National Clearinghouse on Families and Youth, Silver Spring, MD.
This booklet presents the youth development approach to supporting adolescents in dealing with all the issues they face, including preventing unintended pregnancies. The Department of Health and Human Services promotes five principles that research and experience suggest are key to community efforts to prevent teen pregnancy: (1) parental and…
Adolescent pregnancy is a complex and frustrating problem that exacts a large social and personal cost. This year approximately 40,000 Canadian teenagers will become pregnant. With proper prevention, this number could be reduced. Pregnant teenagers seem to be at increased risk for some obstetric complications and their children for some neonatal complications. Family physicians who see patients over the course of a lifetime are in a good position to prevent adolescent pregnancy and the associated complications. PMID:8520241
Haffner, D; Casey, S
The US has one of the highest teenage pregnancy rates in the industrialized world, over 1,000,000 a year. This can add to social problems including poverty, unemployment, family breakup, juvenile crime, school dropouts, and child abuse. In several studies various approaches have been developed and it is concluded that teens must not only be given the knowledge to avoid teen pregnancies, but the motivation to do so. Sex education is an important part of pregnancy prevention, but few programs go beyond the facts of reproduction and less than 14% of them are 40 hours long. Studies have shown mixed results as to the effect of education on teen pregnancy. There are many programs that have been developed by different communities, including computer programs and youth service agencies. Religious groups also play an important part in sex education and they have some distinct advantages in affecting teens' sexual values and activities. Education programs for teen's parents appear to be very important since studies show when sexuality is discussed at home, the teens begin activity later and use birth control more. Clinics have had difficulty recruiting and retaining teen patients and devote special attention to establishing a rapport with them. The school-based clinic is becoming increasingly popular and can provide birth control counseling, contraceptives, family planning clinic referral, examinations, pregnancy testing, and prenatal care. There success is due to confidentiality, convenience, and comprehensive service. However, since nearly all efforts on teen pregnancy prevention are directed at girls, 1/2 of those involved in teen pregnancies--males--are not participating in programs. This must change for longterm success of these programs and also the involvement of the community and media.
Paget, Kathleen D.
An overview of research on pre-adolescent and adolescent pregnancy is provided, and innovative school and community-based prevention programs are discussed. The implications for psychologists with respect to preventive programing in school settings are considered. (SLD)
Proctor, Susan E.
Traditional pregnancy prevention strategies employed with older teens and adults do not recognize significant developmental differences between early adolescents and other age groups. Methods that compliment, reflect, and are consistent with the developmental needs of the young teen provide the best approaches to teen pregnancy prevention.…
Somers, Cheryl L.
This study evaluates the effectiveness of an experiential approach to teen pregnancy (TP) prevention called "Baby Think It Over," a computerized infant simulator, on adolescents' attitudes and behaviors regarding teen pregnancy and sexuality. Recently, a more realistic model called "Real Care Baby" was developed. The small amount of research on…
Santelli, John S.; And Others
Special edition discusses adolescent sexuality, focusing on pregnancy, sexually transmitted diseases, and prevention. The articles focus on demographics, risk factors, school-based risk reduction programs, contraception, early intervention, options, school-based prenatal and postpartum care programs, teenage parenting, abortion, HIV and AIDS,…
Proctor, S E
Traditional pregnancy prevention strategies employed with adults and older teens do not recognize significant developmental differences between early adolescents and other age groups. Methods that compliment, reflect, and are consistent with developmental needs of the young teen provide cogent approaches to teen pregnancy prevention. Particular emphasis should be placed on interpersonal relationships and their importance in the young woman's life, especially the relationship between the young teen and her parents. Developing and improving all relationships instrumental in positively affecting teen decision-making represent potent approaches to pregnancy prevention. The axioms of Piaget, Erikson, and Mercer are examined in regard to cognitive, social, emotional, and psychosexual development in the 12-14 year old. Young teens' responses to sex education as well as their use of contraception are reviewed in relation to developmental theory.
Rubin, Marcia A., Ed.; Wooley, Susan F., Ed.
This resource describes how pregnancy prevention efforts can be integrated into the various components of a school health program (the linkages between classroom instruction to prevent adolescent pregnancy and the school's health and mental health services, the necessary administrative policies, the type and extent of faculty and staff…
Moore, Kristin A.; And Others
Widespread concern about teenage childbearing led to the establishment of numerous intervention programs throughout the United States during the 1980s. Nevertheless, between the mid-1980s and the early 1990s, the teen birth rate rose in every state. This volume examines numerous prevention programs and makes recommendations for establishing…
Sweet, Richard; And Others
Wisconsin legislation on adolescent pregnancy prevention is discussed in this document. The 1991 Senate Bill 324 and Assembly Bill 630, identical bills which relate to adolescent pregnancy prevention, school district instruction in human growth and development, medical assistance services, and making appropriations, are discussed. Part I notes…
Barker, Gary; And Others
This survey analyzed the nature and level of services in adolescent pregnancy prevention in the developing countries of Latin America, Africa, and Asia. While focusing on programs to prevent adolescent pregnancy, many of the groups surveyed were also responding to the Acquired Immune Deficiency Syndrome (AIDS) epidemic in their work with youth.…
Objectives. To determine the impact of Positive Prevention PLUS, a school-based adolescent pregnancy prevention program on delaying sexual intercourse, birth control use, and pregnancy. Methods. I randomly assigned a diverse sample of ninth grade students in 21 suburban public high schools in California into treatment (n = 2483) and control (n = 1784) groups that participated in a clustered randomized controlled trial. Between October 2013 and May 2014, participants completed baseline and 6-month follow-up surveys regarding sexual behavior and pregnancy. Participants in the treatment group were offered Positive Prevention PLUS, an 11-lesson adolescent pregnancy prevention program. Results. The program had statistically significant impacts on delaying sexual intercourse and increasing the use of birth control. However, I detected no program effect on pregnancy rates at 6-month follow-up. Conclusions. The Positive Prevention PLUS program demonstrated positive impacts on adolescent sexual behavior. This suggests that programs that focus on having students practice risk reduction skills may delay sexual activity and increase birth control use. PMID:27689502
Leftwich, Heidi K; Alves, Marcus Vinicius Ortega
Adolescent pregnancy, although on the decline, represents a significant public health concern. Often adolescents present late to prenatal care, either from lack of knowledge, fear of consequences, limited access, stigma, or all of the above. Although multifaceted, there are many risks both to mother and child that are increased in adolescent pregnancy. Many are unintended and are at risk for repeat adolescent pregnancy, especially within the first 2 years. Risks include but are not limited to: low birth weight, preterm delivery, stillbirth, and preeclampsia, as well as feelings of social isolation, delayed or neglected educational goals, and maternal depression.
Gurgel, Maria Glêdes Ibiapina; Alves, Maria Dalva Santos; Moura, Escolástica Rejane Ferreira; Pinheiro, Patrícia Neyva da Costa; Rego, Rita Maria Viana
Working with the development of skills in sexual and reproductive health of adolescents from the perspective of health promotion for the prevention of the precocious pregnancy is a challenge to the nurse. To attend the group on psychosocial and biological transformation, we must consider their particular demands and growth for the protagonists: nurse and adolescent. The study aims to analyze the practice of the nurse in the prevention of the precocious pregnancy in view of skills development. This is a descriptive and exploratory research, with a qualitative approach, developed in Fortaleza, Ceará, Brazil, using the technique of the focal group, whose analysis was performed by means of discursive practices and maps of association of ideas. The results revealed that the promotion of adolescent health is worked out in the nursing consultation and adolescents groups, being this a creative, appropriate interactive space for the development of skills regarding sexuality and the prevention of precocious pregnancy.
Barth, Richard P.; And Others
A 15-session sex education program was delivered by teachers to 586 10th graders using techniques based on social learning theory. Knowledge about sex and contraception were increased, and communication with parents about pregnancy prevention were significantly greater at posttest. No differences in the frequency of sexual intercourse, pregnancy…
Background Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps. Objective This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support. Methods We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist. Results Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern
Pires, Raquel; Araújo-Pedrosa, Anabela; Pereira, Joana; Canavarro, Maria Cristina
Age at first sexual intercourse (AFSI) is the initial factor related to adolescents' sexual life that may increase the risk of adolescent pregnancy. We explored the biological, social, cultural, and political predictors of AFSI addressing several gaps that prevent us from generalizing the results of past research to adolescent pregnancy prevention. We also explored the moderating effects of cultural variables on the links between social and political predictors and AFSI. Our sample consisted of 889 Portuguese female adolescents aged 12-19. Earlier age at menarche, non-intact family structure, maternal history of adolescent pregnancy, lower maternal emotional warmth, absence of religious involvement, and living in Portugal's mainland and in a legal context penalizing abortion predicted earlier AFSI. School attendance predicted earlier AFSI among adolescents of European ethnic origin; adolescents of non-European ethnic origin presented the opposite, but non-significant, pattern. These findings suggest that, in addition to isolated characteristics, factors from different ecological contexts should be considered when planning interventions designed to foster healthy and informed transitions to sexual initiation and prevent the related risks of unwanted outcomes. We discuss implications for future research and practice.
Fisher, Menachem; Ben Shlomo, Izhar; Solt, Ido; Burke, Yechiel Z
We present an overview of the current sexual behavior of adolescents in Israel, including the related social and moral issues, and compare it to that in Western countries. An important factor is the existence of liberal versus conservative views regarding the use of contraception and termination of pregnancy in these young subjects. We describe the current situation where in most cases the medical providers do not provide adequate contraceptive advice to adolescent girls, resulting ultimately in a high rate of unintended pregnancy. In our opinion, it is essential to make effective contraception more accessible to this vulnerable group.
Johnson-Motoyama, Michelle; Moses, Mindi; Kann, Tiffany Koloroutis; Mariscal, E Susana; Levy, Michelle; Navarro, Carolina; Fite, Paula J
Teen pregnancy remains a public health concern particularly among Latinos, whose pregnancy rate of 83.5 per 1000 girls constitutes one of the highest rates of teen pregnancy among all ethnic and racial groups in the United States. To enhance the effectiveness of interventions for diverse Latino populations in the US, it is crucial to assess the community's understanding of the etiology of the problem of adolescent pregnancy and to implement programs that reflect the local community's beliefs and preferences. We present findings from six focus groups held with parents (n = 18), teachers (n = 23) and school stakeholders (n = 8) regarding teen pregnancy prevention among Latino youth at a high school located in a large, Midwestern city. Two investigators analyzed data iteratively using a template organizing approach. A consensus emerged across the groups regarding content that emphasized respect for oneself and one's family, a focus on personal and shared responsibility in reproductive health behavior, information about the "realities" or consequences associated with engaging in sexual activity, and information about contraceptives. The strong request from participants to include a parental education component reflects the community's belief that parents play a crucial, protective role in the socialization and development of adolescent sexual behavior, a view that is supported by empirical research. Findings highlight the importance of involving local school communities in identifying adolescent pregnancy prevention strategies that are responsive to the community's cultural values, beliefs, and preferences, as well as the school's capacity and teacher preferences.
Ortiz, Elizabeth T.; Bassoff, Betty Z.
Most efforts at combating teenage pregnancy have focused on cognitive/educational levels felt by concerned adults to be of greatest importance. However, recent research has demonstrated the connection between lack of career goals, low self-esteem, perception of narrow options, and risk-taking behavior as factors leading to pregnancy. A 3-year…
Schnall, Rebecca; Stockwell, Melissa S; Castaño, Paula M; Higgins, Tracy; Westhoff, Carolyn; Santelli, John; Dayan, Peter S
Background Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. Objective The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females. Methods We conducted semistructured, open-ended interviews in one urban ED in the United States with adolescent females aged 14-19 years. Eligible subjects were adolescents who were sexually active in the past 3 months, presented to the ED for a reproductive health complaint, owned a mobile phone, and did not use effective contraception. Using an interview guide, enrollment continued until saturation of key themes. The investigators designed sample text messages using the Health Beliefs Model and participants viewed these on a mobile phone. The team recorded, transcribed, and coded interviews based on thematic analysis using the qualitative analysis software NVivo and Excel. Results Participants (n=14) were predominantly Hispanic (13/14; 93%), insured (13/14; 93%), ED users in the past year (12/14; 86%), and frequent text users (10/14; 71% had sent or received >30 texts per day). All were interested in receiving text messages from the ED about pregnancy prevention, favoring messages that were “brief,” “professional,” and “nonaccusatory.” Respondents favored texts with links to websites, repeated information regarding places to receive “confidential” care, and focused information on contraception options and misconceptions. Preferences for text message frequency varied from daily to monthly, with random hours of delivery to
Hagen, Janet W.; Skenandore, Alice H.; Scow, Beverly M.; Schanen, Jennifer G.; Clary, Frieda Hugo
Nationally, the United States has a higher rate of teen pregnancy than any other industrialized nation. Native American youth have a higher birth rate than the national rate. A full-year healthy relationship program, based on Native American teachings, traditions, and cultural norms, was delivered to all eighth-grade students at a rural tribal…
Edelman, Marion Wright
For poor and minority teenagers the lack of adequate life options may increase their desire for early pregnancy. Since teen mothers face probable poverty and single parenthood, it is imperative that schools and school social workers provide counseling, health services, and work preparation as well as academic skills training. (VM)
Berganza, Carlos E.; And Others
Conducted 2 studies to explore prevalence of adolescence pregnancy in Guatemala and identify level of contraception. In first study found 89 percent of male and 38 percent of female adolescents (N=850) had experienced coitus. In the second study found pregnancy rate of minors (N=551) in a gynecology clinic was highest for adolescents aged 13-14.…
This information memorandum, prepared for the Wisconsin Special Committee on Pregnancy Options, provides a summary of selected programs in five other states relating to adolescent pregnancy prevention. The memorandum notes that the programs selected have state statutory or administrative rule mandates or receive substantial administrative and…
Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn
Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…
Kappeler, Evelyn M; Farb, Amy Feldman
In Fiscal Year 2010, Federal funds were dedicated to support evidence-based approaches to effectively target teen pregnancy prevention and resulted in the establishment of the Office of Adolescent Health (OAH) and the Teen Pregnancy Prevention (TPP) Program. Through the tiered TPP Program, OAH supports replication and evaluation of programs using models whose effectiveness has been demonstrated through rigorous evaluation and the development and testing of promising or innovative pregnancy prevention strategies and approaches. This article documents the creation of OAH and the development of the TPP Program, the identification of a TPP evidence base, current program and evaluation efforts at OAH, and government coordination and partnerships related to reducing teen pregnancy. This article is of interest to those working to improve the health and wellbeing of adolescents.
Conner, S L
Adolescent childbearing increased 16% over 1986-90 in the Southern region of the US from 38.4 to 44.6 births/1000 girls aged 15-17; adolescent birth rates declined only in Oklahoma at the rate of 1%. Southern states spent more than $5.7 billion in Aid to Families with Dependent Children, Medicaid, and food stamps in 1991 to support families started by adolescent mothers, but federal and state spending combined for the primary prevention of adolescent pregnancy totalled only $110 million in the same states. Public expenditures related to adolescent childbearing in Alabama in fiscal year 1991 totalled more than $117 million, yet less than $1.5 million is spent on preventing teen pregnancy. The author stresses the need for stronger state commitment, leadership, and funds for programs to prevent pregnancy. Thus far, Alabama has definitely not done enough to address the HIV and AIDS pandemic.
Asheer, Subuhi; Berger, Amanda; Meckstroth, Alicia; Kisker, Ellen; Keating, Betsy
This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations.
Molina, Ramiro Cartes; Roca, Carolina Gonzalez; Zamorano, Jorge Sandoval; Araya, Electra Gonzales
High adolescent fecundity principally affects developing countries. In spite of a decrease in the incidence of pregnancies in the developing countries over the past 13 years, the differences that exist with respect to developed countries turn adolescent fecundity into an indicator of the level of development of countries. The impact of adolescent pregnancy is evident in maternal and perinatal morbidity and mortality. Nonetheless, in addition to the age involved in precocious pregnancy, it also reflects previous conditions such as malnutrition, infectious diseases and deficiencies in the health care given to pregnant adolescents. The most important impact lies in the psychosocial area: it contributes to a loss of self-esteem, a destruction of life projects and the maintenance of the circle of poverty. This affects both adolescent mothers and fathers; the latter have been studied very little. Intervention with comprehensive health services and the maintenance of the education of adolescent mothers and fathers prevents repeat pregnancies. Evidence shows success in the prevention of the first pregnancy when the intervention includes comprehensive sexual education, the existence of preferential sexual and reproductive health services for adolescents, the handout of modern contraceptives gauged to the adolescence stage of the subjects and the existence of an information network. There is little research in contraception for adolescents, and for this reason, the indications given are projections of data obtained from adults.
Resnick, M D
The range of pregnancy options available to adolescents each have significant ramifications for future educational and economic achievement. The changing societal context of adolescent pregnancy decision-making are described, and the characteristics of adolescents who choose to terminate their pregnancy, parent their child, or place for adoption are examined. The role of significant others in decision-making and the implications of mandatory parental involvement in pregnancy decision-making is discussed, as well as the roles of schools in promoting the well-being and potential of adolescents considering pregnancy decisions.
Dixon, Angela Coleman; Schoonmaker, Christopher T.; Philliber, William W.
Compares past participants (n=33) in an Afrocentric pregnancy prevention program for adolescent females with nonparticipants (n=32). Results suggest that A Journey Toward Womanhood had a positive impact, delaying the initiation of sexual intercourse, increasing contraceptive use among those who were having intercourse, and reducing the incidence…
The United States must improve its efforts to reduce teen pregnancy. We occupy an alarming position in the developed world from the standpoint of the magnitude of the pregnancy issue. While our society promotes sexuality to sell all sorts of consumer goods, it still refuses for the most part to make contraceptives familiar and available to sexually active teens. The youngest adolescents, 10 to 14 years, are having sex and babies at an increasing rate. Their children will have limited futures. Only by stepping up our efforts to prevent early pregnancy will we make possible a life of opportunity and choice for the young people of our country. Consequences will be costly and tragic if we do not.
Black, Amanda Y; Fleming, Nathalie A; Rome, Ellen S
Adolescent pregnancy remains a public health issue with significant medical, emotional, and societal consequences for the adolescent mother, her child, and her family. Teenage pregnancies are at higher risk of many adverse outcomes, including preterm delivery, low birth weight, and neonatal and infant mortality. Teen pregnancy and motherhood may have detrimental effects on the teen mother and her child; antenatal and postpartum care need to be adapted to meet the special needs of pregnant adolescents because standard obstetrical environments may not do so. This comprehensive review of adolescent pregnancy will highlight global statistics, factors contributing to adolescent pregnancy, social implications of adolescent pregnancy, obstetrical and neonatal outcomes, and the importance of multidisciplinary antenatal and postnatal care.
Gould, J B; Herrchen, B; Pham, T; Bera, S; Brindis, C
Traditional methods of identifying areas in need of adolescent pregnancy prevention programs may overlook small localities with high levels of adolescent childbearing in communities and counties where this is not a universal problem. The present study assessed the potential of a "geomapping" approach based on measurement of the number of births occurring to teens 15-17 years old in each California (US) zip code in 1992-94. A total of 415 zip codes with teen birth rates in excess of the state's 75th percentile cut-off point (62.8 births/1000) were identified. 210 of these zip codes, accounting for 96% of all births to 15-17 year olds in the 75th-percentile zip codes, differed significantly (p 0.01) from the state average of 44.5 births/1000 15-17 year olds. 178 (85%) of these 210 "hot spots" also included birth rates exceeding the third quartile among teens 10-14 and/or 18-19 years old. Panels of local experts reviewed these "hot spots" for accuracy and grouped them into 82 potential project areas on the basis of demographics, geography, and political infrastructure. Although there was substantial variation, localities with the highest teen birth rates tended to be characterized by minority overrepresentation, poverty, and poor prenatal care coverage. In addition to identifying areas with unmet need, this approach encourages community participation in program development.
This publication presents an overview of adolescent pregnancy, including national and state statistical information; funding sources for teen pregnancy prevention programs; examples of the effects of teen pregnancy prevention on society; illustrations of teenagers' perspectives on the issue; recent developments and initiatives in the arena of teen…
Barker, Linda Toms; Chan, Vincent; Eucogco, Jasmine
Objectives. To evaluate the effectiveness of Pono Choices, a culturally responsive adolescent pregnancy and sexually transmitted infection (STI) prevention program targeting middle school youths in Hawai‘i. Methods. We conducted a cluster randomized controlled trial with the school as the unit of random assignment over 3 semesters between 2012 and 2013. The sample consisted of 36 middle schools and 2203 students. We administered student surveys to collect baseline outcomes, student demographic data, and outcomes at 12 months after baseline. Results. We found statistically significant effects for the knowledge assessment, which focused on basic understanding of adolescent pregnancy and STI prevention. The average percentage of correct responses was 73.6 for the treatment group and 60.4 for the control group (P < .001). We did not find statistically significant effects on behavioral outcomes (initiation of sexual activity or engagement in high-risk sexual behavior) or on other nonbehavioral outcomes (attitudes, skills, intentions). Conclusions. Pono Choices had a statistically significant impact on knowledge of adolescent pregnancy and STI prevention among middle school students at 12 months after baseline, though it did not lead to detectable changes in behavioral outcomes within the 1-year observation period. These results call for an exploration of longer-term outcomes to assess effects on knowledge retention and behavioral changes. PMID:27689477
Crosby, Richard A; DiClemente, Ralph J; Wingood, Gina M; Cobb, Brenda K; Harrington, Kathy; Davies, Susan L; Hook, Edward W; Oh, M Kim
This study of 522 African American female adolescents, ages 14 to 18, investigated associations between condom use and infrequently communicating with sex partners about sexually transmitted diseases (STDs) and pregnancy prevention. Correlates of infrequent communication were identified. Sexually active adolescents were recruited from schools and adolescent medicine clinics in low-income neighborhoods of Birmingham, Alabama. Adolescents completed a self-administered survey and face-to-face interview. Communication frequency was assessed using a five-item scale. Infrequent communication was significantly associated with lower odds of condom use. Multivariate correlates of infrequent communication were less frequent communication with parents about STD/pregnancy prevention, recent sex with a nonsteady partner, low perceived ability to negotiate condom use and fear of this negotiation, and low motivation to use condoms. Given the importance of partner communication in promoting safer sex behaviors, STD and pregnancy prevention programs may benefit adolescents by addressing the identified psychosocial correlates of infrequent communication with their partners.
Ounce of Prevention Fund.
This booklet describes two prevention programs, Peer Power, a program for girls, and Awareness and Development for Adolescent Males (ADAM), a program for boys. It is noted that these programs, designed to reach students before high school age, help young adolescents stay in school, delay sexual activity and pregnancy, and develop realistic career…
Johnson, Glen D; Mesler, Kristine; Kacica, Marilyn A
Objective The objective is to estimate community needs with respect to risky adolescent sexual behavior in a way that is risk-adjusted for multiple community factors. Methods Generalized linear mixed modeling was applied for estimating teen pregnancy and sexually transmitted disease (STD) incidence by postal ZIP code in New York State, in a way that adjusts for other community covariables and residual spatial autocorrelation. A community needs index was then obtained by summing the risk-adjusted estimates of pregnancy and STD cases. Results Poisson regression with a spatial random effect was chosen among competing modeling approaches. Both the risk-adjusted caseloads and rates were computed for ZIP codes, which allowed risk-based prioritization to help guide funding decisions for a comprehensive adolescent pregnancy prevention program. Conclusions This approach provides quantitative evidence of community needs with respect to risky adolescent sexual behavior, while adjusting for other community-level variables and stabilizing estimates in areas with small populations. Therefore, it was well accepted by the affected groups and proved valuable for program planning. This methodology may also prove valuable for follow up program evaluation. Current research is directed towards further improving the statistical modeling approach and applying to different health and behavioral outcomes, along with different predictor variables.
Glassman, Jill R.; Franks, Heather M.; Baumler, Elizabeth R.; Coyle, Karin K.
Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable…
Dryfoos, Joy G.
This report presents an overview of programs that may have a potential for prevention of teenage pregnancy. The report starts with a summary of expert opinions on the dimensions of and solutions to the problem and then describes several relatively successful programs. Following this is an overview of interventions with an analysis of program…
Jensen, Jo Anne G; Moreno, Elizabeth L; Rice, Tara M
The Office of Adolescent Health (OAH) developed a systematic approach to review for medical accuracy the educational materials proposed for use in Teen Pregnancy Prevention (TPP) programs. This process is also used by the Administration on Children, Youth, and Families (ACYF) for review of materials used in the Personal Responsibility Education Innovative Strategies (PREIS) Program. This article describes the review process, explaining the methodology, the team implementing the reviews, and the process for distributing review findings and implementing changes. Provided also is the definition of "medically accurate and complete" as used in the programs, and a description of what constitutes "complete" information when discussing sexually transmitted infections and birth control methods. The article is of interest to program providers, curriculum developers and purveyors, and those who are interested in providing medically accurate and complete information to adolescents.
Holt, K. A., Ed.; Langlykke, K., Ed.
This resource guide was compiled to assist state, county, and community personnel in developing comprehensive adolescent health programs which address adolescent pregnancy, prevention, and care. It includes a broad range of topics with materials suitable for both professionals and consumers and for use by regional, state, and local government…
de Anda, Diane
In Los Angeles County, the GIG intervention offers education to adolescents about pregnancy and sexually transmitted infections at a social event geared to the youth culture. Pre- and posttests completed by 609 Latino adolescents indicated an increase in knowledge and attitude changes. Use of peer educators was an important component of program…
Margolis, Amy Lynn; Roper, Allison Yvonne
After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation.
Bouris, Alida; Guilamo-Ramos, Vincent; Jaccard, James; McCoy, Wanda; Aranda, Diane; Pickard, Angela; Boyer, Cherrie B
The purpose of the present study was to examine the feasibility of conducting a parent-based intervention in a pediatric health clinic to prevent HIV, sexually transmitted infections (STIs), and unintended pregnancies among urban African American and Latino youth. Eight focus groups were conducted with health care providers, adolescent patients and the mothers of adolescent patients (n = 41) from December 2007 to February 2008. All participants were recruited from a community-based pediatric health clinic in the Bronx, New York. Content analysis of focus group transcripts identified results in three primary areas: (1) the role of parents and providers in preventing HIV, STDs and unintended pregnancies among adolescents, (2) feasibility of the intervention in the clinic setting; and (3) optimal recruitment, retention and intervention delivery strategies. Study results suggest that a parent-based intervention delivered in a community-based pediatric health clinic setting is feasible. Focused recommendations for intervention recruitment, delivery, and retention are provided.
Godfrey, Emily M
The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent teenage pregnancy is through the use of effective birth control methods. The Centers for Disease Control (CDC) and Prevention has made the prevention of teenage pregnancy 1 of its 10 winnable battles. The CDC has released 2 evidence-based clinical guideline documents regarding contraceptive use for adolescents and adults. The first guideline, US Medical Eligibility Criteria for Contraceptive Use, 2010, helps clinicians recognize when a contraceptive method may not be safe to use for a particular adolescent but also when not to withhold a contraceptive method that is safe to use. The second document, US Selected Practice Recommendations for Contraceptive Use, 2013, provides guidance for how to use contraceptive methods safely and effectively once they are deemed safe. Health care providers are encouraged to use these documents to provide safe and effective contraceptive care to patients seeking family planning, including adolescents.
Danziger, Sandra; Farber, Naomi
This digest reviews trends in adolescent sexual activity and discusses conceptual and programmatic approaches to pregnancy prevention. It discusses a pregnant adolescent's choices for resolving an unplanned pregnancy (i.e. abortion, adoption, keeping the baby, and marriage), and the challenges faced by teenage parents. The final section touches on…
Trad, P V
Even in the best of circumstances, pregnancy is a time of emotional upheaval. This is especially true for pregnant adolescents who are also attempting to adjust to pubertal status and to establish an identity independent from their family. Although research has focused on the etiology of teenage pregnancy, relatively few interventions consider the developmental obstacles encountered when treating pregnant teenagers. In particular, adolescents are cognitively unprepared to predict long-term outcomes, a skill essential for confronting the challenges of pregnancy. One new intervention, known as previewing, seeks to overcome this deficit. Previewing encourages expectant teenage mothers to represent future scenarios with the infant as a means of predicting and rehearsing adaptive outcomes.
Poe, Elisabeth S.; And Others
This guide advocates an alliance among diverse groups for the purpose of decreasing the incidence of adolescent pregnancy and improving the outcome of pregnancies that do occur. It provides useful information for communities interested in developing pregnancy prevention activities. Statistics about adolescent pregnancies are given and the…
The adolescent at risk for suicidal preoccupation and behavior has become an increasing concern for schools and communities. This paper presents some of the causes of teen suicide, things adults should know about adolescent suicide prevention, and what can be done to help such youth. The transition to adolescence is a complex time when many values…
... before and during pregnancy: Protect yourself from Zika virus. Zika virus can be passed from a pregnant woman to ... to her baby around the time of birth. Zika virus infection during pregnancy can cause microcephaly (a birth ...
The International Center for Research on Women (ICRW) is investigating factors which affect the nutritional status of adolescent girls in Benin, Cameroon, Ecuador, Guatemala, India, Jamaica, Mexico, Nepal, and the Philippines. The research is funded through the US Agency for International Development's Office of Nutrition. 22.5% of women in Nepal marry before they reach age 14 years, with most marrying before age 18. The research in the country has found pregnancy to be a burden among these young women which threatens their nutritional and health status as well as that of their offspring. Unequal distribution of food in the household and heavy workloads increase the level of risk faced by adolescent females. Postponing pregnancy in adolescents, however, delays the onset of increased nutritional needs in girls who are already likely to be undernourished. Delayed pregnancy also gives girls more time to complete their physical growth and avoids the risk of medical emergencies in childbirth, such as hemorrhage which, if survived, can lead to anemia which is aggravated by nutritional deficiencies. The ICRW has therefore proposed four strategies for postponing first births among female adolescents: encouraging later marriage, providing family planning and reproductive health services specially for adolescents, providing family life education about options for the future, and increasing educational opportunities for girls.
Clear, specific information about sexual behavior and its consequences is frequently not provided to adolescents by their families, schools and communities. The "sex education" that many receive comes from misinformed or uninformed peers.
Domenico, Desirae M.; Jones, Karen H.
Adolescent pregnancy has occurred throughout America's history. Only in recent years has it been deemed an urgent crisis, as more young adolescent mothers give birth outside of marriage. At-risk circumstances associated with adolescent pregnancy include medical and health complications, less schooling and higher dropout rates, lower career…
Fuller, Taleria R; White, Carla P; Chu, Jocelyn; Dean, Deborah; Clemmons, Naomi; Chaparro, Carmen; Thames, Jessica L; Henderson, Anitra Belle; King, Pebbles
Addressing the social determinants of health (SDOH) that influence teen pregnancy is paramount to eliminating disparities and achieving health equity. Expanding prevention efforts from purely individual behavior change to improving the social, political, economic, and built environments in which people live, learn, work, and play may better equip vulnerable youth to adopt and sustain healthy decisions. In 2010, the Centers for Disease Control and Prevention in partnership with the Office of Adolescent Health funded state- and community-based organizations to develop and implement the Teen Pregnancy Prevention Community-Wide Initiative. This effort approached teen pregnancy from an SDOH perspective, by identifying contextual factors that influence teen pregnancy and other adverse sexual health outcomes among vulnerable youth. Strategies included, but were not limited to, conducting a root cause analysis and establishing nontraditional partnerships to address determinants identified by community members. This article describes the value of an SDOH approach for achieving health equity, explains the integration of such an approach into community-level teen pregnancy prevention activities, and highlights two project partners' efforts to establish and nurture nontraditional partnerships to address specific SDOH.
Clark, J F; Westney, L S; Lawyer, C J
A five-year update of a previous 20-year study of adolescent pregnancy is presented. For the 25-year period, data were collected on 2,789 adolescents. Prematurity and low birth weight infants continue to have a high incidence in adolescent pregnancy. This study found that there has been a significant decrease in preeclampsia and toxemia of pregnancy and a large increase in the incidence of cesarean section.
Fleming, Nathalie; O'Driscoll, Teresa; Becker, Gisela; Spitzer, Rachel F; Allen, Lisa; Millar, Debra; Brain, Philippa; Dalziel, Nancy; Dubuc, Elise; Hakim, Julie; Murphy, Deanna; Spitzer, Rachel
Objectif : Décrire les besoins des adolescentes enceintes au Canada (y compris celles qui sont issues de populations particulières) et les pratiques factuelles propres aux soins qui doivent être offerts à ces femmes. Issues : Grossesses saines chez les adolescentes au Canada; offre de soins sûrs au plan culturel et adaptés à l’âge pour assurer l’obtention des meilleures issues possibles pour ces jeunes femmes, leurs enfants et leur famille; et réduction des taux de grossesse à répétition. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PUBMED et The Cochrane Library le 23 mai 2012, au moyen d’un vocabulaire contrôlé (p. ex. « Pregnancy in Adolescence ») et de mots clés (p. ex. « pregnancy », « teen », « youth ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs. Les résultats ont été limités aux articles publiés en anglais ou en français à partir de 1990. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’au 6 juillet 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats a été évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé préventifs (Tableau). Avantages, désavantages et coûts : La présente directive clinique a été conçue pour aider les praticiens canadiens à offrir aux adolescentes enceintes des soins
Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong
Aims To examine the relationship between personality, pregnancy and birth outcomes in adolescents Background Personality has been shown to be a strong predictor of many health outcomes. Adolescents who become pregnant have worse birth outcomes than adults. Design Cross-sectional study using data from the National Longitudinal Study of Adolescent Health (baseline, 1994-1995; follow-up, 2007-2008). Methods The study sample was 6529 girls, 820 of whom reported on pregnancy outcomes for a teenage birth. Personality data was taken from the Mini International Personality Item Pool personality tool, which measures the five-factor personality traits of neuroticism, conscientiousness, intellect/imagination, extraversion and agreeableness. Logistic regression was used to predict teen pregnancy and linear regression was used to predict birth weight and gestational age with adjustment for confounders and stratification by race. Results Agreeableness and intellect/imagination were associated with a reduced likelihood of becoming pregnant as an adolescent, while neuroticism, conscientiousness and extraversion were all associated with an increased likelihood of becoming pregnant. Higher neuroticism was associated with lower birth weight and gestational age among Black girls, but not non-Black. Conscientiousness was associated with lower gestational age among non-Black girls. No relationships were found with extraversion or agreeableness and birth outcomes. Receiving late or no prenatal care was associated with higher intellect/imagination. Conclusions Personality is understudied with respect to pregnancy and birth outcomes compared with other health outcomes. Such research could help professionals and clinicians design and target programs that best fit the characteristics of the population most likely to need them, such as those with high neuroticism. PMID:25040691
Capuzzi, Dave; Golden, Larry
This book deals with the realities of adolescent suicide. It consists of 15 chapters organized under 5 major headings: The Problem of Adolescent Suicide (chapters 1 and 2); A Profile of the Attempter (chapters 3-6); Assessing Lethality (chapters 7 and 8); Prevention and Intervention (chapters 9-14); and Legal Issues (chapter 15). Individual…
Ireson, C J
This study seeks to link adolescent pregnancy with several aspects of sex-role traditionality and other variables that may be related to sex roles. It is hypothesized that orientation to traditional sex roles is related to the occurrence of pregnancy among sexually active teenagers. For the study sample of teenage females receiving birth control or pregnancy testing services, it is hypothesized that the pregnant teenagers will be more likely than other teenagers to be oriented toward traditional sex roles. The sample consisted of 161 young women, ranging in age from 13-18, with an average age of 16.5 years. Data were collected at selected health related agencies in a city in the Pacific Northwest by staff members who were blind to the hypotheses of the study. The respondents usually completed a brief questionnaire while they waited for a desired service. Of the total sample, 43 were pregnant; 34 had positive pregnancy tests and 9 others already knew they were pregnant when they filled out the questionnaire. 82 obtained birth control information or services and 36 experienced negative pregnancy tests. These groups are referred to as the pregnant group, the birth control group, and the negative pregnancy test group. Sex role values were determined by asking the respondent to indicate degree of agreement or disagreement with a series of opinion statements. The results provide some support for the main hypothesis. Pregnant teenagers were more likely than others to be oriented toward traditional sex roles. Pregnant teenagers, when compared with the birth control seeking group, showed more traditional sex-typing of activities, lower educational expectations and occupational aspirations, lower grades, and were more likely to have dropped out of school. There was only 1 significant difference between the pregnant adolescents and those in the negative pregnant test group. The pregnant teens had lower educational expectations. When all the independent and control variables
Dryfoos, J G
Of more developed nations, the US is unique in its problem with high rates of teen pregnancy. At the heart of our failure to check teen pregnancy may lie the country's poor sexual climate, a lack of government commitment, poor health system performance, local barriers to the provision of quality sex education, and/or lack of access to contraception. Potential solutions to reduce teen pregnancy are equally wide-ranging. Programs may aim to provide better and more health and sex education, improve decision making skills, improve access to contraception and abortion, improve life opportunities as alternatives to pregnancies, restructure welfare, and/or encourage youths to refrain from premarital sex. This essay presents and discusses major prevention efforts which seem to have the highest probability of reducing pregnancy rates, and especially childbearing rates among young, unmarried teens. Literature on program successes, agency reports, and program observations are reviewed, and include programs of sex education and skills enhancement, those helping sexually active youths become better contraceptors, and those which offer life option alternatives. In the area of improving access to contraception, school-based clinics, condom distribution, and other male-oriented programs are covered. Major social structural change is, however, called for with a view to promoting equity in education, housing, and jobs. Short of such change, interventions may target school-based populations, as well as community centers to reach dropouts. Early intervention and collaboration to bolster health, social, and recreational services for children and adolescents is urged.
