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Bader A, Hadden K, Hester M, Gan J. Exploring Knowledge, Beliefs, and Attitudes about Teen Pregnancy among Latino Parents in Arkansas. South Med J 2021; 113:386-391. [PMID: 32747967 DOI: 10.14423/smj.0000000000001129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Arkansas has the highest incidence of teen pregnancy in 15- to 19-year-olds in the United States, and Latinas remain one of the cultural groups that are most at risk of becoming adolescent mothers. Teen mothers and their children are more likely to face poor socioeconomic conditions and negative health sequelae that perpetuate the cycle of poverty. Tailored interventions meant for families, communities, and/or churches should address both abstinence and other types of contraception to educate young people how to stay healthy, prevent unwanted pregnancy, and empower them to make informed decisions. To develop effective educational interventions, it is essential to understand the current knowledge, beliefs, and attitudes toward teen pregnancy among Latino parents in Arkansas. METHODS Adult Latino parents were surveyed at two clinical sites, one church and one school in Little Rock between January 16, 2019 and February 23, 2019. The survey instrument was conducted in Spanish and included questions on demographics, knowledge, attitudes, and beliefs about teenage pregnancy. Response frequencies, percentages and descriptive statistics were calculated for the dataset. RESULTS A total of 181 individuals completed the survey. Participants almost unanimously agreed with the statement that it is important to talk about sex with their children for their sexual health development. Nearly all respondents, 96.1%, believe that it is important to prevent teenage pregnancy. Most respondents agreed that they speak with their sons and daughters differently on the topic of sexual health. In our sample, only 17.8% of parents believed that abstinence-only education should be the primary focus of reproductive health education. "My family values" was most frequently cited as the predominant factor in shaping participants' beliefs about teen pregnancy, followed by a desire for their child to attend college or be economically stable before having a child. CONCLUSIONS Our findings indicate that based on attitudes toward sexual health, interventions should be tailored to certain groups based on children's sex and age and to parents who had children as teens themselves. Educational materials should emphasize the strengths of Latino culture, such as family values and desire for children to attain a college degree and economic stability before bearing children.
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Affiliation(s)
- Alexandra Bader
- From the University of Arkansas for Medical Sciences, Little Rock
| | - Kristie Hadden
- From the University of Arkansas for Medical Sciences, Little Rock
| | - Micah Hester
- From the University of Arkansas for Medical Sciences, Little Rock
| | - Jennifer Gan
- From the University of Arkansas for Medical Sciences, Little Rock
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Pillay N. 'There is no more future for me? Like really, are you kidding?': agency and decision-making in early motherhood in an urban area in Johannesburg, South Africa. Glob Health Action 2021; 14:1886456. [PMID: 33657987 PMCID: PMC7935122 DOI: 10.1080/16549716.2021.1886456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The South African development goals for young women aged 15 to 24 are to reduce HIV incidence, teenage pregnancy and gender-based violence, and to increase school completion and economic security. Early, unintended pregnancy undermines these goals, creating discourses of early motherhood that position young women as powerless. There has been scant attention on the agency of young women in their structural context.Objective: This study explored how young women exercise agency after an unintended pregnancy and make decisions concerning their future, including sexual and reproductive health, school completion and/or income generation, and caregiving for their babies.Methods: I used narrative analysis to explore the lived experiences of young mothers, paying attention to decision-making during pregnancy and motherhood. Domains of analysis included health care, education, and caregiving. I conducted in-depth interviews with 30 young mothers: 30 were interviewed once, nine were interviewed twice, and six were interviewed three times. I interviewed four significant people in the lives of young mothers and six health care providers at a health centre.Results: Progressive policy facilitates increased access to services for young pregnant and parenting women. However, education and health care providers continue to discriminate against them, formally through denying them access to services and informally through discourses of shame which pervade their structural context. Kinship capital in urban and rural contexts and the Child Support Grant mitigate some struggles in early motherhood and help young mothers navigate decision-making.Conclusion: Young mothers exercise agency along a continuum to realise their aspirations. Social and structural support mediate their agency. Policy needs to expand the focus from prevention to include issues of care and support after an early, unintended pregnancy to ensure the health and wellbeing of young mothers and their children.
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Affiliation(s)
- Nirvana Pillay
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Huang CY, Roberts YH, Costeines J, Kaufman JS. Longitudinal Trajectories of Parenting Stress Among Ethnic Minority Adolescent Mothers. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:1368-1378. [PMID: 31213750 PMCID: PMC6581460 DOI: 10.1007/s10826-019-01356-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Parenting stress has been linked with negative outcomes for parents and their infants (e.g., parental depression, negative parenting behaviors, poor attachment). Racial/ethnic minority adolescent mothers have increased risk for experiencing parenting stress compared to their White counterparts. Little is known about the changes in parenting stress over time for this population. METHODS Growth mixture modeling (GMM) was conducted to determine the growth trajectory classes of 185 African American and Latina/Hispanic adolescent mothers over 2 years. Risk and protective factors (e.g., maternal depression, social support, self-esteem) were examined to determine their influence on parenting stress trajectories. RESULTS Three distinct trajectories of parenting stress were found: low stable stress (40.90%), decreasing stress (35.78%), and high stable stress (23.28%). Lower maternal depression (OR = 2.35), higher self-esteem (OR = 1.29), lower perceived social support from family (OR = 0.53) and higher perceived support from friends (OR = 1.65) predicted placement into the low stable parenting stress group over the high stable parenting stress group. Adolescents living with family (OR = 2.74) and Latina race/ethnicity (OR = 2.78) also served as predictors of placement into the low stable parenting stress group. Higher self-esteem (OR = 1.66) predicted placement into the decreasing parenting stress group over the high stable parenting stress group. CONCLUSIONS These findings highlight the importance of perceived peer support by adolescent mothers, regardless of their support family support (e.g., living at home and receiving child care). Considering developmental factors such as peer relationships may be important when working with adolescent mothers.
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Affiliation(s)
- Cindy Y Huang
- Teachers College Columbia University, Department of Counseling and Clinical Psychology, 525 W. 120 Street Box 102, New York, NY, 10027
| | | | - Jessica Costeines
- Yale University School of Medicine, Department of Psychiatry, Division of Prevention and Community Research, New Haven, Connecticut 06511
| | - Joy S Kaufman
- Yale University School of Medicine, Department of Psychiatry, Division of Prevention and Community Research, New Haven, Connecticut 06511
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Parker JJ, Veldhuis CB, Hughes TL, Haider S. Barriers to contraceptive use among adolescents in two semi-rural Nicaraguan communities. Int J Adolesc Med Health 2019; 32:ijamh-2017-0228. [PMID: 30939115 DOI: 10.1515/ijamh-2017-0228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/01/2018] [Indexed: 06/09/2023]
Abstract
Objective To identify barriers to contraceptive use among adolescents in two neighboring semi-rural communities in Nicaragua. Methods We recruited and surveyed a convenience sample of 287 adolescents, ages 15-19 years old, in July and August, 2013 about barriers to contraceptive use. We compared adolescents by gender, sexually active status (sexual intercourse in the previous year) and frequency of contraceptive use. Results More than 40% (43.5%) of the adolescents surveyed reported that they had ever had sexual intercourse. The likelihood of ever having had sexual intercourse differed based on gender, relationship status, sexual activity of peers, and the presence of a father in the home. Contraceptive use was low and female adolescents were more likely than their male counterparts to report never or rarely using contraceptives (46.5% vs. 21.4%, p < 0.007). Contraceptive use for females was positively associated with discussing contraception with a healthcare professional (HCP) [adjusted odds ratio (AOR) 13.32; 95% confidence interval (CI) 1.35-139.98] and a family member (AOR 4.64; 95% CI 1.09-19.72). Reasons for non-use also varied significantly by gender. Low rates of contraceptive use in these two semi-rural Nicaraguan communities appear to be primarily related to gender norms, social stigma, and poor communication about family planning. Conclusions Interventions that focus on promoting gender equality and encouraging adolescent communication with HCPs, schools, families, and partners are imperative to combating adolescent pregnancy in Nicaragua and countries worldwide.
