Introduction
Socio-Ecological Framework to Study Teenage Pregnancy Prevention
Changing Rural Demographics Shaping the Issue of Teenage Pregnancy
The Unique Aspects of Providing Teenage Pregnancy Prevention Interventions in Rural Communities
Methods
Study Design and Sample
Procedures
Measures
Beliefs and attitudes | Questions utilized in interview |
---|---|
Participants’ beliefs regarding teenagers’ health, pregnancy, and contraceptive use | • Community members were asked: – What comes to your mind when you think about sexual health, pregnancy, and contraceptive use by teenagers? – What resources do you have available to find more information about sexual health, teen pregnancy, and contraception? – What resources do you have available for any question that may exceed your comfort level? – Can you think of someone you could refer teens to talk more about these topics? • Healthcare personnel were asked: – What services do pregnant teens need? What services tend to be more helpful and available? – What services do you find more difficult to support? – What is your opinion about different contraceptive methods for adolescents? What type of contraception do you feel most comfortable providing to adolescents? |
Participants’ beliefs regarding potential obstacles to Teenage Pregnancy (TP) prevention | • All participants were asked: – Tell me about individuals or groups that would/would not support you in discussing sexual health issues, teen pregnancy, and contraception with teenagers? – What do you think is the role of religion as it relates to teenagers’ sexual health, pregnancy, and contraception? |
Role of culture in perceptions regarding teen Sexual and Reproductive Health (SRH) behaviors | • All participants were asked: – How do Latino families and teenagers feel about sexual behavior, teen pregnancy, and contraception compared to other racial/ethnic groups? – What is specific or unique to Latino families dealing with reproductive health services, teen pregnancy, and contraception? – How does the Latino culture influence these topics, for example, the way Latinos think about teenage pregnancy? – What are the main barriers Latino families encounter in accessing reproductive health services for their teens? How do health service referrals change for non-US citizens? – What do you think is the role of religion among the Latino community regarding teenage sexual behavior, teenage pregnancy, and reproductive healthcare? |
Data Analysis
Results
Sample Description
N (%) | |
---|---|
Mean age, years (SD) | 43 (15.5) |
Female | 41 (85) |
Role in community | |
Healthcare provider | 8 (17) |
Public Health Department staff | 5 (10) |
Community health worker | 8 (17) |
Community member | 9 (19) |
School staff | 18 (37) |
Religion | |
Catholic/Christian | 33 (72) |
Protestant | 7 (15) |
Other | 6 (13) |
Education | |
High school or less | 10 (21) |
Some college | 8 (17) |
Associate or bachelor’s degree | 14 (29) |
Advanced degree | 16 (33) |
Latino/a | 23 (50) |
Born | |
In the US | 29 (63) |
In Mexico | 15 (33) |
Interview Themes
But I think it’s just the need to feel accepted. In a lot of cultures, mine included, my grandma had babies and was married when she was 16 years old. So, it’s not that uncommon for those families; that’s what they’ve seen, that’s what they’ve known and for a lot of them it’s worked tremendously well. It’s not always the case obviously; but they’ve seen those examples, so they think why not me. You know why it can’t work for me and my boyfriend; we’ve been… you know we love each other; we’re going to stay together forever, whatever… School official.
I think that our population is so busy, and our teenage girls are- trying so hard to establish connections with someone and they’re trying to get these boys to love them; and they think it’s going to be forever, and they have sex with them; they don’t protect themselves, they end up with the babies. Um… I think they think it’s the love is going to last forever. School official, counselor.
I think it’s… to me I think it’s really important, I think that sometimes these girls don’t realize their own potential. And I think in the smaller communities everybody is having babies. And so unfortunately culturally it’s the norm sometimes… School official.They’re bored… they want to be accepted. I think it’s the same way, the same reason kids get in gangs. They want to belong to something and they… you know, I wished I knew. I think very little of it has to do with sex. Public Health staff.