Monterosa Castro, A
According to the 1990 Demographic and Health Survey, 21% of fertile-aged women in Colombia are adolescents aged 15-19. Research throughout the world has revealed that young people are initiating their sexual lives at ever earlier ages, due to earlier sexual maturation, constant erotic stimuli, and a mistaken understanding of sexuality. A Colombian survey showed that 49% of males and 11% of females had sex by age 18. Earlier sexual activity is leading to increased incidence of unwanted pregnancy. 78 of each 1000 adolescents become mothers each year. Among adolescents aged 16-18 with positive pregnancy tests at the Profamilia Adolescent Clinic in Bogota, 80% did not use contraception and 85% did not with to be pregnant. Unwanted adolescent pregnancy is usually traumatic, with implications for all areas of life. None of the options open to an adolescent with an undesired pregnancy is desirable. Keeping the baby exposes the mother to ostracism and rejection by the family, expulsion from school, and societal rejection. Forced marriages almost always end in separation. Adoption leads to frustration and feelings of guilt in the future. Abortion in Colombia is illegal and exposes the women to emotional and physical trauma and to risk of death or injury. The unwanted child is at risk of mistreatment, abandonment, or rejection. A demographic survey by Profamilia showed that 25% of Colombian women are mothers by age 19. 62% of uneducated adolescents are mothers by this age. Low educational level is associated with early pregnancy and limited economic opportunity. Adolescents are at higher risk of pregnancy complications due to physiological immaturity, stress, poor adaptability to pregnancy, and inadequate prenatal care. Adolescent pregnancy should be prevented. The prevention should be achieved through integrated sex education beginning at the first contact of the child with the world outside the family. The child should learn basic concepts of self-esteem, values, and
Cunningham, Michael R.; van Zyl, Michiel A.; Antle, Becky F.; Langley, Cheri N.
Objectives. To test the efficacy of Reducing the Risk (RTR) and Love Notes (LN) on reducing risky sexual behavior among youths yet to experience or cause a pregnancy. Methods. The four dependent variables were ever had sex, condom use, birth control use, and number of sexual partners at 3- and 6-month follow-up in a 3-arm cluster randomized controlled trial of 1448 impoverished youths, aged 14 to 19 years, in 23 community-based organizations in Louisville, Kentucky, from September 2011 through March 2014. Results. At 3 and 6 months, compared with the control condition, youths in RTR reported fewer sexual partners and greater use of birth control. At 6 months, LN participants reported greater use of birth control and condoms, fewer sexual partners, and were less likely to have ever had sex compared with the control condition. Conclusions. We provided additional evidence for the continued efficacy of RTR and the first rigorous study of LN, which embeds sex education into a larger curriculum on healthy relationships and violence prevention. PMID:27689500
Novick, Lloyd F; Cibula, Donald A; Sutphen, Sally M
This case-prevention of adolescent suicide-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. This teaching case examines the issue of prevention of adolescent and young adult suicide both at an individual and at a population or community level, using data from the Onondaga County Health Department. In the first section of the case, students are asked to determine whether five deaths related to falling or jumping at a local shopping mall should be considered to be suicidal deaths. Students then develop skills in the reporting as well as in the epidemiology of adolescent suicidal deaths in Onondaga County. As the case progresses, students analyze the results of a local surveillance study of suicidal attempts and ideation. The case concludes with students evaluating a hypothetical screening study intended to reduce the risk of suicidal death and discussing a research design to examine the effectiveness of this prevention strategy.
Trad, Paul V.
Discusses a method of adolescent pregnancy intervention that addresses the developmental needs of the adolescents. The previewing process alerts the mother to the imminent developmental trends that her infant will soon be undergoing. Adolescent mothers can also learn how to preview their own maturational changes. (GCP)
Lau, May; Lin, Hua; Flores, Glenn
The study purpose was to use recursive partitioning analysis (RPA) to identify factors that, when clustered, are associated with a high prevalence of pregnancy involvement among US adolescent males. The National Survey of Family Growth is a nationally representative survey of individuals 15-44 years old. RPA was done for the 2002 and 2006-2010 cycles to identify factors which, when combined, identify adolescent males with the highest prevalence of pregnancy involvement. Pregnancy-involvement prevalence among adolescent males was 6 %. Two clusters of adolescent males have the highest pregnancy-involvement prevalence, at 84-87 %. In RPA, the highest pregnancy-involvement prevalence (87 %) was seen in adolescent males who ever HIV tested, had >4 lifetime sexual partners, reported less than an almost certain chance of feeling less physical pleasure with condom use, had an educational attainment of <11th grade, and had ≤2 sexual partners in the past 12 months. Adolescent males who ever HIV tested, had >4 lifetime sexual partners, reported less than an almost certain chance of feeling less physical pleasure with condom use, had an educational attainment ≥11th grade, were >17 years old, and had their first contraceptive education ≥10th grade, had a pregnancy-involvement prevalence of 84 %. Pregnancy-prevention efforts among adolescent males who have been involved in a pregnancy may need to target risk factors identified in clusters with the highest pregnancy prevalence to prevent subsequent pregnancies in these adolescent males and improve their future outcomes.
Minnis, A M; Moore, J G; Doherty, I A; Rodas, C; Auerswald, C; Shiboski, S; Padian, N S
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.
Methods for conducting community guide systematic reviews of evidence on effectiveness and economic efficiency of group-based behavioral interventions to prevent adolescent pregnancy, human immunodeficiency virus, and other sexually transmitted infections: comprehensive risk reduction and abstinence education.
Sipe, Theresa Ann; Chin, Helen B; Elder, Randy; Mercer, Shawna L; Chattopadhyay, Sajal K; Jacob, Verughese
This paper describes methods used to conduct systematic reviews and meta-analyses and economic reviews of group-based behavioral interventions for adolescents to prevent pregnancy, HIV, and other sexually transmitted infections. The steps described include developing a conceptual approach, defining the interventions, identifying outcome and moderator variables, searching the literature, abstracting the data, and analyzing the results. In addition, identification of potential harms and benefits, applicability of results, barriers to implementation, and research gaps are described.
Johnson, Clara L.
Adolescent pregnancy is examined from 2 viewpoints: (1) the marital status of young adolescent girls who become mothers at a too young age is less relevant to the social problem of adolescent pregnancy than the attendant adverse effects, i.e., adolescent pregnancy, per se, rather than illegitimacy is the social problem; and (2) too early marriage…
This discussion reviews the approaches used to prevent teen pregnancy, explores ways of measuring the effects of these activities, and includes examples of programs whose effects have been documented. To avoid unintended pregnancy among young persons, 2 conditions must be met: they must have the capacity and a reason to want to control their fertility. Programs directed toward building capacity include sexuality and family life education and birth control services. Programs directed toward developing a reason for avoiding unintended pregnancy include improving the quality of life and expanding opportunities. Numerous studies have shown that sex education can enhance knowledge, at least in the short term, but little evidence exists that school-based sexuality education, per se, has an effect on attitudes, sexual activity, or contraceptive use. This conclusion has not been put to a real test with controls for the quality of the curriculum and the teaching. 2 new trends are developing as efforts are made to upgrade the quality of the education and to introduce concepts that include the life options approach: sex education is combined with vocational guidance and emerges as "life planning;" and the use of training in decision making to assist the student to take control of her life. Preliminary evaluations of the life planning approach suggest a high degree of user satisfaction and interest but no apparent behavioral changes. Evaluation of the problem-solving method, while based on a very small sample, shows a lessening of risk-taking behavior and an increase in contraceptive use among those who did decide to become sexually active. Whether or not teenagers use contraception obviously is related to pregnancy prevention. For the US as a whole, evidence exists that fertility in areas with clinics has decreased more than in areas without clinic, but that fact offers little upon which to base program design. A new study conducted in Baltimore will show lower pregnancy
It is important to bridge the gap between clinical research and counseling practice. The "I Have a Future" (IHAF) program was designed by professionals affiliated with Meharry Medical College in Nashville, Tennessee to serve inner-city African American youths identified as "high risk" for premature pregnancies, drug/alcohol…
Andrade, Ana Gonçalves; Rocha, Sara; Marques, Catarina O; Simões, Mafalda; Martins, Isabel; Biscaia, Isabel; F Barros, Carlos
Key Clinical Message Ovarian pregnancy is one of the rarest types of extrauterine pregnancy. Its preoperative diagnosis remains a challenge since it presents quite similarly to tubal pregnancy and complicated ovarian cysts. Although in most cases, histology is necessary to confirm the diagnosis, we present an ovarian pregnancy in a teenager, correctly diagnosed during ultrasound examination. PMID:26576271
Flick, L H
Adolescent pregnancy and parenthood are increasingly common today and pose many problems for both the individual persons involved and society as a whole. For programs to address these issues successfully, factors associated with unintended pregnancy and resulting parenthood must first be identified and understood. This paper is a review of current research on the factors associated with the four steps leading to an adolescent becoming a parent. Being an adolescent parent requires taking a particular path at four crossroads: becoming sexually active, not using or incorrectly using contraceptives, carrying rather than aborting a pregnancy, and parenting rather than placing a child for adoption. Much research in the last 15 years has explored adolescent childbearing, but many studies only compared adolescent parents to nonparents to reach conclusions about differences in these groups. This review focuses on recent studies that explore the four processes, or crossroads, separately and it excludes studies that generalize and overlap these processes. Factors that influence adolescent behavior at multiple points on the path to parenthood indicate areas particularly relevant for preventive intervention. For instance, boyfriends exert influence at all four crossroads. Sexual activity and contraceptive use increase with longevity of relationships, yet closer relationships are less often associated with raising a child. Better general communication skills, and particularly an increased ability to discuss sexuality, increases use of contraceptives, and low educational and occupational aspirations appear to influence each successive turn toward parenthood. This summary of current research serves to highlight those individual, family, dyadic, and social factors that exert great impact on adolescent parenthood by influencing young people at each of the four crossroads. These factors suggest potentially effective points for intervention to reduce the incidence of adolescent
Jarvis, D. L.
Social workers, Cooperating with doctors, nurses, hospital social workers and educators in other helping systems, conducted a demonstration project described here, aimed at preventing illegitimate teenage pregnancy. (Author)
Hardy, Janet B.; Zabin, Laurie Schwab
An in-depth discussion of national and local statistics regarding teenage and adolescent pregnancy and the developmental issues involved opens this analysis. Problems and adverse consequences of adolescent pregnancy in an urban setting are explored using a city-wide random sample of adolescent births. A model pregnancy and parenting program and…
Moriarty Daley, Alison; Sadler, Lois S; Dawn Reynolds, Heather
Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15-19-year-old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher-order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the healthcare system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood.
Daley, Alison Moriarty; Sadler, Lois S.; Reynolds, Heather Dawn
Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15–19 year old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the health care system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood. PMID:23522339
Glassman, Jill R.; Potter, Susan C.; Baumler, Elizabeth R.; Coyle, Karin K.
Introduction: Group-randomized trials (GRTs) are one of the most rigorous methods for evaluating the effectiveness of group-based health risk prevention programs. Efficiently designing GRTs with a sample size that is sufficient for meeting the trial's power and precision goals while not wasting resources exceeding them requires estimates of the…
This paper presents results from fiscal impact simulations of three national-level policies designed to prevent unintended pregnancy: A media campaign encouraging condom use, a pregnancy prevention program for at-risk youth, and an expansion in Medicaid family planning services. These simulations were performed using FamilyScape, a recently…
Flamer, Mary Guess; Davis, Elaine P.
The purpose of this guide for educators is to provide strategies that schools can adopt to discourage teenage pregnancy. The first section describes adolescent pregnancy in New Jersey, including education efforts to address adolescent pregnancy, and statistics on adolescent fertility. The second section addresses familial, media and peer effects…
National Agricultural Library (USDA), Washington, DC.
This annotated bibliography on nutrition and adolescent pregnancy is intended to be a source of technical assistance for nurses, nutritionists, physicians, educators, social workers, and other personnel concerned with improving the health of teenage mothers and their babies. It is divided into two major sections. The first section lists selected…
Floyd, R. Louise; Sobell, Mark; Velasquez, Mary M.; Ingersoll, Karen; Nettleman, Mary; Sobell, Linda; Mullen, Patricia Dolan; Ceperich, Sherry; von Sternberg, Kirk; Bolton, Burt; Skarpness, Bradley; Nagaraja, Jyothi
Background Prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities in the United States. Design A randomized controlled trial (2002–2005; data analyzed 2005–2006) of a brief motivational intervention to reduce the risk of an alcohol-exposed pregnancy (AEP) in preconceptional women by focusing on both risk drinking and ineffective contraception use. Setting/Participants A total of 830 nonpregnant women, aged 18–44 years, and currently at risk for an AEP were recruited in six diverse settings in Florida, Texas, and Virginia. Combined settings had higher proportions of women at risk for AEP (12.5% overall) than in the general population (2%). Interventions Participants were randomized to receive information plus a brief motivational intervention (n=416) or to receive information only (n=414). The brief motivational intervention consisted of four counseling sessions and one contraception consultation and services visit. Main Outcome Measures Women consuming more than five drinks on any day or more than eight drinks per week on average, were considered risk drinkers; women who had intercourse without effective contraception were considered at risk of pregnancy. Reversing either or both risk conditions resulted in reduced risk of an AEP. Results Across the follow-up period, the odds ratios (ORs) of being at reduced risk for AEP were twofold greater in the intervention group: 3 months, 2.31 (95% confidence interval [CI]=1.69–3.20); 6 months, 2.15 (CI=1.52–3.06); 9 months, 2.11 (CI=1.47–3.03). Between-groups differences by time phase were 18.0%, 17.0%, and 14. 8%, respectively. Conclusions A brief motivational intervention can reduce the risk of an AEP. PMID:17218187
Home economists who work with adolescents can help prepare them for responsible parenthood later in life by explaining the known causes of various birth defects; providing basic information about human genetics, prenatal nutrition, and drug and alcohol effects; and motivating adolescents to exercise increased responsibility in their sexual…
Silva, Lucía; Tonete, Vera Lúcia Pamplona
This qualitative study aimed to apprehend the meaning of adolescents' pregnancy for their families, using semistructured interviews and collective subject discourse. Adolescent pregnancy is represented as a problem to be faced with family support. The families worry and are mobilized to solve adversities. Besides the shock about the news, impotence as to pregnancy prevention, conformism, happiness and improvement in family relationships due to the baby's arrival, participants evidenced frustration due to the interruption/change in the family life project in terms of the adolescent being pregnant without a stable relationship with the child's father. In valuing the family perspective on adolescent pregnancy, professional care to pregnant adolescents and their families can be delivered in partnership with the family and social context, making it easier to cope with conflicts and recognizing the family as an active subject in this process.
Micks, Elizabeth; Raglan, Greta B; Schulkin, Jay
Steroid hormones have been in use for more than a half a century as contraceptive agents, and only now are researchers elucidating the biochemical mechanisms of action and non-target effects. Progesterone and synthetic progestins, critical for women's health in the US and internationally, appear to have important effects on immune functioning and other diverse systems. Apart from the contraceptive world is a separate field that is devoted to understanding progesterone in other contexts. Based on research following a development timeline parallel to hormonal contraception, progesterone and 17-hydroxyprogesterone caproate are now administered to prevent preterm birth in high-risk pregnant women. Preterm birth researchers are similarly working to determine the precise biochemical actions and immunological effects of progesterone. Progesterone research in both areas could benefit from increased collaboration and bringing these two bodies of literature together. Progesterone, through actions on various hormone receptors, has lifelong importance in different organ systems and researchers have much to learn about this molecule from the combination of existing literatures, and from future studies that build on this combined knowledge base. PMID:26581227
Tolli, M. V.
Peer education remains a popular strategy for health promotion and prevention, but evidence of its effectiveness is still limited. This article presents a systematic review of peer education interventions in the European Union that were published between January 1999 and May 2010. The objective of the review is to determine the effectiveness of…
Adolescent pregnancy may occur when childhood developmental needs have not been met adequately. Once the needs have been identified, intervention for the adolescent and her child can be tailored to fill developmental gaps. (Author/MT)
Obstfeld, Lisa S.; Meyers, Andrew W.
This article addresses the issue of adolescent sex education as a means of preventing sexuality-related disorders, including: sexual dysfunction; sexual deviance; physical health problems often contracted from sexual activity; and various psychological and sociological ill effects resulting from unplanned pregnancies. (Author/CJB)
Bryant, Kellie D
Adolescent pregnancy is a social issue that severely jeopardizes the quality of life for young parents and their children. It is estimated that if fertility rates remain unchanged, the United States will see a 26% increase in the number of adolescent pregnancies and births due to an increase in the adolescent population (Henshaw, 1996). With a disproportional rate of Black adolescents becoming pregnant, there is a need to examine factors related to the high adolescent pregnancy rate among the Black community. Black adolescent mothers and their children face additional adverse psychosocial effects due to healthcare disparities, a higher incidence of health problems, and an increase risk of financial hardship (Hogan, Astone, & Kitagawa, 1985; J. V. Horn, 1998; Morgan, Chapar, & Fisher, 1995). Although the teenage pregnancy rate has declined, it is important for practitioners to continue to implement interventions that promote abstinence and increase contraceptive use among sexually active adolescents.
Atkin, Lucille C.; Alatorre-Rico, Javier
Adolescent childbearing has historically been a relatively frequent phenomenon in Mexico and has only recently begun to decline. This study was designed to identify to what extent urban Mexican adolescents, who became pregnant out-of-wedlock and who carried their pregnancy to term, received social support during pregnancy and their emotional…
Rode, Line; Tabor, Ann
The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2-3% of all pregnancies but constitute at least 10% of cases of preterm delivery. Complications from preterm birth are not limited to the neonatal period, such as in retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, respiratory disorder and sepsis; they can also constitute sequelae such as abnormal neurophysiological development in early childhood and underachievement in school. Several treatment modalities have been proposed in singleton high-risk pregnancies. The mechanism of initiating labour may, however, be different in singleton and twin gestations. Therefore, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies.
Varga, Christine A
Although African adolescents' risk of undergoing abortion and of related health complications is well-documented, little is known about the procedure's prominence in their lives and the pathways that lead to their reliance upon it. This study investigates abortion dynamics among male and female Zulu adolescents in KwaZulu/Natal, South Africa. It explores the role of abortion in young people's sexual and reproductive experience, its acceptability, the reasons and likelihood of young people's choosing abortion, and the commonly used methods of pregnancy termination. The study, a rural-urban comparison using focus-group discussions, narrative workshops, and role playing, involved surveys and in-depth interviews. Factors contributing to the commonplace nature of backstreet procedures among adolescents include: social stigma, inadequate knowledge of the legal status of abortion, and a complex group decisionmaking process. Young people invoke "relative moralities" concerning adolescent abortion, recognizing and condoning it on a context-specific basis. Age, gender, and geographic differences are examined. The methodological triangulation used offers the opportunity for alternative theoretical and methodological approaches to research on abortion-related issues.
Loveland-Cherry, C J
Substance abuse often begins in adolescence and is a major factor determining health outcomes for adolescents and adults; thus, it is an important focus for prevention strategies. The use of drugs, especially alcohol, can lead to chronic addiction to substances as well as contribute to a number of common chronic conditions. These conditions include cancer, cardiovascular disease, disability from accidents or violence, and unplanned pregnancy and are major causes of morbidity and mortality among adolescents and adults. As the major social unit responsible for socialization of children and stabilization of adult personalities, the family has been the target of prevention efforts. In this chapter the empirical literature on family interventions to prevent substance use in adolescents is critically reviewed, generalizations and implications for practice identified, and directions for future research projected.
Gama, Silvana Granado Nogueira da; Szwarcwald, Célia Landmann; Leal Md, Maria do Carmo
This paper compares socioeconomic characteristics, prenatal care, and life styles of three groups of post-partum women, one consisting of adolescents (< 20 years) and the other two of women 20-34 years old, classified according to their history of pregnancy during adolescence. A sample of 3,508 post-partum women was selected from public hospitals in the city of Rio de Janeiro, Brazil, and interviewed just after childbirth. To verify the hypothesis of homogeneity of proportions, chi-square tests (chi2) were used. Comparing the three groups, the most adverse conditions were found among the 20-34-year-old mothers with a history of pregnancy during adolescence. These women have the least schooling, the highest rates of smoking and use of illegal drugs during pregnancy, and the fewest prenatal appointments. According to this study, prenatal care proved to be an effective compensatory policy for the prevention of prematurity and low birth weight, especially among adolescent mothers.
Miller-Johnson, Shari; C. Winn, Donna-Marie; Coie, John D.; Malone, Patrick S.; Lochman, John
This study examined childhood and adolescent risk factors for males' reports of getting someone pregnant during adolescence. These questions were examined in an urban sample of 335 African American males involved in a prospective, longitudinal study. Childhood aggression significantly predicted reported pregnancies during adolescence. Boys who…
Haider, Sadia; Stoffel, Cynthia; Donenberg, Geri; Geller, Stacie
Minority women and adolescent females of all races and ethnicities are disproportionately aﬀected by unintended pregnancy in the United States. Adolescents also experience an additional proportion of the burden compared to other age groups, as 82% of pregnancies among women 19 years old and younger are unintended. Moreover, minority and adolescent mothers are at increased risk for having preterm deliveries, low birth weight infants, and other complications. Unintended pregnancy continues to be an important public health problem in the United States, and prevention through family planning is urgently needed. This review presents an overview of the US demographics for unintended pregnancy among both minority and adolescent women and identifies current and past eüorts to reduce unintended pregnancy, specifically among minority and adolescent females, through contraception and family-planning programs.
Harrison, Abigail; Hoffman, Susie; Mantell, Joanne E.; Smit, Jennifer A.; Leu, Cheng-Shiun; Exner, Theresa M.; Stein, Zena A.
This pilot study evaluated a 15 session classroom intervention for HIV and pregnancy prevention among grade 8–10 boys and girls (ages 14–17) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. Main outcome: condom use at last sex; secondary outcomes: partner communication; gender beliefs and values; perceived peer behaviors; self-efficacy for safer sex. At five months post-intervention, change in condom use did not differ between intervention and comparison schools. Intervention school youth had greater increases in self-efficacy for unsafe sex refusal [OR=1.61; 95% CI=1.01, 2.57] and condom use [OR=1.76; 95% CI=1.07, 2.89], partner communication [OR=2.42; 95% CI=1.27, 4.23], and knowledge of HIV testing opportunities [OR=1.76; 95% CI=1.08, 2.87]. This gender-focused pilot intervention increased adolescents’ self-efficacy and partner communication, and has potential to improve preventive behaviors. PMID:27642267
Corcoran, Jacqueline; Pillai, Vijayan K.
Because subsequent pregnancy in teen parents often worsens the impact of adolescent parenting; therefore, a common goal of teenage parent programs has been to reduce repeat pregnancy. To examine the impact of this goal, a meta-analysis was conducted on 16 control-comparison group studies that evaluated the effect of teenage pregnancy and parenting…
Jensen, Jamie; Kenyon, DenYelle Baete; Hanson, Jessica D.
Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur preconceptually, either by reducing alcohol intake in women planning pregnancy or at risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American-Indian (AI) women is…
Atwood, J D; Donnelly, J W
Presented is a multi-systemic theoretical model of adolescent pregnancy that incorporates the school-peer-family-community systems and defines a role for health educators. It is noted that teenagers receive conflicting messages from the adolescent socialization community--all the institutions, individuals, and mass media that influence and shape development. To cope with these multiple, inconsistent messages, many adolescents respond with inconsistent behavior given the impossibility of pleasing all sources of influence. Health educators must coordinate the school-peer-family-community systems to achieve more congruence and less competition surrounding inputs into the daily life of young people. The potential to disseminate sex education is greatest in the school context, where information can be provided on a systematic, regular basis to reinforce learning. Since peers are a major reference group during adolescence, per counseling can be used effectively to discuss factors that lead to unwanted pregnancy and help clarify values. Sex education programs are strengthened by the involvement of parents, and interventions aimed at promoting parent-child communication around sexual issues have been demonstrated to delay the onset of sexual activity. The availability of an adolescent health clinic, either in the school or close by, has been shown to reduce adolescent pregnancy. Overall, the most effective adolescent pregnancy prevention programs are those that are comprehensive in substance and duration.
Kostenuik, Marcia; Ratnapalan, Mohana
Abstract OBJECTIVE To provide family physicians with an approach to suicide prevention in youth. SOURCES OF INFORMATION A literature review was performed using Ovid MEDLINE with the key words suicide, attempted suicide, and evaluation studies or program evaluation, adolescent. MAIN MESSAGE Youth suicide might be prevented by earlier recognition and treatment of mental illness. Family physicians can and should screen for mental illness in youth; there are many diagnostic and treatment resources available to assist with this. CONCLUSION Earlier detection and treatment of mental illness are the most important ways family physicians can reduce morbidity and mortality for youth who are contemplating suicide. PMID:20705879
de Azevedo, Walter Fernandes; Diniz, Michele Baffi; da Fonseca, Eduardo Sérgio Valério Borges; de Azevedo, Lícia Maria Ricarte; Evangelista, Carla Braz
Sexual activity during adolescence can lead to unwanted pregnancy, which in turn can result in serious maternal and fetal complications. The present study aimed to evaluate the complications related to adolescent pregnancy, through a systematic review using the Medical Subject Headings: “pregnancy complication” AND “adolescent” OR “pregnancy in adolescence”. Only full original articles in English or Portuguese with a clearly described methodology, were included. No qualitative studies, reviews or meta-analyses, editorials, case series, or case reports were included. The sample consisted of 15 articles; in that 10 were cross-sectional and 5 were cohort studies. The overall prevalence of adolescent pregnancy was 10%, and among the Brazilian studies, the adolescent pregnancy rate was 26%. The cesarean delivery rate was lower than that reported in the general population. The main maternal and neonatal complications were hypertensive disorders of pregnancy, prematurity and low birth weight, respectively. Adolescent pregnancy is related to increased frequency of neonatal and maternal complications and lower prevalence of cesarean delivery. PMID:26061075
Dehghan-Nayeri, Nahid; Tajvidi, Mansooreh
Background: Pregnancy rate among Iranian adolescents below 20 years of age is increasing. Pregnancy during adolescence is considered a social issue associated with medical, emotional, and social outcomes for the mother, child, and family. The current research examines the experience of pregnancy among Iranian adolescents. Materials and Methods: The qualitative content analysis method was used. A purposive sample of 14 pregnant adolescents was enrolled in the study. Deep interviews were carried out with them. Results: Three themes were came up after analyzing the interviews: 1. Psychological reactions including three subthemes of feelings, concerns, and fears; 2. physical reactions including the subthemes of symptoms and feelings; and 3. spiritual reactions including religious beliefs and faith. Conclusions: The present study showed that for the purpose of assessing pregnancy in adolescents, one should consider the context and culture in which the adolescent lives. This is because factors such as preplanned or unwanted pregnancy and imposed or consensual marriage within or outside the family may draw different reactions from adolescents. Hence, all those factors need to be considered in order to plan health education during pregnancy for this age group. PMID:25949255
Aruda, Mary M; Waddicor, Kathleen; Frese, Liesl; Cole, Joanna C M; Burke, Pamela
Health care providers are faced with many challenges when working with adolescents. Vague symptoms, unreliable menstrual history, and adolescent reluctance to disclose sexual activity present challenges to early diagnosis. When pregnancy is suspected, clinicians need skills for accurate diagnosis, conducting comprehensive assessments, and providing options counseling. Complexities of providing confidential care while balancing the needs of the adolescent and family may deter some clinicians. A clinical case scenario illustrates important elements of care. Through sharing lessons learned from 10 years of working in a Pregnancy Follow-up Clinic, the authors hope to empower other clinicians as they care for adolescents during this critical time.
Dufort, Francine; Boucher, Kathleen; Guilbert, Edith; Saint-Laurent, Louise; Fortin-Pellerin, Laurence
This study was undertaken to gather information on the social representations of teenage pregnancy among adolescents, aged between 15 and 17. Eighteen focus groups were conducted among 150 boys and girls. The data were subjected to a qualitative content analysis. Results show that youths did not form homogeneous groups. The points of view expressed gave rise to 4 dimensions (emotive, reflexive, psychobiological, economic-social) and 4 positions (negative, positive, ambivalent and dynamic). From these dimensions and positions, 4 representations of teenage pregnancy were identified: pregnancy as a problem, pregnancy as a project, pregnancy as a source of tension, and pregnancy as a source of power. This study illustrates the importance of educative strategies such as going beyond alarmist preventive messages, opening dialogue with and between youngsters, and promoting social support and mutual aid.
Williams, Julie E.; And Others
The Appalachian Adolescent Health and Education Project (AAHEP), in operation for 3 years, is a program designed to reduce adolescent pregnancy rates (prevention component) and provide care for pregnant teenagers (care component) in East Tennessee. Limitations in funding and service delivery prompted the AAHEP to modify its 15-county scope by…
Corkindale, Carolyn J; Condon, John T; Russell, Alan; Quinlivan, Julie A
Little is known about what factors adolescent males consider important when making decisions concerning the resolution of an unplanned pregnancy with a teenage partner. Young men's influence on pregnancy outcome decisions can play an important part in the subsequent psychological adjustment of the female. The present report draws on data from a larger study with teenage males [Condon, J. T., Corkindale, C. J., Russell, A., & Quinlivan, J. A. (2006). Processes and factors underlying adolescent males' attitudes and decision-making in relation to an unplanned pregnancy. Journal of Youth and Adolescence, 35, 447-458], and extends the findings of that study. Using a 25-item scale embedded in an electronic role-play, data were obtained from 330 male Australian school students on their priorities and concerns in relation to possible outcomes of a partner's pregnancy. Common factors taken into account by almost the entire adolescent sample related to the negative effects of becoming a teenage father. The differences between participants were identified using cluster analysis, which produced three groupings. The majority group was characterised as 'well-balanced' (80.6%), and the two minority groups as 'unwilling/unready' (10.9%) and 'family-centred' (8.5%). Group membership was strongly predictive of the males' final decision regarding the hypothetical pregnancy outcome. Understanding adolescent attitudes and beliefs when faced with this decision may assist practitioners in their guidance of the young couple and help prevent negative psychological sequelae.
Wesnes, Stian Langeland; Lose, Gunnar
Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease.
... Development Healthy Relationships has sub items, Healthy Relationships Bullying Dating Dating Violence Healthy Friendships LGBTQ Youth Mental ... Pregnancy & Childbearing Teen Pregnancy Prevention Program Trends Negative Impacts Strategies & Approaches for Prevention Engaging Adolescent Males in ...
Citizens for Missouri's Children, St. Louis.
This Kids Count report presents current information on adolescent pregnancy rates in Missouri. Part 1, "Overview of Adolescent Pregnancy in Missouri," discusses the changing pregnancy, abortion, and birth rates for 15- to 19-year-old adolescents, racial differences in pregnancy risk, regional differences suggesting a link between…
Mishra, Shitala P.; Ressler, Robert A.
This chapter discusses adolescent drug abuse relapse prevention. It presents the following four conclusions regarding the efficacy of prevention programs. First, more controlled studies are needed to evaluate the long-term effectiveness of relapse prevention strategies with adolescents in reducing factors such as cravings and increasing their…
Frankford, Evelyn R.
This program seeks to prevent adolescent pregnancy and childbearing through a community-based feminist social service program serving teenage girls. This DAWN program, Discovery and Awareness for Women Now, was initiated as a result of the Women's Movement which has had a serious and positive impact on the lives of most adult women. Yet, teenage…
Smith, Peggy B.; And Others
Study examined perceptions of pregnancy, including life-expectations, desire for pregnancy, and knowledge of menstrual cycle in a sample of pregnant urban adolescents. Results indicate that, although teens were aware of birth control methods, they had little understanding of menstrual cycle and its relationship to intercourse. And while few…
Lieberman, Lisa D.; Berlin, Cydelle; Palen, Lori-Ann; Ashley, Olivia Silber
Early adolescence is a crucial period for preventing teen pregnancy and sexually transmitted infections. This study evaluated STAR LO, a theater-based intervention designed to affect antecedents of sexual activity among urban early adolescents (N = 1,143). Public elementary/middle schools received the intervention or served as a wait-listed…
Vinovskis, Maris A.
Adolescent pregnancy (AP) is explored from historical and policy perspectives. The "epidemic" of AP, with 4 out of every 10 teenage girls becoming pregnant, is typically portrayed as a recent and unprecedented problem that requires massive federal intervention, but the problem is not new. Chapter 1 analyzes adolescent sexuality, AP, and…
Massey-Stokes, Marilyn S.