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Affiliation(s)
- J J Parker
- Center for Global Health, University of Illinois at Chicago, 1940 W Taylor Street, Room 214, Chicago, IL 60612, USA, Phone: +847.525.9882
| | - Cindy B Veldhuis
- Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL, USA
- School of Nursing, Columbia University, New York, NY, USA
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, NY, USA
| | - Sadia Haider
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
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Driver N, Cready CM. Nativity/language, neighborhoods, and teen pregnancy norms among U.S. Hispanics. Women Health 2018; 59:496-509. [PMID: 30040608 DOI: 10.1080/03630242.2018.1500416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study examined the relations of nativity, language, and neighborhood context to pregnancy norms among U.S. Hispanic teens. We used data from a sample of 972 Hispanic females and 960 Hispanic males from Waves I and II (1994-1996) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected in eighty high schools and fifty-two middle schools across the country. Results indicated that nativity, language, and neighborhood context were related to Hispanic teen pregnancy norms, although these relationships varied by gender. Specifically, foreign-born, non-English speaking females and those who lived in immigrant neighborhoods held stronger norms against unmarried teen pregnancies compared to English speakers and/or lived elsewhere. Yet, no relationship was demonstrated for males. The results of this study suggest an immigrant advantage related to female teen pregnancy norms, and that context matters in the formation of pregnancy norms for Hispanic females.
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Affiliation(s)
- Nichola Driver
- a Clinton School of Public Service , University of Arkansas Clinton , Little Rock , Arkansas , USA
| | - Cynthia M Cready
- b Department of Sociology , University of North Texas , Denton , Texas , USA
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Iqbal AM, Schwenk WF, Theall KP. A Rare Presentation of the Syndrome of Inappropriate Antidiuretic Hormone in a 12-Year-Old Girl as the Initial Presentation of an Immature Ovarian Teratoma. J Pediatr Adolesc Gynecol 2018; 31:62-63. [PMID: 28818586 DOI: 10.1016/j.jpag.2017.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/01/2017] [Accepted: 08/06/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Immature ovarian teratoma is very rare in childhood. We report on a 12-year-old girl with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. CASE A 12-year-old girl presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium, 123 mmol/L), that did not respond to fluid management. Computed tomography imaging showed a 15 cm × 9 cm × 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications. She underwent exploratory laparotomy with a right salpingo-oophorectomy, omentectomy, and peritoneal stripping. The pathology revealed metastatic immature teratoma. Hyponatremia resolved soon after the surgery. SUMMARY AND CONCLUSION Although a rare diagnosis, immature ovarian teratoma must be considered in a girl who presents with abdominal mass and hyponatremia.
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Affiliation(s)
- Anoop Mohamed Iqbal
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
| | - W Frederick Schwenk
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
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Sanchez D, Flannigan A, Guevara C, Arango S, Hamilton E. Links among Familial Gender Ideology, Media Portrayal of Women, Dating, and Sexual Behaviors in African American, and Mexican American Adolescent Young Women: A Qualitative Study. SEX ROLES 2017; 77:453-470. [PMID: 38818107 PMCID: PMC11139251 DOI: 10.1007/s11199-017-0739-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Utilizing grounded theory methodology and drawing from sexual script theory as a research lens, we examined familial gender ideologies, media portrayals of Black and Latina women, dating attitudes, and sexual behaviors among 33 low-income early adolescent (aged 11-14) African American and Mexican American young women. Themes revealed divergent experiences for African American and Mexican American young women. In particular, African American participants reported egalitarian familial gender ideologies and sexual objectification of Black women, as well as more open and positive attitudes toward dating and sexuality. In contrast, Mexican American participants reported patriarchal familial gender ideologies and the portrayed mistreatment of Latinas in telenovelas and Spanish language songs, along with cautious attitudes towards dating and sexuality. Additionally, Mexican American participants reported that they censored their communication about sexual matters with their family. Overall, findings suggest that interventions should be tailored accordingly for African American and Mexican American youth. Interventions with African American young women should focus on providing accurate information on safer sexual practices, whereas interventions with Mexican American young women should focus on promoting constructive conceptualizations of gender roles, which could help foster self-efficacy around sexual communication with parents and potential partners.
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Affiliation(s)
- Delida Sanchez
- Department of Educational Psychology, The University of Texas at Austin, 1 University Station, D5800, Austin, TX 78712, USA
| | - Alaina Flannigan
- Department of Educational Psychology, The University of Texas at Austin, 1 University Station, D5800, Austin, TX 78712, USA
| | - Crystal Guevara
- Department of Educational Psychology, The University of Texas at Austin, 1 University Station, D5800, Austin, TX 78712, USA
| | - Sarah Arango
- Department of Educational Psychology, The University of Texas at Austin, 1 University Station, D5800, Austin, TX 78712, USA
| | - Emma Hamilton
- Department of Educational Psychology, The University of Texas at Austin, 1 University Station, D5800, Austin, TX 78712, USA
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Thomas Farrell C, Clyde A, Katta M, Bolland J. The impact of sexuality concerns on teenage pregnancy: a consequence of heteronormativity? CULTURE, HEALTH & SEXUALITY 2017; 19:135-149. [PMID: 27624812 DOI: 10.1080/13691058.2016.1212405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In countries such as the USA, a substantial percentage of teenage pregnancies are intentional, and desire for pregnancy increases risk. Black US Americans have been found to be less accepting of homosexuality than their non-Black peers, which may result in minority ethnic teenagers demonstrating heterosexual orientation through attempting pregnancy. Young, socioeconomically disadvantaged African Americans were surveyed longitudinally regarding attitudes about their sexuality, pregnancy intentions and other psychosocial factors. Young people who reported being somewhat concerned about their sexual orientation were nearly four times more likely to report attempting pregnancy compared to those who were not at all concerned. This relationship held true while accounting for the significant effect of religion, sense of community, hopelessness and numerous demographic factors. The current study suggests that uncertainty regarding sexual orientation, potentially due to social stigma, may impact pregnancy attempts among young Black people from disadvantaged communities.
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Affiliation(s)
- C Thomas Farrell
- a Department of Public Health , Western Kentucky University , Bowling Green , USA
| | - Alexis Clyde
- b School of Medicine , University of Texas Southwestern , Dallas , USA
| | - Madhuri Katta
- a Department of Public Health , Western Kentucky University , Bowling Green , USA
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O'Sullivan LF, Meyer-Bahlburg HFL, McKeague IW. The Development of the Sexual Self-Concept Inventory for Early Adolescent Girls. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.2006.00277.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Sexual Self-Concept Inventory (SSCI) was developed to assess sexual self-concept in an ethnically diverse sample of urban early adolescent girls. Three scales (Sexual Arousability, Sexual Agency, and Negative Sexual Affect) were shown to be distinct and reliable dimensions of girls' sexual self-concepts. Validity was established through comparisons with established instruments. Sexual Arousability and Sexual Agency were associated with positive sexual self-esteem, positive future orientation toward sex, intentions to engage in intercourse, and lower levels of sexual experience. Negative Sexual Affect was associated with stronger abstinence attitudes and lack of intentions or orientation toward sex in the near future. The results indicate that the SSCI constitutes a valid means of assessing early adolescent girls' views of their sexuality and sexual behavior and may be of use in studies of health and risk-related decision making.
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10
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Killoren SE, Zeiders KH, Updegraff KA, Umaña-Taylor AJ. The Sociocultural Context of Mexican-Origin Pregnant Adolescents' Attitudes Toward Teen Pregnancy and Links to Future Outcomes. J Youth Adolesc 2016; 45:887-99. [PMID: 26573862 PMCID: PMC4826852 DOI: 10.1007/s10964-015-0387-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
Given the negative developmental risks associated with adolescent motherhood, it is important to examine the sociocultural context of adolescent mothers' lives to identify those most at risk for poor outcomes. Our goals were to identify profiles of Mexican-origin pregnant adolescents' cultural orientations and their attitudes toward teen pregnancy, and to investigate how these profiles were linked to adolescents' pregnancy intentions, family resources, and short-term family, educational, and parenting outcomes. With a sample of 205 Mexican-origin adolescent mothers, we identified three profiles based on cultural orientations and attitudes toward teen pregnancy: Bicultural-Moderate Attitudes, Acculturated-Moderate Attitudes, and Enculturated-Low Attitudes. The results indicated that enculturated pregnant adolescents had the least favorable attitudes toward teen pregnancy, and the lowest levels of family income, pregnancy intentions, pregnancy support, and educational expectations compared to acculturated and bicultural pregnant adolescents; acculturated adolescents (with the highest family income and high levels of pregnancy support) had the highest levels of parenting efficacy 10 months postpartum. Our findings suggest that enculturated adolescent mothers (with less positive attitudes toward teen pregnancy) may benefit from educational support programs and enculturated and bicultural adolescent mothers (with moderately positive attitudes toward teen pregnancy) may benefit from programs to increase parenting efficacy. Such targeted interventions may, in turn, reduce the likelihood of adolescent mothers experiencing negative educational and parenting outcomes.
