among the most efficient methods when sampling units are spatially correlated. Spatial sampling has been introduced and used for population mean estimation. In addition, few works have also been focused for the population proportion estimation. However, in many health-related data applications, we are interested to also know the proportion of non-rare specific health condition (e.g. asthma) or rate of rare specific health condition (e.g. cancer) in each small area rather than overall population to inform public and policy-makers to focus on areas which are most in need. In this paper, we develop design-based and model-based approaches for overall and area-specific proportion and rate estimation. In particular, we expand dependent unit sequential technique method on model-assisted (ranked set sampling) and model-based (small area estimation) approaches which are more efficient than the sampling methods originated from simple random sampling. We evaluate the performance of proposed approaches using stimulation studies and also by a real data application on teen birth rate in Georgia, USA.

Childbirths and the Prevalence of Potential Risk Factors for Adverse Perinatal Outcomes among Asylum Seekers in The Netherlands: A Five-Year Cross-Sectional Study.

This five-year cross-sectional study mapped the prevalence of several known risk factors for adverse perinatal outcomes in asylum-seeking women in The Netherlands. Characteristics of 2831 registered childbirths among residents of asylum seekers centers (ASCs) in The Netherlands from 2016 to 2020 were included. Results showed a high general and teenage birthrate (2.15 and 6.77 times higher compared to the Dutch, respectively). Most mothers were pregnant upon arrival, and the number of births was highest in the second month of stay in ASCs. Another peak in births between 9 and 12 months after arrival suggested that many women became pregnant shortly after arrival in The Netherlands. Furthermore, 69.5 percent of all asylum-seeking women were relocated between ASCs at least once during pregnancy, which compromises continuity of care. The high prevalence of these risk factors in our study population might explain the increased rate of adverse pregnancy outcomes in asylum seekers compared to native women found in earlier studies. Incorporating migration-related indicators in perinatal health registration is key to support future interventions, policies, and research. Ultimately, our findings call for tailored and timely reproductive and perinatal healthcare for refugee women who simultaneously face the challenges of resettlement and pregnancy.

SUMBER INFORMASI, PENGETAHUAN DAN SIKAP PENCEGAHAN REMAJA TERHADAP PENCEGAHAN KEHAMILAN BAGI REMAJA DI KOTA JAMBI TAHUN 2021

Adolescence is a period of rapid growth and development both physically, psychologically, and intellectually. The characteristics of adolescents who have a great curiosity, like adventure and challenges and tend to dare to take risks without careful consideration, one of the problems that occur during adolescence such as sexuality problems, unwanted pregnancy (KTD) and abortion, infection with sexually transmitted diseases (STDs). ), and drug abuse. The design of this study used descriptive analytic. With a Cross Sectional approach where the research will be conducted aims to determine the relationship between knowledge of reproductive health and attitudes towards prevention of teenage pregnancy in Jambi City. Respondents were teenagers aged 13 to 17 years as many as 76 people

Teenage pregnancy prevention: The church, community, culture and contraceptives.

It is important to prevent teenage pregnancies to enhance their health, educational level and economic prospects. Peer education should be explored as a strategy to prevent teenage pregnancies. The purpose of this paper is to share the perceptions of peer educators who underwent a peer education-training programme and the effect it had on their own sexual behaviour. A qualitative descriptive, explorative and contextual research design was conducted, using in-depth interviews from 15 participants to gather data. The findings revealed that participants had positive educational experiences; positive personal growth; and wanted to become mentors for their peers. Despite their increased level of knowledge and positive experiences, some found it difficult to mentor others due to religion, culture as well as the opinion of their parents and community. Peer education will only have an effect on contraceptives if the church, the community, diverse cultural norms and traditions are included in the dialogue about contraception.