Discusses unhealthy dieting behaviors that can lead to eating disorders during adolescence. Outlines ways middle school and high school teachers and administrators can aid in the prevention of disordered eating among adolescents. Lists resources for eating disorders awareness and prevention. (SR)
Substance misuse is one of the most prevalent causes of adolescent injury and death. Additionally, 5-8% of adolescents in the U.S. qualify for a diagnosis of substance abuse disorder. This article discusses formal prevention and treatment program models, focusing on a continuum of care which extends from prevention to treatment alternatives.…
Mendelson, Tamar; Tandon, S Darius
This article discusses strategies and programs used to prevent depression in children and adolescents. It describes the rationale for depression prevention and discusses prevention approaches in schools and other settings, highlighting examples of programs that have been empirically evaluated. Prevention effects are small but significant, comparable or greater in magnitude than adolescent prevention programs for other issues, including substance use and human immunodeficiency virus. Future research should include rigorous design features, including attention control groups, allocation concealment, larger sample sizes, longer follow-up assessments, and theory-driven tests of moderation and mediation, and should test larger-scale implementation of prevention programs.
Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.
Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…
Journal of School Health, 1994
Examines issues in preventing further Human Immunodeficiency Virus (HIV) infection among adolescents, highlighting HIV and other sexually transmitted diseases, substance use, adolescent development, cultural and language diversity, health and social service needs, socioeconomic contexts, and role of media, school, and youth-serving organizations.…
Bottorff, Joan L; Poole, Nancy; Kelly, Mary T; Greaves, Lorraine; Marcellus, Lenora; Jung, Mary
Adolescent girls are more likely than women of other ages to smoke tobacco or drink alcohol during pregnancy. The health impacts of smoking and drinking for girls and the interconnections between alcohol and tobacco use with adolescent pregnancy underscore the urgent need for integrated approaches to prevent and reduce alcohol and tobacco use among pregnant girls/young women. This article reports on the results of a scoping review of the literature focused on adolescents’ use of tobacco and alcohol during pregnancy and postpartum. A search of CINAHL, Medline, Social Science Index and Web of Science identified 40 articles published in the two decades between 1990 and 2012 that met our inclusion criteria related to this age group, pregnancy/motherhood status, and use of both alcohol and tobacco. The review points to compelling gaps in our knowledge and our responsiveness to adolescents aged 19 and under who use alcohol and tobacco during pregnancy and the postpartum period. Research has been primarily descriptive, with separate, parallel streams of investigation to identify trends and predictors of alcohol and tobacco use, prior to, during and following pregnancy. There is a marked lack of effective interventions described in the literature that are designed to prevent or reduce alcohol and tobacco use during pregnancy among adolescent girls; and there are few examples of gender-informed prevention or treatment programmes for this population. Research is needed on interventions that attend to the context of adolescent girls’ substance use as well as their preferences and developmental needs for support that encourage sustained behaviour change throughout pregnancy and the postpartum period and that effectively address the influence of partners and friends on use. PMID:24405036
Pires, Raquel; Araújo-Pedrosa, Anabela; Canavarro, Maria Cristina
The aims of the current study were to examine the indirect effect of the perceived impact of pregnancy on quality of life (QoL) through the severity of depressive symptoms among a sample of pregnant adolescents, and to explore whether adolescents' satisfaction with support from their mothers (SM) or partners (SP) was a buffer of this effect. Demographic and pregnancy-related data were collected for 395 pregnant adolescents age 12-19 and were controlled for testing the proposed indirect effect. SM and SP were tested as moderators of the links between perceived impact of pregnancy and depressive symptoms and between depressive symptoms and QoL. A computational tool for path analysis-based moderation and mediation analysis as well as their combination was used to test indirect and interaction effects (PROCESS). A significant indirect effect of the perceived impact of pregnancy on QoL through the severity of depressive symptoms was found (0.51, CI = 0.29/0.78). There was no significant direct effect of the perceived impact of pregnancy on QoL after controlling for the severity of depressive symptoms. SM and SP buffered the indirect effect by weakening the association between a negative perception of the impact of pregnancy and higher severity of depressive symptoms. Identifying adolescents with a negative perception of the impact of pregnancy, improving the quality of their relations with their mothers and partners, and promoting satisfactory support from these figures may be extremely important to prevent and treat depressive symptoms and, in so doing, improve adolescents' QoL during pregnancy.
Farber, Naomi B.
Conducted in-depth interviews with both black and white unmarried adolescent mothers (n=28), from a variety of socioeconomic backgrounds, about their pregnancy resolution. Subjects revealed the importance of family members and other significant adults in the decision process. Analysis also indicated that personal, familial, and religious values…
Koshel, Jeffrey J.
This report provides a brief overview of state policies and programs to address the problems of adolescent pregnancy and parenting. Section 1, a brief introduction, is followed by a section which examines a broad set of state policies and programs affecting at-risk youth, including pregnant teenagers and teenage parents. The state-by-state review…
McCleary-Sills, Jennifer; Douglas, Zayid; Rwehumbiza, Annagrace; Hamisi, Aziza; Mabala, Richard
Adolescent pregnancy places girls at increased risk for poor health and educational outcomes that limit livelihood options, economic independence, and empowerment in adulthood. In Tanzania, adolescent pregnancy remains a significant concern, with over half of all first births occurring before women reach the age of 20. A participatory research and action project (Vitu Newala) conducted formative research in a rural district on the dynamics of sexual risk and agency among 82 girls aged 12-17. Four major risk factors undermined girls' ability to protect their own health and well-being: poverty that pushed them into having sex to meet basic needs, sexual expectations on the part of older men and boys their age, rape and coercive sex (including sexual abuse from an early age), and unintended pregnancy. Transactional sex with older men was one of the few available sources of income that allowed adolescent girls to meet their basic needs, making this a common choice for many girls, even though it increased the risk of unintended (early) pregnancy. Yet parents and adult community members blamed the girls alone for putting themselves at risk. These findings were used to inform a pilot project aimed to engage and empower adolescent girls and boys as agents of change to influence powerful gender norms that perpetuate girls' risk.
Wyman, Peter A.
The 2012 National Strategy for Suicide Prevention expands the current suicide prevention paradigm by including a strategic direction aimed at promoting healthy populations. Childhood and adolescence are key suicide prevention window periods, yet knowledge of suicide prevention pathways through universal interventions is limited (Aspirational Goal 11). Epidemiologic evidence suggests that prevention programs in normative social systems such as schools are needed for broad suicide prevention impact. Prevention trial results show that current universal prevention programs for children and young adolescents are effective in reducing adolescent emotional and behavioral problems that are risk factors for suicidal behavior, and in the case of the Good Behavior Game, suicide attempts. A developmentally sequenced upstream suicide prevention approach is proposed: (a) childhood programs to strengthen a broad set of self-regulation skills through family and school-based programs, followed by (b) adolescent programs that leverage social influences to prevent emerging risk behaviors such as substance abuse and strengthen relationships and skills. Key knowledge breakthroughs needed are evidence linking specific intervention strategies to reduced suicidal behaviors and mortality and their mechanisms of action. Short- and long-term objectives to achieve these breakthroughs include combining evidence from completed prevention trials, increasing motivators for prevention researchers to assess suicide-related outcome, and conducting new trials of upstream interventions in populations using efficient designs acceptable to communities. In conclusion, effective upstream prevention programs have been identified that modify risk and protective factors for adolescent suicide, and key knowledge breakthroughs can jump-start progress in realizing the suicide prevention potential of specific strategies. PMID:25145747
Sekiwunga, Richard; Whyte, Susan Reynolds
In Uganda teenage pregnancy is considered a problem for moral and social, as well as health, reasons. This qualitative stud,y in Busia District focused on the views of teenagers themselves as expressed in 9 focus group discussions with girls and boys. Their perspectives were contrasted with those of community leaders and mothers of adolescents. The young people blamed teenage pregnancy on failures of the parental generation. They asserted that parents and guardians were both too lenient and too harsh, that they failed to provide for their daughters' needs, and that they pressured them into early marriages instead of giving priority to education. Although poverty and family breakdown were recognized as underlying structural causes of parental failure, the teenagers experienced these factors in their everyday lives as problems with their parents and guardians. The teenagers expressed the 'enlightened' view that adolescent pregnancy was undesireable, even though many girls have few alternatives to marriage and childbearing.
Tevendale, Heather D; Condron, D Susanne; Garraza, Lucas Godoy; House, L Duane; Romero, Lisa M; Brooks, Megan A M; Walrath, Christine
This paper presents an overview of the key evaluation components for a set of community-wide teen pregnancy prevention initiatives. We first describe the performance measures selected to assess progress toward meeting short-term objectives on the reach and quality of implementation of evidence-based teen pregnancy prevention interventions and adolescent reproductive health services. Next, we describe an evaluation that will compare teen birth rates in intervention communities relative to synthetic control communities. Synthetic controls are developed via a data-driven technique that constructs control communities by combining information from a pool of communities that are similar to the intervention community. Finally, we share lessons learned thus far in the evaluation of the project, with a focus on those lessons that may be valuable for local communities evaluating efforts to reduce teen pregnancy.
Marsiglio, William; Menaghan, Elizabeth G.
Examined gender differences in adolescents' personal views about pregnancy resolution and family formation. Surveyed adolescents (n=577) using vignette involving unplanned pregnancy. Findings showed similar percentages of males and females preferred abortion and adoption as strategies for handling pregnancy, but females were more likely to select…
Pantin, Hilda; Schwartz, Seth J.; Sullivan, Summer; Prado, Guillermo; Szapocznik, José
The purpose of this article is to illustrate how an ecodevelopmental perspective on risk and protection can be applied to the study and prevention of unsafe sexual behavior in Hispanic immigrant adolescents. Special attention is given to culturally based ecodevelopmental risk and protective processes that may influence unsafe sexual behavior among Hispanic adolescents. Principles for designing prevention programs to offset these risks are offered on the basis of an ecodevelopmental HIV prevention program that has been developed and is currently being tested. PMID:15554814
Dierschke, Nicole; Lowe, Diana; Plastino, Kristen
Objectives. To assess whether a sexual health education intervention reduces pregnancy rates in high school students. Methods. We performed a secondary analysis of a 3-year quasi-experimental study performed in South Texas from 2011 to 2015 in which 1437 students without a history of pregnancy at baseline were surveyed each fall and spring. Potentially confounding risk factors considered included sexual behaviors, intentions, and demographics. The outcome measure was self-reported pregnancy status for male and female students. We performed analyses for male and female students using separate discrete time-to-event models. Results. We found no difference in pregnancy rates between intervention and comparison students within the first 3 years of high school. Female and male students in the intervention groups had pregnancy hazard ratios of, respectively, 1.62 (95% CI = 0.9, 2.61; P = .1) and 0.78 (95% CI = 0.44, 1.48; P = .4) relative to the comparison groups. Conclusions. The educational intervention had no impact on the pregnancy rate. Social media tools in pregnancy prevention programs should be adaptive to new technologies and rapidly changing adolescent preferences for these services. PMID:27689503
National Campaign To Prevent Teen Pregnancy, Washington, DC.
This report describes data from focus groups on teen pregnancy involving Hispanic parents of adolescents in four states. Participants wanted a good education for their children and positive, loving relationships with them. They wanted to communicate with their children and be closely involved in their lives. Most believed that to help prevent teen…
Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Dee, Deborah L; Koumans, Emilia H
Seeking to reduce teen pregnancy and births in communities with rates above the national average, the Centers for Disease Control and Prevention, in partnership with the U.S. Department of Health and Human Services Office of Adolescent Health Teen Pregnancy Prevention Program, developed a joint funding opportunity through which grantees worked to implement and test an approach involving community-wide teen pregnancy prevention initiatives. Once these projects had been in the field for 2.5 years, Centers for Disease Control and Prevention staff developed plans for a supplemental issue of the Journal of Adolescent Health to present findings from and lessons learned during implementation of the community-wide initiatives. When the articles included in the supplemental issue are considered together, common themes emerge, particularly those related to initiating, building, and maintaining strong partnerships. Themes seen across articles include the importance of (1) sharing local data with partners to advance initiative implementation, (2) defining partner roles from the beginning of the initiatives, (3) developing teams that include community partners to provide direction to the initiatives, and (4) addressing challenges to maintaining strong partnerships including partner staff turnover and delays in implementation.
East, Patricia L.; Reyes, Barbara T.; Horn, Emily J.
CONTEXT The extent to which young women’s risk of adolescent pregnancy is associated with having a mother who was a teenage parent, a sister who was a teenage parent or both is not known. METHODS A sample of 127 Latina and black adolescent females completed in-depth surveys at three time points between 1994 and 2000. Logistic regression analyses were used to examine whether socioeconomic factors, mothers’ parenting characteristics and certain sibling relationship qualities explain the association between a family history of teenage births and young women’s risk of pregnancy. RESULTS Compared with young women with no family history of teenage births, young women whose sister had had a teenage birth and those whose sister and mother both had had teenage births were significantly more likely to experience a teenage pregnancy (odds ratios, 4.8 and 5.1, respectively). Young women who had only a sister who had had a teenage birth had greater odds of pregnancy than young women who had only a mother who had had a teenage birth (4.5). Having both a mother and a sister who had had teenage births was independently associated with an elevated risk of pregnancy (3.7), even after controlling for socioeconomic and mothers’ parenting characteristics. Frequent companionship with an older sister was associated with increased odds of teenage pregnancy (4.5); frequent conflict with an older sister who had had a teenage birth was marginally associated with decreased odds of the outcome (0.3). CONCLUSION Pregnancy prevention interventions targeting young women according to maternal and sibling teenage birth histories may be effective. PMID:17565624
Hudson, Angela L
Adolescents in foster care are at risk for unplanned pregnancy and sexually transmitted infections, including HIV infection. A study using a qualitative method was conducted to describe how and where foster youth receive reproductive health and risk reduction information to prevent pregnancy and sexually transmitted infections. Participants also were asked to describe their relationship with their primary health care provider while they were in foster care. Nineteen young adults, recently emancipated from foster care, participated in individual interviews. Using grounded theory as the method of analysis, three thematic categories were generated: discomfort visiting and disclosing, receiving and not receiving the bare essentials, and learning prevention from community others. Recommendations include primary health care providers providing a confidential space for foster youth to disclose sexual activity and more opportunities for foster youth to receive reproductive and risk prevention information in the school setting.
Guilamo-Ramos, Vincent; Cherry, Kevin; Dittus, Patricia; Michael, Shannon; Gloppen, Kari
Latina adolescent parents are at increased risk for rapid repeat births (second birth ≤ 24 months after the first), sexually transmitted infections, and negative educational and social outcomes. Although several effective parent-based interventions have been developed to prevent Latino youths’ sexual risk taking, little research has explored the development of interventions to prevent repeat births that involve the parents of these adolescents. Existing preventative interventions involving parents suffer from important methodological limitations. Additional research is needed to advance theories of behavior, identify the causal pathways of parental influence, and specify appropriate behavioral targets. Future parent-based interventions to prevent repeat births should target pregnancy intentions, age of partners, contraceptive use, integrated prevention of pregnancies and sexually transmitted infections, educational attainment, and future orientations. PMID:22897524
Whalen, Mathilde Logan; Loper, Ann Booker
This study examines the association between the incarceration of a household member and adolescent pregnancy, and evaluates whether this association extends beyond that of other variables associated with sexual health. We used data from 12 waves of the National Longitudinal Survey of Youth: Child and Young Adult. After eliminating males and individuals who did not respond to key questions, a sample of 1,229 girls (ages 14-19) was analyzed. Girls who experienced the incarceration of a household member faced more demographic and family environment risk factors than those who did not. Regression analyses demonstrated that the addition of a household incarceration variable afforded superior prediction of teenage pregnancy relative to the prediction based on demographic and family features alone. Programs that are directed toward reducing teen pregnancy will benefit from attention to the home situation of the at-risk girl, particularly the experience of household member incarceration and related family dynamics.
Saxena, B B
The knowledge and use of newer, more sensitive, and reliable pregnancy tests which are easily accessible and of moderate cost are the 1st steps in the early diagnosis and management of pregnancy, especially in adolescent girls. Accurate diagnosis of pregnancy soon after conception offers the option of abortion by simple, effective, and inexpensive procedures or early initiation of prenatal maternity care. Discussion focuses on the symptoms of pregnancy and the historical development and basis of pregnancy tests as well as the specific types of pregnancy tests. The most familiar sign of pregnancy is the missed period. Other symptoms that provide presumptive evidence of pregnancy include fatigue and lassitude, increased body temperature, and breast fullness or pain. Feelings of nausea, vomiting, and weight gain may appear after 2 weeks. The diagnosis of pregnancy by the detection of the human chorionic gonadotropin was initially described 53 years ago by Selmar Aschheim and Bernhardt Zondek. Improvements in the techniques for the measurement of human chorionic gonadotropin (hCG) have been directly related to the progress in the purification and isolation of hCG and elucidation of the amino acid sequence of the hormone-nonspecific alpha subunit and hormone-specific beta subunit of hCG. The history, physical examination, and pregnancy tests will generally provide sufficient information for a definite diagnosis of pregnancy. The presence of hCG in the urine or blood is the most accurate of all the indications of pregnancy. During the last century, 4 different techniques for the determination of hCG in blood and/or urine have been developed. These include the following and are reviewed in detail: 1) bioassays in intact laboratory animals; 2) immunologic tube or slide methods with heme- or latex-agglutination inhibition, as well as the more recently developed competitive protein binding method such as 3) radioimmunoassay (RIA) for the use of radioisotope labeled hormone
Anand, Enu; Unisa, Sayeed; Singh, Jayakant
This study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005-2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15-24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.
Golden, Neville H; Schneider, Marcie; Wood, Christine
Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs.
Background We investigated the association between maternal anthropometric measurements in prepregnancy and at the end of pregnancy and their children's systolic (SBP) and diastolic (DBP) blood pressure at 11 years of age, in a prospective cohort study. Methods All hospital births which took place in 1993 in the city of Pelotas - Brazil, were identified (5,249 live births). In 2004, the overall proportion of follow-up was 85% and we obtained arterial blood pressure measurements of 4,452 adolescents. Results Independent variables analyzed included maternal prepregnancy weight and body mass index (BMI) and maternal weight, and height at the end of pregnancy. Multiple linear regression analysis controlling for the following confounders were carried out: adolescent's skin color, family income at birth, smoking, alcohol intake during pregnancy, and gestational arterial hypertension. Mean SBP and DBP were 101.9 mmHg (SD 12.3) and 63.4 mmHg (SD 9.9), respectively. Maternal prepregnancy weight and BMI, and weight at the end of pregnancy were positively associated with both SBP and DBP in adolescent subjects of both sexes; maternal height was positively associated with SBP only among males. Conclusions Adequate evaluation of maternal anthropometric characteristics during pregnancy may prevent high levels of blood pressure among adolescent children. PMID:20653949
Carnevale, Teresa D.
Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several…
Bereavement researchers have made some significant advances in the understanding of the dynamics and the processes of managing grief. In this article, the author presents three of these advances that are central to a discussion of adolescent grief and of preventive interventions: (1) Increasingly, both clinical and research evidence indicate that…
Two-thirds of all schools in the United States are rural and three-fourths are small. Statistically, most teenage parents are from such school systems. Yet the problem of teenage pregnancy is most frequently overlooked by rural and small school communities. In fact, some cultural factors and resource deficiencies of these communities actually…
Platt, Lois M
Pregnant students are the population group most likely to commit neonaticide, murder of an infant younger than 24 hours old. Denial by the student, lack of early pregnancy detection, and poor social support contribute to this disorder. As the health care professionals with whom the student has the most contact, school nurses are in an excellent position to prevent neonaticide through provision of health education, early detection of pregnancy, and intervention with students and their families to assist them in making healthy choices.
Nystrom, Robert J; Duke, Jessica E A; Victor, Brad
Oregon's work on teen pregnancy prevention during the previous 20 years has shifted from a risk-focused paradigm to a youth development model that places young people at the center of their sexual health and well-being. During 2005, the Oregon Governor's Office requested that an ad hoc committee of state agency and private partners develop recommendations for the next phase of teen pregnancy prevention. As a result of that collaborative effort, engagement of young people, and community input, the Oregon Youth Sexual Health Plan was released in 2009. The plan focuses on development of young people and embraces sexuality as a natural part of adolescent development. The plan's five goals and eight objectives guide the work of state agencies and partners addressing youth sexual health. Oregon's development of a statewide plan can serve as a framework for other states and entities to address all aspects of youth sexual health.
Michaud, P A; Wermelinger, R
In Switzerland, as in most other countries, the number of adolescents with an active sexual life is on the increase. A statistical analysis of the number of deliveries and of the number of abortions in young women aged less than 19 revealed that out of the total 1413 deliveries in 1978, only 21/1000 involved teenage girls, while the percentage was 45/1000 in 1970. It is obvious that since most teenagers have sexual relations, they either use contraception, or that the number of abortions in that age group, is on the increase. There were, between 1969 and 1978 in the university hospital of Lausanne, 600 requests for abortion among young women aged 12-19, i.e. about 16% of the total requests for abortion; such percentage is about 20-30% in most other countries. Many requests for teenage abortion come from young women residing outside of the Vaud canton, or newly established there. Interviews with patients revealed that girls who had had sex education in schools had sometimes used a contraceptive method. It must be remembered that in Vaud social medical care is very accessible and free to all, and that all schools have been offering well organized sex education programs for 10 years. In the opinion of the author this situation accounts for the low percentage of deliveries and of abortions from Vaud adolescents.
Rodgers, Joseph Lee; Rowe, David C.; Buster, Maury
Expands an existing nonlinear dynamic epidemic model of onset of social activities (EMOSA), motivated by social contagion theory, to quantify the likelihood of pregnancy for adolescent girls of different sexuality statuses. Compares five sexuality/pregnancy models to explain variance in national prevalence curves. Finds that adolescent girls have…
East, Patricia L.; Chien, Nina C.; Barber, Jennifer S.
The authors used cross-lagged analyses to examine the across-time influences on and consequences of adolescents' pregnancy intentions, wantedness, and regret. One hundred pregnant Latina adolescents were studied during pregnancy and at 6 and 12 months postpartum. The results revealed 4 main findings: (a) similar to what has been found in adult…
Miller, Brent C.; Coyl, Diana D.
Summarizes trends and recent declines in adolescent pregnancy, abortion, and adoption relinquishment. Reviews research regarding adolescent pregnancy resolution decision-making. Discusses contextual factors, such as attitudes and socialization about abortion, parenting, and adoption, and the influence of parents and partners on likelihood of…
Pereira, Ana I. F.; Canavarro, Maria C.; Cardoso, Margarida F.; Mendonca, Denisa
This study explores multiple relational contexts that promote vulnerability and protection against early pregnancy in a potential risk group of Portuguese adolescents. A comparative analysis was made between two groups of female adolescents of low socioeconomic status: pregnant adolescents (n = 57) and adolescents without a history of pregnancy (n…
Mims, B L
This article gives a detailed overview of the literature on adolescent pregnancy in African American families. According to the latest data available from the National Center for Health Statistics (1998), the greatest decline in adolescent pregnancy was among African Americans. In spite of the decline of 21% from 1991-1996, African American adolescent's birth rate was still almost twice the rate of European Americans. The purpose of this paper was to provide information that may assist health care professionals or others interested in repeat adolescent pregnancy to more effectively provide care and/or to conduct research from an Afrocentric perspective.
Rondanelli, E G; Carosi, G; Filice, G; Maccabruni, A; Minoli, L; Pecorari, D
Programs to prevent congenital toxoplasmosis based on the evaluation of serologic tests can be performed at three periods: 1. before pregnancy (serologic, epidemiologic screening of "at risk" women); 2. during pregnancy (detection by seroconversion); 3. at delivery (diagnosis of evident or latent congenital infection). The screening devices, the IHA, IFA, and IgM-IFA tests, should be performed first and after 3 weeks possibly repeated. During pregnancy the observation of seroconversion or, in any case, an increase in serologic titer at the second blood withdrawal and, at delivery, high serologic titers are signs of fetal risk. The significance of the data has furthermore to be evaluated by specific IgM quantification on pure serologic fractions and by in vivo isolation of Toxoplasma gondii from amniotic fluid, placenta, or the newborn CSF, blood, and/or tissue. This data may suggest the necessity of therapeutic termination of pregnancy or application of a specific chemoprophylaxis/chemotherapy.
Berger, David K.; And Others
Assessed differences between 20 negative and 36 positive pregnancy testers and evaluated pregnancy resolution decision-making process of positive testers. Subjects were Hispanic adolescents requesting pregnancy determination at outpatient clinic. Results indicated that negative and positive testers were similar, although positives were older and…
Murphy, Neil J; Quinlan, Jeffrey D
Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified as minor, yet 60% to 70% of fetal losses after trauma are a result of minor injuries. In minor trauma, four to 24 hours of tocodynamometric monitoring is recommended. Ultrasonography has low sensitivity, but high specificity, for placental abruption. The Kleihauer-Betke test should be performed after major trauma to determine the degree of fetomaternal hemorrhage, regardless of Rh status. To improve the effectiveness of cardiopulmonary resuscitation, clinicians should perform left lateral uterine displacement by tilting the whole maternal body 25 to 30 degrees. Unique aspects of advanced cardiac life support include early intubation, removal of all uterine and fetal monitors, and performance of perimortem cesarean delivery. Proper seat belt use reduces the risk of maternal and fetal injuries in motor vehicle crashes. The lap belt should be placed as low as possible under the protuberant portion of the abdomen and the shoulder belt positioned off to the side of the uterus, between the breasts and over the midportion of the clavicle. All women of childbearing age should be routinely screened for intimate partner violence.
In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy. The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection. The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents. To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF, CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.
Moore, Kristin A.; Sugland, Barbara W.
Rates of adolescent childbearing in the United States are two to ten times higher than in comparable industrialized democracies. Some programs and service options that show promise for reducing the incidence of adolescent pregnancy are identified in this paper. It begins by outlining 11 principles derived from available research and from program…
Korgavkar, K; Wang, F
Striae gravidarum (SG), or stretch marks developing during pregnancy, affect up to 90% of women. While not medically dangerous, SG can be disfiguring, causing emotional and psychological distress. However, studies specifically addressing the prevention of SG, especially during pregnancy, are sparse. Furthermore, the molecular pathogenesis of SG is unclear and may differ from that of striae from other causes. Considering these factors, we review topical modalities that have been used specifically for preventing SG during pregnancy. We identify two major strategies (end points) addressed by these modalities, namely (i) preventing the de novo development of SG and (ii) reducing the severity of SG that have recently developed. We also identify risk factors for the development of SG and suggest that pregnant women with these risk factors are an appropriate target population for prevention. In reviewing the literature, we find that there is limited evidence that centella, and possibly massage with bitter almond oil, may prevent SG and/or reduce their severity. There is weak evidence that hyaluronic acid prevents SG. Tretinoin holds promise for reducing the severity of new-onset SG, but its use is limited by its pregnancy category. Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce. Furthermore, available topical modalities generally lack strong evidence from rigorous, well-designed, randomized controlled trials with ample numbers of subjects. Thus, further research is necessary to elucidate SG pathogenesis, which may lead to effective prevention modalities.
Decker, Michele R.; Reed, Elizabeth; Rothman, Emily F.; Hathaway, Jeanne E.; Raj, Anita; Miller, Elizabeth
The present study explored perceived sexual norms and behaviors related to sexual risk and pregnancy involvement among adolescent males (ages 13 to 20) participating in programs for perpetrators of dating violence. The purpose of this study was to generate hypotheses regarding the contexts and mechanisms underlying the intersection of adolescent dating violence, sexual risk and pregnancy. Six focus groups were conducted (N = 34 participants). A number of major themes emerged: 1) male norm of multiple partnering, 2) perceived gain of male social status from claims of sexual activity, 3) perception that rape is uncommon combined with belief that girls claiming to be raped are liars, 4) perception that men rationalize rapes to avoid responsibility, 5) condom non-use in the context of rape and sex involving substance use, 6) beliefs that girls lie and manipulate boys in order to become pregnant and trap them into relationships, and 7) male avoidance of responsibility and negative responses to pregnancy. The combination of peer-supported norms of male multiple partnering and adversarial sexual beliefs appear to support increased male sexual risk, lack of accountability for sexual risk, and rationalization of rape and negative responses to pregnancy. Further research focused on the context of male sexual risk and abusive relationship behaviors is needed to inform intervention with young men to promote sexual health and prevent rape, dating violence, and adolescent pregnancy. PMID:16845498
Farb, Amy Feldman; Burrus, Barri; Wallace, Ina F; Wilson, Ellen K; Peele, John E
The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process. Issues faced, challenges encountered, and lessons learned have broad applicability for other federal agencies and, specifically, for TPP programs interested in assessing their own performance and progress.
Providing care to adolescent girls and women before and between pregnancies improves their own health and wellbeing, as well as pregnancy and newborn outcomes, and can also reduce the rates of preterm birth. This paper has reviewed the evidence based interventions and services for preventing preterm births; reported the findings from research priority exercise; and prescribed actions for taking this call further. Certain factors in the preconception period have been shown to increase the risk for prematurity and, therefore, preconception care services for all women of reproductive age should address these risk factors through preventing adolescent pregnancy, preventing unintended pregnancies, promoting optimal birth spacing, optimizing pre-pregnancy weight and nutritional status (including a folic acid containing multivitamin supplement, and ensuring that all adolescent girls have received complete vaccination. Preconception care must also address risk factors that may be applicable to only some women. These include screening for and management of chronic diseases, especially diabetes; sexually-transmitted infections; tobacco and smoke exposure; mental health disorders, notably depression; and intimate partner violence. The approach to research in preconception care to prevent preterm births should include a cycle of development and delivery research that evaluates how best to scale up coverage of existing, evidence-based interventions, epidemiologic research that assesses the impact of implementing these interventions, and discovery science that better elucidates the complex causal pathway of preterm birth and helps to develop new screening and intervention tools. In addition to research, policy and financial investment is crucial to increasing opportunities to implement preconception care, and rates of prematurity should be included as a tracking indicator in global and national maternal child health assessments. Declaration This article is part of a supplement
Pereira, Ana I F; Canavarro, Maria C; Cardoso, Margarida F; Mendonça, Denisa
This study explores multiple relational contexts that promote vulnerability and protection against early pregnancy in a potential risk group of Portuguese adolescents. A comparative analysis was made between two groups of female adolescents of low socioeconomic status: pregnant adolescents (n=57) and adolescents without a history of pregnancy (n=81). Results suggest that several variables belonging to different contexts-family and school and peer relations--are important in the characterization of the two groups. Lower levels of mother's overprotection and father's emotional support, presence of early pregnancy in adolescent's mother, lower level of emotional proximity to peer relations, and higher number of school failures are significantly associated with adolescent pregnancy.
Solov'ev, A G; Novikova, G A
The authors have systematized approaches to the prevention of beer dependence in adolescents and presented the inner structure of prevention in educational institutions in terms of consecutive steps. The author's methods for adolescence beer dependence diagnosis are described. Different forms of preventive work with adolescences and their parents allowing to combine flexibly the preventive methods with the participation of cross-functional specialists are presented.
Mueller, Trisha; Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Romero, Lisa M; Brittain, Anna; Varanasi, Bala
This article provides an overview and description of implementation activities of the multicomponent, community-wide initiatives of the Teenage Pregnancy Prevention Program initiated in 2010 by the Office of Adolescent Health and the Centers for Disease Control and Prevention. The community-wide initiatives applied the Interactive Systems Framework for dissemination and implementation through training and technical assistance on the key elements of the initiative: implementation of evidence-based teen pregnancy prevention (TPP) interventions; enhancing quality of and access to youth-friendly reproductive health services; educating stakeholders about TPP; working with youth in communities most at risk of teen pregnancy; and mobilizing the community to garner support. Of nearly 12,000 hours of training and technical assistance provided, the majority was for selecting, implementing, and evaluating an evidence-based TPP program. Real-world implementation of a community-wide approach to TPP takes time and effort. This report describes implementation within each of the components and shares lessons learned during planning and implementation phases of the initiative.
Jensen, Jamie; Baete Kenyon, Den Yelle; Hanson, Jessica D
Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur pre-conceptually with women, either by reducing alcohol intake in women planning pregnancy or at-risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American Indian women is the Oglala Sioux Tribe (OST) CHOICES (Changing High-risk alcohOl use and Increasing Contraception Effectiveness Study) Programme, which shows promise in reducing AEP risk in American Indian women aged 18 or older. A community needs assessment was conducted with key informant interviews and focus groups with an emphasis on how to expand OST CHOICES. To identify interconnected themes, a content analysis methodology was used on the qualitative feedback from the focus groups and interviews. Altogether, key informant interviews were completed with 25 health and social service professionals. Eight focus groups were held with 58 American Indian participants, including adult women of child-bearing age, elder women, and adult men. Several sub-themes regarding the prevention of AEP with youth were identified, expanding the OST CHOICES curriculum into the schools, and the role of family and culture within AEP prevention.
Al-Kadri, Hanan M; Madkhali, Azza; Al-Kadi, Mohammed T; Bakhsh, Hanadi; Alruwaili, Nourah N; Tamim, Hani M
Background In this study, we aimed to assess the rate of adolescent delivery in a Saudi tertiary health care center and to investigate the association between maternal age and fetal, neonatal, and maternal complications where a professional tertiary medical care service is provided. Methods A cross-sectional study was performed between 2005 and 2010 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. All primigravid Saudi women ≥24 weeks gestation, carrying a singleton pregnancy, aged <35 years, and with no chronic medical problems were eligible. Women were divided into three groups based on their age, ie, group 1 (G1) <16 years, group 2 (G2) ≥16 up to 19 years, and group 3 (G3) ≥19 up to 35 years. Data were collected from maternal and neonatal medical records. We calculated the association between the different age groups and maternal characteristics, as well as events and complications during the antenatal period, labor, and delivery. Results The rates of adolescent delivery were 20.0 and 16.3 per 1,000 births in 2009 and 2010, respectively. Compared with G1 and G2 women, G3 women tended to have a higher body mass index, a longer first and second stage of labor, more blood loss at delivery, and a longer hospital stay. Compared with G1 and G2 women, respectively, G3 women had a 42% and a 67% increased risk of cesarean section, and had a 52% increased risk of instrumental delivery. G3 women were more likely to develop gestational diabetes or anemia, G2 women had a three-fold increased risk of premature delivery (odds ratio 2.81), and G3 neonates had a 50% increased overall risk of neonatal complications (odds ratio 0.51). Conclusion The adolescent birth rate appears to be low in central Saudi Arabia compared with other parts of the world. Excluding preterm delivery, adolescent delivery cared for in a tertiary health care center is not associated with a significantly increased medical risk to the mother, fetus, or neonate. The psychosocial effect of
Goplerud, Eric N., Ed.
This monograph provides a framework for communities to build and evaluate adolescent drug abuse prevention programs. The first chapter "Adolescent Transitions and Alcohol and Other Drug Use Prevention," by Laurence Steinberg, focuses on the biological, cognitive, and psychosocial transitions of adolescence and how this knowledge can be used to…
Montgomery, Kristen S.