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Affiliation(s)
- Sarah E. Killoren
- Department of Human Development and Family Science, University of Missouri, 314 Gentry Hall, Columbia, MO 65211
| | - Katharine H. Zeiders
- Department of Human Development and Family Science, University of Missouri, 314 Gentry Hall, Columbia, MO 65211.
| | - Kimberly A. Updegraff
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701 Tempe, AZ 85287-3701,
| | - Adriana J. Umaña-Taylor
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701 Tempe, AZ 85287-3701, Umana-Taylor
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Reyna VF, Mills BA. Theoretically motivated interventions for reducing sexual risk taking in adolescence: a randomized controlled experiment applying fuzzy-trace theory. J Exp Psychol Gen 2014; 143:1627-1648. [PMID: 24773191 PMCID: PMC4115050 DOI: 10.1037/a0036717] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fuzzy-trace theory is a theory of memory, judgment, and decision making, and their development. We applied advances in this theory to increase the efficacy and durability of a multicomponent intervention to promote risk reduction and avoidance of premature pregnancy and sexually transmitted infections. Seven hundred and thirty-four adolescents from high schools and youth programs in 3 states (Arizona, Texas, and New York) were randomly assigned to 1 of 3 curriculum groups: RTR (Reducing the Risk), RTR+ (a modified version of RTR using fuzzy-trace theory), and a control group. We report effects of curriculum on self-reported behaviors and behavioral intentions plus psychosocial mediators of those effects: namely, attitudes and norms, motives to have sex or get pregnant, self-efficacy and behavioral control, and gist/verbatim constructs. Among 26 outcomes, 19 showed an effect of at least 1 curriculum relative to the control group: RTR+ produced improvements for 17 outcomes and RTR produced improvements for 12 outcomes. For RTR+, 2 differences (for perceived parental norms and global benefit perception) were confined to age, gender, or racial/ethnic subgroups. Effects of RTR+ on sexual initiation emerged 6 months after the intervention, when many adolescents became sexually active. Effects of RTR+ were greater than RTR for 9 outcomes, and remained significantly greater than controls at 1-year follow-up for 12 outcomes. Consistent with fuzzy-trace theory, results suggest that by emphasizing gist representations, which are preserved over long periods and are key memories used in decision making, the enhanced intervention produced larger and more sustained effects on behavioral outcomes and psychosocial mediators of adolescent risk taking.
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Affiliation(s)
- Valerie F Reyna
- Department of Human Development, Human Neuroscience Institute
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12
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Shah MK, Gee RE, Theall KP. Partner support and impact on birth outcomes among teen pregnancies in the United States. J Pediatr Adolesc Gynecol 2014; 27:14-9. [PMID: 24316120 PMCID: PMC3947023 DOI: 10.1016/j.jpag.2013.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 06/07/2013] [Accepted: 08/02/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. METHODS In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. RESULTS Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. CONCLUSIONS Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome.
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Affiliation(s)
- Monisha K Shah
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Rebekah E Gee
- Louisiana State University School of Public Health, New Orleans, LA; Louisiana State University School Medicine, Department of Obstetrics and Gynecology, New Orleans, LA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
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Winetrobe H, Rhoades H, Barman-Adhikari A, Cederbaum J, Rice E, Milburn N. Pregnancy attitudes, contraceptive service utilization, and other factors associated with Los Angeles homeless youths' use of effective contraception and withdrawal. J Pediatr Adolesc Gynecol 2013; 26:314-22. [PMID: 24238265 PMCID: PMC3834348 DOI: 10.1016/j.jpag.2013.06.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 06/04/2013] [Accepted: 06/09/2013] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE This study aims to understand the associations of contraceptive service utilization (ie, accessing condoms or birth control), pregnancy attitudes, and lifetime pregnancy history among male and female homeless youth in relation to use of effective contraception and withdrawal. DESIGN, SETTING, AND PARTICIPANTS Between October 2011 and February 2012, homeless youth (14-27 years old) from 2 drop-in centers in Los Angeles (N = 380) were recruited and completed a questionnaire. The data in this paper are restricted to those who reported vaginal sex at last sex (N = 283). MAIN OUTCOME MEASURES Analyses examined history of foster care, sexual abuse, exchange sex, pregnancy, lifetime homelessness duration, current living situation, contraceptive service utilization, and pregnancy attitudes in predicting use of effective contraception and withdrawal at last sex. RESULTS Over 62% of females and 43% of males report having ever been pregnant or impregnating someone. There are no gender-based differences in pregnancy attitudes; 21% agree they would like to become pregnant within the year. Additionally, there are no gender-based differences in reported contraceptive use at last vaginal sex. In the multivariable model, high school education, contraceptive service utilization (Relative Risk Ratio [RRR]: 4.0), and anti-pregnancy attitudes (RRR: 1.3) are significant positive predictors of using effective contraception; anti-pregnancy attitudes (RRR: 1.2) and gender (RRR: 0.3) are significantly associated with using withdrawal. CONCLUSIONS Health professionals should acknowledge that some homeless youth desire pregnancy; for those that do not, access to effective contraception is important. Programs must continue to promote pregnancy prevention, and include discussions of healthy pregnancy habits for pregnancy-desiring youth.
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Affiliation(s)
- H Winetrobe
- School of Social Work, University of Southern California, Los Angeles, CA.
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14
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Rocca CH, Harper CC, Raine-Bennett TR. Young women's perceptions of the benefits of childbearing: associations with contraceptive use and pregnancy. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2013; 45:23-32. [PMID: 23489854 PMCID: PMC3620026 DOI: 10.1363/4502313] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
CONTEXT High unintended pregnancy rates, and inconsistencies between reported pregnancy intentions and contraceptive behaviors, have been well documented among young U.S. women. Women's beliefs about the benefits of childbearing and motherhood may be related to the apparent disconnect between pregnancy intentions and reproductive outcomes. METHODS Perceived benefits of childbearing and feelings about a potential pregnancy were assessed among 1,377 women aged 15-24 (most of them black or Latina) participating in a longitudinal study in 2005-2008. The women, who were initiating hormonal contraception at public family planning clinics and did not want to become pregnant for one year, were followed for 12 months. Differences in perceived benefits of childbearing by participant characteristics were examined with linear regression, using a new multi-item measure. Cox proportional hazard regression was used to investigate the association of perceived benefits of childbearing with subsequent contraceptive discontinuation and pregnancy. RESULTS Perceptions of the benefits of childbearing decreased with increasing age (coefficient, -0.04), and white women perceived fewer benefits to childbearing than blacks (-0.2). As women's perception of the benefits of childbearing increased, their one-year pregnancy rates increased, after demographic characteristics and feelings about a potential pregnancy were controlled for (hazard ratio, 1.2). Benefits of childbearing were not associated with contraceptive discontinuation. CONCLUSIONS To better assess pregnancy risk among young women wanting to avoid pregnancy, it may be useful to acknowledge that they hold not only explicit pregnancy desires, but also beliefs about the benefits of childbearing, which may influence sexual behavior and pregnancy.
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Affiliation(s)
- Corinne H Rocca
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, CA, USA.
