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Finch BK, Thomas K, Gibbons JR, Beck AN. The Impact of Residing in a Gang Territory on Adverse Birth Outcomes: Evidence from Los Angeles. J Urban Health 2021; 98:233-247. [PMID: 33594651 PMCID: PMC8079570 DOI: 10.1007/s11524-020-00512-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Gang violence remains an ongoing crisis in many communities in the United States. This paper assesses the potential association of gang-occupied neighborhoods with birth outcomes. Adverse birth outcomes serve as a "barometer" of population health, denoting both poor conditions for human development and portending future public health concerns. We draw upon (1) Los Angeles County Vital Statistics Birth Records (2008-2012), (2) GIS information on gang territory boundaries, (3) LA city geo-coded crime data, and (4) the 2010 U.S. Census and 2006-2010 American Community Survey. We find an association between gang-occupied neighborhoods and adverse birth outcomes; however, this association is largely explained by other neighborhood socio-demographic characteristics, crime notwithstanding. We also find that gangland neighborhoods tend to exacerbate the effects of crime for all birth outcomes, but only significantly so for small for gestational age births. Lastly, gang co-residence, crime, and other neighborhood demographics explain a substantial portion of socioeconomic and racial/ethnic disparities in adverse birth outcomes. Gangland neighborhoods appear to be a novel contributor to both population health and health disparities. Future studies should address these relationships in a broad range of metropolitan settings, paying careful attention to causal linkages and moderating effects of gangs and crime.
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Affiliation(s)
- Brian Karl Finch
- University of Southern California, 835 Downey Way, 505L VPD, Los Angeles, CA, 90089, USA.
| | - Kyla Thomas
- University of Southern California, 835 Downey Way, 505L VPD, Los Angeles, CA, 90089, USA
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Assari S, Boyce S, Bazargan M, Caldwell CH. Race, Socioeconomic Status, and Sex Hormones among Male and Female American Adolescents. REPRODUCTIVE MEDICINE 2020; 1:108-121. [PMID: 32832919 DOI: 10.3390/reprodmed1020008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although early sexual initiation and childbearing are major barriers against the upward social mobility of American adolescents, particularly those who belong to a low socioeconomic status (SES) and racial minorities such as Blacks, less is known on how SES and race correlate with adolescents' sex hormones. An understanding of the associations between race and SES with adolescents' sex hormones may help better understand why racial, and SES gaps exist in sexual risk behaviors and teen pregnancies. To extend the existing knowledge on social patterning of adolescents' sex hormones, in the current study, we studied social patterning of sex hormones in a national sample of male and female American adolescents, with a particular interest in the role of race and SES. For this cross-sectional study, data came from the baseline data (wave 1) of the Adolescent Brain Cognitive Development (ABCD) study, a national longitudinal prospective study of American adolescents. This analysis included 717 male and 576 female non-Hispanic White or Black adolescents ages 9-10. The dependent variables were sex hormones (testosterone for males and estradiol for females). Independent variables were age, race, family marital status, parental education, and financial difficulties. For data analysis, linear regression models were used. Age, race, parental education, and financial difficulties were associated with estradiol in female and testosterone levels in male adolescents. Associations were not identical for males and females, but the patterns were mainly similar. Low SES explained why race is associated with higher estradiol in female adolescents. Marital status of the family did not correlate with any of the sex hormones. Being Black and low SES were associated with a higher level of sex hormones in male and female adolescents. This information may help us understand the social patterning of sexual initiation and childbearing. Addressing racial and economic inequalities in early puberty, sexual initiation, and childbearing is an essential part of closing the racial and economic gaps in the US.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles Drew University, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
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Odimegwu C, Mkwananzi S. Family structure and community connectedness: Their association with teenage pregnancy in South Africa. JOURNAL OF PSYCHOLOGY IN AFRICA 2018. [DOI: 10.1080/14330237.2018.1544390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand
| | - Sibusiso Mkwananzi
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand
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Summers L, Lee YM, Lee H. Contributing factors of teenage pregnancy among African-American females living in economically disadvantaged communities. Appl Nurs Res 2017; 37:44-49. [PMID: 28985919 DOI: 10.1016/j.apnr.2017.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 07/25/2017] [Accepted: 07/30/2017] [Indexed: 11/16/2022]