Adolescent pregnancy can have devastating effects for both mother and child. However, little is known about the experience of planned pregnancy among adolescents. This paper presents an in-depth analysis of themes identified in a previous study of the experience of planned adolescent pregnancy. The experience of planning a pregnancy during adolescence consists of typical adolescent behavior in that these girls demonstrated the need for control, invulnerability, and a present focus to their lives. In addition to this typical behavior, a component manifests itself in which adolescent girls make reproductive health choices to gain control. By establishing a level of control over their hectic and stressful lives, they are able to add meaning to their lives. The need for consistency and control seem to be linked, because many of the adolescent girls' statements reflected dimensions of both concepts. This initial, descriptive study can be used to further explore adolescent pregnancy and to develop interventions that might assist these girls to lead healthy lives. PMID:17273226
National Campaign To Prevent Teen Pregnancy, Washington, DC.
This report discusses critical social issues linked to teen pregnancy, explaining that teen pregnancy prevention should be viewed as working to improve these social issues. After providing general background on teen pregnancy, the report offers five fact sheets: (1) "Teen Pregnancy, Welfare Dependency, and Poverty" (continuing to reduce…
Killoren, Sarah E; Zeiders, Katharine H; Updegraff, Kimberly A; Umaña-Taylor, Adriana J
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.
Persona, Lia; Shimo, Antonieta Keiko Kakuda; Tarallo, Maria Celina
This study identified the biopsychosocial profile of adolescent with repeated pregnancies, who were attended at a prenatal clinic. Data were collected through patient records and interviews and were subject to quantitative analysis. Based on the obtained results and in accordance with literature, factors that are strongly associated with the occurrence of pregnancy repetition were selected in the adolescents' profiles. These are: early menarche; first sexual intercourse shortly after menarche; school repetition; school dropout; non remunerated occupation; low family income; involvement with older partners; living with the partner; consensual union with the partner; one partner; low condom use; family history of adolescent pregnancy; father's absence because of death or abandonment; positive family reaction to previous pregnancy; previous abortion; adolescent's positive concepts about previous delivery; and absence from previous postpartum consultations.
Schinke, Steven P.; Fang, Lin; Cole, Kristin C.
This study tested a computerized gender-specific, parent-involvement intervention program grounded in family interaction theory and aimed at preventing substance use among adolescent girls. Following program delivery and 1 year later, girls randomly assigned to the intervention arm improved more than girls in a control arm on variables associated with reduced risks for substance use, including communication with their mothers, knowledge of family rules about substance use, awareness of parental monitoring of their discretionary time, non-acceptance of peer substance use, problem-solving skills, and ability to refuse peer pressure to use substances. Relative to control-arm girls, those in the intervention arm also reported less 30-day use of alcohol and marijuana and lower intentions to smoke, drink, and take illicit drugs in the future. Girls’ mothers in the intervention arm reported greater improvements after the program and relative to control-arm mothers in their communication with their daughters, establishment of family rules about substance use, and monitoring of their daughters’ discretionary time. Study findings lend support to the potential of gender-specific, parent-involvement, and computerized approaches to preventing substance use among adolescent girls. PMID:19632053
Coyle, Karin K.; Glassman, Jill R.; Kershner, Sarah; Prince, Mary S.
Objectives. To evaluate the effectiveness of an evidence-based HIV/sexually transmitted infection (STI)/pregnancy prevention program for middle schools implemented by school staff in South Carolina. Methods. Twenty-four schools, representing 3143 youths, participated in a randomized trial from 2011 to 2014. Students completed surveys before programming (fall of seventh grade), after completing the 2-year It’s Your Game…Keep It Real program (spring of eighth grade), and 1-year postprogram (spring of ninth grade). Results. There was no statistically significant effect on initiation of vaginal sex between baseline and eighth grade. Significantly fewer students in the comparison condition reported initiating sex at ninth grade, relative to the intervention condition. No group differences existed on other behavioral outcomes that addressed sexual activity in the past 3 months at ninth grade. Seven of 26 psychosocial outcomes (3 knowledge, 1 attitude, 1 self-efficacy, 2 personal limits) were positively affected at eighth grade; 4 remained significant at ninth grade. Conclusions. The original studies’ behavioral effects were not replicated in this population, possibly as a result of this being an effectiveness trial instead of an efficacy trial, counterfactual exposure design issues, or postprogram exposure to evidence-based programming. PMID:27689496
Herrman, Judith W.; Moore, Christopher C.; Anthony, Becky
Teaching pregnancy prevention to large groups offers many challenges. This article describes the use of film clips, with guided discussion, to teach pregnancy prevention. In order to analyze the costs associated with teen pregnancy, a film clip discussion session based with the film "The Gloucester 18" was the keynote of a youth summit. The lesson…
Solomon, Nancy M.
This policy brief highlights the interrelationship between sports participation and teen pregnancy prevention, noting barriers that have prevented sports from being utilized in teen pregnancy prevention. Discrimination against girls and women in school sports persists 30 years after Congress enacted Title IX, and this prevents girls and young…
Lipovsek, Varja; Karim, Ali Mehryar; Gutierrez, Emily Zielinski; Magnani, Robert J.; Gomez, Maria del Carmen Castro
Study explores why some female adolescents in La Paz, Bolivia, become pregnant while others in similar circumstances avoid early pregnancy. Results reveal that girls who had experienced a pregnancy were less likely to have reported affectionate and supportive parents, more likely to have reported fighting in their home, and exhibited lower levels…
Ravert, April A; Martin, Jennifer
Examines family-of-origin stress, age of first menarche, and the perceptions of pregnancy as a life event in 97 pregnant adolescents. Participants' reported high levels of family stress with only a moderate level of impact or stress attributed to the pregnancy. As a group, the girls' first menarche matched national averages. (RJM)
Vincent, Murray; Drane, J. Wanzer; Joshi, Praphul; Shankarnarayan, Saikiran; Nimmons, Michelle
The resident population of Bamberg County, SC, has been exposed to multiples of public health information and education interventions since October 1982 with the intent to reduce the occurrence of unintended pregnancies among unmarried adolescents. Data analyses were conducted to compare 20 years of pregnancy rates among girls aged 14-17 years for…
Corkindale, Carolyn J.; Condon, John T.; Russell, Alan; Quinlivan, Julie A.
Little is known about what factors adolescent males consider important when making decisions concerning the resolution of an unplanned pregnancy with a teenage partner. Young men's influence on pregnancy outcome decisions can play an important part in the subsequent psychological adjustment of the female. The present report draws on data from a…
Kasen, S; Cohen, P; Brook, J S
Outside of the family, schools are the most proximal socializing agent available to convey societal norms and prohibitions to young people. In some cases, a positive school experience can compensate for the antisocial influence of family and community. The present study investigated the predictive ability of school-related factors on later deviancy in a random sample of 452 US adolescents 12-18 years of age attending 150 junior or senior high schools in upstate New York and enrolled in a broader prospective study. A measure of conduct problems, obtained 2 years before measurement of school factors, was used to control for the predisposing effects of problematic behavior on later deviance. Academic achievement, academic aspirations, and a learning-focused school environment had deterrent effects on all deviant outcomes assessed--dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse--independent of age, gender, intelligence quotient, socioeconomic status, childhood conduct problems, and proportion of deviance-oriented friends in adolescence. Given the persistence of deviant behavioral patterns of adolescence into adulthood, the systems-level influences identified in this study should be given careful attention.
Atuyambe, Lynn; Mirembe, Florence; Annika, Johansson; Kirumira, Edward K.; Faxelid, Elisabeth
Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study…
Boyer, Glenda J.
The purpose of this qualitative study was to describe how family members experience the phenomenon of adolescent pregnancy and parenting in the family unit, over time, and to examine the meanings family members attach to the experience. The participants were six nuclear families (20 individuals) of six adolescent mothers who had previously…
Zapata, Lauren B.; Hillis, Susan D.; Marchbanks; Polly A.; Curtis, Kathryn M.; Lowry, Richard
Background: Lifetime methamphetamine use among adolescents is estimated to be between 5% and 10%. Youth substance use in general is known to be associated with risky sexual behaviors, but the effect of methamphetamine use on recent risky sexual behaviors and adolescent pregnancy has received little attention. The purpose of this analysis was to…
Background When toxoplasmosis is acquired during pregnancy, it can be transmitted to the fetus causing severe lesions in the first two gestational trimesters. This study analyzed the main factors associated with the preventive behavior for toxoplasmosis among pregnant adolescents in the city of Fortaleza in northeast Brazil. Methods It is a cross-sectional study conducted from March 2009 to November 2010, with a sample of 320 pregnant adolescents, ages ranging from 12 to 19 years old, receiving prenatal care in the Public Health Care System. Bivariate and multivariate logistic regression model analyses were used to identify the association between preventive behavior for toxoplasmosis, and the independent variables and 95% confidence interval. Results We observed that 16.3% of the pregnant adolescents showed preventive behavior for toxoplasmosis. The factors positively associated to the preventive behavior for toxoplasmosis were: age group between 12 and 14 years old (OR = 2.75; 95%CI 1.23-6.12) and more than two prenatal consultations (OR = 2.19; 95%CI 1.17-4.09). Conclusions Noteworthy is the importance of a serologic follow-up for pregnant adolescents with clearer and more precise information about risk factors and the importance of adopting preventive behaviors. Thus, it is necessary to establish educational measures for handling food and raising kittens during prenatal care. PMID:22272659
Pawils, Silke; Metzner, Franka
Aggressive and violent behaviour in children and adolescents can be associated with physical and psychological health effects continuing into adulthood. Early programs for violence prevention in childhood and adolescence are intended to prevent or reduce aggressive behaviour in order to decrease the risk for short- and long-term developmental impairments. In a literature review, research findings on prevalence, typical courses of development, and predictors of violent behavior in childhood are first summarized and compared with findings on the frequency, developmental course, and consequences of youth violence. International and German programs for violence prevention in children and adolescents are presented in the context of various settings (family, school, community), target groups (primary vs. secondary prevention) as well as target variables (universal vs. specific). Empirical findings on efficacy testing of violence prevention programs are described and discussed. The presented findings stress the relevance and potential of services for violence prevention for children and adolescents, but also demonstrate the challenges and gaps.
Moos, Merry K; Bartholomew, Neva E; Lohr, Kathleen N
Unintended pregnancies account for about half of all pregnancies in the United States and, in 1995, numbered nearly 3 million pregnancies. They pose appreciable medical, emotional, social and financial costs on women, their families and society. The US is not attaining national goals to decrease unintended pregnancies, and little is known about effective means for reducing unintended pregnancy rates in adults or adolescents.To examine the evidence about the effectiveness, benefits and harms of counseling in a clinical setting to prevent unintended pregnancy in adults and adolescents and to use the evidence to propose a research agenda.We identified English-language articles from comprehensive searches of the MEDLINE, CINAHL, PsychLit and other databases from 1985 through May 2000; the main clinical search terms included pregnancy (mistimed, unintended, unplanned, unwanted), family planning, contraceptive behavior, counseling, sex counseling, and knowledge, attitudes and behavior. We also used published systematic reviews, hand searching of relevant articles, the second Guide to Clinical Preventive Services and extensive peer review to identify important articles not otherwise found and to assure completeness. Of 673 abstracts examined, we retained 354 for full article review; of these, we used 74 for the systematic evidence review and abstracted data from 13 articles for evidence tables. Four studies addressed the effectiveness of counseling in a clinical setting in changing knowledge, skills and attitudes about contraception and pregnancy; all had poor internal validity and generalizability and collectively did not provide definitive guidance about effective counseling strategies. Nine studies (three in teenage populations) addressed the relationship of knowledge on contraceptive use and adherence. Knowledge of correct contraceptive methods may be positively associated with appropriate use, but reservations about the method itself, partner support of the method
Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W.
Purpose To examine the influence of prepregnancy parental support and control on adolescent girls’ pregnancy resolution decisions. Methods Data from the National Longitudinal Study of Adolescent Health were analyzed. Girls whose first pregnancy reported in wave IV occurred after wave I and before age 20 were included (n = 1,107). Participants self-reported pregnancy disposition (abortion, ectopic or tubal pregnancy, miscarriage, stillbirth, live birth) for each pregnancy; responses were dichotomized as abortion versus other. Girls’ perceptions of parental support and control were measured at wave I. Controls were included for wave I age, age at pregnancy, year at the end of pregnancy, race/ethnicity, and parent characteristics (i.e., education, religious affiliation, age at first marriage, and educational expectations). Weighted multivariable logistic regression models were performed. Results Approximately 18% of girls reporting a teen pregnancy reported having an abortion. In crude analyses, parental support was marginally negatively related to abortion (odds ratio [OR] =.83, p =.06) and parental control was significantly negatively related to abortion (OR = .78, p = .02). In multivariable analyses, higher parental control was significantly negatively related to abortion versus other pregnancy outcomes (adjusted OR .80, 95% confidence interval .66–.98). Perceived parental support was unassociated with pregnancy resolution decisions. The only other factor associated with abortion decisions was parent education: odds of choosing abortion versus other pregnancy outcomes were significantly higher for adolescent girls whose parents had a bachelor’s degree or greater versus those with lower educational attainment. Conclusions Pregnant adolescents with less educated parents or parents exercising greater control were less likely to have an abortion. PMID:23763966
Daley, Alison Moriarty
This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.
Iams, Jay D.
Some of the principal research advances of the 1970s related to pregnancy and newborn infants and consequent changes in obstetrical practice are summarized in this report. The process of infant-parent attachment (bonding), adolescent pregnancy, and the reproductive hazards of tobacco, alcohol, and poor nutrition have been investigated and, in…
Okwumabua, T M; Okwumabua, J O; Elliott, V
Strategies must be developed to address the high rate of adolescent pregnancy among Blacks in the US and the adverse consequences of premature parenting. A number of programs and strategies have been developed and are being implemented in various sites across the US. The "Let the Circle Be Unbroken: Rites of Passage" program is an effort to incorporate an Afrocentric conceptual model into a prevention program. It involves adapting socialization processes often observed in African cultures, which openly acknowledge the need to formally help adolescents during their transition from childhood to adulthood. That socialization process tends to be a cultural experience which requires that ideology, education, training, and culture be taught before an activity or celebration marking the successful transition from one stage of development to another. The "Rites of Passage" approach follows these basic premises to teach adolescents the knowledge and skills needed to become responsible community members and spiritually mature adults. It is specifically designed to help young people build self-esteem; enhance self-image; develop leadership skills, cultural awareness, and appreciation; and make healthy, productive, and self-affirming life choices.
Teenage pregnancy is an overwhelming problem in Fort Worth, Texas. To examine the problem of teenage pregnancy, figures on total live births by age, race, repeat pregnancy, and at-risk infants were gathered from 1981 and 1982 Department of Public Health data. In addition, consequences of teenage pregnancy and motivation factors were examined. An…
Interstate Conference of Employment Security Agencies, Inc., Washington, DC.
The purpose of the conference reported in this document was to improve and coordinate state-level efforts to ameliorate the crisis of adolescent pregnancy. The document includes summaries of addresses by Edgar May, vice-president of the American Public Welfare Association's board of directors; Ann Rosewater, staff director of the Select Committee…
Craft, Lesley R.; Brandt, Heather M.; Prince, Mary
Background: To reduce teen pregnancy rates, prevention programs must be consistently available to large numbers of youth. However, prevention efforts have been historically conducted with little emphasis on ensuring program sustainability. This study examined the needs and barriers to sustaining teen pregnancy prevention (TPP) programming in…
Arikawa, Shino; Eboua, Tanoh; Kouakou, Kouadio; N'Gbeche, Marie-Sylvie; Amorissani-Folquet, Madeleine; Moh, Corinne; Amoussou-Bouah, Ursula Belinda; Coffie, Patrick Ahuatchi; Becquet, Renaud; Leroy, Valériane
Objective Adolescents living with HIV are sexually active and engaged in risky sexual behaviors. Knowledge on how and to what extent adolescents in HIV care are affected by pregnancy is needed so as to adopt better preventive services. We estimated 4-year pregnancy incidence and correlates among HIV-infected female adolescents in HIV care in urban Côte d'Ivoire. Design We conducted retrospective analysis of a pediatric prospective cohort of the International epidemiological Databases to Evaluate AIDS (IeDEA) West Africa Collaboration. Female patients with confirmed HIV infection aged 10–19 years, having at least one clinical visit in 2009 to health facilities participating in the pediatric IeDEA West African cohort in Abidjan, Côte d'Ivoire, were included. Data on incident pregnancies were obtained through medical records and interviews with health professionals. Pregnancy incidence rate was estimated per 100 person-years (PY). Poisson regression models were used to identify factors associated with the first pregnancy and provided incidence rate ratios (IRR) with 95% confidence intervals (CI). Results In 2009, 266 female adolescents were included, with a median age of 12.8 years (interquartile range, IQR: 10.0–15.0), CD4 cell counts of 506 cells/mm3 (IQR: 302–737), and 80% on antiretroviral treatment. At the 48th month, 17 new pregnancies were reported after 938 PY of follow-up: 13 girls had one pregnancy while 2 had two pregnancies. Overall incidence rate of pregnancy was 1.8/100 PY (95% CI: 1.1–2.9). High incidence was observed among those aged 15–19 years: 3.6/100 PY (95% CI: 2.2–5.9). Role of maternal death in the risk of pregnancy was at the limit of statistical significance (adjusted IRR: 3.1, 95% CI: 0.9–11.0; ref. non-maternal orphans). Conclusions Incidence of pregnancy among HIV-infected adolescents in care aged 15–19 years reached a level observed in adult cohorts in Sub-Saharan Africa. Health personnel in pediatric care have to
Loredo-Abdalá, Arturo; Vargas-Campuzano, Edgar; Casas-Muñoz, Abigail; González-Corona, Jessica; Gutiérrez-Leyva, César Jesús
Teen pregnancy (TP) is a global public health problem that affects the physical and emotional health, educational and economic status of prospective parents and often also affects the product of gestation. In most cases, the TP is an unplanned event, and often difficult to accept by the couple. But it is more complicated for the future mother who suddenly finds herself without the protection of the couple, her family and her school companions. The risks to which the young mothers are exposed are diverse, but include: submitting to a clandestine abortion, falling into drug addiction, prostitution and crime; Also, it should be noted that with so many adversities, she can develop child maltreatment and frequently, she may be attacked at home, at school or in society giving rise to the twin phenomena of child abuse. To address this problem, it is necessary to develop preventive strategies aimed at risk of early pregnancy or acquiring sexually transmitted diseases by implementing educational programs for personal, family or schools for this age group range. It stresses the need for these programs to be consistent and persistent, as a basic strategy to reduce the consequent risks to unplanned or accepted sex life.
Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul
Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981
Furby, Lita; Ochs, Linda M.; Thomas, Catherine W.
Reports on interviews of 48 sexually active adolescents concerning the possible secondary consequences of taking measures to reduce the risk of contracting a sexually transmitted disease (STD). Adolescents generated 134 consequences, suggesting that considering all the relevant consequences for a rational decision about STD prevention is not…
Depression is one of the most common psychological disorders experienced by adolescents. Research has shown depression rates are higher in Asian-American adolescents when compared to their European-American counterparts. This paper will investigate possible programs for preventing and responding to Asian-American youths' depression through a…
Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa
With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…
Faisal-Cury, Alexandre; Tabb, Karen M; Niciunovas, Guilherme; Cunningham, Carrie; Menezes, Paulo R; Huang, Hsiang
Adolescent pregnancy has social, economic, and educational consequences and is also linked to adverse perinatal outcomes. However, studies show a positive relationship between pregnancy and increased social status among low-income adolescents. This study aims to assess the association between planned pregnancy and years of schooling among low-income Brazilian adolescents. This is a secondary analysis of a cohort study conducted from May 2005 to March 2007 in public primary care clinics in São Paulo, Brazil. Participants (n=168) completed a detailed structured questionnaire. Logistic regression was used to examine the association between years of schooling and planned pregnancy. After adjusting for the covariates income, wealth score, crowding, age, marital status, and race, planned pregnancy was independently associated with lower years of education (odds ratio: 1.82; 95% confidence interval: 1.02–3.23). Although this finding may be related to these adolescents having less access to information and health services, another possible explanation is that they have a greater desire to have children during adolescence. PMID:28176946
Miura, Paula Orchiucci; Passarini, Gislaine Martins Ricardo; Ferreira, Loraine Seixas; Paixão, Rui Alexandre Paquete; Tardivo, Leila Salomão de La Plata Cury; Barrientos, Dora Mariela Salcedo
A pregnant adolescent's vulnerability increases when she is a victim of intrafamilial violence and drug addiction, which cause physical and biopsychosocial damage to the mother and her baby. Objective Present and analyze the case of an adolescent who is addicted to drugs, pregnant and the victim of lifelong intrafamilial violence. Method A case study based on a semi-structured interview conducted in the Obstetrics Emergency Unit at the Teaching Hospital of the University of São Paulo. The data were interpreted and analyzed using Content Analysis. Results intrafamilial violence experienced at the beginning of the adolescent's early relationships seriously affected her emotional maturity, triggering the development of psychopathologies and leaving her more susceptible to the use and abuse of alcohol and other drugs. The adolescent is repeating her history with her daughter, reproducing the cycle of violence. Conclusion Adolescent pregnancy combined with intrafamilial violence and drug addiction and multiplies the adolescent's psychosocial vulnerability increased the adolescent's vulnerability.
Enah, Comfort; Moneyham, Linda; Vance, David E; Childs, Gwendolyn
The search for intervention strategies appropriate for young adolescents has recently led to the use of digital games. Digital gaming interventions are promising because they may be developmentally appropriate for adolescent populations. The gaming approach also capitalizes on an inherent interest to adolescents and circumvents traditional barriers to access to prevention interventions faced in some geographical areas. Notwithstanding, research on gaming in HIV prevention is quite limited. In this review article, we examine the need for contextually relevant HIV prevention interventions among young adolescents. From this, we provide a theoretical framework for exploring contextually relevant HIV risk factors and a foundation for gathering and using input from the target population to adapt an existing game or to create a developmentally appropriate and contextually relevant HIV prevention game.
Odgers, Candice L.; Caspi, Avshalom; Nagin, Daniel S.; Piquero, Alex R.; Slutske, Wendy S.; Milne, Barry J.; Dickson, Nigel; Poulton, Richie; Moffitt, Terrie E.
Exposure to alcohol and illicit drugs during early adolescence has been associated with poor outcomes in adulthood. However, many adolescents with exposure to these substances also have a history of conduct problems, which raises the question of whether early exposure to alcohol and drugs leads to poor outcomes only for those adolescents who are already at risk. In a 30-year prospective study, we tested whether there was evidence that early substance exposure can be a causal factor for adolescents’ future lives. After propensity-score matching, early-exposed adolescents remained at an increased risk for a number of poor outcomes. Approximately 50% of adolescents exposed to alcohol and illicit drugs prior to age 15 had no conduct-problem history, yet were still at an increased risk for adult substance dependence, herpes infection, early pregnancy, and crime. Efforts to reduce or delay early substance exposure may prevent a wide range of adult health problems and should not be restricted to adolescents who are already at risk. PMID:19000215
Campero, Lourdes; Herrera, Cristina; Benítez, Alejandra; Atienzo, Erika; González, Guillermo; Marín, Eréndira
Research focused on adolescent pregnancy reports that this event acquires significance and has different consequences according to the context and social subjects who experience it. In this study, by means of a sample formed by adolescent women and men who are socially vulnerable in Mexico, with and without a history of pregnancy, we can see how…
Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J.; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K. Brown, Larry
ABSTRACT Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent–child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent–adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352). PMID
Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K Brown, Larry
Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent-adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352).
Rosenbaum, Janet E; Zenilman, Jonathan; Rose, Eve; Wingood, Gina; DiClemente, Ralph
Reproductive coercion has been hypothesized as a cause of unprotected sex and unplanned pregnancies, but research has focused on a narrow set of potential sources of reproductive coercion. We identified and evaluated eight potential sources of reproductive coercion from the Theory of Gender and Power including economic inequality between adolescent girls and their boyfriends, cohabitation, and age differences. The sample comprised sexually active African-American female adolescents, ages 15-21. At baseline (n = 715), 6 months (n = 607), and 12 months (n = 605), participants completed a 40-min interview and were tested for semen Y-chromosome with polymerase chain reaction from a self-administered vaginal swab. We predicted unprotected sex and pregnancy using multivariate regression controlling for demographics, economic factors, relationship attributes, and intervention status using a Poisson working model. Factors associated with unprotected sex included cohabitation (incidence risk ratio (IRR) 1.48, 95 % confidence interval (1.22, 1.81)), physical abuse (IRR 1.55 (1.21, 2.00)), emotional abuse (IRR 1.31 (1.06, 1.63)), and having a boyfriend as a primary source of spending money (IRR 1.18 (1.00, 1.39)). Factors associated with unplanned pregnancy 6 months later included being at least 4 years younger than the boyfriend (IRR 1.68 (1.14, 2.49)) and cohabitation (2.19 (1.35, 3.56)). Among minors, cohabitation predicted even larger risks of unprotected sex (IRR 1.93 (1.23, 3.03)) and unplanned pregnancy (3.84 (1.47, 10.0)). Adolescent cohabitation is a marker for unprotected sex and unplanned pregnancy, especially among minors. Cohabitation may have stemmed from greater commitment, but the shortage of affordable housing in urban areas could induce women to stay in relationships for housing. Pregnancy prevention interventions should attempt to delay cohabitation until adulthood and help cohabiting adolescents to find affordable housing.
Guijarro, S; Naranjo, J; Padilla, M; Gutiérez, R; Lammers, C; Blum, R W
This paper presents the study on the family risk factors associated with adolescent pregnancy among adolescent girls and their families in Quito, Ecuador. The study aimed to identify characteristics within the family associated with adolescent pregnancy. A total of 135 female adolescents (aged 12-19 years) and their families were separately interviewed. 47 were pregnant and attending prenatal care at an inner city hospital in Quito, and 88 were nonpregnant students from schools located within the same geographical area. Results showed that when compared to their pregnant peers, more nonpregnant adolescents lived with their biological parents (p 0.002); they showed higher school performance (p 0.001); and more values and religiosity (p 0.0001). Pregnant adolescents reported lower mother-daughter and father-daughter communication (p 0.02), lesser life satisfaction in general, and more school and economic difficulties (p 0.001). Moreover, they were less likely to find support for their problems in or outside the family (p 0.0001) and showed higher levels of depression (68.8%) and sexual abuse (14.9%). Parental education was higher in the families of nonpregnant adolescents and both parents worked to provide financial support for the family.
Altay, Naime; Toruner, Ebru Kilicarslan; Citak, Ebru Akgun
Smoking and alcohol drinking in adolescents cause significant problems in most countries. The aim of this cross-sectional descriptive study was to determine the prevalence, causes, risk factors, and preventive factors for cigarette and alcohol use in adolescents. The sample included 1,133 students enrolled in grades 9-12. Data were collected using a descriptive data form, the Psychological Resilience and Adolescent Development Scale, and the Family Environment Scale. Most adolescents stated that stress and psychological problems were the causes of smoking and alcohol use. Preventive factors were indicated as developing skills for saying "no," good coping skills, and peer groups not using cigarettes. The Psychological Resilience and Adolescent Development Scale mean score for cigarette and alcohol use was significantly higher than for nonuse. The Family Environment Scale mean score for cigarette and alcohol use was significantly lower than for nonuse.
Malow, Robert M; Kershaw, Trace; Sipsma, Heather; Rosenberg, Rhonda; Dévieux, Jessy G
HIV and sexual risk continue to be central threats to the health and well-being of adolescents in the United States and abroad. Great strides have been made in creating interventions that reduce contracting and transmitting the deadly virus among adolescents. Numerous interventions have been designed and evaluated, with many having positive results in reducing adolescents' HIV risk behavior. However, the complexity of adolescents as well as limited effects on many sexual risk outcomes indicate that much more work needs to be done. This article provides a review of the literature on interventions among adolescents, summarizing why adolescents provide a unique challenge for HIV prevention, the intervention approaches that have been taken, and the challenges and recommendations for the future as the field confronts the neurobiologic dimension of risk.
This paper concerns future policy development and programs of research for the prevention of mental disorders based on research emerging from fetal and early life programming. The current review offers an overview of findings on pregnancy exposures such as maternal mental health, lifestyle factors, and potential teratogenic and neurotoxic exposures on child outcomes. Outcomes of interest are common child and adolescent mental disorders including hyperactive, behavioral and emotional disorders. This literature suggests that the preconception and perinatal periods offer important opportunities for the prevention of deleterious fetal exposures. As such, the perinatal period is a critical period where future mental health prevention efforts should be focused and prevention models developed. Interventions grounded in evidence-based recommendations for the perinatal period could take the form of public health, universal and more targeted interventions. If successful, such interventions are likely to have lifelong effects on (mental) health. PMID:24559477
Wilkinson-Lee, Ada M.; Russell, Stephen T.; Lee, Faye C. H.
This study examined practitioners' understandings of cultural sensitivity in the context of pregnancy prevention programs for Latina teens. Fifty-eight practitioners from teen pregnancy prevention programs in California were interviewed in a guided conversation format. Three themes emerged in our analysis. First, practitioners' definitions of…
Antonishak, Jill; Connolly, Chelsey
The National Campaign to Prevent Teen and Unplanned Pregnancy published free online lessons that help students take action to prevent unplanned pregnancy and complete their education. From the fall of 2012 to the spring of 2014, approximately 2,800 students took the online lessons and participated in pre- and post-lesson evaluation surveys at four…
Suicide is the second leading cause of death among adolescents and young adults between the ages of 15-25. Every day, over 1,000 young adults attempt to destroy themselves. Although adolescents contemplate suicide for many reasons, research suggests that depression is the number one risk factor in suicide. Accordingly, this paper describes many of…
Severi T, María Cecilia; Alonso, Rafael; Atalah S, Eduardo
Te aim of the study was to evaluate pregnancy nutritional consequences in adolescent pregnant women and to identify factors which increase risk of an adverse postpartum nutritional result. We conducted a prospective cohort study in 742 adolescent and 779 adult pregnant women in Guatemala, Dominican Republic and Uruguay, assessing demographic, social, obstetric, weight gain and BMI at first prenatal control, and 4 +/- 1 month postpartum. BMI in adults was classified according to WHO recommendations and NCHS/WHO in adolescents. We assessed changes of BMI between the beginning and postpartum time and a logistic model analysis was applied about the risk of having low BMI at postpartum time. At the beginning of pregnancy the prevalence of low weight was higher in adolescent group and the overweight and obesity higher in adults (p < 0.001). Weight gain was significantly higher in adolescents at same nutritional BMI, except for low weighted. Adolescents had a significant change in their BMI at postpartum time, showing a tendency to increase weight and a higher prevalence of overweight and obesity (p < 0.001). Higher risk of low BMI in postpartum was associated with low prenatal BMI (OR 25,6, CI 12,6 - 52), adolescence (OR 3,3 CI 1,6 - 6,6) and gestational weight gain < 300 g. per week (OR 1,4 CI 1,1 - 3,9). In conclusion adolescent nutritional status was not damaged after pregnancy. The strongest variable associated with postpartum low BMI was BMI which mothers begin pregnancy as equal of adult mothers.
Peach, Larry; Reddick, Thomas L.
Asserts that school counselors can play vital role in the prevention of adolescent suicide. Lists warning signs of suicide risk and characteristics of at-risk students. Presents set of guidelines for helping potential suicide victims. Sees key to teenage suicide prevention to be communication skills. Identifies components for suicide prevention…
Jenson, Jeffrey M.
Recent advances in the field of prevention have led to a deeper understanding of the causes of adolescent problem behavior and to the identification of efficacious strategies to prevent delinquency, drug use, and other antisocial conduct. This 2009 Aaron Rosen lecture to members of the "Society for Social Work and Research" traces the evolution of…
Talpade, Medha; Lynch, Diane; Lattimore, Barbara; Graham, Ashlee
The Juvenile and Adolescent Substance Abuse Prevention Program (JASAP) is a curriculum-based prevention and health promotion program for youth between the ages of 13 to 18 years in Fulton County, Georgia. The program was established in 2007 to promote healthy decision-making skills that would eventually lead to informed choices and decisions…
Marek, E; Berenyi, K; Dergez, T; Kiss, I; D'Cruz, G
An anonymous questionnaire survey was conducted among the Hungarian adolescents to establish their use of tobacco, alcohol and drugs in relation to sexual behaviours, knowledge of human papillomavirus (HPV) and cervical cancer, and beliefs and attitudes towards screening and vaccination. Results indicated that adolescent risk-taking health behaviours correlate with risky sexual behaviours. As risk-taking behaviours do not correlate with a better awareness of the risk associated with HPV infection, it is of crucial importance that HPV/cervical cancer preventing educational programmes shall be sensitive to this 'vulnerable' population and draw the attention of these adolescents to their increased risk of sexually transmitted diseases and undesired pregnancies. Well-designed behavioural change interventions may be effective when in addition to providing adolescents (both men and women) with clear information about the implications of an HPV infection, they also aim to improve safer sex behaviours: consistent condom usage, limiting the number of sex partners, as well as encouraging regular participation in gynaecological screenings and uptake of the HPV vaccine. As this study population demonstrated positive attitudes towards the primary and secondary prevention of cervical cancer, the free HPV vaccination for the 12-13-year-old girls in Autumn 2014 will hopefully increase the currently low uptake of the vaccine in Hungary.
Uhl, Kathleen; Trontell, Anne; Kennedy, Dianne
According to the March of Dimes, approximately 4% (1/28) of babies are born in the US each year with a birth defect. For the majority of birth defects the etiology is unknown, although chemicals, including drug exposures, probably account for less than 1% of all birth defects. The identification of potential human teratogenicity during drug development is important because drug-induced adverse fetal effects are potentially preventable with the application of risk assessment strategies and risk minimization tools and programs to minimize risk of pregnancy exposure while preserving access to drug benefits; risk assessment and risk minimization together comprise risk management. It is important that risk minimization programs intended to limit fetal exposure use a consistent approach and are tailored to the product-specific risk concerns in order to optimize the benefit-risk balance for a particular drug. This paper highlights general considerations in developing specific risk minimization programs to prevent fetal drug exposure including the relative advantages and disadvantages of each strategy.