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Tucker JS, Sussell J, Golinelli D, Zhou A, Kennedy DP, Wenzel SL. Understanding pregnancy-related attitudes and behaviors: a mixed-methods study of homeless youth. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2012; 44:252-261. [PMID: 23231333 PMCID: PMC3531816 DOI: 10.1363/4425212] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
CONTEXT Pregnancy rates are substantially higher among homeless youth than in the general population of youth, yet little is known about homeless adolescents' and young adults' pregnancy-related attitudes and behaviors. METHODS Pregnancy-related attitudes and behaviors were examined among two samples of sexually active homeless 13-24-year-olds in Los Angeles County. Data from 37 semistructured interviews conducted in March-April 2011 were analyzed using standard qualitative methods. Data from a structured survey with 277 respondents, conducted between October 2008 and August 2009, were analyzed primarily using regression modeling. RESULTS More than half of interview respondents held ambivalent attitudes toward pregnancy, and ambivalent youth reported less contraceptive use than others. The interviews identified several potential influences on pregnancy attitudes: barriers associated with homelessness, readiness to settle down, desire to achieve goals, belief that a child would create something positive in life, and family and partners. In the survey, having positive attitudes toward pregnancy was positively associated with duration of homelessness (odds ratio, 1.6), contact with relatives (1.1) and relationship commitment (1.8); it was negatively associated with frequency of drinking (0.9). Relationship commitment was positively associated with nonuse of an effective contraceptive method at last sex (1.5). CONCLUSIONS Effective and accessible pregnancy prevention and family planning programs for homeless youth are needed. Youths' ambivalence toward pregnancy and feelings of relationship commitment warrant attention as possible areas for programs to address.
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Effects of Age and the Pre-Term Birth of an Infant on Adolescent Mothers' Psychological Adjustment. CHILDRENS HEALTH CARE 2012. [DOI: 10.1080/02739615.2012.721713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rocca CH, Harper CC. Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use? PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2012; 44:150-158. [PMID: 22958659 DOI: 10.1363/4415012] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
CONTEXT Sustained efforts have not attenuated racial and ethnic disparities in unintended pregnancy and effective contraceptive use in the United States. The roles of attitudes toward contraception, pregnancy and fertility remain relatively unexplored. METHODS Knowledge of contraceptive methods and attitudes about contraception, pregnancy, childbearing and fertility were assessed among 602 unmarried women aged 18-29 at risk for unintended pregnancy who participated in the 2009 National Survey of Reproductive and Contraceptive Knowledge. The contribution of attitudes to racial and ethnic disparities in effective method use was assessed via mediation analysis, using a series of regression models. RESULTS Blacks and Latinas were more likely than whites to believe that the government encourages contraceptive use to limit minority populations (odds ratio, 2.5 for each). Compared with white women, Latinas held more favorable attitudes toward pregnancy (2.5) and childbearing (coefficient, 0.3) and were more fatalistic about the timing of pregnancy (odds ratio, 2.3); blacks were more fatalistic about life in general (2.0). Only one attitude, skepticism that the government ensures contraceptive safety, was associated with contraceptive use (0.7), but this belief did not differ by race or ethnicity. Although blacks and Latinas used less effective methods than whites (0.3 and 0.4, respectively), attitudes did not explain disparities. Lower contraceptive knowledge partially explained Latinas' use of less effective methods. CONCLUSIONS Providing basic information about effective methods might help to decrease ethnic disparities in use. Research should examine other variables that might account for these disparities, including health system characteristics and provider behavior.
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Affiliation(s)
- Corinne H Rocca
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, CA, USA.
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Roberts S, Graham M, Barter-Godfrey S. Young mothers' lived experiences prior to becoming pregnant in rural Victoria: a phenomenological study. Aust J Rural Health 2012; 19:312-7. [PMID: 22098215 DOI: 10.1111/j.1440-1584.2011.01228.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To explore the lived experiences and social context prior to becoming pregnant, of women who became mothers during adolescence in rural Victoria. DESIGN Qualitative interpretive phenomenological study using semistructured interviews. SETTING Rural community in North East Victoria, Australia. PARTICIPANTS Four rural women who gave birth to a child between the ages of 15 and 19. RESULTS Five themes emerged from the data as being essential to the participants' experiences prior to pregnancy. These included feeling isolated; life change: transition into adulthood; support and understanding in sexual relationships; feeling dissatisfied; and overcoming adversity. Participants' provided practical recommendations to improve life for young people in rural areas through reflecting on their own experiences. CONCLUSION These findings highlight the complex nature of rural young women's experiences leading up to pregnancy and suggest that early motherhood might be largely reflective of the social environment in which one lives prior to pregnancy. Providing somewhere safe to go, organised and appropriate social activities and increasing access to health services were identified as being pertinent to improving experiences for rural young people prior to pregnancy. Health professionals should consider the importance of supporting young women through non-judgemental, approachable and accessible services.
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Affiliation(s)
- Sarah Roberts
- Centre for Health through Action on Social Exclusion (CHASE), School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
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Perceptions of teen motherhood in Australian adolescent females: life-line or lifederailment. Women Birth 2011; 25:181-6. [PMID: 22137849 DOI: 10.1016/j.wombi.2011.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 10/20/2011] [Accepted: 10/31/2011] [Indexed: 11/22/2022]
Abstract
PURPOSE The findings presented in this paper describe the beliefs and attitudes of three different groups of adolescent females about teen motherhood. These were elicited from a larger analysis that explored and theorized contraceptive pathways in a sample of young Australian women. METHODS A purposive sample of females aged 14 to 19 years was recruited from three distinct populations in the city of Perth, Western Australia: (1) never-pregnant; (2) pregnant-terminated; and (3) pregnant-continued. Grounded theory principles were used to analyze data generated from 69 semi-structured interviews conducted over a 21 month period (2006-2008). RESULTS Two categories that described teenagers' attitudes to pregnancy and motherhood were elicited from the analysis. These explained the level of priority that teenagers placed on using contraception and postponing the transition to parenthood. The category labeled 'life derailment' represented how those who had never had a pregnancy or had terminated a pregnancy constructed teen motherhood as potentially restricting their personal, career and social transition to adulthood. The alternative category, 'life-line', reflected how those who continued with their pregnancy perceived teen motherhood as a positive and transformative experience that fostered personal growth. CONCLUSIONS The findings from this study contribute further insight into the complex nature of adolescent contraceptive use and pregnancy risk. The analysis has strengthened evidence of the critical role of self-perceptions of pregnancy and childbearing on teenagers' fertility outcomes. It has also emphasized the broader life circumstances that shape these attitudes, intentions and related behavior. Strategies directed toward academic support and vocational skill development may broaden teenage girls' perceived future options and achievement capacity, thus influencing key reproductive health outcomes.
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Smith JL, Skinner SR, Fenwick J. How Australian Female Adolescents Prioritize Pregnancy Protection. JOURNAL OF ADOLESCENT RESEARCH 2011. [DOI: 10.1177/0743558411402338] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Grounded theory principles were systematically employed to reveal key differences in pregnancy risk and underlying disparities in contraceptive use in (a) never-pregnant (b) pregnant-terminated and (c) pregnant-continued teenagers. Analysis of 69 semistructured interviews revealed a bicausal model of pregnancy protection that accounted for variation in contraceptive use across the sample. Diverging pregnancy/childbearing desires and risk perceptions were conceptualized into three behavioral patterns that represented higher and lower levels of commitment to prevent pregnancy. The various ways that teenagers made sense of their behavior highlight the importance of acknowledging and respecting diversity in perspectives and experiences and provide a useful framework for educational and practitioner-delivered interventions with greater relevance and impact.
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Johns SE, Dickins TE, Clegg HT. Teenage pregnancy and motherhood: How might evolutionary theory inform policy? ACTA ACUST UNITED AC 2011. [DOI: 10.1556/jep.9.2011.37.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Unexpected increases in the teen birth rates have stimulated a renewed focus on the prevention of teen pregnancy. Although many adults believe there are certain costs associated with teen parenting, the attitudes of teens toward the parenting experience are not known. The purpose of this descriptive study was to determine teens’ thoughts on how their lives would change if they experienced a teen birth in the areas of relationships, vocation, and life impacts. The Thoughts on Teen Parenting Survey (TTPS), designed to measure demographic variables and perspectives on the costs and rewards of teen parenting, was administered to 695 high school students. The survey yielded a composite score, subscale scores, and aggregate data measuring teen thoughts on the consequences of the teen parenting experience. Findings may be used to identify teens at risk for pregnancy, develop interventions, and evaluate prevention strategies based on the insights of teens.