Abstract
AIM To identify contributing factors that increased the risk of pregnancy among African-American adolescent females living in economically disadvantaged communities and to evaluate the current pregnancy prevention programs addressing these factors in order to provide suggestions for the development of tailored pregnancy prevention programs for this target population. BACKGROUND Pregnancy rates among adolescents in the United States have declined over the past several years. Despite this trend, the pregnancy rate for African-American adolescent females is disproportionately higher than the adolescent pregnancy rates for other ethnicities. Limited attempts have been made to compile and synthesize the factors that increase risk of pregnancy in this population or to evaluate the effectiveness of intervention programs for African-American females that incorporate these risk factors. METHOD An integrative literature review was conducted to identify the major contributing factors of pregnancy among African American adolescents living in economically disadvantaged areas. RESULTS Of the identified contributing risk factors for early pregnancy among African-American adolescent females, the five most supported risk factors were: parental influence, peer influence, social messages, substance use including alcohol, and pregnancy desire. Twelve pregnancy prevention programs were identified that addressed one or more of the five contributing factors to pregnancy. Parental influence and social messages were the most addressed factors among these programs. CONCLUSIONS This review found five contributing factors related to teenage pregnancy; however, current intervention programs are not well addressed substance use as a component of alcohol use. Thus, development of a tailored pregnancy prevention program incorporating those factors will help decrease the high pregnancy rate among this target population.
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Affiliation(s)
- Lauren Summers
- School of Nursing, DePaul University, 990 W. Fullerton Ave, Chicago, IL 60640, United States
| | - Young-Me Lee
- School of Nursing, DePaul University, 990 W. Fullerton Ave, Chicago, IL 60640, United States.
| | - Hyeonkyeong Lee
- Dept. of Nursing Environments and Systems, Yonsei University College of Nursing, Mo-Im Kim Nursing Research Institute, 50 Yonsei-ro Seodaemun-gu, Seoul 120-749, South Korea.
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Whitaker R, Hendry M, Aslam R, Booth A, Carter B, Charles JM, Craine N, Tudor Edwards R, Noyes J, Ives Ntambwe L, Pasterfield D, Rycroft-Malone J, Williams N. Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement. Health Technol Assess 2016; 20:1-214. [PMID: 26931051 DOI: 10.3310/hta20160] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The UK has one of the highest rates of teenage pregnancies in Western Europe. One-fifth of these are repeat pregnancies. Unintended conceptions can cause substantial emotional, psychological and educational harm to teenagers, often with enduring implications for life chances. Babies of teenage mothers have increased mortality and are at a significantly increased risk of poverty, educational underachievement and unemployment later in life, with associated costs to society. It is important to identify effective, cost-effective and acceptable interventions. OBJECTIVES To identify who is at the greatest risk of repeat unintended pregnancies; which interventions are effective and cost-effective; and what the barriers to and facilitators of the uptake of these interventions are. DATA SOURCES We conducted a multistreamed, mixed-methods systematic review informed by service user and provider consultation to examine worldwide peer-reviewed evidence and UK-generated grey literature to find and evaluate interventions to reduce repeat unintended teenage pregnancies. We searched the following electronic databases: MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database), EMBASE (Excerpta Medica database), British Nursing Index, Educational Resources Information Center, Sociological Abstracts, Applied Social Sciences Index and Abstracts, BiblioMap (the Evidence for Policy and Practice Information and Co-ordinating Centre register of health promotion and public health research), Social Sciences Citation Index (supported by Web of Knowledge), Research Papers in Economics, EconLit (American Economic Association's electronic bibliography), OpenGrey, Scopus, Scirus, Social Care Online, National Research Register, National Institute for Health Research Clinical Research Network Portfolio and Index to THESES. Searches were conducted in May 2013 and updated in June 2014. In addition, we conducted a systematic search of Google (Google Inc., Mountain View, CA, USA) in January 2014. Database searches were guided by an advisory group of stakeholders. REVIEW METHODS To address the topic's complexities, we used a structured, innovative and iterative approach combining methods tailored to each evidence stream. Quantitative data (effectiveness, cost-effectiveness, risk