Malonda, Elisabeth; Samper, Paula
Background Emotions are potent modulators and motivators of the behaviour that the individual displays in the different situations they have to live and they can act as a protection factor or vulnerability of the adapted or maladaptive behaviour. This study focuses on anxiety in adolescence. Objectives. The objective is, through a longitudinal study, to analyse the psychological processes and emotions that facilitate the symptoms of anxiety and those which protect the adolescent from these symptoms. Material and Methods 417 adolescents (192 boys and 225 girls) participated in a three-wave longitudinal study in Valencia, Spain. In the first wave, adolescents were either in the third year of secondary school (81 boys and 85 girls) or the fourth year of secondary school (111 boys and 140 girls). The mean age was 14.70 (SD = 0.68; range = 13-17 years). This study monitored participating adolescents for three years. Results The results indicate a differential profile in the evaluated emotions according to sex, with the girls being the ones to experiment more anxiety and more empathy, while the boys show more emotional instability and aggression. Conclusions It is concluded that the best predictors for anxiety are anger state, aggressive behaviour, empathic concern together with the lack of coping mechanisms focused on problem solving and the perception of stress as a threat. Key words:Adolescence, anxiety, emotions, coping, stress. PMID:27988785
Monteiro, Estela Maria Leite Meirelles; Neto, Waldemar Brandão; de Lima, Luciane Soares; de Aquino, Jael Maria; Gontijo, Daniela Tavares; Pereira, Beatriz Oliveira
An action research based on Paulo Freire's Culture Circles was developed to implement a health education intervention involving adolescents, in collective knowledge construction about strategies for the prevention of violence. The data collection in the Culture Circles involved 11 adolescents and included observation and field diary, photographic records and recording. The educational action aroused a critical socio-political and cultural position in the adolescents towards the situations of vulnerability to violence, including the guarantee of human rights, justice and the combat of inequities; changes in the social relations, combat against discrimination and intolerance; expansion of access and reorientation of health services through intersectoral public policies. The intervention empowered the group of adolescents for the prevention of violence and permitted the inclusion of health professionals in the school context, from an interdisciplinary perspective, contributing to the establishment of social support and protection networks.
Monteiro, Estela Maria Leite Meirelles; Neto, Waldemar Brandão; de Lima, Luciane Soares; de Aquino, Jael Maria; Gontijo, Daniela Tavares; Pereira, Beatriz Oliveira
An action research based on Paulo Freire's Culture Circles was developed to implement a health education intervention involving adolescents, in collective knowledge construction about strategies for the prevention of violence. The data collection in the Culture Circles involved 11 adolescents and included observation and field diary, photographic records and recording. The educational action aroused a critical socio-political and cultural position in the adolescents towards the situations of vulnerability to violence, including the guarantee of human rights, justice and the combat of inequities; changes in the social relations, combat against discrimination and intolerance; expansion of access and reorientation of health services through intersectoral public policies. The intervention empowered the group of adolescents for the prevention of violence and permitted the inclusion of health professionals in the school context, from an interdisciplinary perspective, contributing to the establishment of social support and protection networks. PMID:25931647
Saewyc, E M; Bearinger, L H; Blum, R W; Resnick, M D
The influence of sexual orientation on adolescents' sexual behaviors and pregnancy histories was investigated in a subsample of 3816 female adolescents, 12-19 years old, who completed the 1987 Minnesota (US) Adolescent Health Survey. 182 identified themselves as bisexual or lesbian, 1753 were unsure of their sexual orientation, and 1881 were heterosexual. Bisexual/lesbian respondents were about as likely as heterosexual respondents ever to have had intercourse (33.0% and 29.3%, respectively), but they had a significantly higher prevalence of childhood physical abuse (19.3% vs. 11.9%) and sexual abuse (22.1% vs. 15.3%) than their heterosexual counterparts. Among sexually experienced respondents, 29.8% of bisexual/lesbian adolescents, 43.5% of those unsure about their identity, and 23.1% of heterosexuals used no contraception and 12.3%, 8.5%, and 14.5%, respectively, of those who used contraception used an ineffective method. 12.3% of bisexual/lesbian women, 6.1% of those unsure about their sexual orientation, and 5.3% of heterosexual adolescents had experienced a pregnancy; 2 or more pregnancies were reported by 23.5%, 15.1%, and 9.8%, respectively, of ever-pregnant teens. Finally, 9.7% of bisexual/lesbian women had engaged in prostitution in the year preceding the survey, compared with 1.9% of heterosexuals and 3.4% of those unsure about their orientation. These findings suggest that adolescents who identify themselves as lesbian or bisexual are at high risk of pregnancy and poor contraceptive practices. Providers of reproductive health care and family planning services should not assume that their pregnant adolescent patients are heterosexual or that lesbian clients or those unsure of their sexual orientation are not in need of contraception.
Davies, Susan L.; DiClemente, Ralph J.; Wingood, Gina M.; Person, Sharina D.; Crosby, Richard A.; Harrington, Kathleen F.; Dix, Emily S.
This study examined associations between African American adolescent girls' desire to become pregnant and their sexual and relationship practices. Odds ratios and 95% confidence intervals were used to detect significant associations between pregnancy desire and the assessed correlates. Of 522 participants (14 to 18 years old), 67 (12.8%) were…
Kaleida, Phillip; And Others
This minority report is a rebuttal to the recommendations made by the Task Force on Adolescent Pregnancy and Parenting of the Pittsburgh Board of Public Education. It takes issue with the way in which decisions were made and especially with the recommendation to establish school-based clinics (SBCs) in or near high risk schools. This minority…
A girl's success in school--and after leaving school--is determined in part by the characteristics of and factors in her household and community. Many policies and programmes are based on an assumption that early marriage and adolescent pregnancy hamper continued progress toward gender equality in education. While education and age at marriage and…
Smith, Delores E.; And Others
Self-esteem measures were administered to 100 pregnant/parenting or never-pregnant adolescents; 41 were African American and 59 European American. Self-esteem was associated with pregnancy for the latter but not the former. Never-pregnant European American girls scored significantly higher than pregnant/parenting European Americans on 10 of 12…
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Gyan, Sylvia Esther; Ahorlu, Collins; Dzorgbo, Dan-Bright S; Fayorsey, Clara K
This study focuses on how older adolescent girls access and utilize social capital to develop resilience against teenage pregnancy in Begoro, Ghana. A survey of 419 non-pregnant girls aged 15-19 years, selected using a multi-stage cluster sampling technique, was conducted in 2012. Qualitative data were gathered through in-depth interviews with ten girls purposively selected from the survey respondents. Parents, relatives, teachers and religious groups were found to be important sources of social capital for the non-pregnant girls in developing resilience against teenage pregnancy. In addition, resilient girls tended to rely on multiple sources of social capital. It is recommended that stakeholders and policymakers in Ghana ensure that these significant sources of social capital in adolescent girls' sexual experience are equipped with the right information to help girls decrease the risk of teenage pregnancy.
Dobkin, Loren M; Perrucci, Alissa C; Dehlendorf, Christine
Current clinical guidelines for counseling adolescent patients about their pregnancy options fail to give concrete suggestions for how to begin and hold conversations that support patient autonomy, provide accurate and unbiased information, and address barriers to care. Recent research suggests that relative to adult women, adolescents are at increased risk of being denied abortion because they present beyond facilities' gestational age limits. Counseling that neglects to address the structural and developmental challenges that adolescents face when seeking care may contribute to the risk of abortion denial as well as subsequent delays in prenatal care. The task of providing non-directive, patient-centered, evidence-based pregnancy options counseling to an adolescent while ensuring that she receives her chosen course of care in a timely manner is challenging. This article presents a shared decision-making framework and specific suggestions for healthcare providers to support adolescent patients in coming to their decision about whether to continue or terminate an unplanned pregnancy and access follow-up care within the current sociopolitical environment.
Bezerra, Flávia F; Laboissière, Fabrícia P; King, Janet C; Donangelo, Carmen M
Physiologic adaptation to the high calcium demand during pregnancy and lactation may be different in adolescents than in adults, particularly at low calcium intake. The aim of this cross-sectional study was to compare biochemical markers of calcium and bone metabolism between adolescent (14-19 y) and adult (21-35 y) women with calcium intake approximately 500 mg/d, in three different physiologic states, i.e., control (nonpregnant, nonlactating; NPNL), pregnant and lactating. Markers of calcium metabolism [serum Ca, P and intact parathyroid hormone (iPTH); urinary Ca and P] and of bone turnover [urinary deoxypyridinoline (D-Pyr) and plasma bone alkaline phosphatase (BAP)] were measured in NPNL (adolescents, n = 12 and adults, n = 25), pregnant (adolescents, n = 30 and adults, n = 36) and lactating (adolescents, n = 19 and adults, n = 26) women. In the NPNL women, iPTH, D-Pyr and BAP were higher (P < 0.001) and urinary Ca was lower (P < 0.001) in adolescents than in adults. Serum iPTH was higher (P < 0.001) and urinary Ca was lower (P < 0.01) in adolescents than in adults also in pregnancy and lactation. Compared with NPNL women, serum Ca decreased (P < 0.001) with pregnancy in adolescents but not in adults. The increase in D-Pyr with pregnancy and lactation was very pronounced in adults ( approximately 130%, P < 0.001) but less in adolescents (<25%, P < 0.01). BAP increased (P < 0.001) with pregnancy and lactation in adults ( approximately 60%) but decreased (P < 0.001) with pregnancy in adolescents ( approximately 13%). Pregnancy and lactation appear to affect bone turnover in adolescent and adult women with low calcium intake differently.
Baldwin, Maureen K; Edelman, Alison B
Repeat pregnancy within 2 years of a previous birth or abortion occurs in approximately 35% of recently pregnant female adolescents. The majority of these pregnancies are classified as unintended with about half ending in births and the remainder in abortions. Rapid repeat pregnancy (RRP) is associated with increased maternal and neonatal morbidity and continues a cycle of economic deprivation for young women and their families. Immediately following a pregnancy, most young women report an intention to avoid pregnancy in the near future, but many change their minds or become ambivalent within months. Lack of contraceptive use is more common among those teens that resume sexual intercourse earlier, live with a male partner, had a preterm delivery, or had an intended teen pregnancy. Adolescents who do not initiate a long-acting reversible contraceptive (LARC) method (intrauterine device or contraceptive implant) have up to a 35 times increased risk of RRP compared with their peers using LARC. Risk of RRP is decreased when LARC methods are initiated earlier after an abortion or within the postpartum period. This review will focus on the prevalence of RRP, the risk factors for RRP, and the effectiveness of strategies to reduce unintended RRP including counseling and early initiation of long-acting contraceptive methods.
von Dadelszen, Peter; Magee, Laura A
In this chapter, taking a life cycle and both civil society and medically oriented approach, we will discuss the contribution of the hypertensive disorders of pregnancy (HDPs) to maternal, perinatal and newborn mortality and morbidity. Here we review various interventions and approaches to preventing deaths due to HDPs and discuss effectiveness, resource needs and long-term sustainability of the different approaches. Societal approaches, addressing sustainable development goals (SDGs) 2.2 (malnutrition), 3.7 (access to sexual and reproductive care), 3.8 (universal health coverage) and 3c (health workforce strengthening), are required to achieve SDGs 3.1 (maternal survival), 3.2 (perinatal survival) and 3.4 (reduced impact of non-communicable diseases (NCDs)). Medical solutions require greater clarity around the classification of the HDPs, increased frequency of effective antenatal visits, mandatory responses to the HDPs when encountered, prompt provision of life-saving interventions and sustained surveillance for NCD risk for women with a history of the HDPs.
Papiernik, E; Grangé, G; Zeitlin, J
This article reviews the arguments for the use of multifetal pregnancy reduction (MFPR) for the prevention of preterm deliveries in triplet and higher order multiple pregnancies and evaluates its effectiveness based on data from published studies. The arguments in favour of pregnancy reduction are based on the substantial mortality and morbidity associated with these pregnancies. Triplets and higher order multiples have increased rates of preterm delivery and intrauterine growth retardation, both of which are independent risk factors for death and handicap. Even controlling for gestational age, rates of mortality and handicap are higher for multiples than for singletons. Moreover, the family's risk of losing a child or having a handicapped child is greater because there are more infants at risk. MFPR effectively lowers these risk by reducing the frequency of preterm delivery. However, its effectiveness may be limited. In some studies, the proportion of preterm deliveries in reduced pregnancies remains above levels found in spontaneous twin or singleton pregnancies and MFPR does not appear to reduce the prevalence of low birth weight. Furthermore, the procedure itself has unwanted side effects: it increases the risk of miscarriage, premature rupture of the membranes and causes adverse psychological effects such as grief or depression for many patients. The authors note that a majority of the higher order multiple pregnancies result from a medical intervention in the first place, either through IVF techniques or the use of ovulation stimulation drugs. Although MFPR is an effective measure for reducing the substantial morbidity and mortality associated with higher order multiple pregnancies, preventive methods, such as limiting to 2 the number of embryos transferred for IVF and better control of the use of ovulation induction drugs, remain more effective and less intrusive.
Dryden, Annabelle; Jones, Rosemary
Presents lesson plans that have students explore and discuss various aspects of adolescent suicide as a means of coping with their depressive or suicidal feelings and as a preparation for them to help their peers. Each plan contains goals, objectives, activities, and suggested evaluation. Teacher information is included. (CT)
National Campaign To Prevent Teen Pregnancy, Washington, DC.
This report offers findings and recommendations by the National Campaign To Prevent Teen Pregnancy. Nearly one million teens become pregnant annually. The teen birth rate increased 24 percent between 1986-91 and has fallen 20 percent since then. Overall, too many parents and adult leaders do not take a strong stand against teen pregnancy. Strident…
Rose, India; Prince, Mary; Flynn, Shannon; Kershner, Sarah; Taylor, Doug
Teenage pregnancy is a major public health issue in the USA; this is especially true in the state of South Carolina (SC). Research shows that well developed, good-quality teenage pregnancy prevention (TPP) programmes can be effective in modifying young people's sexual behaviour. While several quantitative studies have examined parents' perceptions…
Bustos, Patrick D.
This document reviews three teenage pregnancy prevention strategies which were selected because of their easy access to teenagers and to illustrate the cost of implementation. After a discussion of the high cost of teenage pregnancy, the role of the state legislatures is described. Accessibility and acceptability are cited as two important…
Nolte, William H., Jr.; And Others
This pregnancy prevention curriculum guide for seventh and eighth grades is based upon the concept that individuals with social behavioral problems such as teenage pregnancy, drug abuse, criminal records, and other disruptive behaviors have a set of symptoms in common. Those symptoms include poor self-esteem, a lack of assertiveness, the inability…
Mombo-Ngoma, Ghyslain; Mackanga, Jean Rodolphe; González, Raquel; Ouedraogo, Smaila; Kakolwa, Mwaka A; Manego, Rella Zoleko; Basra, Arti; Rupérez, María; Cot, Michel; Kabanywany, Abdunoor M; Matsiegui, Pierre-Blaise; Agnandji, Seldiji T; Vala, Anifa; Massougbodji, Achille; Abdulla, Salim; Adegnika, Ayôla A; Sevene, Esperança; Macete, Eusebio; Yazdanbakhsh, Maria; Kremsner, Peter G; Aponte, John J; Menéndez, Clara; Ramharter, Michael
Objectives One of Africa's most important challenges is to improve maternal and neonatal health. The identification of groups at highest risk for adverse pregnancy outcomes is important for developing and implementing targeted prevention programmes. This study assessed whether young adolescent girls constitute a group at increased risk for adverse birth outcomes among pregnant women in sub-Saharan Africa. Setting Data were collected prospectively as part of a large randomised controlled clinical trial evaluating intermittent preventive treatment of malaria in pregnancy (NCT00811421—Clinical Trials.gov), conducted between September 2009 and December 2013 in Benin, Gabon, Mozambique and Tanzania. Participants Of 4749 participants, pregnancy outcomes were collected for 4388 deliveries with 4183 live births including 83 multiple gestations. Of 4100 mothers with a singleton live birth delivery, 24% (975/4100) were adolescents (≤19 years of age) and 6% (248/4100) were aged ≤16 years. Primary and secondary outcome measures Primary outcomes of this predefined analysis were preterm delivery and low birth weight. Results The overall prevalence of low birthweight infants and preterm delivery was 10% (371/3851) and 4% (159/3862), respectively. Mothers aged ≤16 years showed higher risk for the delivery of a low birthweight infant (OR: 1.96; 95% CI 1.35 to 2.83). Similarly, preterm delivery was associated with young maternal age (≤16 years; OR: 2.62; 95% CI 1.59 to 4.30). In a subanalysis restricted to primiparous women: preterm delivery, OR 4.28; 95% CI 2.05 to 8.93; low birth weight, OR: 1.29; 95% CI 0.82 to 2.01. Conclusions Young maternal age increases the risk for adverse pregnancy outcomes and it is a stronger predictor for low birth weight and preterm delivery than other established risk factors in sub-Saharan Africa. This finding highlights the need to improve adolescent reproductive health in sub-Saharan Africa. Trial registration number NCT00811421
Stirtzinger, Ruth; McDermid, Stephanie; Grusec, Joan; Bernardini, Silvia; Quinlan, Kathy; Marshall, Michelle
Describes the creation of a parenting course for high-risk adolescent mothers. This study supports direction away from 'knowledge-only' prevention/interventions with high risk adolescents and advocates the integration of this type of mental health/education parenting course with secondary school health class curricula using selected, trained…
Duffett, Lisa; Rodger, Marc
Placenta-mediated pregnancy complications, including preeclampsia, placental abruption, intrauterine growth restriction/small for gestational age and recurrent or late pregnancy loss, affect over 5% of pregnancies and can result in significant maternal and perinatal morbidity and mortality. These complications have been suggested to at least partly arise from placental insufficiency, possibly as a result of inappropriate coagulation activation. This association has led to the hypothesis that anticoagulant therapy, such as low molecular weight heparin, might reduce their occurrence. The following review will attempt to summarize the extensive research that has been performed to date exploring this hypothesis and provide guidance on the current and future role of low molecular weight heparin in women at risk for placenta-mediated pregnancy complications. A case will be made to question the widely adopted practice of prescribing low molecular weight heparin to women with prior placenta-mediated pregnancy complications and suggest possible areas for future research.
Solivan, Amber E.; Wallace, Maeve E.; Kaplan, Kathryn C.; Harville, Emily W.
Introduction Adolescent childbearing has been viewed as a social, political, and public health priority since the 1970s. Research has primarily focused on the negative consequences of teen pregnancy; less research has explored factors associated with healthy pregnancy and birth experiences in this population. Methods Using open-ended and qualitative techniques, researchers performed individual interviews with fifteen adolescent mothers (15–19 years of age) recruited from a Women’s and Children’s Clinic in Southern Louisiana, who had experienced a healthy pregnancy and bore a full-term, normal birth weight infant. We used a resiliency framework to identify factors that may have supported positive health outcomes despite risks associated with low-income and/or marginalized minority status. Results A total of 15 mothers of multiple racial/ethnic identities were included in the analysis. Mothers discussed potential protective factors that we classified as either assets (internal factors) or resources (external factors). Mothers demonstrated strong assets including self-efficacy and self-acceptance and important resources including familial support and partner support during pregnancy which may have contributed to their resiliency. Discussion Ensuring access to social and structural supports as well as supporting adolescent-friendly health and social policies may be key to promoting healthy maternal and infant outcomes among young women who become pregnant. PMID:26237055
Abernethy, Liz; Bleakley, Chris
This systematic review set out to identify randomised controlled trials and controlled intervention studies that evaluated the effectiveness of preventive strategies in adolescent sport and to draw conclusions on the strength of the evidence. A literature search in seven databases (Medline, SportDiscus, EMBASE, CINAHL, PEDro, Cochrane Review and DARE) was carried out using four keywords: adolescent, sport, injury and prevention (expanded to capture any relevant literature). Assessment of 154 papers found 12 studies eligible for inclusion. It can be concluded that injury prevention strategies that focus on preseason conditioning, functional training, education, balance and sport‐specific skills, which should be continued throughout the sporting season, are effective. The evidence for the effectiveness of protective equipment in injury prevention is inconclusive and requires further assessment. PMID:17496070
Harvey, Alison; Peden, Margie; Soori, Hamid; Bartolomeos, Kidist
Abstract Urgent attention is required to tackle the problem of child and adolescent injury across the world. There have been considerable shifts in the epidemiological patterns of child deaths; while great progress has been made in preventing infectious diseases, the exposure of children and adolescents to the risks of injury appear to be increasing and will continue to do so in the future. The issue of injuries is too often absent from child and adolescent health agendas. In December 2008, WHO and the United Nations Children’s Fund published the World report on child injury prevention, calling global attention to the problem of child injuries. This article expands on the report’s arguments that child injuries must be integrated into child health initiatives and proposes initial steps for achieving this integration. PMID:19551258
Remafedi, G J
In order to be effective, the national effort to contain the spread of Acquired Immunodeficiency Syndrome (AIDS) must include a youth focus. Knowledge of adolescent sexual behavior, drug use, and sexually transmitted diseases suggests that many adolescents are in jeopardy of acquiring Human Immunodeficiency Virus (HIV) infections; and they are among those most likely to benefit from preventative efforts as they explore adult roles and lifestyles. Preventative education should particularly target gay and other homosexually active young men. Effective teaching uses a variety of approaches and media, both inside and outside the classroom. Learning about AIDS is most likely to effect behavioral change when accompanied by other programs to build social supports, self-esteem, and positive identity. The ethical and rational use of HIV antibody testing may be a helpful adjunct to education for certain adolescents. Ultimately, our society's ability to address complex, associated social issues will determine our ability to control AIDS.
Barfield, Wanda D; Warner, Lee; Kappeler, Evelyn
Teen pregnancy and childbearing have declined over the past two decades to historic lows. The most recent declines have occurred during a time of coordinated national efforts focused on teen pregnancy. This article highlights a federal partnership to reduce teen pregnancy through the implementation of innovative, evidence-based approaches in affected communities, with a focus on reaching African-American and Latino/Hispanic youth. This initiative has the potential to transform the design and implementation of future teen pregnancy prevention efforts and provide a model that can be replicated in communities across the nation.
Englander-Golden, Paula; And Others
Patterns of drug use among teenagers indicate they are highly influenced by peers. To examine the influence of Say It Straight, an alcohol/drug abuse prevention program aimed at teaching adolescents to deal with peer pressure, sixth, seventh and eighth graders (N=509) created and role played situations in which they wanted to say "no" to…
The aim of this study was to present results of our one year experience with Cognitive Behavioral Psychology Program, in order to contribute to the building of whole school approach and positive psychology preventive mental health problems model. Based on Penn Resilience program (PRP), we modify and create program for early adolescents: how to…
Hohman, Melinda; Shillington, Audrey M.; Min, Jong Won; Clapp, John D.; Mueller, Kristin; Hovell, Melbourne
This study compared two groups of adolescents seeking help at HIV prevention drop-in agencies. The first group attended agencies in low-income Hispanic neighborhoods which recruited within the locale. The second group of youth attended agencies that recruited based upon a specific population--they targeted homeless and LGBQ youth. We explored the…
Ellickson, Phyllis L.; Bell, Robert M.
This report describes an experimental program developed by the RAND Corporation to prevent or reduce the use of alcohol, cigarettes and marijuana by adolescents. Section 1 introduces Project ALERT and presents major findings and conclusions from a study which assessed the program's effects at several points over a period of 15 months in 30…
Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W
Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birth weight and gestational age of infants born to adolescent mothers. Data from the National Longitudinal Study of Adolescent Health Waves I (1995/1996), II (1996), and IV (2007/2008) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (N = 558) self-reported infants' birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age, parent education, age at pregnancy, time between reporting abuse and birth, and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black).On average, births occurred 2 years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birth weight and prevalence of verbal dating violence victimization were significantly lower in Black compared with non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birth weight (p< .001) and 4.72 fewer weeks gestational age (p< .01) for Black mothers who gave birth 2 years post-reporting abuse. Physical dating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Reducing physical dating violence in adolescent relationships prior to
Koleva, Hristina; Stuart, Scott
Depression in adolescent pregnancy is common but underrecognized and can be associated with negative medical outcomes. This brief report examines the relationship between depressive symptoms and various demographic and obstetrical risk factors, as well as the use of antidepressants in pregnant adolescents of late teenage years. Data were derived from a relatively large sample (506 women) recruited from university-based and community mental health centers in Iowa. A cross-sectional analysis did not reveal significant statistical associations between the risk factors and depressive symptoms (Beck Depression Inventory). Antidepressant use was very low (3.7 %), and adolescents with higher depression scores were more likely to take medications. In conclusion, screening for depression in pregnant adolescents should be universal, regardless of demographic and obstetrical risk factors, and promptly addressed.
Rivara, F P; Aitken, M
Injury prevention is one of the most important preventive health challenges for pediatricians worldwide. A science of injury control has developed. Matching a child's skill and development age is needed for anticipatory guidance. Poor children living in rural areas are at greatest risk and require continuous reinforcement. Family function relates closely to injuries and recovery from injury. Prevention involves education, legislation, environmental modification, and engineering techniques.
Workman, Lauren M.; Flynn, Shannon; Kenison, Kelli; Prince, Mary
Continued efforts are needed to reduce teenage pregnancy in the United States. Implementation of evidence-based curricula in schools is one strategy toward meeting this goal. In 2010, the South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign) received funding to implement a teen pregnancy prevention (TPP) curriculum. Congruent with South…
Wallace, Jacqueline M; Milne, John S; Redmer, Dale A; Aitken, Raymond P
When pregnant adolescent sheep are overnourished to promote maternal growth during pregnancy, growth of the placenta is impaired and results in the premature delivery of low birth weight lambs relative to control-fed adolescents of equivalent age. These effects have been achieved by feeding two levels of the same complete diet. The present study evaluated the role of protein in pregnancy outcome in our adolescent sheep paradigm. Adolescent ewes were implanted with single embryos on day 4 post-oestrus. Thereafter ewes were offered ad libitum an isoenergetic diet (11.4 MJ metabolisable energy/kg DM) containing either 12% (basic, B) or 17% (extra, E) crude protein. At day 75 of gestation, half the pregnant ewes on each protein level were switched to yield four groups, BB, EE, BE and EB protein. A further optimally nourished control group received a moderate quantity of a ration (14% crude protein) designed to provide 100% of the estimated energy and protein requirement of the adolescent sheep according to stage of pregnancy. Pregnancy outcome was determined at term. Feed intakes were independent of protein level in the four groups of ewes fed ad libitum and were higher (P<0.001) than in the control group throughout. Maternal plasma urea concentrations reflected the current crude protein content of the diet offered and were elevated in the 17% compared with 12% protein groups (P<0.001). Within groups fed ad libitum, maternal plasma insulin, glucose, NEFA and homocysteine concentrations were largely independent of protein level. Gestation length, placental weight, lamb birth weight and initial colostrum yield were reduced (P<0.05) in all groups fed ad libitum relative to the optimally nourished control group. Similarly, total colostrum IgG, butterfat, lactose and crude protein content at parturition were attenuated in the ad libitum compared with the control groups. However, within ad libitum groups pregnancy outcome parameters were largely unaffected by level or timing
Communities across the country are having to deal with teenage suicide--a tragedy because it is preventable in many situations. Characteristics of a suicidal person are discussed. Recommendations for intervening with students after the suicide death of a peer in order to help prevent subsequent suicide deaths are made. (RM)
Knishkowy, Barry; Schein, Moshe; Kiderman, Alexander; Velber, Aliza; Edman, Richard; Yaphe, John
The AMA Guidelines for Adolescent Preventive Services (GAPS) has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice-based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC) program targeted all adolescent patients aged 12-18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57%) of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.
Meeks, Linda; And Others
The Gynecology Clinic, Wilce Health Center, Ohio State University, is putting into operation a comprehensive family planning service program that includes (1) patient education, (2) medical care, (3) pregnancy counseling, and (4) reproductive and sexuality counseling. (Author)
Nitric Oxide (NO) has been proposed as a mediator of vascular expansion during pregnancy. Inability to increase NO synthesis and/or production of its precursor, arginine, may contribute to pregnancy-induced hypertension. Adolescents have a higher incidence of gestational hypertension. It is not know...
Coleman, Priscilla K.
Using data from the National Longitudinal Study of Adolescent Health, various demographic, psychological, educational, and family variables were explored as predictors of pregnancy resolution. Only 2 of the 17 variables examined were significantly associated with pregnancy resolution (risk-taking and the desire to leave home). After controlling…
Hayes, Cheryl D., Ed.
This book examines in detail the complex, controversial problem of teenage pregnancy in the United States. Compiled by a panel of distinguished experts, it is a comprehensive review of data on such issues as sex education in the schools, contraception, abortion, adoption, prenatal and pediatric care, child support enforcement, and Aid to Families…
Davis, Richard A.
Examined data from state of North Carolina to test assumption that inordinately high Black teenage pregnancy rate accounts for difference between Black and White infant mortality rates. Results suggest that poverty, not race, plays crucial role in infant mortality. (Author/NB)
Lederman, Regina P.; Chan, Wenyaw; Roberts-Gray, Cynthia
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 role-played, 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. PMID:18316271
Lebrun, Victoria; Muessig, Kathryn E
Background Over 50% of pregnancies in the United States are unintended, meaning that the pregnancy is mistimed, unplanned, or unwanted. Unintended pregnancy increases health risks for mother and child, leads to high economic costs for society, and increases social disparities. Mobile phone ownership is rapidly increasing, providing opportunities to reach at-risk populations with reproductive health information and tailored unintended pregnancy prevention interventions through mobile phone apps. However, apps that offer support for unintended pregnancy prevention remain unevaluated. Objective To identify, describe, and evaluate mobile phone apps that purport to help users prevent unintended pregnancy. Methods We conducted an extensive search of the Apple iTunes and Android Google Play stores for apps that explicitly included or advertised pregnancy prevention or decision-making support in the context of fertility information/tracking, birth control reminders, contraceptive information, pregnancy decision-making, abortion information or counseling, sexual communication/negotiation, and pregnancy tests. We excluded apps that targeted medical professionals or that cost more than US $1.99. Eligible apps were downloaded and categorized by primary purpose. Data extraction was performed on a minimum of 143 attributes in 3 domains: (1) pregnancy prevention best practices, (2) contraceptive methods and clinical services, and (3) user interface. Apps were assigned points for their inclusion of features overall and for pregnancy prevention best practices and contraceptive information. Results Our search identified 6805 app descriptions in iTunes and Google Play. Of these, 218 unique apps met inclusion criteria and were included in the review. Apps were grouped into 9 categories: fertility trackers (n=72), centers and resources (n=38), birth control reminders (n=35), general sexual and reproductive health (SRH) information (n=17), SRH information targeted specifically to young
Toomey, Russell B.; Umana-Taylor, Adriana J.; Jahromi, Laudan B.; Updegraff, Kimberly A.
Social support for adolescent mothers, particularly from mother figures, can buffer risks and promote well-being. To date, no longitudinal research has investigated how the dimensions of social support may change during the transition from pregnancy to parenthood for adolescent mothers. This study examined stability and change in dimensions of…
Rah, Jee H; Christian, Parul; Shamim, Abu Ahmed; Arju, Ummeh T; Labrique, Alain B; Rashid, Mahbubur
Adolescent pregnancy is associated with adverse birth outcomes. Less is known about its influence on maternal growth and nutritional status. We determined how pregnancy and lactation during adolescence affects postmenarcheal linear and ponderal growth and body composition of 12-19 y olds in rural Bangladesh. In a prospective cohort study, anthropometric measurements were taken among primigravidae (n = 229) in the early first trimester of pregnancy and at 6 mo postpartum. Randomly selected never-pregnant adolescents (n = 458) of the same age and time since menarche were measured within 1 wk of these assessments. Annual changes in anthropometric measurements were compared between the 2 groups adjusting for confounders using mixed effects regression models. The mean +/- SD age and age at menarche of adolescents were 16.3 +/- 1.6 y and 12.7 +/- 1.2 y, respectively. Unlike pregnant girls who did not grow in height (-0.09 +/- 0.08 cm/y), never-pregnant girls increased in stature by 0.35 +/- 0.05 cm/y. The adjusted mean difference between the 2 groups was 0.43 +/- 0.1cm (P < 0.001). Similarly, whereas never-pregnant girls gained BMI, mid-upper arm circumference, and percent body fat, pregnant girls declined in every measurement by 6 mo postpartum, resulting in adjusted mean +/- SD differences in annual changes of 0.62 +/- 0.11 kg/m(2), 0.89 +/- 0.12 cm, and 1.54 +/- 0.25%, respectively (all P < 0.001). Differences in changes in all anthropometric measurements except height were greater among adolescents whose first pregnancy occurred <24 mo vs. > or =24 mo since menarche (BMI, -1.40 +/- 0.18 vs. -0.60 +/- 0.11 kg/m(2); all interaction terms, P < 0.05). Pregnancy and lactation during adolescence ceased linear growth and resulted in weight loss and depletion of fat and lean body mass of young girls.
New York State Council on Children and Families, New York.
In 1985 over 60,000 adolescents ages 10-19 became pregnant in New York State. Of these, almost 26,000 gave birth and over 33,000 terminated their pregnancies. While the majority of those who became pregnant were 18- and 19-year-olds, 1,700 were aged 10 to 14. Of the total, 59 percent were white, and 39 percent were black or from another ethnic…
Griesler, Pamela C.; Kandel, Denise B.; Davies, Mark
Used longitudinal sample of 187 mother-child dyads to examine the role of child behavior problems in explaining the effect of maternal prenatal smoking on adolescent daughters' smoking. Found that maternal prenatal smoking retained a unique effect on girls' current smoking with controls for current maternal smoking, child behavior problems, and…
Kozhimannil, Katy B.; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini
Purpose Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Methods Pregnancy and chlamydia infection rates among 15–19 year-old females were compared across Minnesota’s 87 counties, stratified by rural/urban designations. Regression models for rural counties (n=66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Findings Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. Conclusions This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study. PMID:25344773
Adolescent pregnancy prevention programs in the US pertain to sex education about reproduction, condom availability in schools, and outreach. This review of state actions on reproductive health policy in 1995 shows that, of the more than 100 bills introduced in 41 states, 16 bills were enacted. Some states eliminated condom and sex education programs in schools. 64 bills related to sexuality education in 30 states. 75% of these bills aimed to eliminate or restrict the scope of comprehensive sexuality education. The five laws enacted were identified as receiving a comprehensive analysis in the "State Reproductive Health Monitor," Vol.6, No.2, June 1995. The conservative states of North Carolina, Oklahoma, and Texas enacted new laws, which eliminated the teacher requirement for providing pregnancy prevention and disease education. These states retained education about sexually transmitted diseases and sexuality education. North Carolina and Texas granted parents the right to remove students from these classes, and schools must inform parents of their rights. Oklahoma required parental consent for attendance in these classes. Most proposed legislation about condom distribution in schools attempts to prohibit condom access. In 1995, there were 11 measures on prohibiting condom access proposed in 9 states, but none were enacted. Massachusetts is the only state where the State Board of Education policy recommends that schools consider condom availability as part of their HIV/AIDS prevention education efforts. This action was upheld in the Massachusetts Supreme Court. Four bills, out of 50 bills introduced in 1995, were enacted on unintended teenage pregnancy prevention issues. Opponents to sexuality education tend to promote abstinence-only education and an emphasis on the immorality and negative consequences of sexual intercourse. Opponents also tend to remove information from the curricula on pregnancy prevention and disease prevention on the grounds that it promotes
Nöstlinger, Christiana; Jasna, Loos; Sabrina, Bakeera-Kitaka; Obong'o, Christopher; Eric, Wobudeya; Buvé, Anne
There is an urgent need to develop positive prevention interventions for adolescents living with HIV in high endemic regions. Adapting existing evidence-based interventions for resource-constrained settings is effective when the intervention's theoretical core elements are preserved while achieving cultural relevance. We describe the process of adapting a primary prevention to a secondary/positive prevention programme for adolescents living with HIV in Kenya and Uganda. The systematic adaptation was guided by the Centers for Diseases Control's map for the adaptation process, describing an iterative process. The procedure included: assessing the target positive prevention group's needs (safer sex; fertility-related issues), identifying the potential interventions through a literature review, conducting qualitative adaptation research to identify areas for adaptation by ensuring cultural relevance (revising the intervention logic by adding topics such as adherence; HIV-related stigma; HIV-disclosure; safer sex), pilot-testing the adapted programme and conducting a process evaluation of its first implementation. Areas added onto the original intervention's logic framework, based on social cognitive theory, the theories of reasoned action and planned behaviour were information and skills building on sexual relationships and protection behaviour, prevention of vertical HIV transmission, contraception, HIV-disclosure, HIV-related stigma, HIV-treatment and adherence. The process evaluation using mixed methods showed that we delivered a feasible and acceptable intervention for HIV-positive adolescents aged 13-17 years. The systematic approach adopted facilitated the development of a contextualized and developmentally appropriate (i.e. age-specific) intervention for adolescents living with HIV.