Romantic relationship and pregnancy dynamics among adolescent African Americans and refugees living in the United States

AbstractFew studies have examined romantic relationship attitudes and behaviors among ethnic or racial minority youth. The purpose of this study was to compare African American (AA) and mostly African refugee adolescents living in a U.S. city on romantic relationship attitudes and behaviors. A baseline questionnaire was given to 1448 adolescents between the ages of 14 and 19 from 2011 to 2014 as part of a larger study on teen pregnancy prevention (Barbee et al., 2016). The sample included both U.S.‐born AA youth and a sample of mostly African refugee youth. Eighty‐eight percent of youth were on free and reduced lunch and living in the highest poverty neighborhoods of a southern U.S. city. AAs reported more favorable life history expectations than refugees. In addition, refugee youth were more likely than AAs to see the ecology as dangerous and their lives as likely to be short. Results also found that AA youth were more secure and less avoidant in their attachment styles than refugee youth. Using a measure of romantic motives, refugee youth were more likely to display traits of “parasites” and less likely to be “partners” or “players” than AA youth. Implications for pregnancy outcomes, youth development, and interventions are discussed.

A systematic review of comprehensive sexuality education for South African adolescents

Comprehensive sexuality education (CSE) was implemented in South African schools in the year 2000 as part of the subject Life Orientation, with the aim of contributing positively to adolescent sexual health in a holistic manner. Continued high rate of teenage pregnancy and HIV infection is an indication; however, that the programme is not entirely successful. To establish why the aims of the programme and the consequences of learners’ sexual behaviour do not correspond, this systematic review aimed to determine how the programme contributes to the sexual health of adolescents and to make recommendations for its improvement. Nine databases were searched, after which two reviewers independently evaluated the methodological quality of the identified studies using an appraisal tool. The 22 articles that met the criteria for final inclusion were qualitative in nature and included cross-sectional and cohort studies. Results indicate that the contribution of the CSE programme is reflected in teachers, learners and the curriculum. Teachers are in need of expert training and learners are neither actively involved in the learning process nor the development of the programme as they need and would like to be. Recommendations include the development of context-specific training curricula for pre- and in-service teachers as developed collaboratively by various experts and stakeholders. Learners’ voices, active involvement, cultural context and needs are fundamental to the development and delivery of CSE. The teaching method and content of sexuality education should meet the contemporary needs of the 21st century adolescent to ensure optimal sexual health.

Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006–2016: analysis of the Uganda Demographic and Health Surveys

ObjectiveTeenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the...

Influence of socio-economic factors on prevalence of teenage pregnancy in Nigeria.

The study utilized the theory of fertility as initiated by Davis and Blakes (1956) and developed by Bongaarts in 1978 to underscore why teenage fertility has remained high in Nigeria. This study investigates women socio-economic factors influencing pregnancy in Nigeria. A total sample of 8448 female teenagers with pregnancy experiences were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS). The study revealed that 19% of young girls with 15-19 years have experienced teenage pregnancy in Nigeria. More importantly, the socio-economic factors with significant influence on teenage pregnancy are: respondents with age 18-19 years (33.2 percent), rural (27.2 percent), Islamic religion (25.2 percent), North-west (28.5 percent), poorest (32 percent), no educational (43.7 percent), married/living with partners (73.9 percent), employed (21.5 percent), visited any health facility in the last 12 months (42 percent) and those who were informed about family planning at a health facility (84.3 per cent) . There is need for sound education for females in Nigeria that will equip girls and women with adequate knowledge needed to make informed decisions on matters relating to sexual and reproductive health, hence resulting in the actualization of the SDG 5.