Well obviously, like any other Latino family… the initial reaction is anger, then obviously the planning to assist her to carry a healthy pregnancy… and help with the baby and obviously evaluate the state of relationship with the boyfriend or the individual or couple and ... just assist so she has a healthy pregnancy. Translated, Community member.
Once she delivers, if they want to get involved um…Catholic social service has a teen mom’s group, which is a fabulous group. She does it in the schools, if there’s enough that can attend, but she also does it on Wednesday nights and I think it goes up until 23 girls, but um- she just has different members from the community that pair up and mentor the teen girls. So again, that’s just that extra adult in their life to make sure they’re getting what they need. And then she brings in different resources too. And each time they come to the meeting or whatever, they can earn teen mom bucks. They have a little store there and they can buy diapers, formula, clothes, whatever they need for the baby. It’s just a meal- they share a meal together that’s brought in by the volunteers. They bring in, like I said, different resources from the community. Again, they continue to talk about their education, taking interest surveys; to you know ‘what do you want to do for career and how do we help you get there’ and stuff like that… School official.
I think the kids take our guidance, but it’s the parents that are sometimes more set in their ways and don’t want those conversations. And they tell us a lot of times that they don’t want the school having those conversation because they’re going to have those conversations with their kids, but most of them don’t…. School Official.This topic is still taboo. And here in school there is not much we can do. I know some other schools offer condoms … to the kids. Not here. It’s not forbidden but does not look good. The thought of most, and actually mine included, is that if they have condoms in their pockets, they are going to want to use it (translated)… CHW.
Main themes | Health care provider | Public Health Department | Community Health Worker | School staff | Community members |
---|---|---|---|---|---|
1-Teen Pregnancy (TP) treated as a cultural norm - Pregnant teens support programs vs. TP prevention programs | + | + | + | + | + |
2- Support for comprehensive sex education and Sexual Reproductive Healthcare (SRH) -Obstacles to accessing Sex education and SRH healthcare | + | + | ± | + | ± |
3- Strategies to support teen pregnancy (TP) prevention - Open the conversation with parents first - Utilize ongoing family venues to implement educational workshops | + | + | + | + | + |
Other than just going to their family doctor, but that’s up to their family doctor if they’re bound to tell their parents and usually by the time with insurance- I mean all that goes through insurance; the parents are going to find out anyways. So, I would say from the counselor point of view, and for students that are coming to us and they’re thinking about that, we always encourage at least trying to have that conversation with their parents. Make informed decisions with their parents. School official.
So, there’s times where I have to reassure them and tell them, you know I’m not here for that report due to immigrant status. So even just like their prenatal care, some of them are scared. They don’t want to go to the doctor. Because they’re afraid if they go, they’re going to get reported and they’re going to get in trouble. And I always tell them “You know you need to do your prenatal care, let’s not worry about all this other stuff. Take care of you and your baby.” And so, it helps a lot. And the health department is really good about you know the- we’ll do prenatal care. Public Health staff.
At the health department ... So basically, you don't get prenatal care till you're about to deliver... I really don't know, I really don't know…what makes a difference there as I tell you is the legal situation, if you don’t have documents, obviously it's a government service, that may require permanent residency or citizenship, and maybe you as an undocumented person or without documents will not be able to access those services. That's why I'm telling you, in our community it's a little harder for people who don't have documents. Translated, Community member.
There was this girl I talked to, she was in high school, and wanted to know if I could take her to get birth control, and I told her I could not, but could tell her where to go, thou could not go with her. She was very scared of going and having to use her insurance, then having her parents find out. So, there’s no place that offers confidential services, there’s no way their parents won’t find out. Translated, School official.
Parents need education on how to talk to their, their, young kids, so have a parent night, you know. And talk to them about how they need to open up and not just, um… “we need to talk about that later,” you know. Be able to help parents learn the language, to open up, and open-ended conversations and their kids. So not only at school or, with the young teens, help parents be able to communicate better. HCP.
But I think that would be a way to do it, via workshops and promote them to those who want to go. Um, to allow parents to attend too, even workshops that, like, help the parents communicate with their children on the subject. Because, ignoring it doesn't work. School official.