factors and effect modifiers) were synthesised with reference to Cochrane guidelines for evaluating evidence on public health interventions. Qualitative evidence addressing facilitators of and barriers to the uptake of interventions, experience and acceptability of interventions was synthesised thematically. We applied the principles of realist synthesis to uncover theories and mechanisms underpinning interventions (what works, for whom and in what context). Finally, we conducted an overarching narrative of synthesis of evidence and gathered service user feedback. RESULTS We identified 8664 documents initially, and 816 in repeat searches. We filtered these to 12 randomised controlled trials (RCTs), four quasi-RCTs, 10 qualitative studies and 53 other quantitative studies published between 1996 and 2012. None of the RCTs was based in the UK. The RCTs evaluated an emergency contraception programme and psychosocial interventions. We found no evidence for effectiveness with regard to condom use, contraceptive use or rates of unprotected sex or use of birth control. Our primary outcome was repeat conception rate: the event rate was 132 of 308 (43%) in the intervention group versus 140 of 289 (48%) for the control goup, with a non-significant risk ratio (RR) of 0.92 [95% confidence interval (CI) 0.78 to 1.08]. Four studies reported subsequent birth rates: 29 of 237 (12%) events for the intervention arm versus 46 out of 224 (21%) for the control arm, with a RR of 0.60 (95% CI 0.39 to 0.93). Many repeat conceptions occurred in the context of poverty, low expectations and aspirations, and negligible opportunities. Service user feedback suggested that there were specific motivations for many repeat conceptions, for example to replace loss or to please a partner. Realist synthesis highlighted that context, motivation, planning for the future and letting young women take control with connectedness and tailoring provide a conceptual framework for future research. LIMITATIONS Included studies rarely characterised adolescent pregnancy as intended or unintended, that is interventions to reduce repeat conceptions rarely addressed whether or not pregnancies were intended. Furthermore, interventions were often not clearly defined, had multiple aims and did not indicate which elements were intended to address which aims. Nearly all of the studies were conducted in the USA and focused largely on African American or Hispanic and Latina American populations. CONCLUSIONS We found no evidence to indicate that existing interventions to reduce repeat teenage pregnancy were effective; however, subsequent births were reduced by home-based interventions. Qualitative and realist evidence helped to explain gaps in intervention design that should be addressed. More theory-based, rigorously evaluated programmes need to be developed to reduce repeat teenage pregnancy in the UK. STUDY REGISTRATION This study is registered as PROSPERO CRD42012003168. Cochrane registration number: i=fertility/0068. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Maggie Hendry
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - Rabeea'h Aslam
- Liverpool Review and Implementation Group, University of Liverpool, Liverpool, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ben Carter
- Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Joanna M Charles
- Centre for Health Economics and Medicines Evaluation, School of Healthcare Sciences, Bangor University, Bangor, UK
| | - Noel Craine
- Microbiology Department, Public Health Wales, Ysbyty Gwynedd, Bangor, UK
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation, School of Healthcare Sciences, Bangor University, Bangor, UK
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, UK
| | | | - Diana Pasterfield
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | | | - Nefyn Williams
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK.,North Wales Organisation for Randomised Trials in Health (& Social Care), School of Healthcare Sciences, Bangor University, Bangor, UK
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Childs GD, Knight C, White R. Never-pregnant African American adolescent girls' perceptions of adolescent pregnancy. J Pediatr Nurs 2015; 30:310-20. [PMID: 25236337 PMCID: PMC4362966 DOI: 10.1016/j.pedn.2014.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 08/20/2014] [Accepted: 08/29/2014] [Indexed: 11/17/2022]
Abstract
Despite the decrease in adolescent pregnancy rates, rates among African American girls remain higher than other racial/ethnic adolescent groups. This descriptive qualitative study explored never-pregnant African American adolescent girls' perceptions about adolescent pregnancy. Sixty-four participants participated in individual interviews and focus groups. Individual interviews examined beliefs about adolescent pregnancy and perceptions of life changes resulting from becoming pregnant during adolescence. Focus groups were held to validate findings from the interviews. Participants agreed that becoming pregnant during adolescence would negatively impact their education, family, and peers. Participants anticipated feelings of shame and embarrassment in the event that they became pregnant.