COVID-19 Pandemic and Increased Teenage Pregnancy in Uganda

ABSTRACT
 In writing this paper, secondary review methodology has been used to explore the link between COVID-19 pandemic and increased teenage pregnancy in Uganda. Data from journal articles, text books, media outlets, government documents and Non-Governmental Organizations reports have been used in coming up with this paper. The paper begins with the general discussion of teenage pregnancy with emphasis on its negative implications on teenage girls and the reasons young girls get pregnant. This is followed by the discussion about teenage pregnancy in Uganda. This part has shown that before the advent of COVID-19 pandemic, Uganda was considered one of the countries with the highest rates of teenage pregnancy in Sub Saharan Africa. Then is a discussion on how past disasters like Ebola were also associated with an increase in teenage pregnancy. This connects to the discussion on how COVID-19 pandemic is similar to earlier disasters in causing an increase in teenage pregnancy. The increase in teenage pregnancy is attributed to preventive measures such as school closures and movement restrictions that have made girls more vulnerable to sexual advances from the perpetrators. This part is followed by the discussion on how teenage pregnancy has been amplified by COVID-19 pandemic in Uganda, Finally, the paper has recommended a multi-sectoral approach to addressing teenage pregnancy and the need for incorporating teenage pregnancy in the future plans aimed at addressing pandemics and epidemics.

Community-Engaged Teen Pregnancy Prevention: A Needs Assessment.

Teen birth is a contributor to significant challenges, including poverty, foster care, increased medical expenses, and high school dropout. Although teen birth rates have declined, disparities persist by state. Oklahoma's teen birth rate is fifth highest in the nation. Recognizing population-level change is not possible through the work of any single organization, Thrive is the convening leader of a multipartner collaboration called the Central Oklahoma Teen Pregnancy Prevention Collaboration. This collaboration utilizes the Collective Impact framework to bring organizations together to address teen pregnancy. The purpose of this article is to detail the consulting phase of the Collective Impact Community Engagement Toolkit, welcoming feedback from community members regarding programs. Method. Researchers conducted a mixed-methods needs assessment, including interviews and surveys with community-based organization staff, faith members, and caregivers. Data were analyzed using SPSS 26 and NVIVO 12 Pro. Results. A total of 350 surveys and 25 interviews were included in the analysis. Looking across all three populations, participants wanted to learn most about parent-child communication, communication skills with partners, and sexually transmitted infections/sexually transmitted diseases. Participants wanted topics delivered through educational programs, handouts/brochures, group settings, and websites. Common barriers were needing additional training/information, limited time, and lack of approval/support from others. Conclusions. This community needs assessment provided valuable information regarding needs of community-based organization staff, faith members, and parents related to adolescent sexual health. By including the community in needs assessments and using multiple tools, researchers/practitioners are able to see which strategies are best for gathering rich feedback and planning sustainable programs.

Factors influencing contraceptive decision making and use among young adolescents in urban Lilongwe, Malawi: a qualitative study

BackgroundThe prevalence of teenage pregnancies in Malawi is 29%. About 25% of those are married while 30% are unmarried adolescents (15–19 years old) who use contraceptives. Data on contraceptive use has focused on older adolescents (15–19 years old) leaving out the young adolescents (10–14 years old). This study assessed factors that influence contraceptive decision-making and use among young adolescents aged 10–14 years.MethodsThis was a qualitative study that used the Theory of Reasoned Action (TRA) model to understand the processes that influence contraceptive decision-making among young adolescents (10–14 years old) in urban Lilongwe. The study was conducted in six youth health-friendly service centers and 12 youth clubs. Two focus group discussions and 26 in-depth interviews were conducted among sexually active in and out of school young adolescents and key informants. The results are organized into themes identified during the analysis.ResultsResults showed that contraceptive decision-making is influenced by social factors (individual, interpersonal, society) and adolescents’ perceptions regarding hormonal contraceptives. There is also a disconnect between Education and Adolescent Sexual and Reproductive Health policies.ConclusionThe findings suggest that interventions that scale up contraceptive use need male and female involvement in decision making. Addressing myths around contraceptives, and harmonization of Education and Sexual and Reproductive Health policies in the country would motivate adolescents to use contraceptives.

Identifying Implementation Drivers for Teen Sexual Health Education Curricula.