Muraro, Ana Paula; Gonçalves-Silva, Regina Maria Veras; Ferreira, Márcia Gonçalves; Silva, Gulnar Azevedo e; Sichieri, Rosely
OBJECTIVE Investigate the effect of exposure to smoking during pregnancy and early childhood on changes in the body mass index (BMI) from birth to adolescence. METHODS A population-based cohort of children (0-5 years old) from Cuiabá, Midwest Brazil, was assessed in 1999-2000 (n = 2,405). Between 2009 and 2011, the cohort was re-evaluated. Information about birth weight was obtained from medical records, and exposure to smoking during pregnancy and childhood was assessed at the first interview. Linear mixed effects models were used to estimate the association between exposure to maternal smoking during pregnancy and preschool age, and the body mass index of children at birth, childhood and adolescence. RESULTS Only 11.3% of the mothers reported smoking during pregnancy, but most of them (78.2%) also smoked during early childhood. Among mothers who smoked only during pregnancy (n = 59), 97.7% had smoked only in the first trimester. The changes in body mass index at birth and in childhood were similar for children exposed and those not exposed to maternal smoking. However, from childhood to adolescence the rate of change in the body mass index was higher among those exposed only during pregnancy than among those who were not exposed. CONCLUSIONS Exposure to smoking only during pregnancy, especially in the first trimester, seems to affect changes in the body mass index until adolescence, supporting guidelines that recommend women of childbearing age to stop smoking. PMID:26247384
Teitelman, Anne M.; Bevilacqua, Amanda W.; Jemmott, Loretta Sweet
Background: Women and adolescent girls bear a significant burden of the global HIV pandemic. Both behavioral and biomedical prevention approaches have been shown to be effective. In order to foster the most effective combination HIV-prevention approaches for women and girls, it is imperative to understand the unique biological, social, and structural considerations that increase vulnerability to acquiring HIV within this population. Primary Study Objective: The purpose of this article is to propose novel ideas for personalized biobehavioral HIV prevention for women and adolescent girls. The central argument is that we must transcend unilevel solutions for HIV prevention toward comprehensive, multilevel combination HIV prevention packages to actualize personalized biobehavioral HIV prevention. Our hope is to foster transnational dialogue among researchers, practitioners, educators, and policy makers toward the actualization of the proposed recommendations. Methods: We present a commentary organized to review biological, social, and structural factors that increase vulnerability to HIV acquisition among women and adolescent girls. The overview is followed by recommendations to curb HIV rates in the target population in a sustainable manner. Results: The physiology of the lower female reproductive system biologically increases HIV risk among women and girls. Social (eg, intimate partner violence) and structural (eg, gender inequality) factors exacerbate this risk by increasing the likelihood of viral exposure. Our recommendations for personalized biobehavioral HIV prevention are to (1) create innovative mechanisms for personalized HIV risk—reduction assessments; (2) develop mathematical models of local epidemics; (3) prepare personalized, evidence-based combination HIV risk—reduction packages; (4) structure gender equity into society; and (5) eliminate violence (both physical and structural) against women and girls. Conclusions: Generalized programs and
Despite policy provision enabling sexuality education to address more than disease and pregnancy prevention, this focus continues to permeate many school programmes. This paper problematises the danger prevention emphasis in sexuality education, examines school's investment in it and asks how useful it is. The ways this kind of sexuality education…
Trivedi, D.; Brooks, F.; Bunn, F.; Graham, M.
Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual…
Viteri, Fernando E; Berger, Jacques
Most women worldwide enter pregnancy without adequate iron reserves or are already iron deficient. Estimates of iron needs during pregnancy are markedly reduced when iron reserves are available. The needs of absorbed iron to correct mild to moderate anemia in the last two trimesters are estimated. Pre-pregnancy and prenatal weekly supplementation can improve iron reserves effectively and safely, preventing excess iron and favoring better pregnancy outcomes. We explain how the weekly supplementation idea was developed, why current hemoglobin norms may be inadequately high (especially in pregnancy), and why excess iron as recommended by many agencies for developing populations can be undesirable.
McMahon, Tracey R; Hanson, Jessica D; Griese, Emily R; Kenyon, DenYelle Baete
Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Northern Plains American Indian youth. We employed a mixed-methods analysis of 24 focus groups and 20 interviews with a combined total of 185 urban and reservation-based American Indian youth and elders, local health care providers, and local school personnel to detail recommendations for the cultural adaptation, content, and implementation of a teen pregnancy prevention program specific to this population. Gender differences and urban /reservation site differences in the types of recommendations offered and the potential reasons for these differences are discussed.
Patchen, Loral; Letourneau, Kathryn; Berggren, Erica
This article details the evaluation of a clinical services program for teen mothers in the District of Columbia. The program's primary objectives are to prevent unintended subsequent pregnancy and to promote contraceptive utilization. We calculated contraceptive utilization at 6, 12, 18, and 24 months after delivery, as well as occurrence of subsequent pregnancy and birth. Nearly seven in ten (69.5%) teen mothers used contraception at 24 months after delivery, and 57.1% of contraceptive users elected long-acting reversible contraception. In the 24-month follow-up period, 19.3% experienced at least one subsequent pregnancy and 8.0% experienced a subsequent birth. These results suggest that an integrated clinical services model may contribute to sustained contraceptive use and may prove beneficial in preventing subsequent teen pregnancy and birth.
McMahon, Tracey R.; Hanson, Jessica D.; Griese, Emily R.; Kenyon, DenYelle Baete
Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Northern Plains American Indian youth. We employed a mixed-methods analysis of 24 focus groups and 20 interviews with a combined total of 185 urban and reservation-based American Indian youth and elders, local health care providers, and local school personnel to detail recommendations for the cultural adaptation, content, and implementation of a teen pregnancy prevention program specific to this population. Gender differences and urban /reservation site differences in the types of recommendations offered and the potential reasons for these differences are discussed. PMID:26550005
Marsiglia, Flavio F; Ayers, Stephanie; Gance-Cleveland, Bonnie; Mettler, Kathleen; Booth, Jaime
Classroom-based primary prevention programs with adolescents are effective in inhibiting the onset of drug use, but these programs are not designed to directly address the unique needs of adolescents at higher risk of use or already using alcohol and other drugs. This article describes the initial efficacy evaluation of a companion psychosocial small group program which aims at addressing the needs of Mexican heritage students identified by their teachers as being at higher risk for substance use or already experimenting with alcohol and other drugs. The adolescent (7th grade) small group curricula, REAL Groups, is a secondary prevention program which supplements the primary classroom-based substance use prevention program, keepin' it REAL. Following a mutual aid approach, a total of 109 7th grade students were referred by their teachers and participated in the REAL Groups. The remaining 252 7th grade students who did not participate served as the control group. To account for biased selection into REAL Groups, propensity score matching (PSM) was employed. The estimated average treatment effect for participants' use of alcohol was calculated at the end of the 8th grade. Results indicate that alcohol use decreased among students who participated in the REAL Groups relative to matched students who did not participate. These findings suggest that REAL Groups may be an effective secondary prevention program for higher-risk Mexican heritage adolescents.
Rosewater, K M; Burr, B H
Increasing rates of adolescent suicide are a significant health concern and the third leading cause of death for this age group. Recent research into psychiatric, gender-related, family, cultural and neurobiologic risk factors is reviewed. The effects of suicide exposure and media influences are also examined. Although many risk factors have been identified, the application of this knowledge to clinical practice requires further study. The limited number of studies on prevention and intervention strategies are discussed. High rates of nonadherence to follow-up remain problematic. More research is needed to develop appropriate treatments, prevention programs and outcome measures.
Family support has been demonstrated to be essential for successful long-term outcomes of low-income, African American adolescent mothers and their children [Apfel, N., & Seitz, V. (1996). Urban girls: Resisting stereotypes, creating identities. NY: New York University Press]. Family support may also be essential for the continued paternal involvement of unmarried, low-income, African American adolescent fathers. Twenty mothers of unmarried, low-income, African American adolescent parents were individually interviewed for this qualitative study to describe the experiences of paternal grandmothers (mothers of adolescent fathers) and maternal grandmothers (mothers of adolescent mothers) during transition to fatherhood for unmarried, low-income, African American adolescent fathers. Findings are presented according to the six factors of transition conditions from the nursing model of transitions [Schumacher, K., & Meleis, A. I. (1994). Image, 26, 119-127]: meanings, expectations, level of knowledge and skill, the environment, level of planning, and emotional and physical well-being. Findings indicate that transition to parenthood and grandparenthood is often abrupt and complicated for unmarried, low-income, African American adolescent parents and their families. Paternal and maternal grandmothers continue to act as primary parents for their adolescents while compensating for the lack of skills and attributes for the adolescents' children. Findings from this study can be used to design developmentally and culturally appropriate health care interventions that can support these families during this complex process.
Andersen, Susan L
Adolescence as highlighted in this special issue is a period of tremendous growth, synaptic exuberance, and plasticity, but also a period for the emergence of mental illness and addiction. This commentary aims to stimulate research on prevention science to reduce the impact of early life events that often manifest during adolescence. By promoting a better understanding of what creates a normal and abnormal trajectory, the reviews by van Duijvenvoorde et al., Kilford et al., Lichenstein et al., and Tottenham and Galvan in this special issue comprehensively describe how the adolescent brain develops under typical conditions and how this process can go awry in humans. Preclinical reviews also within this issue describe how adolescents have prolonged extinction periods to maximize learning about their environment (Baker et al.), whereas Schulz and Sisk focus on the importance of puberty and how it interacts with stress (Romeo). Caballero and Tseng then set the stage of describing the neural circuitry that is often central to these changes and psychopathology. Factors that affect the mis-wiring of the brain for illness, including prenatal exposure to anti-mitotic agents (Gomes et al.) and early life stress and inflammation (Schwarz and Brenhouse), are included as examples of how exposure to early adversity manifests. These reviews are synthesized and show how information from the maturational stages that precede or occur during adolescence is likely to hold the key towards optimizing development to produce an adolescent and adult that is resilient and well adapted to their environment.
Adolescence as highlighted in this special issue is a period of tremendous growth, synaptic exuberance, and plasticity, but also a period for the emergence of mental illness and addiction. This commentary aims to stimulate research on prevention science to reduce the impact of early life events that often manifest during adolescence. By promoting a better understanding of what creates a normal and abnormal trajectory, the reviews by van Duijvenvoorde et al., Kilford et al., Lichenstein et al., and Tottenham and Galvan in this special issue comprehensively describe how the adolescent brain develops under typical conditions and how this process can go awry in humans. Preclinical reviews also within this issue describe how adolescents have prolonged extinction periods to maximize learning about their environment (Baker et al.), whereas Schulz and Sisk focus on the importance of puberty and how it interacts with stress (Romeo). Caballero and Tseng then set the stage of describing the neural circuitry that is often central to these changes and psychopathology. Factors that affect the mis-wiring of the brain for illness, including prenatal exposure to anti-mitotic agents (Gomes et al.) and early life stress and inflammation (Schwarz and Brenhouse), are included as examples of how exposure to early adversity manifests. These reviews are synthesized and show how information from the maturational stages that precede or occur during adolescence is likely to hold the key towards optimizing development to produce an adolescent and adult that is resilient and well adapted to their environment. PMID:27423540
management are difficult, and medication and surgery are expensive and may have potentially adverse side effects (Barlow, 2007). Weight loss tends to be...approach to the adolescent bariatric surgical patient. J Pediatr Surg, 39(3), 442-447; discussion 446-447. Ingerski, L. M., Janicke, D. M
Philliber, Susan; Nolte, Kim
This paper reports the results of a project funded by the Centers for Disease Control and Prevention intended to promote the use of science-based approaches to teen pregnancy prevention. As with other efforts to promote diffusion of innovations, adoption of these successful programs faced a number of barriers including lack of knowledge of programs that work, lack of funding for training and materials, devaluing science-based approaches, complexity of successful programs, politics, funding streams and compatibility with particular community characteristics. Nevertheless, five state and three national teen pregnancy organizations provided intensive technical assistance, produced materials, and provided training to encourage use of programs that work. Local barriers to their work included the fact that teen pregnancy rates were already dropping, instability of funding to pay for such programs, turnover of agency staff, the need for intensive follow-up to promote adoption, the internal organization of the initiative, and the fragility of local teen pregnancy prevention coalitions. Still, in each of five states, there was increased adoption of science-based approaches to prevent teen pregnancy.
Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W.
Background Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birthweight and gestational age of infants born to adolescent mothers. Methods Data from the National Longitudinal Study of Adolescent Health Waves I (1995/96), II (1996), and IV (2007/08) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (n=558) self-reported infants’ birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age; parent education; age at pregnancy; time between reporting abuse and birth; and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black). Results On average, births occurred two years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birthweight and prevalence of verbal dating violence victimization were significantly lower in Black compared to non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birthweight (p<.001) and 4.72 fewer weeks gestational age (p<0.01) for Black mothers who gave birth two years post-reporting abuse. Physical dating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Conclusions Reducing physical dating violence in
Hsu, Jean W; Thame, Minerva M; Gibson, Raquel; Baker, Tameka M; Tang, Grace J; Chacko, Shaji K; Jackson, Alan A; Jahoor, Farook
During pregnancy, glycine and serine become more important because they are the primary suppliers of methyl groups for the synthesis of fetal DNA, and more glycine is required for fetal collagen synthesis as pregnancy progresses. In an earlier study, we reported that glycine flux decreased by 39% from the first to the third trimester in pregnant adolescent girls. As serine is a primary precursor for glycine synthesis, the objective of this study was to measure and compare glycine and serine fluxes and inter-conversions in pregnant adolescent girls and adult women in the first and third trimesters. Measurements were made after an overnight fast by continuous intravenous infusions of 2H2-glycine and 15N-serine in eleven adolescent girls (17·4 (se 0·1) years of age) and in ten adult women (25·8 (se 0·5) years of age) for 4 h. Adolescent girls had significantly slower glycine flux and they made less glycine from serine in the third (P<0·05) than in the first trimester. Baby birth length was significantly shorter of adolescent girls (P=0·04) and was significantly associated with third trimester glycine flux. These findings suggest that the pregnant adolescent cannot maintain glycine flux in late pregnancy compared with early pregnancy because of decreased synthesis from serine. It is possible that the inability to maintain glycine synthesis makes her fetus vulnerable to impaired cartilage synthesis, and thus linear growth.
Taliaferro, Lindsay A; Borowsky, Iris Wagman
Many young people who present to primary care providers (PCPs) have high levels of emotional distress and/or suicidal ideation. Therefore, PCPs are in an ideal position to recognize and respond to early symptoms and distress signals that accompany suicide warning signs, yet they underrecognize mood disorders and suicidality among youth. Medical school and residency programs typically provide inadequate training on pediatric mental health and adolescent suicide prevention. Thus, PCPs lack complete knowledge of risk factors and feel unprepared to handle mental health problems among youth. In this article, the authors provide an overview of the epidemiology of adolescent suicide and describe risk factors, protective factors, and warning signs. They propose that physician education represents a promising strategy to prevent adolescent suicide, and they establish the need for improved educational opportunities that would provide PCPs with the necessary skills and supports to identify and respond to psychosocial concerns that may increase suicide risk among youth. They recommend strategies, methods, and content areas for addressing educational gaps, as well as organizational approaches to support enhanced physician education. They also suggest areas for future research.
Mott (C.S.) Foundation, Flint, MI.
Proceedings of a conference on adolescent pregnancy are presented in this document. Eunice Kennedy Shriver's opening address, in which she urged the building of "communities of caring" is summarized, as is the address by Gina C. Adams who discussed recent findings on the topic of adolescent pregnancy. Several programs developed to address the…
Raidoo, Shandhini; Kaneshiro, Bliss
Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand.
Gallo-Vallejo, J L; Naveiro-Fuentes, M; Puertas-Prieto, A; Gallo-Vallejo, F J
After noting that there are a number of risk factors for venous thromboembolism disease during pregnancy, it emphasizes primary prevention and treatment of this serious condition during pregnancy and the postpartum period are essential to reduce maternal morbidity and mortality. Low molecular-weight heparins are under the anticoagulant of choice in pregnancy. Your prescription may make both the primary care physician, as the hematologist and obstetrician. As for prescribing terms, an application protocol in both primary and specialized, multidisciplinary care, based on the existing literature on the subject is presented, which indicated that the hypercoagulable disorders associated with some of the risk factors, forced to do thromboprophylaxis with low molecular-weight heparins throughout pregnancy and the postpartum period presented.
Atuyambe, Lynn; Mirembe, Florence; Tumwesigye, Nazarius M; Annika, Johansson; Kirumira, Edward K; Faxelid, Elisabeth
Background Maternal health services have a potentially critical role in the improvement of reproductive health. In order to get a better understanding of adolescent mothers'needs we compared health seeking practices of first time adolescent and adult mothers during pregnancy and early motherhood in Wakiso district, Uganda. Methods This was a cross-sectional study conducted between May and August, 2007 in Wakiso district. A total of 762 women (442 adolescents and 320 adult) were interviewed using a structured questionnaire. We calculated odds ratios with their 95% CI for antenatal and postnatal health care seeking, stigmatisation and violence experienced from parents comparing adolescents to adult first time mothers. STATA V.8 was used for data analysis. Results Adolescent mothers were significantly more disadvantaged in terms of health care seeking for reproductive health services and faced more challenges during pregnancy and early motherhood compared to adult mothers. Adolescent mothers were more likely to have dropped out of school due to pregnancy (OR = 3.61, 95% CI: 2.40–5.44), less likely to earn a salary (OR = 0.43, 95%CI: 0.24–0.76), and more likely to attend antenatal care visits less than four times compared to adult mothers (OR = 1.52, 95%CI: 1.12–2.07). Adolescents were also more likely to experience violence from parents (OR = 2.07, 95%CI: 1.39–3.08) and to be stigmatized by the community (CI = 1.58, 95%CI: 1.09–2.59). In early motherhood, adolescent mothers were less likely to seek for second and third vaccine doses for their infants [Polio2 (OR = 0.73, 95% CI: 0.55–0.98), Polio3 (OR = 0.70: 95% CI: 0.51–0.95), DPT2 (OR = 0.71, 95% CI: 0.53–0.96), DPT3 (OR = 0.68, 95% CI: 0.50–0.92)] compared to adult mothers. These results are compelling and call for urgent adolescent focused interventions. Conclusion Adolescents showed poorer health care seeking behaviour for themselves and their children, and experienced increased community
Antecedent factors operative in the causation of adolescent pregnancy include: The sexuality of contemporary society, especially the media. Prolongation of educational any vocational preparation in industrialized western society. Normal physical maturation at an early age. Peer and social pressure. Low expectations of life among minority and economically poor individuals. The conspiracy of silence surrounding sexuality and the inability of society to admit and deal realistically with the sexual activity of adolescents. Failure to provide sex education, clarification of values, family-life education, preparation for parenthood, and knowledge of birth-control and family-planning services targeted to teenagers, including adolescent males. Psychological and emotional problems. Failure to provide available and accessible early pregnancy-detection services with adequate counseling and support services. Failure to provide abortion services. Failure to provide supportive services to adolescents who have a child in order to prevent repeated pregnancy. Pregnancy, childbearing, and motherhood represent ultimate feminine fulfillment to many in our society, and unless attainable expectations and desirable alternatives are available, adolescents will continue to see little reason to postpone pregnancy and childbearing.
In the Andean region of Latin America over one million adolescent girls get pregnant every year. Adolescent pregnancy (AP) has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. AP can also be conceptualized as a marker of inequity, since it disproportionately affects girls from the poorest households and those who have not been able to attend school. Using results from a study carried out in the Amazon Basin of Ecuador, this paper explores APs and adolescents' sexual and reproductive health from a rights and gender approach. The paper points out the main features of a rights and gender approach, and how it can be applied to explore APs. Afterward it describes the methodologies (quantitative and qualitative) and main results of the study, framing the findings within the rights and gender approach. Finally, some implications that could be generalizable to global reserach on APs are highlighted. The application of the rights and gender framework to explore APs contributes to a more integral view of the issue. The rights and gender framework stresses the importance of the interaction between rights-holders and duty-bearers on the realization of sexual and reproductive rights, and acknowledges the importance of gender–power relations on sexual and reproductive decisions. A rights and gender approach could lead to more integral and constructive interventions, and it could also be useful when exploring other sexual and reproductive health matters. PMID:20596248
Trigo, Lucas Augusto Monteiro Castro; Surita, Fernanda Garanhani; Parpinelli, Mary Angela; Pereira, Belmiro Gonçalves; Fertrin, Kleber Yotsumoto; Costa, Maria Laura
Beta thalassemia major is a rare hereditary blood disease in which impaired synthesis of beta globin chains causes severe anemia. Medical treatment consists of chronic blood transfusions and iron chelation. We describe two cases of adolescents with beta thalassemia major with unplanned pregnancies and late onset of prenatal care. One had worsening of anemia with increased transfusional requirement, fetal growth restriction, and placental senescence. The other was also diagnosed with hypothyroidism and low maternal weight, and was admitted twice during pregnancy due to dengue shock syndrome and influenza H1N1-associated respiratory infection. She also developed fetal growth restriction and underwent vaginal delivery at term complicated by uterine hypotonia. Both patients required blood transfusions after birth and chose medroxyprogesterone as a contraceptive method afterwards. This report highlights the importance of medical advice on contraceptive methods for these women and the role of a specialized prenatal follow-up in association with a hematologist.
Ladner, Joyce A.
Analyzes the impact of teen pregnancy on the education of Black adolescents. Examines the scope of the problem, its social context, and its consequences. Discusses several effective approaches to teenage pregnancy prevention, including sex/family life education, school-based health clinics, life skills instruction, school retention, and…
Horn, Andrea B; Cañizares, Catalina; Gómez, Yvonne
This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency.
Horn, Andrea B.; Cañizares, Catalina; Gómez, Yvonne
This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency. PMID:24871258
Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia
Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…
Oman, Roy F.; Merritt, Breanca T.; Fluhr, Janene; Williams, Jean M.
Background: The purpose of this study is to compare the effectiveness of a national comprehensive teen pregnancy prevention (TPP) intervention to a national abstinence-only TPP intervention on middle school students' knowledge, attitudes, and behaviors related to teen sexual behaviors in a state with high teen birth rates. Methods: Pre- and…
Rhodes, Darson L.; Jozkowski, Kristen N.; Hammig, Bart J.; Ogletree, Roberta J.; Fogarty, Erin C.
Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted.…
Emily Hall Tremaine Foundation, Inc., Hartford, CT.
This competency-based secondary learning guide on preventing teen pregnancy is part of a series that are adaptations of guides developed for adult consumer and homemaking education programs. The guides provide students with experiences that help them learn to do the following: make decisions; use creative approaches to solve problems; establish…
National Campaign To Prevent Teen Pregnancy, Washington, DC.
This guide discusses the importance of parent influence in preventing teen pregnancy, offering insights from research regarding: closeness between parents and their children; parent-child communication; parental attitudes and values about abstinence and/or the dangers of unprotected sex; parents' reluctance to discuss the issue; parental…
Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison
The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…
Young, Jami F.; Mufson, Laura; Davies, Mark
Background: Indicated interventions for adolescents with elevated depressive symptoms may help decrease rates of depression. The current study reports on the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group indicated preventive intervention. Methods: Forty-one adolescents with elevated depression symptoms were…
Espada, Jose P.; Orgiles, Mireia; Morales, Alexandra; Ballester, Rafael; Huedo-Medina, Tania B.
Due to a lack of controlled studies on HIV prevention interventions among Spanish adolescents, COMPAS, a five-session behavioral intervention, was developed and tested on Spanish adolescents aged 15-18. Participants included 827 adolescents from central, east and north Spain. Six hundred and seven students (M = 15.71 years) received the…
Simons, Anne D.; Rohde, Paul; Kennard, Betsy D.; Robins, Michele
Relapse and recurrence in adolescent depression are important problems. Much less is known about relapse prevention compared to the acute treatment of depression in adolescents. Based on previous research, theoretical predictions, and clinical experience, the Treatment for Adolescents With Depression Study (TADS) protocol was designed to determine…
Thrasher, James F.; Niederdeppe, Jeffrey D.; Jackson, Christine; Farrelly, Matthew C.
Media campaigns to prevent adolescent tobacco use in the United States increasingly focus on the deceitful practices of the tobacco industry; however, little is known about how adolescents at elevated smoking risk respond to this strategy. This study used data from a nationally representative survey of 10,035 adolescents, ages 12-17 years, in…
Predicting and preventing suicide represent very difficult challenges for clinicians. The awareness of adolescent suicide as a major social and medical problem has increased over the past years. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Suicide prevention efforts among adolescents are restricted by the fact that there are five key problems related to the evaluation and management of suicidality in adolescents: 1. Many clinicians underestimate the importance of the problem of adolescent suicidal behavior and underestimate its prevalence. 2. There is a misconception that direct questioning of adolescents about suicidality is sufficient to evaluate suicide risk. 3. Another misconception is that adolescents with non-psychiatric illnesses do not need to be evaluated for suicidality. 4. Many clinicians do not know about or underestimate the role of contagion in adolescent suicidal behavior. 5. There is a mistaken belief that adolescent males are at lower suicide risk than adolescent females. Educating medical professionals and trainees about the warning signs and symptoms of adolescent suicide and providing them with tools to recognize, evaluate, and manage suicidal patients represent a promising approach to adolescent suicide prevention.
Skeith, Leslie; Rodger, Marc
Placenta-mediated pregnancy complications, such as pre-eclampsia, placental abruption, birth of a small-for-gestational age infant and late pregnancy loss, are common and carry significant morbidity and mortality. The etiology of placenta-mediated pregnancy complications is likely multifactorial and may include abnormal coagulation activation of the maternal-fetal interface. The use of antepartum low-molecular-weight heparin (LMWH) prophylaxis to prevent recurrent placenta-mediated pregnancy complications has become common practice despite limited and conflicting evidence to support its use. This paper reviews the evidence, including recently published data from an individual patient level meta-analysis, which challenges the role of LMWH in preventing recurrent placenta-mediated pregnancy complications. Incorporating this recent evidence, we recommend against the use of LMWH to prevent recurrent placenta-mediated pregnancy complications in women with and without inherited thrombophilia.
Brabin, Loretta; Stokes, Elizabeth; Dumbaya, Isatou; Owens, Stephen
Background The use of most anti-malarial medications is restricted during pregnancy, but two doses of sulphadoxine-pyrimethamine are recommended after the first trimester as intermittent preventive treatment in pregnancy (IPTp). In The Gambia, only 32% of women receive two doses and very little research has been conducted on women's awareness of drug safety during pregnancy. The objective of this paper was to assess whether rural Gambian women were aware of the importance of the timing of the two-dose IPT dose schedule and its relevance to drug safety. Methods This was a qualitative study in which 41 interviews and 16 focus group discussions with women, adolescents, men and traditional birth attendants were conducted. A generic qualitative approach was used to generate a theory as to why women might not participate in IPTp as recommended. Results Although most women used calendar months to count their stage of pregnancy, these months did not correlate with their concept of foetal development. Foetal growth was described following Islamic tradition as water, clot, piece of meat and human being, although there was little consensus about the order or timing in which these stages occurred. Common signs and conditions of malaria were known. Women were anxious about miscarriage and recognized that some medicines should not be taken in the first trimester, but were urged by men and traditional birth attendants to attend for antenatal care in the first trimester to "start treatment." General knowledge about the purpose of pregnancy medications and when they should be taken was poor among both men and women. One important result was that women relied entirely on health workers to provide safe drugs, at the correct time. Conclusion Women did not have relevant information to judge the safety and appropriate timing of pregnancy drugs, which made them over-reliant on health workers. They should be encouraged to date their own pregnancies in culturally relevant terms and to
Rishel, Carrie W.; Cottrell, Lesley; Kingery, Tricia
Adolescent risk behavior remains prevalent and contributes to numerous social problems and growing health care costs. Contrary to popular perception, adolescents in rural areas engage in risky behaviors at least as much as youth from urban or suburban settings. Little research, however, focuses on risk behavior prevention in the rural context.…
Weinstein, Erica S.
This paper presents a review of 25 sources on school-based eating disorder prevention programs for pre-adolescents and adolescents. The sources used to collect the information include Search ERIC database, PsycINFO, InterScience, and Expanded Academic. A review of the literature concluded that the most effective method of implementing a…
Pickle, Sarah; Wu, Justine; Burbank-Schmitt, Edith
This article summarizes the literature regarding the epidemiology and prevention of unintended pregnancy in the United States. Because of the Affordable Care Act and its accompanying contraceptive provision, there is a need for more primary care clinicians to provide family planning services. Office-based interventions to incorporate family planning services in primary care are presented, including clinical tools and electronic health record use. Special attention is paid to long-acting reversible contraceptive methods (the subdermal implant and intrauterine devices); these highly effective and safe methods have the greatest potential to decrease the rate of unintended pregnancy, but have been underused.
Hanson, Mark; Barker, Mary; Dodd, Jodie M; Kumanyika, Shiriki; Norris, Shane; Steegers, Eric; Stephenson, Judith; Thangaratinam, Shakila; Yang, Huixia
Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception. To improve preconception health, an integrated approach, including pregnancy prevention, planning, and preparation is needed, involving more than the primary health-care sector and adopting an ecological approach to risk reduction that addresses personal, societal, and cultural influences. Raising awareness of the importance of good health in the period before pregnancy will require a new social movement: combining bottom-up mobilisation of individuals and communities with a top-down approach from policy initiatives. Interventions to reduce or prevent obesity before conception and during pregnancy could contribute substantially to achievement of the global Sustainable Development Goals, in terms of health, wellbeing, productivity, and equity in current and future generations.
Anderman, Eric M.; Cupp, Pamela K.; Lane, Derek R.; Zimmerman, Rick; Gray, DeLeon L.; O'Connell, Ann
Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV/pregnancy instruction, three months after instruction, and one year after instruction). Results indicated that classroom goal structures were related to both proximal and distal knowledge, attitudes, intentions, and efficacy beliefs. Results in particular indicate that the perception of a mastery goal structure in health education classrooms fosters knowledge, improved attitudes, enhanced efficacy beliefs, and lower intentions to have sexual intercourse. PMID:24876759
Worthman, C M; Whiting, J W
This report documents an example of interactions of cultural change with adolescent fertility and marriage patterns in an East African community. Between 1950 and 1980 the rate of unwed motherhood in Ngeca, Kenya, showed a marked increase from 0% in the 1940s to 11.4% in the 1960s. The authors present evidence of recent changes in Kikuyu culture that may account for this change. Traditional Kikuyu culture structured adolescence through status and role changes bounded and reinforced by ritual and instruction. Abandonment of traditional initiation rites and attenuation of the age-set system have most markedly altered the structure of adolescent experience by shifting the content and context of socialization. Major agents for change in this process have been the school, church, and modern economy. Responsibility for mate selection has remained with young people, but the determinants of partner desirability and gender ratios in partner availability have shifted considerably. Traditional criteria of male desirability included ability to pay bridewealth and to provide the wife with land; diligence and demeanor measured female attractiveness. At present, education and wage earning capacity affect partner attractiveness of each sex. The decline of polygyny has both shifted the balance of competition for spouses toward females, and has had significant repercussions in the marital and reproductive histories of males. Decreases in brideprice and reversals in direction of transfers of wealth at marriage are tangible signs of change in the marriage market. Deritualization of genital operations and attendant weakening of the age-set system have interrupted the flow of information on sex behavior and reproduction, controlled physical intimacy, and partner selection reinforced by peer pressure. Denial of contraception, the continued importance of marriage and fertility, and ambivalence toward sexual activity in adolescence all support adolescent sexual experimentation and
Horowitz, Jason L.; Garber, Judy; Ciesla, Jeffrey A.; Young, Jami F.; Mufson, Laura
This study evaluated the efficacy of 2 programs for preventing depressive symptoms in adolescents. Participants were 380 high school students randomly assigned to a cognitive-behavioral program (CB), an interpersonal psychotherapy-adolescent skills training program (IPT-AST), or a no-intervention control. The interventions involved eight 90-min…
La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn
Background: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the…
During pregnancy, growth of the fetus depends on an adequate glycine supply because it is needed for synthesis of fetal DNA, collagen, and serine. Since pregnant adolescent girls give birth to lower birth weight babies, it is possible that they do not produce sufficient glycine to meet overall deman...
Diniz, Eva; Koller, Sílvia H.; Volling, Brenda L.
Adolescent motherhood is a risky situation related to poorer quality of infant caregiving. The lack of social support and increased odds for maternal depression are the main concerns. This study aimed to investigate whether maternal-foetal attachment, social support and maternal depression measured during pregnancy and after birth were associated…
This field survey relative to adolescent pregnancy was undertaken through site visits and interviews. Data indicated that: (1) while many people are carrying out excellent programs and activities, the numbers are small compared to the need; (2) in some types of services the old tried-and-found-wanting approaches are perpetuated; (3) in some,…
Barton, Maria; Santucci-Pereira, Julia; Russo, Jose
Pregnancy produces a protective effect against breast cancer in women who had their first full term pregnancy (FTP) in their middle twenties. The later in life the first delivery occurs, the higher the risk of breast cancer development. Also, transiently during the postpartum period, the risk of developing breast cancer increases. This transient increased risk is taken over by a long-lasting protective period. The genomic profile of parous women has shown pregnancy induces a long-lasting “genomic signature” that explains the preventive effect on breast cancer. This signature reveals that chromatin remodeling is the driver of the differentiation process conferred by FTP. The chromatin remodeling process may be the ultimate step mediating the protection of the breast against developing breast cancer in post-menopausal years. PMID:25540638
Greenberg, James A; Bell, Stacey J; Guan, Yong; Yu, Yan-Hong
Folate (vitamin B(9)) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities). This article reviews the metabolism of folic acid, the appropriate use of folic acid supplementation in pregnancy, and the potential benefits of folic acid, as well as the possible supplementation of l-methylfolate for the prevention of pregnancy-related complications other than neural tube defects.