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Schechter DE, Francis CM. A Life History Approach to Understanding Youth Time Preference. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2010. [DOI: 10.1007/s12110-010-9084-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Skinner SR, Smith J, Fenwick J, Hendriks J, Fyfe S, Kendall G. Pregnancy and protection: Perceptions, attitudes and experiences of Australian female adolescents. Women Birth 2009; 22:50-6. [DOI: 10.1016/j.wombi.2008.12.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Revised: 12/08/2008] [Accepted: 12/08/2008] [Indexed: 10/21/2022]
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Sheeder J, Tocce K, Stevens-Simon C. Reasons for Ineffective Contraceptive Use Antedating Adolescent Pregnancies Part 1: An Indicator of Gaps in Family Planning Services. Matern Child Health J 2008; 13:295-305. [DOI: 10.1007/s10995-008-0360-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 05/02/2008] [Indexed: 11/29/2022]
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Lederman RP, Chan W, Roberts-Gray C. Parent-adolescent relationship education (PARE): program delivery to reduce risks for adolescent pregnancy and STDs. Behav Med 2008; 33:137-43. [PMID: 18316271 PMCID: PMC2566304 DOI: 10.3200/bmed.33.4.137-144] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The first author recruited parent-adolescent dyads (N = 192) into after-school prevention education groups at middle schools in southeast Texas. This author placed participants in either (1) an Interactive Program (IP) in which they roleplayed, practiced resistance skills, and held parent-child discussions or (2) an Attention Control Program (ACP) that used the same curriculum but was delivered in a traditional, didactic format. Questionnaires administered at the beginning and end of the 4-session program and again after booster sessions in 3 subsequent semesters provided measures of social controls (eg, communication with parents) and self controls (eg, protection against risk) on the youths' sexual health behaviors. Linear mixed models adjusted for gender, age, and ethnicity showed that the IP, in comparison with the ACP, achieved significant gains in social control by increasing parental rules about having sex and other risky behaviors and also enhanced students' self-control by increasing their knowledge about prevention and enhancing resistance responses when pressured to have sex.
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Affiliation(s)
- Regina P. Lederman
- Dr Lederman is a professor at the University of Texas Medical Branch, Galveston
| | - Wenyaw Chan
- Dr Chan is a professor with The University of Texas Health Science Center at Houston's School of Public Health
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Burns VE, Porter EJ. The experience of having become sexually active for teen mothers. J Community Health Nurs 2007; 24:215-36. [PMID: 18092915 DOI: 10.1080/07370010701645877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this phenomenological study was to describe teen mothers' experience of having become sexually active. Most scholars who have studied teen sexual behavior have used quantitative methods and measured constructs such as self-esteem. Prior to data-gathering, literature about teen sexual behavior was reviewed and set aside to enable a more direct focus on data. Parental consent for participation was obtained for participants under 18. Of the 10 participants (aged 16 to 19 years), all had at least one living child. Each participant took part in 3 audiotaped interviews. Data about perceptions, actions, and intentions were compared across each participant's interviews and interviews of all participants. Four phenomena were discerned as ways in which participants had structured their experiences: (a) making a safe place, (b) redefining myself, (c) creating my own life story, and (c) engaging with the unknown. Compared to prior literature, the phenomena offer a richer and deeper perspective on teen sexual behavior. Findings suggest that efforts to increase perceptions of safety, to support personal identity, to bolster creativity, and to offer exploratory opportunities beyond sexual encounters could enhance effectiveness of programs designed to prevent early-onset sexual activity.
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Cuffee JJ, Hallfors DD, Waller MW. Racial and gender differences in adolescent sexual attitudes and longitudinal associations with coital debut. J Adolesc Health 2007; 41:19-26. [PMID: 17577530 PMCID: PMC2231516 DOI: 10.1016/j.jadohealth.2007.02.012] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Revised: 01/08/2007] [Accepted: 02/16/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE Delay of sexual debut is an important strategy in reducing the risk of negative adolescent health outcomes. Race and gender are known to be related to sexual behavior and outcomes, but little is known about how these characteristics affect sexual attitudes. This article examines differences in coital and pregnancy attitudes by gender and race, the influence of attitudes on transition to first coitus for each subgroup, and implications for prevention. METHODS Data are from Waves I and II of the National Longitudinal Study of Adolescent Health, limited to Non-Hispanic White and African American adolescents (n = 6652). We factor analyzed attitude items, and examined effects of race, gender, and their interaction, controlling for sexual debut at Wave I. We regressed sexual debut longitudinally by attitudes for virgins (n = 3281) separately for each subgroup, controlling for covariates. RESULTS Compared with boys, girls perceived less positive benefits from sex and more shame and guilt with sex, but had fewer negative perceptions about pregnancy. Compared with White boys, African American boys perceived less shame and guilt about sex; girls did not differ by race. Higher perceived benefits of sex increased the likelihood of sexual debut among African American girls. Perceived shame and guilt lowered the likelihood for White boys and girls. CONCLUSIONS Reinforcing protective attitudes through gender and race-specific programs may delay sexual intercourse, but more research is needed. More research is also needed to determine whether there is an optimal coital age after which negative health outcomes are attenuated, and whether this differs by gender and race.
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Affiliation(s)
- Juanita J Cuffee
- Division of Pediatric Endocrinology, Duke University Medical Center, Durham, North Carolina, USA
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Kinsella EO, Crane LA, Ogden LG, Stevens-Simon C. Characteristics of adolescent women who stop using contraception after use at first sexual intercourse. J Pediatr Adolesc Gynecol 2007; 20:73-81. [PMID: 17418390 DOI: 10.1016/j.jpag.2007.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE Identify correlates of contraceptive discontinuation, which if modified, might make teenagers more, not less, effective contraceptors as they age. SETTING Teen clinic. PARTICIPANTS Teenagers who used contraception at first intercourse (N = 120). Some "never" used contraception during the 4 months immediately prior to the survey ("contraceptive stoppers"; n = 38). The others (n = 82) did so "always" or "most of the time" ("consistent contraceptive users"). INTERVENTIONS Questionnaire responses were used to determine univariate and multivariate associations between contraceptive use group and five categories of factors: inability to plan for sex, belief that pregnancy is unlikely to occur, belief that contraceptives are unsafe, inability to negotiate contraceptive use, and lack of desire to remain non-pregnant. MAIN OUTCOME MEASURE Odds of being a contraceptive stopper. RESULTS In univariate analyses contraceptive stoppers scored significantly higher on scales that assessed inability to plan for sex, belief that pregnancy is unlikely, and lack of desire to remain non-pregnant. Contraceptive stoppers were also older and more likely to have been sexually active for at least 6 months. In multivariate analyses, those who were sexually active for at least 6 months (odds ratio [OR]: 2.9, confidence interval [95%CI]: 1.1-7.1), those who believed that pregnancy was unlikely (OR: 3.8; 95% CI: 1.7-8.6), and those who lacked the desire to remain non-pregnant (OR: 2.7; 95% CI: 1.4-5.1) were more likely to stop using contraception. CONCLUSIONS Our findings suggest that teens who use contraception at coitarche stop doing so as they mature sexually because they begin to doubt the necessity and desirability of using contraceptives. Longitudinal studies are needed to determine if such doubts are preventable and if doing so encourages teens to continue to use contraception.
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Affiliation(s)
- Emily O Kinsella
- Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA.