This article focuses on examining the implementation of evidence-based teen pregnancy prevention programming in a select school district. Results are presented based on the following implementation drivers: (1) actions taken by leadership to make decisions, provide guidance, and support how the school site and community-based organizations are functioning in support of implementation; (2) actions taken to ensure competent staff delivery of the curricula; and (3) actions taken to create and sustain a hospitable context in order to implement the interventions at the school site. The need for adolescent sexual health education is evident in this geographic location where Hispanic or Latino teens consistently have higher birth rates among race and ethnicities that are routinely reported. For 2018, when this project started, those rates were 40 births per 1,000 females aged 15 to 19 years. For 2018, the birth rates for African Americans was 31 and for Whites was 17 per 1,000 females aged 15 to 19 years. The project goals were to reduce teen birth rates by (1) providing evidence-based teen pregnancy prevention curricula to youth aged 11 to 19 years over the course of the 5-year project period, (2) training school staff and community members in the curricula, and (3) generating community support of youth access to reproductive health care and education. Despite a funding interruption to implementation of the project and the impact of COVD-19, educational programming was provided to 9,616 youth. The article details the key implementation strategies and solutions so that other practitioners can consider application of these implementation drivers in their own adolescent health education programming.

Does a Rising Median Income Lift All Birth Weights? County Median Income Changes and Low Birth Weight Rates Among Births to Black and White Mothers.

Low birth weight (LBW; <2,500 grams) and infant mortality rates vary among place and racial group in the United States, with economic resources being a likely fundamental contributor to these disparities. The goals of this study were to examine time-varying county median income as a predictor of LBW rates and Black-White LBW disparities and to test county prevalence and racial disparities in maternal sociodemographic and health risk factors as mediators. Using national birth records for 1992-2014 from the National Center for Health Statistics, a total of approximately 27.4 million singleton births to non-Hispanic Black and White mothers were included. Data were aggregated in three-year county-period observations for 868 US counties meeting eligibility requirements (n = 3,723 observations). Sociodemographic factors included rates of low maternal education, nonmarital childbearing, teenage pregnancy, and advanced-age pregnancy; and health factors included rates of smoking during pregnancy and inadequate prenatal care. Among other covariates, linear models included county and period fixed effects and unemployment, poverty, and income inequality. An increase of $10,000 in county median income was associated with 0.34 fewer LBW cases per 100 live births and smaller Black-White LBW disparities of 0.58 per 100 births. Time-varying county rates of maternal sociodemographic and health risks mediated the association between median income and LBW, accounting for 65% and 25% of this estimate, respectively, but racial disparities in risk factors did not mediate the income association with Black-White LBW disparities. Similarly, county median income was associated with very low birth weight rates and related Black-White disparities. Efforts to increase income levels-for example, through investing in human capital, enacting labor union protections, or attracting well-paying employment-have broad potential to influence population reproductive health. Higher income levels may reduce LBW rates and lead to more equitable outcomes between Black and White mothers.

Impacts of Re:MIX-A School-Based Teen Pregnancy Prevention Program Incorporating Young Parent Coeducators.

Latinx adolescents are at increased risk of teen pregnancy. This study evaluates the impact of Re:MIX, a comprehensive sexuality education program cofacilitated by professional health educators paired with young parent educators implemented with primarily Latinx youth in Texas. A cluster randomized trial was conducted with students in grades 8-10 in 57 classrooms across three schools. Students completed baseline, post-test, and long-term follow-up surveys to determine the impact of the program on behavioral outcomes-sexual experience and unprotected sex-and on mediating factors including intentions, attitudes, knowledge, and self-efficacy related to sexual activity and contraception. Re:MIX was implemented with fidelity and educators were well-received. At post-test, compared to control students, Re:MIX students were more likely to intend to use hormonal or long-acting contraceptive methods if they had sex, had greater reproductive health knowledge, had more confidence in their ability to ask for and give consent, and were more likely to know where to obtain contraception. Most findings were sustained at the long-term follow-up, but there were no impacts on behaviors. The implementation and impact findings highlight the promising approach of pairing young parent educators with experienced health educators for teen pregnancy prevention among Latinx students.