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Affiliation(s)
| | - Candace Knight
- University of Alabama at Birmingham, School of Nursing, Birmingham, AL
| | - Reashanda White
- University of Alabama at Birmingham, School of Nursing, Birmingham, AL
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Aslam RW, Hendry M, Carter B, Noyes J, Rycroft Malone J, Booth A, Pasterfield D, Charles JM, Craine N, Tudor Edwards R, Ntambwe LI, Williams N, Whitaker R. Interventions for preventing unintended repeat pregnancies among adolescents. Hippokratia 2015. [DOI: 10.1002/14651858.cd011477] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Ben Carter
- Cardiff University School of Medicine; Institute of Primary Care & Public Health; 3rd Floor, Neuadd Meirionnydd, Heath Park Cardiff UK CF14 4YS
| | - Jane Noyes
- Bangor University; Centre for Health-Related Research, Fron Heulog; Bangor Wales UK LL57 2EF
| | - Jo Rycroft Malone
- Bangor University; Health Services & Implementation Research; Bangor UK
| | - Andrew Booth
- University of Sheffield, ScHARR; School of Health and Related Research; Regent Court, 30 Regent Street Sheffield UK S1 4DA
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8
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Lyons HA, Smith SJ. Religiosity and the Transition to Nonmarital Parity. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2014; 11:163-175. [PMID: 25298755 PMCID: PMC4186654 DOI: 10.1007/s13178-014-0153-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Nonmarital parity is associated with several negative outcomes, including health problems, educational problems, and poverty. Understanding the risk and protective factors associated with nonmarital parenthood can inform policy and interventions, reducing both the incidences and associated consequences. The current study focuses on how intrinsic and extrinsic religiosity (the degree to which individuals or groups employ religious ideology in forming values and making decisions) are related to the timing of nonmarital parity using discrete time hazard modeling of a nationally representative sample of adolescent females (N=7,367) from the National Longitudinal Study of Adolescent Health. The majority of the sample (86 %) claimed a religious affiliation and almost a third (32 %) had a nonmarital birth during the study. Even though the majority of the sample is White (67 %), Black and Hispanic females were more likely to experience a nonmarital birth. Results indicate that intrinsic and extrinsic religiosity and religious affiliation assert protective effects for some populations while religious affiliation increases risk in the full model. Recommendations for policy, intervention, and future research are offered.
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Affiliation(s)
- Heidi Ann Lyons
- Department of Sociology, Anthropology, Social Work, and Criminal Justice, Oakland University, Rochester, MI 48309, USA
| | - Scott James Smith
- Department of Sociology, Anthropology, Social Work, and Criminal Justice, Oakland University, Rochester, MI 48309, USA
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9
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Killebrew AE, Smith ML, Nevels RM, Weiss NH, Gontkovsky ST. African-American Adolescent Females in the Southeastern United States: Associations Among Risk Factors for Teen Pregnancy. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2014. [DOI: 10.1080/1067828x.2012.748591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Affiliation(s)
- Luz S Porter
- Florida International University, Miami, FL, USA.