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Buhi ER, Goodson P. Predictors of adolescent sexual behavior and intention: a theory-guided systematic review. J Adolesc Health 2007; 40:4-21. [PMID: 17185201 DOI: 10.1016/j.jadohealth.2006.09.027] [Citation(s) in RCA: 259] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 09/21/2006] [Accepted: 09/21/2006] [Indexed: 11/21/2022]
Abstract
PURPOSE To better understand why adolescents initiate sexual activity at early ages, we conducted a systematic literature review guided by eight key elements outlined in an integrative theoretical framework. METHODS Using the matrix method for literature reviews, we extracted-from 69 published studies-statistically significant and nonsignificant findings (related to the attempted prediction/explanation of adolescents' sexual behavior and intention) and organized them using the various integrative model elements. We also assessed these publications' methodological quality including each study's deployment of theory, appropriate design, and data analytic/reporting techniques. RESULTS Three integrative theoretical framework elements-intention, perceived norms, and an environmental constraint variable, time home alone-emerged as stable predictors of sexual behavior outcomes in this body of literature. This analysis revealed, however, a literature that has remained rather stagnant regarding its methodological quality, over time. CONCLUSIONS Implications for adolescent sexual health promotion practice and research are discussed.
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Affiliation(s)
- Eric R Buhi
- Department of Community and Family Health, University of South Florida, Tampa, Florida 33612, USA.
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Abstract
Because the success of teen mothers is enhanced by completing high school, school districts should give high priority to supporting teen mothers to remain in school and to graduate. This article reviews the literature on the educational attainment of these students, their school aspirations, and the policies affecting their education. Although teens often begin mothering with a range of educational and social disadvantages, many teen mothers recommit to school to enhance their future opportunities. Unfortunately, rising school aspirations among teen mothers often are undermined by competing demands and the lack of consistent family and school support. School nurses can support teen mothers' aspirations and contribute to their long-term success by linking them to resources and advocating for policies and practices that promote high school graduation.
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Affiliation(s)
- Lee Smithbattle
- School of Nursing, Saint Louis University, St. Louis, MO, USA
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Reproductive Health of Urban Adolescents: Differences in the Behaviors, Cognitions, and Social Context of African-American and Puerto Rican Females. J Youth Adolesc 2006. [DOI: 10.1007/s10964-006-9084-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wilson EK, McQuiston C. Motivations for pregnancy planning among Mexican immigrant women in North Carolina. Matern Child Health J 2006; 10:311-20. [PMID: 16555140 DOI: 10.1007/s10995-005-0055-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 11/16/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To enhance understanding of 1) Mexican immigrant women's attitudes toward planning their pregnancies and the factors that influence their fertility preferences, and 2) the effect of migration on their pregnancy planning decisions. METHODS Qualitative in-depth interviews were conducted with 11 Mexican immigrant women living in North Carolina. Participants were recruited by means of snowball sampling. Interviews were conducted in Spanish in the women's homes. Interviewing and analysis were conducted iteratively to allow emerging themes and interpretations to be developed and validated in subsequent interviews. RESULTS The women were strongly motivated to plan their pregnancies. Their primary considerations in pregnancy planning were their ability to give their children a good life and their ability to enjoy their families. Individual personal aspirations did not emerge as an important consideration. Migration intensified the women's felt need to plan their pregnancies. CONCLUSIONS The Mexican immigrant women in this study had a strong familistic orientation. Far from diminishing their interest in planning their pregnancies, however, the high value they placed on family was their primary motivation for pregnancy planning. Migration to the U.S. intensified their felt need to plan their pregnancies. Understanding of the women's motivations for family planning may help health care providers better address the family planning needs of Mexican immigrant women.
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Affiliation(s)
- Ellen K Wilson
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA.
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Condon JT, Corkindale CJ, Russell A, Quinlivan JA. Processes and Factors Underlying Adolescent Males’ Attitudes and Decision-Making in Relation to an Unplanned Pregnancy. J Youth Adolesc 2006. [DOI: 10.1007/s10964-005-9025-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Afable-Munsuz A, Speizer I, Magnus JH, Kendall C. A Positive Orientation Toward Early Motherhood Is Associated with Unintended Pregnancy Among New Orleans Youth. Matern Child Health J 2005; 10:265-76. [PMID: 16382331 DOI: 10.1007/s10995-005-0049-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2005] [Accepted: 10/25/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Characterizing young women's willingness to enter motherhood is critical to understanding the high rates of unintended pregnancy among women under 20 years. Our objectives were to discuss a measure called Positive Orientation towards Early Motherhood (POEM), and investigate its association with self-reported unintended pregnancy experience. METHODS We used data from 332 African-American women 13-19 years old recruited at public family planning and prenatal clinics in New Orleans. Using a series of ANOVAs and multinomial logistic regression, we assessed differences in POEM between four different outcome groups: women who were never pregnant and those who had only intended pregnancies, only unintended pregnancies and both unintended and intended pregnancies. RESULTS The data suggested that young women perceive pregnancy as an opportunity to assert responsibility, become closer with their families and achieve greater intimacy with their boyfriends. Multiple regression analysis indicated that this positive orientation toward early motherhood independently raised the likelihood that young women experienced unintended pregnancies. In particular, the perception that a pregnancy makes a young woman feel more responsible was associated with an increased likelihood that a young woman had only unintended pregnancies compared to no pregnancies at all. Interestingly, this perception did not differentiate young women who had only intended pregnancies from those who were never pregnant. CONCLUSION When interpreting reports of unintended pregnancy, more attention should be given to young women's orientation toward early motherhood. Doing so will inform policies that address both personal and structural factors that contribute to persistently high rates of unintended pregnancy among adolescents.
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Affiliation(s)
- Aimee Afable-Munsuz
- Center for Reproductive Health Research and Policy, University of California, San Francisco, San Francisco, California 94143, USA.
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Stevens-Simon C, Sheeder J, Harter S. Teen Contraceptive Decisions: Childbearing Intentions Are the Tip of the Iceberg. Women Health 2005; 42:55-73. [PMID: 16418122 DOI: 10.1300/j013v42n01_04] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To validate a model we developed while trying to understand why pregnant teens so often report that they did not want to become pregnant and could have obtained contraceptives before they conceived. METHOD The study enrolled a racially/ethnically diverse group of 351 teenagers. Participants completed a questionnaire that asked about teen pregnancy risk factors, the expected effects of childbearing, the desire to remain non-pregnant, deterrents to contraceptive use, and contraceptive plans. RESULTS Most participants were capable of using contraceptives but at high risk for unintended conception because they exhibited numerous sociodemographic risk factors, were unsure that pregnancy would affect their lives adversely, and were ambivalent about remaining non-pregnant. Believing a boyfriend wanted a baby and the anticipated effect of childbearing on 5 specific aspects of life explained 63% of the variance in the desire to remain non-pregnant, which, in conjunction with fears about using contraceptives, explained 20.5% of the variance in future contraceptive plans. CONCLUSIONS Our new findings that expectations about the effect of childbearing explain the desire to remain non-pregnant may well help providers determine why teenagers who do not plan to conceive are often willing to allow themselves to do so by default. Further research is needed, as the model did not explain contraceptive decision-making adequately.
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Affiliation(s)
- Catherine Stevens-Simon
- Dept. of Pediatrics, Division of Adolescent Medicine, University of Colorado Health Sciences Center, Denver, CO 80218, USA
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Stevens-Simon C, Sheeder J, Beach R, Harter S. Adolescent pregnancy: do expectations affect intentions? J Adolesc Health 2005; 37:243. [PMID: 16109346 DOI: 10.1016/j.jadohealth.2005.01.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2004] [Revised: 01/03/2005] [Accepted: 01/19/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To establish the relationship between expectations about the effects of childbearing on specific aspects of life and the strength of the desire to remain nonpregnant during adolescence. We hypothesized that the absence of negative childbearing expectations is associated with an increase in the odds that sexually active, inadequately contracepting teenage girls are cognitively susceptible to conception. METHOD A racially and ethnically diverse group of 351 nulligravida, inadequately contracepting teenagers was studied. Participants responded to 60 items that asked about their expectation about the effects of becoming pregnant and not doing so. Analyses were performed to determine the factorial structure of the childbearing expectations items and their relationship to cognitive susceptibility to conception, defined as the lack of desire to remain nonpregnant. RESULTS The analysis yielded a 9-factor solution for the childbearing expectations items. All 9 sub-scales exhibited acceptable reliability coefficients, stable factor patterns, and correlated significantly with the desire to remain nonpregnant. A dose-dependent relationship suggestive of causality was also apparent. In stepwise regression the sub-scales that assessed the anticipated effect of childbearing on future plans, self-esteem, and boyfriend relations remained significant and accounted for 56% of the variance in the desire to remain nonpregnant. The lengthy research instrument was reduced to an 8-item screening tool without loss of psychometric integrity or explanatory power. CONCLUSIONS Childbearing expectations reflect distinct concepts and account for a significant portion of the variance in the desire to remain nonpregnant during adolescence. Thus the 8-item screening tool we validated might be used to formulate a differential diagnosis for the enigmatic behavior of teens who say they do not "want" to become pregnant but do not "mind" doing so enough to try to avoid conceiving by default.
