Preventing Teenage Pregnancy and Childbearing: Best Bets from Research Jennifer Manlove, Ph.D.
www.childtrends.org www.childtrendsdatabank.org
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Preventing Teenage Pregnancy and Childbearing: Best Bets from Research 150 Research and Evaluation Studies: 1. Findings from research studies 2. Findings from program evaluations
Risk & Protective Factors for Pregnancy/Childbearing 1. Adolescent: •
Risk factors ¾ ¾ ¾ ¾ ¾ ¾ ¾
Males; racial/ethnic minorities; older teens Early physical maturation Other risky behaviors (drugs, alcohol) Sexually abused teens Non-voluntary sexual experiences Teens uninformed about reproductive health Risky attitudes
Risk & Protective Factors for Pregnancy/Childbearing 1. Adolescent: •
Protective factors ¾ Engagement and performance in school ¾ Religious activities ¾ Sports (for girls)
Risk & Protective Factors for Pregnancy/Childbearing 2. Family: • Risk factors ¾Single-parent household; mother was a teen mom ¾Parents with low income or low education ¾Sexually experienced or pregnant sibling(s)
Risk & Protective Factors for Pregnancy/Childbearing 2. Family: • Protective factors ¾Parent-teen relationships, communication, and monitoring ¾Strong disapproval of sex from parents ¾Discussions with parents about sex and birth control ¾High parental involvement in schooling
Risk & Protective Factors for Pregnancy/Childbearing 3. Peers: • Risk factors ¾Sexually active friends ¾Perception that peers are sexually active or don’t use contraception ¾Peers who are risk-takers (e.g. drink, do drugs)
• Protective factors ¾Friends with high educational aspirations / achievement
Risk & Protective Factors for Pregnancy/Childbearing 4. Partners: • Risk factors ¾Teens who have dated/been in a romantic relationship ¾Having an older partner
• Protective factors ¾Teens who communicate with partners about sexual risk
Risk & Protective Factors for Pregnancy/Childbearing 5. Schools/Community Context: • Risk factors ¾Schools that are perceived to be unsafe (e.g. high crime/vandalism) ¾Schools with a high percentage of low-income youth ¾Disadvantaged communities with high poverty rates ¾Communities with high crime rates
Risk & Protective Factors for Pregnancy/Childbearing 5. Schools/Community Context: • Protective factors ¾Private (vs. public) schools ¾More advantaged schools and communities
Best Bets from Research Addressing risk and protective factors for teens, their families, partners, peers, and communities
Pregnancy Prevention Programs Study Criteria 1. 2. 3. 4. 5.
Conducted in U.S. or Canada Completed in 1980 or later Targeted adolescents under age 18 Experimental Design Measured Behavioral Outcomes
Outcomes Measured 1. 2. 3. 4. 5. 6.
Initiation of Sexual Intercourse Sexual Activity Number of Sexual Partners Condom Use Contraceptive Use Pregnancy/Childbearing
Types of Effective Programs 1. Curriculum-Based Sexuality Education Programs 2. Early Childhood Programs 3. Community Service Learning 4. Youth Development Approaches
Curriculum-Based Sexuality Education Programs Types of Programs: • Sexuality Education • HIV/AIDs Education • Abstinence-Only Components: • Fairly short-term (4-20 hours) • Most address delaying sex and using contraception
Summary of Sexuality Education Programs: Impacts by Program Type Sexual Initiation
Sexual Activity
# of Partners
Condom Use
Contraceptive Use
Pregnancy/ Births
Sex Education (8 programs) Positive
3
1
2
1
4
Negative
1
0
0
0
0
No Impact
4
3
1
3
1
1
HIV/AIDS Education (9 programs) Positive
2
4
1
5
Negative
0
0
0
0
None
1
2
4
4
Abstinence Education Programs (1 program) Positive
0
0
0
0
Negative
0
0
0
0
None
1
1
1
1
Curriculum-Based Sexuality Education Programs Mixed Findings: • Many show some impacts for some populations • Many show no impacts
Findings from Curriculum-Based Sexuality Education Programs 10 Characteristics of Successful Programs: 1. Focus on reducing one or more sexual behaviors that lead to unintended pregnancy/STD 2. Are based on theoretical approaches 3. Give a clear message about sexual activity and condom/contraceptive use 4. Provide accurate information 5. Include activities that address social pressures that influence sexual behavior Kirby, D. (2001). Emerging answers: Research findings on programs to reduce teen pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
Findings from Curriculum-Based Sexuality Education Programs 10 Characteristics of Successful Programs (continued): 6. Provide modeling of and practice with communication, negotiation, and refusal skills 7. Use a variety of teaching methods designed to involve the participants 8. Are appropriate to the age, sexual experience, and culture of the students 9. Last a sufficient length of time 10. Select and train teachers/leaders who believe in the program Kirby, D. (2001). Emerging answers: Research findings on programs to reduce teen pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
Early Childhood Investments Components: • High-quality pre-school • High-quality child care
Early Childhood Investments Effective Programs & Outcomes: • High/Scope Perry Preschool: – Reduced nonmarital births
• Abecedarian: – Delayed childbearing
Early Childhood Investments Implications: • Investing in high quality care and education can effectively delay childbearing years later
Community Volunteer Service Learning Programs Components: • Community volunteer experience • Classroom discussions
Community Volunteer Service Learning Programs Effective Programs & Outcomes: • Teen Outreach Program (grades 9-12): – Delayed pregnancy for females
• Reach for Health (grades 7-8): – Abstinence for males and females
Community Volunteer Service Learning Programs Implications: • Can reduce sexual activity and teen pregnancy without a specific focus on sexual behavior • Also influences educational outcomes
Youth Development Programs that Include a Sexuality Education Component Include: • Multiple components • Sexuality education •Youth development activities
Youth Development Programs that Include a Sexuality Education Component Effective Programs & Outcomes: •Children’s Aid Society Carrera Program: –Abstinence among females –Lower pregnancy among females
•Quantum Opportunities Program: –Lower childbearing among males and females
Youth Development Programs that Include a Sexuality Education Component Implications: • Intensive long-term programs that incorporate multiple youth development components in combination with sexuality education may have the strongest and most long-term outcomes.
Types of Effective Programs 1. Curriculum-Based Sexuality Education Programs (short-term, 10 characteristics) 2. Early Childhood Programs (longer-term, impacts years later) 3. Community Service Learning (1 year) 4. Youth Development Approaches (multiyear, intensive)
Future Directions • Limited number of rigorously evaluated pregnancy prevention programs • Some of these programs work only with specific populations • We don’t know which components of programs are the most effective • Continued evaluation of promising programs and approaches
Question and Answer Period Additional questions: Amber Moore
[email protected]
www.childtrends.org The Policy Institute for Family Impact Seminars http://www.uwex.edu/ces/familyimpact/wisconsin.htm