Unplanned pregnancy-now what? : Effectiveness and acceptance of medical teaching units for primary and secondary prevention in schools

The German Medical Society for Health Promotion (ÄGGF) has developed aschool-based teaching unit for students in grade8 and higher that aims at primary and secondary prevention of unplanned pregnancies. The accompanying evaluation study analyzes the effects of the teaching unit on the students' knowledge and their experience with self-efficacy concerning unplanned pregnancies. Atwo-armed cluster-randomized controlled study was conducted using aten-page anonymous questionnaire with aclosed answer format before and after the intervention. In the first survey, 1855students participated; 1523students participated in the second. Participants in the intervention group showed agreater increase in knowledge over time. Compared to the control group, they showed an increased intention to use the pill and condoms as well as amarked increase in self-efficacy in the case of an unplanned pregnancy. Furthermore, they significantly corrected their perception of the age at which same-aged boys start having sexual intercourse. All effects remained stable when covariates were controlled. The teaching units were highly accepted: more than 90% of the participants stated that they would recommend them to other students. Aschool-based medical teaching unit about the prevention of unplanned teenage pregnancies was able to contribute to the improvement of students' knowledge and competency. The intervention itself was highly accepted within the target group.

Faktor-Faktor yang Mempengaruhi Perilaku Remaja ke Posyandu di Wilayah Kerja Puskesmas Muara Bulian

Posyandu is expected to be a place to facilitate youth in understanding adolescent health problems, find alternative solutions to problems, form youth support groups, expand the reach of PKPR Puskesmas, especially for regional youth who have limited access Data shows that Muara Bulian Health Center, one of the Puskesmas in Batang Hari has provided health services to adolescents through PKPR activities. In 2018 the teen pregnancy rate was 24 teenagers (1.4%), in 2019 there were 27 teenagers (1.6%) An increase of 0.2%. In December 2019, two pilots polyandrous were formed in the work area of the Muara Bulian Community Health Center.This research is a descriptive analytic study with cross sectional method. The population in this study were adolescents who came to Posyandu cendana and singkawang which amounted to 75 people,while the number of samples is 43 people. This research uses purposive sampling technique. Data collection is done by questionnaire. The analysis was carried out univariately and bivariately. Results of the study Some respondents had bad behavior (51.2%) visited Posyandu Most respondents had poor knowledge (55.8%), positive attitude (51.2%), and good family support (62.8%), a good source of information (58.1%), most cadres had a good role (53.5%) in providing services in the Posyandu area of Muara Bulian Puskesmas in 2020. There is a meaningful relationship between knowledge and adolescent behavior . There is a significant relationship between attitude and adolescent behavior. There is a significant relationship between distance with adolescent behavior, there is a significant relationship between information sources and adolescent behavior, there is a relationship between the role of officers with adolescent behavior, and there is a significant relationship between family support and adolescent behavior to the Posyandu in the Public Health Service Muara Bulian Work Area

Network analysis of a community-wide teenage pregnancy prevention initiative.

Although US teenage birth rates substantially decreased over the past two decades, it still remains the highest in the developed world. More innovative, community-wide initiatives are needed to combat the issue. In Oklahoma County, Oklahoma, the Central Oklahoma Teen Pregnancy Prevention Collaboration is utilizing the collective impact model to convene multiple organizations with the goal of making systems-level changes related to teenage pregnancy within the community. This study used an interorganizational network analysis to evaluate the current strength of relationships between organizations in the Collaboration. An interorganizational network survey assessed collaborative relationships (e.g. information sharing and joint planning) within the network. Using R software, network diagrams were developed to depict partner relationships, and network measures, including node-, group- and network-level measures, were calculated. The network depiction (n = 23) revealed that the network core was composed of organizations from multiple sectors, and the backbone organization served as the most central organization for most centrality measures. This study provides insight into how organizational relationships can be assessed in order to increase community capacity to address teenage pregnancy. Continuous monitoring of the strength of relationships is important to ensure success in achieving goals as well as collective impact.