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Affiliation(s)
- Catherine Stevens-Simon
- Division of Adolescent Medicine, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado 80218, USA.
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Didion J, Gatzke H. The Baby Think It Overtm Experience to Prevent Teen Pregnancy: A Postintervention Evaluation. Public Health Nurs 2004; 21:331-7. [PMID: 15260838 DOI: 10.1111/j.0737-1209.2004.21406.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
An evaluation was conducted to describe the personal impact of the "In Your Care" pregnancy prevention intervention program using Baby Think It Over infant simulator. Data was collected regarding the attitudes, actual and intended sexual practices, feelings, and opinions of participants 2 or 3 years after the intervention. Student recommendations for program continuation and improvement were also solicited. Male and female 11(th) grade students in rural and suburban Midwestern communities, who had experienced the program 2 or 3 years earlier, completed surveys and were interviewed in focus groups. Participants vividly recalled and described the simulated experience in statements that reflected insight and feelings about parental responsibility and the consequences of teen pregnancy. The teens also made several recommendations for enhancing the program. The findings suggest that simulated experiences can be a powerful strategy for effective learning about complex decisions regarding the risks of sexual activity and the realities of parenting.
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Sabroza AR, Leal MDC, Souza PRD, Gama SGND. [Some emotional repercussions of adolescent pregnancy in Rio de Janeiro, Brazil (1999-2001)]. CAD SAUDE PUBLICA 2004; 20 Suppl 1:S130-7. [PMID: 16636743 DOI: 10.1590/s0102-311x2004000700014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the association between early pregnancy and negative emotional repercussions for adolescents, according to socio-demographic and psychosocial variables. The study interviewed 1,228 adolescents in maternity hospitals in the City of Rio de Janeiro. Emotional repercussions were evaluated with negative self-assessment variables, showing little or no expectation towards the future, as well as psychological distress. The chi2 test and odds ratio were used to analyze the data. Adolescents who reported a negative reaction by the family felt less valued (OR 1.8), with little expectation towards the future (OR 2.3), and presented major psychological distress (OR 1.5). Those not enrolled in school when they became pregnant also showed worse self-esteem (OR 1.9) and fewer expectations towards the future (OR 2.2). Greater psychological distress was inversely related to frequency of prenatal care (0.7). The article concludes that family support, regardless of original social conditions, was identified as the principal factor for minimizing negative emotional repercussions of pregnancy during adolescence.
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Affiliation(s)
- Adriane Reis Sabroza
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Abstract
OBJECTIVE To determine why teenagers who say they do not plan to parent if they become pregnant fail to use contraceptives consistently enough to avoid conceiving by default. METHODS A racially diverse group of 333 inadequately contracepting, nulligravida teens, 45 (13.5%) of whom did not plan to parent if they became pregnant was studied. Participants completed scales assessing traditional teen pregnancy risk factors, deterrents to contraceptive use, expectations about the effect of pregnancy, the desire to remain non-pregnant, and sexual behavior. RESULTS Teens who said they would not parent if pregnant were less apt to report boyfriends who wanted them to conceive (RR=0.7; 95% CI=0.5-0.9) and deterrents to contraceptive use (RRs around: 0.6; 95% CI: 0.3-0.9) and more apt to anticipate that childbearing would negatively impact their lives (RR: 1.9; 95% CI: 1.6-2.2), to want to remain non-pregnant (RR: 2.2; 95% CI: 1.8-2.4), and to have used contraception at last sexual intercourse (RR: 1.8; 95% CI: 1.3-2.4). In the group that did not intend to parent the only difference between those who had and had not used contraception at last intercourse was their willingness to plan for sexual activity (OR: 4.6; 95% CI: 1.3-16.7). CONCLUSION This study suggests that further progress toward preventing unwanted teen pregnancies might be made by dispelling the notion that for young, unmarried women, unplanned sexual intercourse is preferable to planned sexual intercourse.
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Affiliation(s)
- Catherine Stevens-Simon
- Department of Pediatrics, Division of Adolescent Medicine, University of Colorado Health Sciences Center, The Children's Hospital, 1056 East 19th Street, Denver, CO 80218, USA.
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Abstract
It is clear that a variable number of teenage mothers have, to some extent, planned parenthood. From an evolutionary perspective, it could be argued that teenage childbearing may in fact be a positive adaptive mechanism for humans raised in a hostile environment. Life history theory suggests that in risky and uncertain environments the optimal reproductive strategy is to reproduce early in order to maximise the probability of leaving any descendents at all. If some teenagers are planning or hoping for pregnancy, it is possible that some positive behavioural changes may be observed. This has proven to be the case with many teenagers altering their risk taking behaviours in the anticipation and expectation of pregnancy. There is now substantial evidence that teenagers who become pregnant were at higher risk than the general population for using cigarettes, alcohol, and marijuana. However, once pregnant, rates of consumption are usually lower compared with their non-pregnant peers or even their own personal pre-pregnancy rates of consumption. Therefore, for some teenagers, the conscious or unconscious prospect of pregnancy represents a potential space in which to rethink behaviours that may be harmful to themselves as a future mother, and also to their child.
Given that teenage motherhood is not going to simply vanish, it is important to remember to focus research and services on validated interventions that may assist teenage mothers fulfill their ambitions of parenthood and simultaneously provide the best outcomes for their offspring. Evidence-based interventions focus on sustained home visitation by nurses, with limited evidence supporting the use of volunteers. In contrast, evidence suggests that home visitation by paraprofessionals may not be effective. Other strategies that may be helpful include the use of multidisciplinary teenage pregnancy clinics that have been noted to be associated with improved pregnancy outcomes. The role of new mothers’ groups, other community based group activities, peer support workers and intensive educational interventions to encourage return to schooling may be useful but have not been subjected to randomised evaluation. Such evaluation needs to occur.
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Affiliation(s)
- Julie A Quinlivan
- Department of Obstetrics and Gynaecology, The University of Melbourne, The Royal Women's Hospital, 132 Grattan Streeet, Carlton, Vic. 3053, Australia.
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Abstract
Teen mothers most often appear in professional discourse as voiceless subjects who are to be "brought in line" with scientific norms. This paper challenges this scientific "rule book" and offers a corrective that recovers the practical and engaged reasoning of teen mothers and the public health nurses (PHNs) who serve them. This corrective approach validates and supports the "voices" of teen mothers and the clinical acumen of PHNs.
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Abstract
Teen birth rates have decreased steadily over the past decade, but the United States still has the highest birth rates among all developed countries. Young women who give birth as adolescents are likely to have poor school performance, and come from families with low socioeconomic status, a history of teen pregnancies, and low maternal education. The fathers of babies who are born to teen mothers are likely to be unsuccessful in school, have limited earnings, have high rates of substance use, and have trouble with the law. Infants who are born to teen mothers are at risk for low birth weight and physical neglect and abuse; at school age, these children are more likely than children born to adult women to have trouble with school achievement, and they are at risk for becoming teen mothers or fathers themselves. Programs that are successful in reducing teen birthrates are usually multifactorial and combine comprehensive sexuality education with youth development activities; reduction in repeat pregnancies is associated with home visits by nurses combined with long-acting contraceptive use.