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11
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The Role of Socio-Psychological Determinants in the Sexual Behaviors of Latina Early Adolescents. SEX ROLES 2012. [DOI: 10.1007/s11199-012-0133-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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12
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Richardson DM, Nuru-Jeter AM. Neighborhood contexts experienced by young Mexican-American women: enhancing our understanding of risk for early childbearing. J Urban Health 2012; 89:59-73. [PMID: 22143409 PMCID: PMC3284584 DOI: 10.1007/s11524-011-9627-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Young Mexican-American women are disproportionately affected by teen pregnancy and early childbearing. While many of the studies that have investigated this population's high risk for early childbearing have focused predominantly on micro-level factors, a growing body of research has demonstrated the importance of neighborhood-level factors in shaping risk for this outcome. In order to elucidate the role of neighborhood context with regards to early childbearing among adolescent Mexican-American women, it is important to understand what these young women consider to be their neighborhood context and how they experience these contexts. This study utilized a mixed-methods design incorporating participatory photography, photo-elicitation, and focus groups in order to gain a more nuanced understanding of how neighborhood context is conceptualized and experienced by Mexican-American young women, and how these experiences may influence risk for early childbearing. Major findings include: (1) participants view the blocks on which they live as their neighborhood, but their exposure to neighborhood context extends beyond these blocks and includes the transient spaces they move through daily; and (2) within their neighborhood contexts, participants are influenced by experiences of discrimination and the presence of gangs and violence. These findings point to the importance of neighborhood-level factors in the lives of adolescent Mexican-American women, and may be used to inform future studies looking at the role of neighborhood context in shaping risk for early childbearing among this population.
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Affiliation(s)
- Dawn M Richardson
- Kellogg Health Scholars Program, University of Michigan School of Public Health, 1415 Washington Heights SPH II, Room M2242, Ann Arbor, MI 48109-2029, USA.
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Exposure to partner, family, and community violence: gang-affiliated Latina women and risk of unintended pregnancy. J Urban Health 2012; 89:74-86. [PMID: 22160445 PMCID: PMC3284591 DOI: 10.1007/s11524-011-9631-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
While teen pregnancy rates appear to be declining in the U.S.A. overall, the rate of decline among young Latinas has been less than other ethnic groups. Among the myriad factors associated with elevated pregnancy rates, for Latina girls living in the inner city, exposure to gang and community violence may be a critical context for increased pregnancy risk. This study explores the relationship between gang involvement and reproductive health, and the pathways through which childhood, family, and relationship violence exposure may lead to unintended pregnancy. Interviews of 20 young adult Latinas with known gang involvement in Los Angeles County were audiotaped, transcribed, and coded for key themes related to violence exposure and reproductive health. Limited access to reproductive health care compounded by male partner sexual and pregnancy coercion, as well as physical and sexual violence, emerged in the interviews. Exposures to interparental domestic violence, childhood physical and sexual abuse, and gang violence were prominent and closely associated with unhealthy and abusive intimate relationships. Adverse childhood experiences and exposure to partner, family, and community violence impact the reproductive lives and choices of young Latina women in gangs. These findings may guide targeted pregnancy prevention efforts among urban gang-affiliated Latinas as well as encourage the integration of sexual violence prevention and reproductive health promotion within gang violence intervention programs.
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Sterrett E, Jones DJ, Forehand R, Garai E. Predictors of Coparenting Relationship Quality in African American Single Mother Families: An Ecological Model. JOURNAL OF BLACK PSYCHOLOGY 2009. [DOI: 10.1177/0095798409353754] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nonmarital coparents, or adults who assist mothers with childrearing, play a significant role in the lives of African American single mothers and their children. Yet relatively little research has examined correlates of the quality of the coparenting relationship in these families. Using a broad ecological framework, the current study examined correlates of maternal-report of coparenting relationship quality in a sample of 242 low-income African American single mother families in the southeastern United States. Cross-sectionally, at each of two time points, neighborhoods characterized by lower levels of risk, higher levels of lax maternal parenting, and higher levels of maternal depressive symptoms were associated with a more compromised coparenting relationship.These findings were partially replicated in longitudinal analyses predicting coparenting relationship quality at Assessment 2 from Assessment 1 variables. Clinical implications and future research directions are discussed.