Heilmann, L; Hojnacki, B; Fischer, W M
Twenty-two cases of acute venous thrombosis in pregnancy (0.64%) were studied. Concomitant pulmonary embolism was documented in 0.23%. Prophylactic heparinization was performed in 32 gravidae. In the acute thrombosis group therapy was instituted in the 26th week, and in the prophylaxis group in the 20th week of pregnancy. Recurrent thromboses after cesarean section occurred in 4.5% of the patients with acute venous thrombosis and in 5.6% of those in the prophylaxis group. Reduced red blood cell deformability, low antithrombin III and high leukocyte count were identified as risk factors. Heparinization did not prevent increased red blood cell aggregation and plasma viscosity at birth. Rheologic factors played only a secondary role in the prophylaxis group. Prophylactic heparinization in pregnancy is currently the only means of reducing the thrombosis recurrence rate in patients with a history of thromboembolism.
Background There is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence. Methods We evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children. Results We evaluated 2405 children in 1999–2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p < 0.01). Adjusting for age, sex, maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: −0.32, p < 0.001) compared to non
East, Patricia L.; Barber, Jennifer S.
On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first-time-pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long-term negative consequences of high educational aspirations for pregnant adolescents’ adjustment to parenting are discussed. PMID:25641985
Contreras Campos, María Elena; Rodríguez-Cervantes, Nora; Reza-López, Sandra; Ávila-Esparza, Marina; Chávez-Corral, Dora Virginia; Levario-Carrillo, Margarita
Teenage pregnancy has been associated with adverse effects for the mother and the newborn (NB). In order to compare body composition (BC) between adolescents (Ad) and mature women (MW) during pregnancy and to determine the difference in birthweight and perinatal morbidity, pregnant Ad (n=40) and MW (n=227) were studied. BC changes between the second and third trimesters were determined by multifrequency bioelectrical impedance analysis, and birthweight and NB morbidity were evaluated. During the second and third trimesters of the pregnancy, fat mass was lower in the Ad group [16 kg (13-19)] than in the MW group [22 kg (17-27)] (P<0.01; median and quartiles 1-3). Fat-free mass increased by 3.09 kg (2.29-4.20) and 2.20 kg (1.0-3.59) (P≤0.01), and total body water increased by 2.77 L (0.84-4.49) vs. 2.04 L (0.55-3.89) (P=0.36), in the Ad and MW groups, respectively (median and quartiles 1-3). Birthweight was not significantly different between NBs of Ad (3223 ± 399 g) and NBs of MW (3312 ± 427 g, P=0.22). The youngest Ad (<18 year old, n=8) had NB with lower birthweight than MW (3031 ± 503 g, P=0.06). NBs of Ad mothers showed a non-significant trend towards a higher rate of morbidity relative to the NBs of MW. In conclusion, the BC of Ad differs from that of MW during pregnancy. In addition, the NB infants of Ad mothers tended to have a lower birthweight than those from MW, a result that suggests that the Ad should be in strict prenatal control.
Choi, Hong-Seok; Kim, Na-Young
Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions. Cervical ectopic pregnancy can usually be treated by methotrexate injection or surgery. We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods. By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding. PMID:26430673
Murphy-Erby, Yvette; Stauss, Kim; Koh, Eun
Despite an overall reduction in teenage pregnancy rates in the USA, the decrease for young women of Mexican heritage in the USA has been less significant than the decrease for their White and African-American peers. Furthermore, the availability of teenage pregnancy prevention models that are conceptualised specifically for people of Mexican…
Carvajal, Jorge A.
Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction). Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called “deep placentation disorders”; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids) rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA) supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction. PMID:25019084
Sheffield, Jeanie K.; Fiorenza, Erika; Sofronoff, Kate
Although a relatively high percentage of Australian adolescents experience mental health problems, many disturbed adolescents do not receive the help they require, and only a small proportion of adolescents seek professional psychological help. The present study examined adolescents' willingness to seek help and investigated factors that promote…
Aubrey, Jennifer Stevens; Behm-Morawitz, Elizabeth; Kim, Kyungbo
This article examines the impact of a popular documentary series about teen pregnancy, MTV's 16 and Pregnant, on adolescent girls' pregnancy-related attitudes, beliefs, and behavioral intentions. The results suggest that girls who watched 16 and Pregnant, compared with a control group, reported a lower perception of their own risk for pregnancy and a greater perception that the benefits of teen pregnancy outweigh the risks. The authors also examined the relationships between homophily and parasocial interaction with the teen moms featured in 16 and Pregnant and attitudes, beliefs, and behavioral intentions, finding that homophily predicted lower risk perceptions, greater acceptance of myths about teen pregnancy, and more favorable attitudes about teen pregnancy. Parasocial interaction demonstrated the same pattern of results, with the addition of also predicting fewer behavioral intentions to avoid teen pregnancy. Last, results revealed that teen girls' perceptions that the message of 16 and Pregnant was encouraging of teen pregnancy predicted homophily and parasocial interaction with the teen moms. Theoretical and practical implications are discussed.
Hindin, Michelle J; Kalamar, Amanda M; Thompson, Terri-Ann; Upadhyay, Ushma D
Adolescent pregnancy, particularly unintended pregnancy, can have lasting social, economic, and health outcomes. The objective of this review is to identify high-quality interventions and evaluations to decrease unintended and repeat pregnancy among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched for all languages for articles published through November 2015. Gray literature was searched by hand. Reference tracing was utilized, as well as unpacking systematic reviews. Selected articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Twenty-one high-quality interventions and evaluations were abstracted. Nine reported statistically significant declines in pregnancy rates (five cash transfer programs, one education curriculum, two life-skills curricula, and a provision of contraception intervention), seven reported increases in contraceptive use (three provision of contraception interventions, two life-skills curricula, a peer education program, and a mass media campaign), two reported decreases in sexual activity (a cash transfer program and an education and life-skills curriculum), and two reported an increase in age of sexual debut (both cash transfer programs). The selected high quality, effective interventions included in this review can inform researchers, donors, and policy makers about where to make strategic investments to decrease unintended pregnancy during young adulthood. Additionally, this review can assist with avoiding investments in interventions that failed to produce significant impact on the intended outcomes. The diversity of successful high-quality interventions, implemented in a range of venues, with a diversity of young people, suggests that there are multiple strategies that can work to prevent unintended pregnancy.
Stanis, Jessica J.; Andersen, Susan L.
Rationale Most substance use is initiated during adolescence when substantial development of relevant brain circuitry is still rapidly maturing. Developmental differences in reward processing, behavioral flexibility, and self-regulation lead to changes in resilience or vulnerability to drugs of abuse depending on exposure to risk factors. Intervention and prevention approaches to reducing addiction in teens may be able to capitalize on malleable brain systems in a predictable manner. Objective To review what is known about how factors that increase vulnerability to addiction, including developmental stage, exposure to early life adversity (ranging from abuse, neglect, and bullying), drug exposure, and genetic predisposition, impact the development of relevant systems. Results and Conclusions Appropriate, early intervention may restore the normal course of an abnormal trajectory and reduce the likelihood of developing a substance use disorder (SUD) later in life. A considerable amount is known about the functional neuroanatomy and/or pharmacology of risky behaviors based on clinical and preclinical studies, but relatively little has been directly translated to reduce their impact on addiction in high-risk children or teenagers. An opportunity exists to effectively intervene before adolescence when substance use is likely to emerge. PMID:24464527
Crano, William D; Alvaro, Eusebio M; Tan, Cara N; Siegel, Jason T
Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed 3 antimarijuana advertisements, each followed immediately by videotaped discussions involving 4 adults or 4 adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants' perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants' perceived control (both p < .02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p < .05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p < .05). The findings may facilitate development of more effective prevention methods that emphasize the importance of the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. (PsycINFO Database Record
Taylor, Myra; Jinabhai, Champak; Dlamini, Siyabonga; Sathiparsad, Reshma; Eggers, Matthijs S; De Vries, Hein
Researchers aimed to determine the effects of a teenage pregnancy (TP) prevention program for 816 high school students attending 16 KwaZulu-Natal, South African schools through a randomized control trial. Data were collected at baseline and at the 8-month follow-up in 2009. Results were calculated using multivariate analyses of program effects employing Mplus 6, and indicated significantly healthier attitudes, including intentions to abstain from sex whilst at school, plans to communicate with partners about teenage pregnancy, and increased reports of condom use. Researchers thus provide some support for the effectiveness of a TP prevention program that should be further strengthened in a comprehensive approach that includes schools and families.
Martínez-García, Genevieve; Carter-Pokras, Olivia; Atkinson, Nancy; Portnoy, Barry; Lee, Sunmin
Despite recent declines, Latinas bear a disproportionate burden of teen births. Understanding social, cultural, and demographic factors underlying pregnancy desire among Latino adolescents is needed to design effective teen pregnancy prevention interventions. A questionnaire was completed by 794 Latino youth including a "pregnancy wantedness…
Browne, J L; Klipstein-Grobusch, K; Franx, A; Grobbee, D E
Nearly all of the annual 287,000 global maternal deaths are preventable. Hypertensive disorders of pregnancy (HDP) are among the major causes. A novel fixed-dose combination pill or polypill to prevent cardiovascular disease is a promising strategy for prevention of HDP. The aim of this study was to identify eligible candidates for a polypill for the prevention of HDP. A comprehensive review of systematic reviews on drug and dietary interventions to prevent HDP was conducted. Interventions were evaluated based on efficacy, dose, route of administration, and side effects. Fourteen interventions were assessed. Low-dose aspirin and calcium were identified as candidates for a polypill, with risk reduction estimations for pregnancy-induced hypertension and preeclampsia ranging between 10 and 62 %, depending on patient population characteristics including a priori risk, and gestation age at start of intervention. Their effect may be augmented through the addition of vitamin D, vitamin B12, and folic acid. The effect and optimal composition needs to be evaluated in future trials. Given the persistent burden of maternal and perinatal mortality associated with HDP, prevention of these disorders is key-especially in low-resource settings. The polypill approach with a combination of aspirin, calcium, vitamin D, vitamin B12, and folic acid is a promising strategy to improve maternal and perinatal health outcomes.
Hill, Julie C.; Lynne-Landsman, Sarah D.; Graber, Julia A.; Johnson, Kelly J.
Objective: Young people in urban areas are often the focus of pregnancy and sexually transmitted infection (STI) prevention programmes because of their high risk of unwanted pregnancy and contracting an STI. Young people in rural areas are far less studied but also have a high risk of similar outcomes. This study evaluates Giving Our Girls…
... each trimester are described below. 1 First Trimester (Week 1 to Week 12) The events that lead to pregnancy begin ... and oxygen to the fetus. 2 Second Trimester (Week 13 to Week 28) At 16 weeks, and ...
Martyn, K K; Hutchinson, S A
The purpose of this research was to generate a grounded theory that explains the social-psychological processes of low-income African American adolescents who avoided pregnancy. Data collection included focus groups and in-depth interviews with 17 women aged 19 to 26. Data analysis using the grounded theory method revealed that these girls were the recipients of negative social-psychological scripts, putting them at risk for poverty and early childbearing. The "tough girls" struggled to rewrite these scripts by recognizing their negativity, being disenchanted with the scripts, determining to be different, and creating better lives. These aware, introspective young women believed in self-responsibility, self-protection, education, and financial independence. Practice implications and considerations for programmatic interventions can be based on this analysis.
Huizink, Anja C.; Dick, Danielle M.; Sihvola, Elina; Pulkkinen, Lea; Rose, Richard J.; Kaprio, Jaakko
Objective To study the potential harmful effect of in utero exposure to the Chernobyl disaster in April 1986, and maternal anxiety associated with that exposure, on symptoms of behavior disorder observed at age 14. Method The sample included 419 Finnish twin pairs, born in 1985–1987. Prenatal exposure to Chernobyl was determined, and a group of exposed twins (n=232) were compared with a non-exposed reference group of twins (n= 572). The exposed group was further subdivided into three trimesters of pregnancy in which exposure occurred. The Finnish translation of the adolescent Semi-Structured Assessment of Genetics of Alcoholism (C-SSAGA-A) interview was used to assess symptoms of common psychiatric disorders based on DSM-III-R criteria when the twins were age 14. The number of lifetime symptoms of depression, generalized anxiety disorder, attention deficit hyperactivity disorder, conduct disorder and oppositional defiant disorder symptoms were compared by means of Poisson regression analyses, adjusted for SES, sex, age and clustering of data. Results Adolescents who were exposed from the second trimester in pregnancy onwards, had a 2.32-fold risk (95 % CI: 1.13 – 4.72) of having lifetime depression symptoms, an increased risk of fulfilling DSM-III-R criteria of a Major Depressive Disorder (OR = 2.48, 95 % CI: 1.06 – 5.7) , and a 2.01-fold risk (95 % CI: 1.14 – 3.52) of having ADHD symptoms. No associations with anxiety, CD or ODD symptoms were found. Conclusions Perturbations in fetal brain development may result in the increased prevalence of depressive and AHDH symptoms after prenatal stress exposure from second trimester onwards. PMID:17997723
Rodger, Marc A; Carrier, Marc; Le Gal, Grégoire; Martinelli, Ida; Perna, Annalisa; Rey, Evelyne; de Vries, J I P; Gris, Jean-Christophe
A 35-year-old woman with recurrent severe placenta-mediated pregnancy complications in her 2 pregnancies asks: Will low-molecular-weight heparin help prevent recurrent placenta-mediated pregnancy complications in my next pregnancy? We performed a meta-analysis of randomized controlled trials (RCTs) comparing low-molecular-weight heparin (LMWH) vs no LMWH for the prevention of recurrent placenta-mediated pregnancy complications. We identified six RCTs that included a total of 848 pregnant women with prior placenta-mediated pregnancy complications. The primary outcome was a composite of pre-eclampsia (PE), birth of a small-for-gestational-age (SGA) newborn (<10th percentile), placental abruption, or pregnancy loss >20 weeks. Overall, 67 (18.7%) of 358 of women being given prophylactic LMWH had recurrent severe placenta-mediated pregnancy complications compared with 127 (42.9%) of 296 women with no LMWH (relative risk reduction, 0.52; 95% CI, 0.32 to 0.86; P = .01; I(2), 69%, indicating moderate heterogeneity). We identified similar relative risk reductions with LMWH for individual outcomes, including any PE, severe PE, SGA <10th percentile, SGA <5th percentile, preterm delivery <37 weeks, and preterm delivery <34 weeks with minimal heterogeneity. LMWH may be a promising therapy for recurrent, especially severe, placenta-mediated pregnancy complications, but further research is required.
Fallahi, Arezoo; Ghofranipour, Fazlollah; Ahmadi, Fazlollah; Malekafzali, Beheshteh; Hajizadeh, Ebrahim
Background: Oral health plays a vital role in people’s general health and well-being. With regard to the costly treatments of oral diseases, preventive programs need to be designed for dental caries based on children’s perspectives. Objectives: The purpose of this study was to describe and explore challenges for caring dental health based on children’s perspectives. Patients and Methods: A qualitative design with content analysis approach was applied to collect and analyze the perspectives of students about factors influencing oral and dental care. Eighteen Iranian students in 8 guidance schools were chosen through the purposive sampling. Semi-structured interviews were held for data gathering. In order to support the validity and rigor of the data, different criteria such as acceptability, confirmability, and transferability were utilized. Results: During data analysis, four main themes developed: “barriers to dental health,” “maintaining dental health,” “uncertainty in decision-making” and “supportive factors”. “Uncertainty in decision-making” and “barriers to dental health” were the main challenges for preventing dental caries among adolescents. Conclusions: “Certainty in decision-making” to maintain dental health depends on overcoming the barriers of dental health. Further research is needed to confirm the findings of this study. PMID:25593720
Miller, Faith Y; Campus, Guglielmo; Giuliana, Giovanna; Piscopo, Maria R; Pizzo, Giuseppe
The use of topically applied fluoride has been widely researched as a means to reduce the risk of dental caries in conjunction with other treatment modalities (mechanical oral hygiene, dietary control, antimicrobial intervention, pit and fissure sealants). There is overwhelming evidence that reports not only the significance and importance of the use of fluoride as a caries-preventive agent, but also how safe fluoride application is when used appropriately, particularly in higher risk individuals and populations. This paper reviews the caries-protective benefits of topical fluoride application in children and adolescents, with an emphasis on the clinical efficacy and safety of the vehicles by which fluoride is topically delivered. Fluoride toothpaste represents today the most cost-effective fluoride-delivery system in the oral cavity and its use should be the centerpiece in all caries-preventive strategies. On the other hand, mouthrinses, gels and varnishes currently represent adjuncts to toothpaste use and should be targeted towards individuals and groups at high risk of caries.
Dickson, Laurie M.; Derevensky, Jeffrey L.; Gupta, Rina
Despite the growing popularity of the harm reduction approach in the field of adolescent alcohol and substance abuse, a harm reduction approach to prevention and treatment of youth problem gambling remains largely unexplored. This article poses the question of whether the harm reduction paradigm is a promising approach to the prevention of…
Suárez-Pinto, Tatiana A; Blanco-Gómez, Argénida; Díaz-Martínez, Luis A
Seventy percent of adolescent morbidity and mortality is related to six risky behaviors. The Rapid Assessment for Adolescent Preventive Services is a screening questionnaire consisting of 21 questions but there is not a validated Spanish-language version. The obj ective of this study was to validate the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services in two Colombian cities: Bucaramanga and Medellin. The questionnaire was administered to 270 randomly selected adolescent students aged between 11 and 19 years old. Its internal consistency measured using Cronbach's alpha was 0.7207. The factor analysis showed that two factors accounted for 84.5% of variance, but factor loading indicates that only one of these is valid in Colombia: substance use (tobacco, alcohol, narcotics, and psychoactive substances).
Hoefnagels, Cees; Hospers, Harm J; Hosman, Clemens; Schouten, Leo; Schaalma, Herman
Although the dual function of condom use (preventing pregnancy and preventing STDs) is well known, little is known about the determinants of condom use for STD prevention when contraception is not an issue. We compared two intentions to use condoms with a new sex partner: one based on a vignette not mentioning pregnancy risk and one on a vignette explicitly stating there was no risk of pregnancy. We also investigated whether intentions to use condoms change when there is no pregnancy risk, to allow such changes to be predicted from an STD risk-perception perspective. This cross-sectional survey was completed by 151 undergraduate students. The correlation coefficient between the two intentions about condom use approached zero (0.02; p=.783). Logistic regression showed that two STD risk-perception variables distinguished between consistent and non-consistent reporters of their intention to use condoms. Findings are discussed from the perspectives of policy, methodology and theory.
Connolly, Jennifer; Josephson, Wendy
The emergence of romantic relationships is one of the most striking features of adolescence. By the late adolescent years, most teenagers have been in a romantic relationship at least once and roughly half of teens are dating currently. Alarmingly though, in many of these relationships adolescents act aggressively toward each other and this…
De Grace, Alyssa; Clarke, Angela
To inform practitioners and researchers interested in the prevention of intimate partner violence (IPV) among adolescents, 9 principles of effective prevention programs (Nation et al., 2003) were described and examples of how these principles have been incorporated into existing teen dating violence prevention programs were provided. An investigation of current prevention practices for adolescent IPV resulted in one noteworthy program that has successfully incorporated all 9 principles of effective prevention programming-Safe Dates (Substance Abuse and Mental Health Services Administration, National Registry of Evidence-based Programs and Practices [SAMHSA-NREPP], 2006). Although Safe Dates serves as a model teen dating violence prevention program, it may not be equally effective across contexts and diverse groups. Therefore, as researchers and practitioners continue to develop and refine programs to reduce adolescent IPV, the principles of effective prevention programs should serve as a guiding framework.
The problems and risks of unprotected sex, unintended pregnancy and sexually transmitted infections are inextricably linked. In this context, the critical yet overlooked problem of infertility also needs to be addressed. Dual protection means concurrent protection against unintended pregnancy and STI/HIV. This paper argues for a more comprehensive notion of "triple protection" to include the safeguarding of fertility. This is intended explicitly to draw out the connection between infertility and STIs--using the "visibility" of fertility and infertility and people's immediate connection with them--and in so doing to bolster STI prevention and control efforts. It could also serve to highlight the connections between infertility and unsafe abortion and delivery practices, which still exist in many developing countries. Understanding differences in perception and weighting of protection concerns by young women and men, whether they wish to start, postpone or avoid pregnancy, is essential for the creation of effective programmes. Building on efforts to promote dual protection, a strategic opportunity exists to include prevention of infertility into safer sex messages and to address the fragmentation of reproductive health and HIV/AIDS programmes.
Background Malaria remains a major public health problem in sub Saharan Africa and the extent of utilisation of malaria preventive measures may impact on the burden of malaria in pregnancy. This study sought to determine the association between malaria preventive measures utilized during pregnancy and the birth outcomes of birth weight and preterm delivery. Methods This cross sectional survey involved 800 mothers who delivered at the University College Hospital, and Adeoyo Maternity Hospital, Ibadan. Data obtained included obstetric information, gestational age, birth weight and self reported use of malaria prevention strategies in index pregnancy. Results Most (95.6%) mothers used one or more malaria control measures. The most commonly used vector control measures were window net (84.0%), insecticide spray (71.5%) and insecticide treated bed nets (20.1%), while chemoprophylactic agents were pyrimethamine (23.5%), Intermittent Preventive Treatments with Sulphadoxine-Pyrimethamine (IPTsp) (18.5%) and intermittent chloroquine (9.5%) and 21.7% used herbal medications. The mean ± SD birthweight and gestational age of the babies were 3.02 kg ± 0.56 and 37.9 weeks ± 2.5 respectively. Preterm delivery rate was 19.4% and 9% had low birth weight. Comparing babies whose mothers had IPTsp with those who did not, mean birth weight was 3.13 kg ± 0.52 versus 3.0 kg ± 0.56 (p = 0.016) and mean gestational age was 38.5 weeks ± 2.1 versus 37.8 weeks ± 2.5 (p = 0.002). The non-use of IPTsp was associated with increased risk of having low birth weight babies (AOR: 2.27, 95% CI: 0.98; 5.28) and preterm birth (AOR: 1.93, 95% CI: 1.08, 3.44). The non use of herbal preparations (AOR: 0.55, 95% CI: 0.36, 0.85) was associated with reduced risk of preterm birth. The mean ± SD birth weight and gestational ages of babies born to mothers who slept under ITNs were not significantly different from those who did not (p = 0.07 and 0.09 respectively). Conclusions There is a need for
Reilly, John J.
Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the “energy gap” that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers. PMID:22798005
During pregnancy, adult women with a normal BMI synthesize extra amino acids after an overnight fast by increasing body protein breakdown and decreasing amino acid oxidation. It is not known whether adolescent girls can make these adaptations during pregnancy. The present study aimed to measure and ...
Radzilani-Makatu, Makondelele; Takalani, James F.
Background Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education) suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. Aim The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP) in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Setting The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. Methodology A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Results Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that TP could be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. Conclusion The conclusion drawn was that learners are aware of the measures for preventing TP. PMID:27380836
Abatemarco, Diane J.; West, Bernadette; Zec, Vesna; Russo, Andrea; Sosiak, Persis; Mardesic, Vedran
War and social transition in Croatia have increased unemployment and rates of substance abuse. A decrease in prevention programs places adolescents at an increased risk. Data collected from the 2002 Split Youth Behavior Risk Survey (YRBS) showed that adolescents are at risk for alcohol use and related problems. Thus, there is a need to strengthen…
Muehlenkamp, Jennifer J.; Walsh, Barent W.; McDade, Moira
Non-suicidal self-injury (NSSI) continues to be a problem among youth and there is a great need for programming aimed at reducing NSSI in adolescents. The signs of self-injury program is the first known NSSI school-based prevention program for adolescents that attempts to increase knowledge, improve help-seeking attitudes and behaviors, and…
Longshore, Douglas; Ellickson, Phyllis L.; McCaffrey, Daniel F.; St. Clair, Patricia A.
In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth…
Gonzales, Nancy A.; Dumka, Larry E.; Millsap, Roger E.; Gottschall, Amanda; McClain, Darya B.; Wong, Jessie J.; German, Miguelina; Mauricio, Anne M.; Wheeler, Lorey; Carpentier, Francesca D.; Kim, Su Yeong
Objective: This randomized trial of a family-focused preventive intervention for Mexican American (MA) adolescents evaluated intervention effects on adolescent substance use, internalizing and externalizing symptoms, and school discipline and grade records in 8th grade, 1 year after completion of the intervention. The study also examined…
Wolfe, Vicky Veitch; Dozois, David J. A.; Fisman, Sandra; DePace, JoAnne
Up to 25% of adolescent girls experience an episode of major depression, at least twice the rate found with adolescent boys. In addition to reducing the suffering associated with depression, prevention efforts with this high-risk population have the potential to avert short- and long-term functional impairment, reduce the risk of associated mental…
Miller, Brenda A.; Aalborg, Annette E.; Byrnes, Hilary F.; Bauman, Karl; Spoth, Richard
Mothers were allowed to choose between two different family-based adolescent alcohol-drug prevention strategies and the choice was examined in relation to parent and teen characteristics. Under real world conditions, parents are making choices regarding health promotion strategies for their adolescents and little is known about how parent and teen…
Buckley, Lisa; Chapman, Rebekah L.; Sheehan, Mary C.; Reveruzzi, Bianca N.
Injury is a significant public health problem among youth. A primary cause of adolescent injury is risk-taking behavior, including alcohol use, interpersonal violence and road-related risks. A novel approach to prevention is building on friendships by encouraging adolescents to intervene into their friends' risk taking. Fifty-one early adolescents…
Wilson, Louise F.
Obesity is a major pediatric public health problem. Adolescents are a priority population for intervention strategies. School nurses are in key positions to design intervention strategies to promote healthy lifestyles and prevent adolescent obesity in the students they serve. To design effective programs, school nurses need to know what components…
Sponsored by the Ounce of Prevention Fund, this report presents a comprehensive look at three Toward Teen Health high school-based, adolescent health centers in Chicago, Illinois. Following a brief introduction, the report provides the rationale for opening adolescent health centers and outlines the principles that guide the centers. Next, a…
It has come to light that Zika virus (ZIKV) infection during pregnancy can result in trans-placental transmission to the fetus along with fetal death, congenital microcephaly, and/or Central Nervous System (CNS) malformations. There are projected to be >9,200,000 births annually in countries with ongoing ZIKV transmission. In response to the ZIKV threat, the World Health Organization (WHO) is strategically targeting prevention of infection in pregnant women and funding contraception in epidemic regions. I propose that the damaging effects of ZIKV can be reduced using a seasonal window of opportunity for conception that may minimize maternal exposure. Like other acute viral infections—including the related flavivirus, dengue virus (DENV)—the transmission of ZIKV is anticipated to be seasonal. By seasonally planning pregnancy, this aspect of pathogen ecology can be leveraged to align sensitive periods of gestation with the low-transmission season. PMID:27467271
Martinez, Micaela Elvira
It has come to light that Zika virus (ZIKV) infection during pregnancy can result in trans-placental transmission to the fetus along with fetal death, congenital microcephaly, and/or Central Nervous System (CNS) malformations. There are projected to be >9,200,000 births annually in countries with ongoing ZIKV transmission. In response to the ZIKV threat, the World Health Organization (WHO) is strategically targeting prevention of infection in pregnant women and funding contraception in epidemic regions. I propose that the damaging effects of ZIKV can be reduced using a seasonal window of opportunity for conception that may minimize maternal exposure. Like other acute viral infections-including the related flavivirus, dengue virus (DENV)-the transmission of ZIKV is anticipated to be seasonal. By seasonally planning pregnancy, this aspect of pathogen ecology can be leveraged to align sensitive periods of gestation with the low-transmission season.
Sorhaindo, Annik; Bonell, Chris; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Mitchell, Kirstin
Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women. Black and minority ethnic young women perceived that the assessment of their risk was based on stereotyping. Others felt their outgoing character was misinterpreted as signifying risk. To manage these imposed labels, stigma and reputational risks, young women responded to being targeted by adopting strategies, such as distancing, silence and refusal. To limit harmful consequences, programmes could involve prospective participants in determining their need for intervention or introduce programmes for young people at all levels of risk.
Clapis, Maria José; Parenti, Patricia Wottrich
Aiming at getting to know the work of nurses concerning pregnant adolescents, we have opted to develop a study to identify the characteristics of scientific production made by nurses about adolescence pregnancy by means of national and international indexed articles, between 1996 and 2000. The bibliographic survey resulted in a sample of 27 indexed articles. The participation of nurses in assisting pregnant adolescents is highlighted by taking part in adolescence pregnancy prevention programs, by assisting in the gravidic-puerperal period and by providing social support. As possibilities of participation for nurses, we have identified the important role of sexual education and adolescence pregnancy prevention programs, prenatal and post-delivery assistance programs. Also, we have emphasized the need to organize the nurse's work to facilitate access to contraceptive methods and to prevent sexually transmissible diseases.
... also be tired and need more rest. Your body will change as your baby grows during the nine months of your pregnancy. Don't hesitate to call your health care provider if you think you have a problem or something is bothering or worrying you.
Shaffer, David, Ed.; And Others
The book describes Project Prevention, an interdisciplinary project developed by the American Academy of Child and Adolescent Psychiatry, to identify risk factors for mental disorders and preventive interventions. After an introductory chapter, the following eight chapters cover: the scope of Project Prevention; children at high risk (e.g.,…
Patel, Viraj V.; Cunningham, Chinazo O.
Although the proportion of new HIV infections in the United States among women has decreased over the last few years, still, approximately 20% of new infections occur annually among adolescent and adult women. The development of effective evidence-based prevention interventions remains an important approach to further decreasing these numbers. Technology-delivered prevention interventions hold tremendous potential due, in part, to their ability to reach beyond the walls of brick-and-mortar intervention sites to engage individuals where they are. While most technology-delivered interventions have focused on adolescents and men who have sex with men, much fewer have specifically targeted adolescent or adult women despite evidence showing interventions tailored to specific target populations are most effective. We summarize the recently published literature on technology-delivered HIV prevention interventions for U.S. adolescent and adult women and provide suggestions for next steps in this nascent but emergent area of prevention research. PMID:26412086
Karam, Jocelyne G; McFarlane, Samy I
Type 2 Diabetes has reached epidemic proportions among adults in the USA and worldwide. With the rising epidemic of obesity among children and adolescents, a parallel epidemic of type 2 diabetes is also observed in this patient population. Control of diabetes and its complications, mainly cardiovascular disease has been sub-optimal at best. Therefore, effort trials have been conducted and others are ongoing to assess various modalities for diabetes prevention among adults, ranging from diet and exercise to pharmacological agents of various classes. Recently, concerted efforts have been made for prevention of type 2 diabetes among children and adolescents. In this paper we discuss the diabetes prevention rationale and methods among adults and the implications of these efforts for children and adolescents. We also highlight the ongoing efforts for diabetes prevention in trials specifically designed to address the adolescent population.
Shelton, Andrea; Harvin, Sheila; White, Janeana
This paper describes a community-based substance abuse prevention program utilizing a cognitive-behavioral curriculum to children and adolescents affected by a substance use disorder in a parent or caretaker.
Koren, G.; Pastuszak, A. )
As part of a new approach to counselling pregnant women concerned about antenatal exposure to drugs, chemicals, or radiation, we measured their tendency to terminate their pregnancy by using a visual analogue scale (VAS). Analysis of 78 cases where women had less than 50% tendency to continue pregnancy before they were advised by us reveals that 61 decided to continue their pregnancy after the consultation (57 normal, healthy infants, four miscarriages) and 17 terminated. Women who continued their pregnancy significantly changed their tendency after we discussed relevant information with them (from 34.3 +/- 2.5% to 84.5 +/- 3.3%, P less than 0.00001), whereas most of those who eventually terminated pregnancy did not change their tendency to continue pregnancy beyond the 50% mark (from 24.8 +/- 5.4% to 45.1 +/- 9.8%) (P greater than 0.1). Only two of the women who terminated their pregnancy were exposed to teratogenic drugs; however, in most other cases, other obvious reasons, unrelated to the exposure in question, were identified by the women as leading reasons for termination. An appropriate intervention in early pregnancy can prevent unnecessary pregnancy terminations by correcting misinformation and thereby decreasing the unrealistically high perception of risk by women exposed to nonteratogens.
Dating violence (also known as adolescent relationship abuse) and sexual violence are prevalent from the middle school years throughout adolescence, peak in young adulthood, and are associated with multiple poor physical and mental health consequences. By offering universal education and brief anticipatory guidance with all adolescent patients about healthy and unhealthy relationships and sexual consent, health care providers can help promote healthy adolescent sexual relationships, ensure youth know about available resources and supports for relationship abuse and sexual violence (including how to help a friend), and facilitate connections to victim service advocates, both for prevention and intervention.
Fuertes Martín, Antonio; Orgaz Baz, M Begoña; Vicario-Molina, Isabel; Martínez Alvarez, José Luis; Fernández Fuertes, Andrés; Carcedo González, Rodrigo J
This study's focus is to evaluate a sexual coercion prevention program in adolescents. Using a before-and-after design with both a treatment group (n = 93) and a control group (n = 76), an intervention of seven sessions was completed. Said sessions included such content as conceptualizing sexual freedom, sexual coercion and voluntary consent, analyzing different sexual coercion tactics and the contexts in which they occur, empathy toward the victim, and developing abilities to avoid risky situations. Other risk factors for coercive behavior and sexual victimization are explored as well, such as alcohol use, sexist attitudes and inadequate communication, among others. The intervention's results include a decrease in stereotypical beliefs about the opposite sex and increased empathy toward victims of sexual coercion. These changes were maintained with the passage of time. Also, in the treatment group, a more acute decline was observed in the proportion of young people engaging in sexually coercive behaviors, This article emphasizes the importance, necessity and efficacy of such interventions, and discusses and analyzes possible improvements to the program for its future implementation.
Hill, Briony; McPhie, Skye; Moran, Lisa J; Harrison, Paul; Huang, Terry T-K; Teede, Helena; Skouteris, Helen
Maternal obesity and excessive gestational weight gain (GWG) are significant contributors to the global obesity epidemic. However, isolated lifestyle interventions to address this in pregnancy appear to have only modest benefit and responses can be variable. This paper aims to address the question of why the success of lifestyle interventions to prevent excessive GWG is suboptimal and variable. We suggest that there are inherent barriers to lifestyle change within pregnancy as a life stage, including the short window available for habit formation; the choice for women not to prioritise their weight; competing demands including physiological, financial, relationship, and social situations; and lack of self-efficacy among healthcare professionals on this topic. In order to address this problem, we propose that just like all successful public health approaches seeking to change behaviour, individual lifestyle interventions must be provided in the context of a supportive environment that enables, incentivises and rewards healthy changes. Future research should focus on a systems approach that integrates the needs of individuals with the context within which they exist. Borrowing from the social marketing principle of 'audience segmentation', we also need to truly understand the needs of individuals to design appropriately tailored interventions. This approach should also be applied to the preconception period for comprehensive prevention approaches. Additionally, relevant policy needs to reflect the changing evidence-based climate. Interventions in the clinical setting need to be integrally linked to multipronged obesity prevention efforts in the community, so that healthy weight goals are reinforced throughout the system.
