Teen pregnancy and early childbearing are complex issues which have attracted a great deal of attention from service providers, educators, and policy makers in recent years. Experience and research clearly indicate that adolescent pregnancy is associated with a variety of factors—it is not simply a problem of teens having unprotected sexual intercourse at an early age. For many young people, the issues related to early pregnancy and childbearing include much broader social, economic, cultural, and psychological factors, including poverty, school failure, and sexual abuse. A further complicating factor is that adult men are frequently the fathers of children born to teenage women.

These complexities pose particular challenges to pregnancy prevention program planners. It must be recognized that there is no "magic solution" to teen pregnancy nor will a single intervention work for all teens. Communities should not look for immediately lower pregnancy or birth rates over a short period because the process is time-consuming, requires affirmation from young people, and a serious commitment of financial resources. To reach a broad teen audience, programmers need to implement a combination of strategies and involve all key members of the community.

While there is still much to learn about the causes and consequences of early pregnancy, program planners can benefit greatly from the research and the "lessons learned" from the numerous programs already in place across the country. This document summarizes key ingredients of successful teen pregnancy prevention programs and may be used as a guide for developing new strategies and strengthening existing interventions.

General Principles

The following principles are important for program implementation:

Program Strategies

Pregnancy prevention programs must account for the varying levels of risk among teens. When developing specific interventions, the following issues are important to consider:

Sexuality Education

All young people need comprehensive sexuality education to prepare them for healthy adult relationships. Sexuality education programs should increase adolescents' knowledge and help them to explore attitudes, feelings, and values about human development, relationships, dating, gender roles, sexual orientation, sexual behavior, and healthy sexual decision-making. Educational programs are most effective when they

Contraceptive Services

A sensitive, well-trained, and non-judgmental staff person plays an important role by helping teens learn about and decide to use contraception effectively and consistently. The first contact with a family planning service provider is critical in setting the stage for future visits. Family planning staff should utilize a guided counseling process to help a teen decide which method of contraception is most appropriate. This type of counseling is particularly useful for teens who receive a negative pregnancy test during a "pregnancy scare." In addition, the role of males should be addressed in family planning settings. Although men are influential in contraceptive use and acceptance among young women, they are seldom specifically engaged in prevention efforts.

Comprehensive sexual and reproductive health services for adolescents should include gynecological exams, contraceptive methods, pregnancy testing and screening, treatment, and/or referral for sexually transmitted diseases including HIV/AIDS.

Teen-friendly services are most effective when they

Motivational Opportunities and Related Services

Call to Action

Based upon these program strategies and principles, communities may want to assess adolescent needs, review service availability, identify gaps and resources, and develop a comprehensive plan of action for adolescent pregnancy prevention. This plan should address ways to develop new programs, strengthen existing efforts, or better coordinate activities and referral networks so that all teens have access to a wide array of prevention services. To be most effective, community-wide program efforts must be supported by expanded financial resources, increased public awareness, and the implementation of favorable policies at the national, state, and local levels.

Written by: Laura Davis, 1996

Source: The Components of Promising Teen Pregnancy Prevention Programs were developed by Advocates for Youth's National Teen Pregnancy Prevention Initiative Advisory Committee

References

  1. Committee on Unintendd Pregnancy, Institute of Medicine, National Academy of Sciences; Brown SS, Eisenberg L, editors. The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington, DC: National Academy Press, 1995.
  2. Landry DJ, Forrest JD. How old are U.S. fathers? Fam Plann Perspect 1995;27:159-161.
  3. Males M. School-age pregnancy: why hasn't prevention worked? J Sch Health 1993;63:429-432.
  4. Frost JJ, Forrest JD. Understanding the impact of effective teenage pregnancy prevention programs. Fam Plann Perspect 1995;27: 188-195.
  5. Girls Incorporated. Truth, Trust and Technology: New Research on Preventing Adolescent Pregnancy. Indianapolis IN: Girls Inc. 1991.
  6. Howard M, McCabe JB. Helping teenagers postpone sexual involvement. Fam Plann Perspect 1990;22:21-26.
  7. Kirby D, Barth RP, Leland N. Fetro JV. Reducing the Risk: impact of a new curriculum on sexual risk-taking. Fam Plann Perspect 1991;23:253-263.
  8. Zahin LS, Emerson MR, Ringers PA, Sedivy V. Adolescents with negative pregnancy test results. JAMB 1996;275:113-117.
  9. Brindis C. Adolescent Pregnancy Prevention: A Guidebook for Communities. Palo Alto Calif: Health Promotion Resource Center, Stanford Center for Research in Disease Prevention, 1991.
  10. Nathanson C, Becker MH. The influence of client-provider relationships on teenage women's subsequent use of contraception. Amer J Pub Health 1985;75: 33-38.
  11. Armstrong KA, Stover MA. SMART START: an option for adolescents to delay the pelvic examination and blood work in family planning clinics. J Adolesc Health 1994;15:389-395.
  12. Moore KA, [et al]. Adolescent Pregnancy Prevention Programs: Interventions and Evaluations. Washington, DC: Child Trends 1995.
  13. Berenson AB, San Miguel, VV. Wilkinson GS. Violence and its relationship to substance use in adolescent pregnancy. J Adolesc Health 1992;13:470-74.
  14. Boyer D, Fine D. Sexual abuse as a factor in adolescent pregnancy and child maltreatment. Fam Plann Perspect 1992;24:4-11+.
  15. Tiemey JP, Grossman JB, Resch NL. Making a Difference: An Impact Study of Big Brother/Big Sisters. Philadelphia PA: Public/Private Ventures, 1995.
  16. Carrera MA, Dempsey P. Philliber W. Philliber S. Evaluating a comprehensive pregnancy prevention program. Fam Life Ed 1992;11(1):4-9.
  17. Philliber S. Allen JP. Life Options and Community Service: Teen Outreach Program. In Miller BC, Card JJ, Paikoff RL, Peterson JL. Preventing Adolescent Pregnancy: Model Programs and Evaluations. Newbury Park, CA: Sage Publications, 1992.