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Affiliation(s)
- Emma Sterrett
- University of North Carolina at Chapel Hill, NC, USA
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15
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Thompson SJ, Bender KA, Lewis CM, Watkins R. Runaway and pregnant: risk factors associated with pregnancy in a national sample of runaway/homeless female adolescents. J Adolesc Health 2008; 43:125-32. [PMID: 18639785 PMCID: PMC2742657 DOI: 10.1016/j.jadohealth.2007.12.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Revised: 12/07/2007] [Accepted: 12/21/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Homeless youth are at particularly high risk for teen pregnancy; research indicates as many as 20% of homeless young women become pregnant. These pregnant and homeless teens lack financial resources and adequate health care, resulting in increased risk for low-birth-weight babies and high infant mortality. This study investigated individual and family-level predictors of teen pregnancy among a national sample of runaway/homeless youth in order to better understand the needs of this vulnerable population. METHODS Data from the Runaway/Homeless Youth Management Information System (RHY MIS) provided a national sample of youth seeking services at crisis shelters. A sub-sample of pregnant females and a random sub-sample (matched by age) of nonpregnant females comprised the study sample (N = 951). Chi-square and t tests identified differences between pregnant and nonpregnant runaway females; maximum likelihood logistic regression identified individual and family-level predictors of teen pregnancy. RESULTS Teen pregnancy was associated with being an ethnic minority, dropping out of school, being away from home for longer periods of time, having a sexually transmitted disease, and feeling abandoned by one's family. Family factors, such as living in a single parent household and experiencing emotional abuse by one's mother, increased the odds of a teen being pregnant. CONCLUSIONS The complex problems associated with pregnant runaway/homeless teens create challenges for short-term shelter services. Suggestions are made for extending shelter services to include referrals and coordination with teen parenting programs and other systems of care.
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Affiliation(s)
- Sanna J. Thompson
- Address correspondence to: Sanna Thompson, Ph.D., University of Texas at Austin, School of Social Work, Center for Social Work Research, 1717 W. 6th St. Suite 335, Austin, TX 78703.
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Minnis AM, Moore JG, Doherty IA, Rodas C, Auerswald C, Shiboski S, Padian NS. Gang exposure and pregnancy incidence among female adolescents in San Francisco: evidence for the need to integrate reproductive health with violence prevention efforts. Am J Epidemiol 2008; 167:1102-9. [PMID: 18308693 PMCID: PMC4226274 DOI: 10.1093/aje/kwn011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Among a cohort of 237 sexually active females aged 14-19 years recruited from community venues in a predominantly Latino neighborhood in San Francisco, California, the authors examined the relation between gang exposure and pregnancy incidence over 2 years of follow-up between 2001 and 2004. Using discrete-time survival analysis, they investigated whether gang membership by individuals and partners was associated with pregnancy incidence and determined whether partnership characteristics, contraceptive behaviors, and pregnancy intentions mediated the relation between gang membership and pregnancy. Pregnancy incidence was determined by urine-based testing and self-report. Latinas represented 77% of participants, with one in five born outside the United States. One quarter (27.4%) became pregnant over follow-up. Participants' gang membership had no significant effect on pregnancy incidence (hazard ratio = 1.25, 95% confidence interval: 0.54, 3.45); however, having partners who were in gangs was associated with pregnancy (hazard ratio = 1.90, 95% confidence interval: 1.09, 3.32). The male partner's perceived pregnancy intentions and having a partner in detention each mediated the effect of partner's gang membership on pregnancy risk. Increased pregnancy incidence among young women with gang-involved partners highlights the importance of integrating reproductive health prevention into programs for gang-involved youth. In addition, high pregnancy rates indicate a heightened risk for sexually transmitted infections.
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Affiliation(s)
- A M Minnis
- Women's Global Health Imperative, RTI International, San Francisco, CA 94104, USA.
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17
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Abstract
PURPOSE This papers aims to clarify and explore the topic of adolescent decision-making regarding sexual activity. SOURCES Published literature. CONCLUSIONS Adolescent decision-making regarding the initiation or continuation of sexual activity is influenced by desire for intimacy, perceived relationship safety, problem-solving ability, cognitive ability, family and peer relationships, and concern regarding pregnancy or sexually transmitted infection.
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Affiliation(s)
- Heidi C Fantasia
- Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA.
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