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Affiliation(s)
- Dianne S Elfenbein
- Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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Smith TE, Steen JA, Spaulding-Givens J, Schwendinger A. Measurement in abstinence education. Critique and recommendations. Eval Health Prof 2003; 26:180-205. [PMID: 12789711 DOI: 10.1177/0163278703026002004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to identify, assess, and offer solutions to common measurement errors found in sexual abstinence education evaluation. A critical review of the methodology of adolescent sexuality research was performed. "Gold standards" of their measurement strategy were derived and applied against 14 selected studies. Many of the articles reviewed had substantial limitations in their measurement strategies. However, several articles demonstrated excellence and serve as models for future efforts. Sexual abstinence education evaluation is plagued by the inherent weaknesses of self-report and health outcome measures. However, with careful adherence to the gold standards proposed, it is possible to limit the threat from these weaknesses, maximizing the benefit of self-report surveys and county-level health indicators.
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Affiliation(s)
- Thomas E Smith
- School of Social Work, Florida State University, Tallahassee, FL 32306-2570, USA.
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Malinowski A, Stamler LL. Adolescent girls' personal experience with Baby Think It Over infant simulator. MCN Am J Matern Child Nurs 2003; 28:205-11. [PMID: 12771700 DOI: 10.1097/00005721-200305000-00013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore adolescent girls' personal experience with an infant simulator that had to be cared for over a period of 1 to 2 weeks. STUDY DESIGN AND METHODS This qualitative study employed the phenomenological approach and utilized Colaizzi's method of analysis. Participants were nine adolescent high school girls who were interviewed and audiotaped. Interview data were coded using NUD*IST 4 software. RESULTS Three themes emerged from the data. They were (1) a parenting journey incorporating intellectual, emotive, and physical faculties; (2) recognizing the illusionary nature of previously held ideas about parenting an infant; and (3) offering counsel based on the BTIO experience. CLINICAL IMPLICATIONS The new perspectives gained by the participants about parenting a newborn infant differed markedly from the romantic fantasies they held prior to the experience. The teens started thinking more seriously about the consequences of sexual activity. Used for 1 to 2 weeks, in conjunction with budgeting exercises and provocative small-group discussions, the BTIO shows promise as an effective tool in helping to modify unrealistic and idealized teen views of adolescent pregnancy and parenting.
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Kornreich JL, Hearn KD, Rodriguez G, O'Sullivan LF. Sibling influence, gender roles, and the sexual socialization of urban early adolescent girls. JOURNAL OF SEX RESEARCH 2003; 40:101-110. [PMID: 12806535 DOI: 10.1080/00224490309552170] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study examined whether older siblings influence early adolescent girls' sexual socialization. Participants were 180 girls, 12 to 14-years-old, from predominantly ethnic minority backgrounds. They completed a battery of interviewer-administered measures assessing a range of sexual cognitions and romantic and sexual behaviors. As predicted, compared with other girls, girls with older brothers placed greater value in becoming a parent, had lower levels of sexual responsivity or interest, and reported smaller age discrepancies between themselves and their partners for their first romantic kiss. Regardless of sibling sex, having older siblings was associated with more restrictive sexual cognitions and behaviors. Findings are interpreted in the context of sexual script theory.
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Crosby RA, DiClemente RJ, Wingood GM, Harrington K, Davies S, Hook EW, Oh MK. Psychosocial predictors of pregnancy among low-income African-American adolescent females: a prospective analysis. J Pediatr Adolesc Gynecol 2002; 15:293-9. [PMID: 12547660 DOI: 10.1016/s1083-3188(02)00195-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To prospectively identify psychosocial predictors of pregnancy among African-American adolescent females. METHODS African-American females, 14-18 yrs old, were recruited from schools and health clinics in low-income neighborhoods. Adolescents completed an in-depth survey and provided urine specimens for pregnancy testing at baseline and 6-month intervals for 1.5 years. Selected problem behaviors, demographic, and psychosocial variables were tested for bivariate and multivariate significance relative to biologically confirmed pregnancy during the follow-up period. Only adolescents who initially tested negative for pregnancy were included (n = 241). RESULTS About 26% (n = 63) of the adolescents became pregnant over the follow-up period. Although a broad spectrum of variables achieved bivariate significance, few retained significance in the multivariate model. Multivariate predictors of pregnancy were biologically confirmed marijuana use (adjusted odds ratios [AOR] = 12.4, P = 0.0003) and perceiving that the sex partner desired pregnancy (AOR = 1.27, P = 0.01). A protective effect was observed for adolescents who reported that a family member received welfare benefits; these adolescents were about 60% less likely to become pregnant (AOR = 0.38, P = 0.04). CONCLUSIONS Pediatricians and other health professionals who participate in community efforts to prevent first and subsequent adolescent pregnancies may benefit from recognizing that marijuana use and pregnancy may be co-occurring problems. Adolescents' perceptions of their boyfriends' level of desire for conception may also be an important predictor of pregnancy risk. The findings also suggest a possible protective effect of receiving TANF (Temporary Assistance to Needy Families) benefits; adolescent recipients of these programs may be more vigilant in their pregnancy prevention practices than those who are not recipients.
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Affiliation(s)
- Richard A Crosby
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA.
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Rickert VI, Wiemann CM, Harrykissoon SD, Berenson AB, Kolb E. The relationship among demographics, reproductive characteristics, and intimate partner violence. Am J Obstet Gynecol 2002; 187:1002-7. [PMID: 12388996 DOI: 10.1067/mob.2002.126649] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our purpose was to examine the associations between demographics and reproductive characteristics on the occurrence of intimate partner violence (IPV) in young women. STUDY DESIGN An anonymous questionnaire was completed by 727 women between 14 and 26 years old who were seen in the family planning clinics in southeast Texas between March 1997 and February 1998 and who reported a current spouse or partner. Subjects completed a standardized measure of violence perpetrated by a partner and provided information on demographics and reproductive characteristics. Separate logistic regression analyses were used to analyze factors associated with physical and verbal violence. RESULTS Significant and positive associations with physical violence were found for race, employment, and parity (> or =1); risk of verbal abuse included employment, history of sexual abuse, and inconsistent condom and prescription contraceptive use. Protective factors for physical violence included education level, use of hormonal methods of contraception or condoms at last intercourse, and older age at first intercourse and at first childbirth; protection from verbal assault included dual contraceptive use, as well as barrier and hormonal contraception at last intercourse. CONCLUSION Different patterns of risk emerge between physical and verbal assault among young women seen in a publicly funded family planning clinic. Minority parous women with limited education, early onset of sexual activity, and who report no contraception use at last intercourse appear to be at highest risk for reporting physical violence, whereas history of sexual victimization, early sexual activity, and younger age at first child birth elevates risk for verbal abuse.
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Affiliation(s)
- Vaughn I Rickert
- Department of Pediatrics, Mt Sinai School of Medicine, New York, NY, USA.
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Zink TM, Shireman TI, Ho M, Buchanan T. High-risk teen compliance with prescription contraception: an analysis of Ohio Medicaid claims. J Pediatr Adolesc Gynecol 2002; 15:15-21. [PMID: 11888805 DOI: 10.1016/s1083-3188(01)00134-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE This study examines utilization of and compliance with prescription contraception by adolescents. DESIGN Retrospective cohort analysis of billing and pharmacy claims. SETTING Ohio Medicaid fee-for-service enrollees. PARTICIPANTS Claims data of 12- to 19-year-olds identified at high risk for pregnancy by sexually related service billing or procedure code. MAIN OUTCOME MEASURE Prescription contraception use and compliance patterns were examined over a 12-month study period. RESULTS During a 6-month enrollment period, 3338 females were identified at risk for pregnancy. Over one-fourth (920) became pregnant. Across the 12-month follow-up, 40% (1328) used no prescription contraception and 33% (1090) used some prescribed contraceptive. Most teens used injectable medroxyprogesterone (517) or oral contraceptive pills (492). About 20% of those using any type of prescribed contraceptive were compliant for the full year; less than 30% used a method for 3 months or less. Whites were more compliant with contraception than nonwhites. Younger age and concurrent mental health condition were also predictors of noncompliance. CONCLUSIONS Teens at risk for pregnancy demonstrated poor compliance with prescribed contraceptives. Billing/pharmacy claims analysis is a useful tool for identifying teens at risk for pregnancy in order to target and evaluate interventions or to benchmark care provided to adolescents.
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Affiliation(s)
- Therese M Zink
- Department of Family Medicine, University of Cincinnati, Cincinnati, OH 45267-0582, USA.
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