Assessing the Opinion of Mothers about School-Based Sexual Education in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe.

Background and Objectives: Without mandatory school-based education, Romania is a leading European country in teen pregnancy. This survey aimed at assessing the level of knowledge and the opinions about sexual education and sexual-related issues among mothers of female teenagers aged 13–18 years old. Material and Methods: The survey was conducted between 2015 and 2017 and had four parts, collecting data about sociodemographic variables, the level of knowledge about sexuality, sexually transmitted diseases, and contraception. The respondents were mothers of female teenagers hospitalized in a tertiary pediatric clinic. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 25 (Inc., Chicago, IL, USA). Results: One hundred and thirty-five mothers (42.46 ± 6.81 years old) were included in the research. Most of them were from rural areas, had graduated secondary school, were Christian-orthodox, married, and with a stable job. More than half of the mothers (61.42%) declared that they personally knew adolescents that were already mothers. In great proportion, mothers proved good knowledge about sexual education, contraception, and STDs. They considered that the minimum age for becoming married, in general, is about M = 18.62 ± 2.09 years old but in the case of their daughters, mothers appreciated that the best age would be 23.56 ± 9.37. Mothers considered that they had good communication with their daughters (M = 4.28 ± 0.99) and two-thirds sustained that they had discussed with them about sexual activity, pregnancy, sexually transmitted diseases, and contraception. In case of unwanted pregnancy of their daughters, one-third of the mothers (38.50%) would advise their girls to continue the pregnancy and 7.40% mentioned the termination of pregnancy. Two-thirds of them (74.10%) agreed to school-based sexual education. In the order of preferred sources for sexual education, mothers mentioned parents (85.90%), teachers (33.30%), and family doctors (24.40%). Comparative results regarding their own sex life and that of their daughters are presented. Conclusions: School-based programs should meet parental beliefs about sexuality and sexual education. School, as a creator of values and models, should find the golden ratio to better shape the personal, familial, and social needs for the healthy sexual behavior of the new generation.

Risky sexual behaviour among Russian adolescents: association with internalizing and externalizing symptoms

BackgroundRisky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents.MethodsSelf-reported data were collected from 2573 Russian adolescents aged 13–17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB.ResultsBoys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB.ConclusionsEarly detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.

Trends in initiation of hormonal contraceptive methods among teenagers born between 1989 and 1997 in Norway and the United States

ObjectiveTo assess initiation of hormonal contraception among women aged 15-19 in the US and Norway by birth cohort. Study designWe used population-based survey (US) and administrative (Norway) data to estimate the cumulative probability of age at first use of hormonal contraception for female residents born between 1989 and 1997 in 3-year birth cohorts. Differences between countries were assessed using confidence intervals, and differences between birth cohorts were assessed using survival analysis. ResultsAt age 15, first use of any hormonal method was higher among US respondents (16%-17% US vs 10%-13% Norway), whereas for ages 16 to 19 use was higher among Norwegian women (by age 19, 60%-64% US vs 76%-78% Norway). Similar patterns were observed for pill use; however, depot medroxy-progesterone acetate (DMPA), implant, and intrauterine device (IUD) use tended to be higher among US women. In both countries, cumulative first use of the pill, patch, ring, and DMPA declined across birth cohorts while first use of implants and IUDs increased. ConclusionAge at initiation and type of first hormonal method use differed between US and Norwegian teenagers. These differences may contribute to the lower teen birth rate in Norway. ImplicationsAge at initiation of hormonal contraception among teenagers is earlier in Norway than in the United States, and types of hormonal methods used vary. These differences may contribute to the lower teen birth rate in Norway.