Lee, Yi-Hui; Salman, Ali; Cooksey-James, Tawna
The aim of the cross-sectional study was to understand gender differences in HIV/AIDS preventive self-efficacy among Taiwanese adolescents. Self-administered questionnaires were used to measure HIV/AIDS preventive self-efficacy and covariates (age, substance use, and sexual experiences). Data were collected from 734 Taiwanese high school adolescents aged 16 to 18 years. Descriptive statistic analyses, t-test, and ANCOVA were utilized to analyze data. The results indicate significant differences exist between genders in HIV/AIDS preventive self-efficacy among Taiwanese adolescents. Compared to the males, female adolescents were found having significantly higher HIV/AIDS preventive self-efficacy related to refusing sexual intercourse, condom use, and questioning potential sexual partners than those who are males. While controlling age, sexual experience, and substance use, female Taiwanese adolescents also had higher HIV/AIDS preventive self-efficacy than those who are males. The findings suggest the importance of addressing gender differences in HIV/AIDS preventive self-efficacy when developing HIV reduction programs for Taiwanese adolescents.
Mitchell, A A; Van Bennekom, C M; Louik, C
Isotretinoin is effective in treating severe acne, but it is also teratogenic. To minimize pregnancies among exposed women, the manufacturer, together with the US Food and Drug Administration, implemented a multicomponent Pregnancy Prevention Program in 1988. The results of an ongoing survey designed to assess compliance with this program are reported. Treated women enrolled in the survey through their physician, by filling out a form in the medication package, or by calling a toll-free telephone number. They were randomly assigned to be followed by telephone or by mail. Telephone interviews were conducted at the start of therapy, in the middle of it, and 6 months after it ended; mailed questionnaires were completed 6 months after therapy ended (median duration of therapy, 20 weeks). Between January 1, 1989, and December 31, 1993, 177,216 eligible women enrolled in the survey. First telephone interviews were completed with 24,503 women within 1 month of enrollment. The median age of these women was 26 years, the median number of years of education was 14, and the median duration of acne was 8 years. 99% had been told to avoid pregnancy; 85% were told of the importance of using effective contraception for 1 month before starting isotretinoin. At that time, approximately 54% were not sexually active (of whom 37% used contraception); 42% were sexually active (of whom 99% used contraception); and 4% were infertile. As of June 30, 1994, 124,216 women had completed telephone or mail follow-up. There were 402 pregnancies during therapy (0.3% or 3.4 per 1000 20-week courses of isotretinoin); 46 were pregnant when therapy began, and 356 became pregnant during therapy. 290 (72%) of the 402 pregnant women had elective abortions, 63 (16%) had spontaneous abortions, 13 (3%) had ectopic pregnancies, and 32 (8%) had live births. Of the 32 liveborn infants, the survey teratologist examined 13, of whom 5 were judged to have defects compatible with the isotretinoin embryopathy. The
Fang, Lin; Barnes-Ceeney, Kevin; Lee, Rebecca A.; Tao, John
Rarely has substance use prevention programming targeted Asian American adolescents. Using a focus group methodology, we explored perceptions of substance use and preferences for prevention programming among 31 Asian American adolescents in New York City. Participants considered substance use common in the community. Factors contributing to substance use among Asian American adolescents (e.g., peer pressure, pressure to achieve, family factors, and community influence) were identified, and the need for prevention programs tailored for the Asian American community was highlighted. Participants discussed preferred program content, delivery settings, and recruitment and retention strategies. Despite the favorable attitude for family-based prevention programming, participants raised potential issues concerning the feasibility of such a program. Study findings facilitate understanding of Asian American adolescents’ substance use behavior and shed light on prevention program development for this underserved population. PMID:21919640
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Kumar, V. Jurist Lionial
Adolescence is a transitional stage of physical and mental human development that occurs between child hood and adulthood. Adolescent period starts with puberty. The period during which the capability for sexual reproduction is attained; it is marked by changes in both primary and secondary sexual characteristics and is dated from menarche in…
Gordon, Susan M.
This report highlights the important trends in adolescent drug use. Although the focus is on the abuse of alcohol, nicotine, marijuana, cocaine, heroin, and inhalants, it is important to remember that adolescents abuse a wide range and combination of drugs. This report also addresses state-of-the-art treatment methods, and summarizes research on…
Griffin, S F; Reininger, B M; Parra-Medina, D; Evans, A E; Sanderson, M; Vincent, M L
This study discusses the development of scales to measure key leaders' self-reported involvement in community capacity building, perceptions of organizational capacity for teen pregnancy prevention, and the relationship between capacity and teen pregnancy rates. Data were collected from 1,516 key leaders across a rural southern state. Findings indicate that key leaders' perceptions of organizational capacity are related to their involvement in community capacity building efforts and community capacity is associated with teen pregnancy rates. This research represents progress toward measuring community and organizational capacity and may be used to inform future work focusing on developing quantitative measures of community capacity.
Lewis, Kelly M; Lesesne, Catherine A; Zahniser, S Christine; Wilson, Mary Martha; Desiderio, Gina; Wandersman, Abraham; Green, Diane C
The Interactive Systems Framework for Dissemination and Implementation (ISF) is a multi-system framework that can guide research-to-practice efforts by building and supporting the work of three interacting systems: the Prevention Delivery, Support, and Synthesis and Translation Systems. The Synthesis and Translation system is vital to bridging science and practice, yet how to develop it and train support system partners to use it is under-researched. This article bridges this gap by offering a case example of the planning, development, and use of a synthesis and translation product called Promoting Science-based Approaches to Teen Pregnancy Prevention using Getting To Outcomes. The case presented documents the process used for developing the synthesis and translation product, reports on efforts to engage the Prevention Support system to use the product, and how we approached building interaction between the Synthesis and Translation System and the Support System partners. Practice-oriented evaluation data are also presented. Implications for practice, policy and research are discussed.
Williams, Letitia; Harrison, Leslie; Ahluwalia, Indu B.
Most women in the US have access to health care and insurance during pregnancy; however women with Medicaid-paid deliveries lose Medicaid eligibility in the early postpartum period. This study examined the association between health insurance coverage at the time of delivery and health conditions that may require preventive or treatment services extending beyond pregnancy into the postpartum period. We used 2008 Pregnancy Risk Assessment Monitoring System data from 27 states (n = 35,980). We calculated the prevalence of maternal health conditions, including emotional and behavioral risks, by health insurance status at the time of delivery. We used multivariable logistic regression to assess the association between health insurance coverage, whether Medicaid or private, and maternal health status. As compared to women with private health insurance, women with Medicaid-paid deliveries had higher odds of reporting smoking during pregnancy (adjusted odds ratio [AOR]: 1.85, 95 % confidence interval [CI]: 1.56–2.18), physical abuse during pregnancy (AOR: 1.73, 95 % CI: 1.24–2.40), having six or more stressors during pregnancy (AOR: 2.48, 95 % CI: 1.93–3.18), and experiencing postpartum depressive symptoms (AOR: 1.24, 95 % CI: 1.04–1.48). There were no significant differences by insurance status at delivery in pre-pregnancy overweight/obesity, pre-pregnancy physical activity, weight gain during pregnancy, alcohol consumption during pregnancy, or postpartum contraceptive use. Compared to women with private insurance, women with Medicaid-paid deliveries were more likely to experience risk factors during pregnancy such as physical abuse, stress, and smoking, and postpartum depressive symptoms for which continued screening, counseling, or treatment in the postpartum period could be beneficial. PMID:23124817
Beauséjour, Annie; Auger, Karine; St-Louis, Jean; Brochu, Michéle
Despite an increase of circulatory volume and of renin-angiotensin-aldosterone system (RAAS) activity, pregnancy is paradoxically accompanied by a decrease in blood pressure. We have reported that the decrease in blood pressure was maintained in pregnant rats despite overactivation of RAAS following reduction in sodium intake. The purpose of this study was to evaluate the impact of the opposite condition, e.g., decreased activation of RAAS during pregnancy in the rat. To do so, 0.9% or 1.8% NaCl in drinking water was given to nonpregnant and pregnant Sprague-Dawley rats for 7 days (last week of gestation). Increased sodium intakes (between 10- and 20-fold) produced reduction of plasma renin activity and aldosterone in both nonpregnant and pregnant rats. Systolic blood pressure was not affected in nonpregnant rats. However, in pregnant rats, 0.9% sodium supplement prevented the decreased blood pressure. Moreover, an increase of systolic blood pressure was obtained in pregnant rats receiving 1.8% NaCl. The 0.9% sodium supplement did not affect plasma and fetal parameters. However, 1.8% NaCl supplement has larger effects during gestation as shown by increased plasma sodium concentration, hematocrit level, negative water balance, proteinuria, and intrauterine growth restriction. With both sodium supplements, decreased AT1 mRNA levels in the kidney and in the placenta were observed. Our results showed that a high-sodium intake prevents the pregnancy-induced decrease of blood pressure in rats. Nonpregnant rats were able to maintain homeostasis but not the pregnant ones in response to sodium load. Furthermore, pregnant rats on a high-sodium intake (1.8% NaCl) showed some physiological responses that resemble manifestations observed in preeclampsia.
Chico, R Matthew; Pittrof, Rudiger; Greenwood, Brian; Chandramohan, Daniel
In the high malaria-transmission settings of sub-Saharan Africa, malaria in pregnancy is an important cause of maternal, perinatal and neonatal morbidity. Intermittent preventive treatment of malaria in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) reduces the incidence of low birth-weight, pre-term delivery, intrauterine growth-retardation and maternal anaemia. However, the public health benefits of IPTp are declining due to SP resistance. The combination of azithromycin and chloroquine is a potential alternative to SP for IPTp. This review summarizes key in vitro and in vivo evidence of azithromycin and chloroquine activity against Plasmodium falciparum and Plasmodium vivax, as well as the anticipated secondary benefits that may result from their combined use in IPTp, including the cure and prevention of many sexually transmitted diseases. Drug costs and the necessity for external financing are discussed along with a range of issues related to drug resistance and surveillance. Several scientific and programmatic questions of interest to policymakers and programme managers are also presented that would need to be addressed before azithromycin-chloroquine could be adopted for use in IPTp. PMID:19087267
Toska, Elona; Gittings, Lesley; Hodes, Rebecca; Cluver, Lucie D; Govender, Kaymarlin; Chademana, K Emma; Gutiérrez, Vincent Evans
Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child-and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with "care" and "capability" among children and adolescents. Social protection programmes should be dynamic and flexible, and consider age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach and uptake. Effective HIV prevention also requires integrated social protection policies, developed through strong national
St-Pierre, Renée A; Temcheff, Caroline E; Derevensky, Jeffrey L; Gupta, Rina
Given its serious implications for psychological and socio-emotional health, the prevention of problem gambling among adolescents is increasingly acknowledged as an area requiring attention. The theory of planned behavior (TPB) is a well-established model of behavior change that has been studied in the development and evaluation of primary preventive interventions aimed at modifying cognitions and behavior. However, the utility of the TPB has yet to be explored as a framework for the development of adolescent problem gambling prevention initiatives. This paper first examines the existing empirical literature addressing the effectiveness of school-based primary prevention programs for adolescent gambling. Given the limitations of existing programs, we then present a conceptual framework for the integration of the TPB in the development of effective problem gambling preventive interventions. The paper describes the TPB, demonstrates how the framework has been applied to gambling behavior, and reviews the strengths and limitations of the model for the design of primary prevention initiatives targeting adolescent risk and addictive behaviors, including adolescent gambling.
Singh, Nisha; Krishnan-Sarin, Suchitra
Aim: Emerging racial/ethnic disparities in tobacco use behaviors and resulting long-term health outcomes highlight the importance of developing culturally tailored/targeted tobacco prevention and cessation interventions. This manuscript describes the efficacy and the components of prevention and cessation interventions developed for minority adolescents. Methods: Thirteen studies focused on culturally tailoring and targeting tobacco prevention/cessation interventions were selected and information on intervention design (type, number of sessions), setting (school or community), theoretical constructs, culture-specific components (surface/deep structures), and treatment outcomes were extracted. Results: Of the 13 studies, 5 focused on prevention, 4 on cessation, and 4 combined prevention and cessation, and most of the studies were primarily school-based, while a few used community locations. Although diverse minority groups were targeted, a majority of the studies (n = 6) worked with Hispanic adolescents. The most common theoretical construct examined was the Social Influence Model (n = 5). The overall findings indicated that culturally tailoring cessation interventions did not appear to improve tobacco quit rates among minority adolescents, but culturally tailored prevention interventions appeared to produce lower tobacco initiation rates among minority adolescents than control conditions. Conclusions: The results of review suggest that there is a critical need to develop better interventions to reduce tobacco use among minority adolescents and that developing a better understanding of cultural issues related to both cessation and initiation of tobacco use among minority populations is a key component of this endeavor. PMID:22614548
Singer, Merrill; Garcia, Roberto
Although there is a strong experiential sense among people in the substance abuse prevention field that Hispanic adolescents may be particularly at-risk for the abuse of licit and illicit drugs, this concern has produced only limited research or culturally sensitive, ethnically targeted prevention efforts. The following factors hinder the…
Broderick, Patricia C.; Jennings, Patricia A.
This article reviews the contextual and neuropsychological challenges of the adolescent period with particular attention to the role that universal prevention can play in moderating the harmful effects of stress. The centrality of emotion regulation skills to long-term health and wellness suggests their importance in prevention and intervention…
Giannotta, Fabrizia; Ortega, Enrique; Stattin, Hakan
Background: In spite of the proven effectiveness of parenting based programs to prevent adolescent risk behaviors, such programs are rarely implemented in Mediterranean countries. Objective: This pilot study was aimed at assessing the feasibility and the effects of a parenting based universal prevention program (Connect) in Italy. Methods: Our…
Kindt, Karlijn C. M.; Kleinjan, Marloes; Janssens, Jan M. A. M.; Scholte, Ron H. J.
As restructuring a negative cognitive style is a central skill taught in many depression prevention programs, we tested whether a universal prevention program evoked a change in negative cognitive style in adolescents. In addition, we examined distinct developmental trajectories of negative cognitive styles and assessed whether research condition…
Maznichenko, Marina A.; Neskoromnykh, Nataliya I.
This article provides a rationale for the need to take an integrated approach to prevention of social dependencies in adolescents. Through this approach, the authors fine-tune the determination of the phenomenon of prevention of social dependencies. The authors bring to light the potential of the scenario method in resolving the above objective.…
Metzger, Isha; Cooper, Shauna M.; Zarrett, Nicole; Flory, Kate
The current review conducted a systematic assessment of culturally sensitive risk prevention programs for African American adolescents. Prevention programs meeting the inclusion and exclusion criteria were evaluated across several domains: (1) theoretical orientation and foundation; (2) methodological rigor; (3) level of cultural integration; (4)…
Giles, Michelle; Hass, Michael
Eating disorders are among the most frequently seen chronic illnesses found in adolescent females. In this paper, we discuss school-based prevention and intervention efforts that seek to reduce the impact of this serious illness. School counselors play a key role in the prevention of eating disorders and can provide support even when not directly…
de la Cuesta Benjumea, C
The authors reveal the findings of an qualitative investigation on teenage pregnancy. Their data came from 21 semi-structured interviews with pregnant teenagers. The analysis of this data followed the procedures set forth in tested theories. This study reveals that the nature of the interplay a teenager who gets pregnant is that of a serious love affair in which the ideas of romantic love and the rules of that genre guide their behavior. This is the social milieu in which youths live and where they construct their identifies. Sexual relations are part of the natural course of a love affair since they link sex with love. This is not an easy love affair; it develops under unstable conditions. The aspects revealed by this study show the difficulties which surround conventional anti-conceptive practices. The authors hope this study serves as a guide, as orientation, in order that promotional and preventative compaigns become relevant, meaningful and acceptable to youths.
Robinson, W. LaVome; Case, Mary H.; Whipple, Christopher R.; Gooden, Adia S.; Lopez-Tamayo, Roberto; Lambert, Sharon F.; Jason, Leonard A.
Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9th, 10th and 11th grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed. PMID:27517094
Robinson, W LaVome; Case, Mary H; Whipple, Christopher R; Gooden, Adia S; Lopez-Tamayo, Roberto; Lambert, Sharon F; Jason, Leonard A
Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9(th,) 10(th) and 11(th) grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed.
Goonewardene, Malik; Shehata, Mishkat; Hamad, Asma
Anaemia in pregnancy, defined as a haemoglobin concentration (Hb) < 110 g/L, affects more than 56 million women globally, two thirds of them being from Asia. Multiple factors lead to anaemia in pregnancy, nutritional iron deficiency anaemia (IDA) being the commonest. Underlying inflammatory conditions, physiological haemodilution and several factors affecting Hb and iron status in pregnancy lead to difficulties in establishing a definitive diagnosis. IDA is associated with increased maternal and perinatal morbidity and mortality, and long-term adverse effects in the new born. Strategies to prevent anaemia in pregnancy and its adverse effects include treatment of underlying conditions, iron and folate supplementation given weekly for all menstruating women including adolescents and daily for women during pregnancy and the post partum period, and delayed clamping of the umbilical cord at delivery. Oral iron is preferable to intravenous therapy for treatment of IDA. B12 and folate deficiencies in pregnancy are rare and may be due to inadequate dietary intake with the latter being more common. These vitamins play an important role in embryo genesis and hence any relative deficiencies may result in congenital abnormalities. Finding the underlying cause are crucial to the management of these deficiencies. Haemolytic anaemias rare also rare in pregnancy, but may have life-threatening complications if the diagnosis is not made in good time and acted upon appropriately.
Kim, Hae Won; Kim, Duck Hee
Objectives Korean adolescent girls are unprepared for cervical cancer prevention due to the lack of a mandatory policy regarding human papilloma virus (HPV) vaccination and school health education regarding cervical cancer. The aim of this study was to determine how aware mothers are about cervical cancer prevention in their adolescent daughters, with a view to developing strategies for expanding primary cervical cancer prevention for adolescent girls through the mothers’ involvement. Design A qualitative design was employed. Nine mothers with adolescent daughters participated in this study and were interviewed using open-ended questions. The themes were extracted by content analysis. Setting A general living area in Seoul, South Korea. Participants The snowball method was used to select mothers. Results Five themes emerged. In general, the mothers’ awareness of cervical cancer was not clear, and they exhibited a lack of awareness of the importance of having a regular Papanicolaou screening test. The mothers recognised that they were role models for their daughters, and realised and accepted the necessity of educating their daughters regarding cervical cancer; however, they perceived barriers related to the prevention of cervical cancer in their daughters. The mothers recommended enforcing sex education in schools and the provision of financial support for HPV vaccination. Conclusions The mothers’ awareness and preparedness with respect to the prevention of cervical cancer in their adolescent daughters were low and inadequate. Mothers should be informed and motivated to play a role in the education of their daughters regarding cervical cancer prevention. Strategies for disseminating information regarding early cervical cancer prevention for adolescent girls are recommended by communicating with both the girls and their mothers and providing them with education regarding cervical cancer prevention. PMID:25976761
Duffy, Jennifer L; Prince, Mary Severson; Johnson, Erin E; Alton, Forrest L; Flynn, Shannon; Faye, Amy Mattison; Padgett, Polly Edwards; Rollison, Chris; Becker, Dana; Hinzey, Angela L
Getting To Outcomes (GTO), an innovative framework for planning, implementing, evaluating, and sustaining interventions has been shown to be effective in helping community-based organizations (CBOs) introduce science-based approaches into their prevention work. However, the Interactive Systems Framework (ISF) suggests that adopting innovations like GTO requires a significant amount of capacity building through training and technical assistance (T/TA). In this study, 11 CBOs and three schools in South Carolina entered into a 3 year program of intense and proactive T/TA based on the ISF to learn how to apply an adaptation of GTO (Promoting Science-Based Approaches-Getting To Outcomes, PSBA-GTO) to their teen pregnancy prevention programs. Using semi-structured interviews, the partnering organizations were assessed at three points in time, pre-T/TA, 12 months, and post T/TA (30 months) for their performance of the steps of GTO in their work. The seven organizations which participated in T/TA until the end of the project received an average of 76 h of TA and 112 h of training per organization. Interview results showed increased performance of all 10 steps of PSBA-GTO by these organizations when conducting their teen pregnancy programs. These results suggest targeted and proactive T/TA can successfully bridge the gap between research and practice by using a three part delivery system, as prescribed in the ISF, which relies on an intermediary prevention support system to ensure accurate and effective translation of research to the everyday work of community-based practitioners.
Naing, Zin W; Scott, Gillian M; Shand, Antonia; Hamilton, Stuart T; van Zuylen, Wendy J; Basha, James; Hall, Beverly; Craig, Maria E; Rawlinson, William D
Human cytomegalovirus (CMV) is under-recognised, despite being the leading infectious cause of congenital malformation, affecting ~0.3% of Australian live births. Approximately 11% of infants born with congenital CMV infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly, intrauterine growth restriction and death. Congenital CMV infection may cause severe long-term sequelae, including progressive sensorineural hearing loss and developmental delay in 40-58% of symptomatic neonates, and ~14% of initially asymptomatic infected neonates. Up to 50% of maternal CMV infections have nonspecific clinical manifestations, and most remain undetected unless specific serological testing is undertaken. The combination of serology tests for CMV-specific IgM, IgG and IgG avidity provide improved distinction between primary and secondary maternal infections. In pregnancies with confirmed primary maternal CMV infection, amniocentesis with CMV-PCR performed on amniotic fluid, undertaken after 21-22 weeks gestation, may determine whether maternofetal virus transmission has occurred. Ultrasound and, to a lesser extent, magnetic resonance imaging are valuable tools to assess fetal structural and growth abnormalities, although the absence of fetal abnormalities does not exclude fetal damage. Diagnosis of congenital CMV infection at birth or in the first 3 weeks of an infant's life is crucial, as this should prompt interventions for prevention of delayed-onset hearing loss and neurodevelopmental delay in affected infants. Prevention strategies should also target mothers because increased awareness and hygiene measures may reduce maternal infection. Recognition of the importance of CMV in pregnancy and in neonates is increasingly needed, particularly as therapeutic and preventive interventions expand for this serious problem.
Branch, Meredith; Harvey, S Marie; Zukoski, Ann P; Warren, Jocelyn
Latino women in the United States are disproportionately at risk for unintended pregnancy, HIV, and sexually transmitted infections (STIs). We conducted nine focus groups with health care practitioners who provide reproductive health care to Latinos in rural areas of the Northwest. From the practitioner perspective, we explored barriers and facilitators to the acquisition and use of contraceptives and to the prevention of HIV/STIs among rural Latinos. Suggestions for improving reproductive health care included Spanish-language resources/materials and convenient contraceptive methods. Findings provide context to the complex issues related to unintended pregnancy and disease prevention among Latinos residing in rural communities.
Handa, Sudhanshu; Peterman, Amber; Huang, Carolyn; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha
There is promising evidence that poverty-targeted cash transfer programs can have positive impacts on adolescent transitions to adulthood in resource poor settings, however existing research is typically from small scale programs in diverse geographic and cultural settings. We provide estimates of the impact of a national unconditional cash transfer program, the Kenya Cash Transfer for Orphans and Vulnerable Children, on pregnancy and early marriage among females aged 12 to 24, four years after program initiation. The evaluation was designed as a clustered randomized controlled trial and ran from 2007 to 2011, capitalizing on the existence of a control group, which was delayed entry to the program due to budget constraints. Findings indicate that, among 1549 females included in the study, while the program reduced the likelihood of pregnancy by five percentage points, there was no significant impact on likelihood of early marriage. Program impacts on pregnancy appear to work through increasing the enrollment of young women in school, financial stability of the household and delayed age at first sex. The Kenyan program is similar in design to most other major national cash transfer programs in Eastern and Southern Africa, suggesting a degree of generalizability of the results reported here. Although the objective of the program is primarily poverty alleviation, it appears to have an important impact on facilitating the successful transition of adolescent girls into adulthood.
Handa, Sudhanshu; Huang, Carolyn; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha
There is promising evidence that poverty-targeted cash transfer programs can have positive impacts on adolescent transitions to adulthood in resource poor settings, however existing research is typically from small scale programs in diverse geographic and cultural settings. We provide estimates of the impact of a national unconditional cash transfer program, the Kenya Cash Transfer for Orphans and Vulnerable Children, on pregnancy and early marriage among females aged 12 to 24, four years after program initiation. The evaluation was designed as a clustered randomized controlled trial and ran from 2007 to 2011, capitalizing on the existence of a control group, which was delayed entry to the program due to budget constraints. Findings indicate that, among 1,549 females included in the study, while the program reduced the likelihood of pregnancy by five percentage points, there was no significant impact on likelihood of early marriage. Program impacts on pregnancy appear to work through increasing the enrollment of young women in school, financial stability of the household and delayed age at first sex. The Kenyan program is similar in design to most other major national cash transfer programs in Eastern and Southern Africa, suggesting a degree of generalizability of the results reported here. Although the objective of the program is primarily poverty alleviation, it appears to have an important impact on facilitating the successful transition of adolescent girls into adulthood. PMID:26246032
Molina Cartes, Ramiro; González Araya, Electra
Teen pregnancy is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of development. In developing countries that are expected to follow the sexual behaviour patterns of developed countries, without offering the levels of education and services for adolescents, the consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexuality and reproduction both in parents, teachers and adolescents increases the early initiation of coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an adolescent mother are risk factors of repeating the early pregnancy model. The application of predictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to diminish the maternal and perinatal mortality is discussed as well as the social factors associated with adolescent pregnancy as socioeconomic levels, structure - types and characteristics of the family, early leaving school, schooling after delivery, female employment, lack of sexual education, parental and family attitudes in different periods of adolescent pregnancy, adolescent decisions on pregnancy and children, unstable partner relationship and adoption as an option. Social consequences are analyzed as: incomplete education, more numerous families, difficulties in maternal role, abandonment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater difficulty in improving their socioeconomic level and less probability of social advancement, lack of protection of the recognition of the child. Finally, based on evidence, some measures that can reduce adverse consequences on adolescent mothers, fathers and their children are suggested.
Fabbri, Stefania; Farrell, Leah V.; Penberthy, J. Kim; Ceperich, Sherry Dyche; Ingersoll, Karen S.
Alcohol-exposed pregnancy is a leading cause of preventable birth defects in the United States. This paper describes the motivational patterns that relate to risky drinking and ineffective contraception, two behaviors that can result in alcohol-exposed pregnancy. As part of an intervention study aimed at reducing alcohol-exposed pregnancy 124 women were recruited and reported demographic characteristics, readiness to change, stages of change, drinking, contraception, and sexual behavior history. Our results showed the following. Drinking: A significant positive correlation was found between the number of drinks consumed in 90 days and the Importance to reduce drinking (r = .23, p = .008). A significant negative correlation between number of drinks and confidence to reduce drinking (r = −.39, p = .000) was found as well. Significant differences were found in the total number of drinks consumed in 90 days between the five stages of change (F = (4,118), 3.12, p = .01). Women in Preparation reported drinking a significantly higher number of drinks than women in other stages of change. Contraception: There were significant negative correlations between ineffective contraception and Importance (r = −.38, p = .00), confidence (r = −.20, p = .02) and Readiness (r = −.43, p = .00) to use contraception effectively. Significant differences in contraception ineffectiveness were found for women in different stages of change (F = (4,115) 8.58, p = .000). Women in Precontemplation reported significantly higher levels of contraception ineffectiveness compared to women in other stages of change. Results show a clear relationship between higher alcohol consumption and higher levels of motivation to reduce drinking. In contrast, higher levels of ineffective contraception were related to lower levels of motivation to use contraception effectively. This suggests risky drinking may be better targeted with brief skills building interventions and ineffective contraception may
Bay, Jacquie L.; Morton, Susan M.; Vickers, Mark H.
Evidence from the field of Developmental Origins of Health and Disease (DOHaD) demonstrates that early life environmental exposures impact later-life risk of non-communicable diseases (NCDs). This has revealed the transgenerational nature of NCD risk, thus demonstrating that interventions to improve environmental exposures during early life offer important potential for primary prevention of DOHaD-related NCDs. Based on this evidence, the prospect of multi-sectoral approaches to enable primary NCD risk reduction has been highlighted in major international reports. It is agreed that pregnancy, lactation and early childhood offer significant intervention opportunities. However, the importance of interventions that establish positive behaviors impacting nutritional and non-nutritional environmental exposures in the pre-conceptual period in both males and females, thus capturing the full potential of DOHaD, must not be overlooked. Adolescence, a period where life-long health-related behaviors are established, is therefore an important life-stage for DOHaD-informed intervention. DOHaD evidence underpinning this potential is well documented. However, there is a gap in the literature with respect to combined application of theoretical evidence from science, education and public health to inform intervention design. This paper addresses this gap, presenting a review of evidence informing theoretical frameworks for adolescent DOHaD interventions that is accessible collectively to all relevant sectors. PMID:27417627
Robinson, W. LaVome; Droege, Jocelyn R.; Case, Mary H.; Jason, Leonard A.
Evidenced-based and culturally adapted stress-reduction interventions for urban African American adolescents who are at risk for anxiety and other problems related to stress are needed. This study presents intervention components and preliminary outcome findings of a culturally adapted stress-reduction intervention for urban African American adolescents. Preliminary findings support the efficacy of the intervention to reduce anxiety and enhance general cognitive competencies, such as coping strategies, self-efficacy, and positive thinking, among participants, in comparison to controls. Clinical implications of the stress-reduction intervention for the prevention of psychopathology, particularly among African American adolescents, are discussed. PMID:27042702
St Lawrence, Janet S; Seloilwe, Esther; Magowe, Mabel; Dithole, Kefalotse; Kgosikwena, Billy; Kokoro, Elija; Lesaane, Dipuo
An evidence-based HIV prevention intervention was adapted for Botswana youth with qualitative interviews, input from an adolescent panel, and social validation. Qualitative interviews were conducted with 40 boys and girls ages 13-19. An adolescent panel then drafted scenarios reflecting social situations described in the interviews that posed risk for HIV. A social validation sample (N = 65) then indicated the prevalence and difficulty of each situation. Youth described informational needs, pressures to use alcohol and drugs, peer pressure for unprotected sex, and intergenerational sex initiations as risk-priming situations. From 17% to 57% of the social validation sample had personally experienced the situations drafted by the adolescent panel. There were no differences in the ratings of boys versus girls, but youth over age 16 more often reported that they had experienced these risky situations. The results were embedded into the intervention. Major changes to the intervention resulted from this three-phase process.
Barton, Allen W.; Beach, Steven R. H.; Kogan, Steven M.; Stanley, Scott M.; Fincham, Frank D.; Hurt, Tera R.; Brody, Gene H.
The present study investigates the trajectory of children's exposure to interparental conflict during adolescence, its effects on adolescents' psychological adjustment, as well as the ability of a family-centered prevention program to alter this trajectory. A total of 331 African American couples with an adolescent or pre-adolescent child participated in a randomized control trial of the Promoting Strong African American Families (ProSAAF) program, a newly-developed program targeting couple and co-caregiving processes. Using a multi-informant, latent growth curve approach, child exposure to interparental conflict during adolescence was found to be stable over a period of two years among families in the control group, but significantly declined among families in the treatment condition. Rates of change were significantly different between intervention and control groups based on parents' report of youth exposure to interparental conflict, but not for child's report. Structural equation models found trajectory parameters of interparental conflict predicted changes in adolescent depressive symptoms, with increasing rates of changes in conflict associated with increases in adolescent internalizing symptoms over the 2-year duration of the study. Finally, a significant indirect effect was identified linking treatment, changes in parents' reports of child exposure to interparental conflict, and adolescent depressive symptoms. The implications for research and intervention are discussed. PMID:25844492
Lete, Iñaki; Allué, José
The rhizomes of Zingiber officinale (ginger) have been used since ancient times as a traditional remedy for gastrointestinal complaints. The most active ingredients in ginger are the pungent principles, particularly gingerols and shogaols. Various preclinical and clinical studies have evaluated ginger as an effective and safe treatment for nausea and vomiting in the context of pregnancy and as an adjuvant treatment for chemotherapy-induced nausea and vomiting. Here, we provide an update and analysis of ginger use for the prevention of nausea and vomiting, with a focus on the types and presentations of ginger available. We also examine the pharmacokinetic properties of ginger and highlight the type and posology of ginger and its metabolites.
Lete, Iñaki; Allué, José
The rhizomes of Zingiber officinale (ginger) have been used since ancient times as a traditional remedy for gastrointestinal complaints. The most active ingredients in ginger are the pungent principles, particularly gingerols and shogaols. Various preclinical and clinical studies have evaluated ginger as an effective and safe treatment for nausea and vomiting in the context of pregnancy and as an adjuvant treatment for chemotherapy-induced nausea and vomiting. Here, we provide an update and analysis of ginger use for the prevention of nausea and vomiting, with a focus on the types and presentations of ginger available. We also examine the pharmacokinetic properties of ginger and highlight the type and posology of ginger and its metabolites. PMID:27053918
Thorburn, Sheryl; Bogart, Laura M
This article examines the endorsement of conspiracy beliefs about birth control (e.g., the belief that birth control is a form of Black genocide) and their association with contraceptive attitudes and behavior among African Americans. The authors conducted a telephone survey with a random sample of 500 African Americans (aged 15-44). Many respondents endorsed birth control conspiracy beliefs, including conspiracy beliefs about Black genocide and the safety of contraceptive methods. Stronger conspiracy beliefs predicted more negative attitudes toward contraceptives. In addition, men with stronger contraceptive safety conspiracy beliefs were less likely to be currently using any birth control. Among current birth control users, women with stronger contraceptive safety conspiracy beliefs were less likely to be using contraceptive methods that must be obtained from a health care provider. Results suggest that conspiracy beliefs are a barrier to pregnancy prevention. Findings point to the need for addressing conspiracy beliefs in public health practice.
Johnson, Lisa A; Parsons, Mary E
Suicide is a major public health problem. Nationally, suicide is the third leading cause of death for adolescents. The purpose of this quality improvement project was to initiate and evaluate a gatekeeper suicide-prevention program within a local school system targeting faculty and staff without a medical or psychology background who interact regularly with middle- and high-school students. Following the implementation of this program, evaluation of increased knowledge related to adolescent suicide prevention was completed. All participants completed a pretest and posttest, and results indicate that the staff members' knowledge about identification of risk factors, behavioral responses to suicidal students, and knowledge of community resources were increased. This project highlights the need for planned and sustainable education and training for faculty and school staff who regularly interact with adolescents. Additionally, the importance of continued monitoring, training, and advocating for suicide prevention programming is noted.
Brown, Larry K.; Houck, Christopher; Donenberg, Geri; Emerson, Erin; Donahue, Kelly; Misbin, Jesse
Adolescents in therapeutic schools are at greater risk for HIV and other STIs than their peers due to earlier higher rates of sexual risk and difficulty managing strong emotions. HIV prevention programs that incorporate techniques for affect management during sexual situations may be beneficial. This paper determined the immediate impact of such an intervention, Affect Management (AM), compared to a standard, skills-based HIV prevention intervention (SB) and a general health promotion intervention (HP) for 377 youth, ages 13 to 19, in therapeutic schools in two cities. One month after the intervention, analyses that adjusted for the baseline scores found adolescents in AM were more likely to report condom use at last sex than those in HP (.89 vs. .67, p=.02) and that their HIV knowledge was significantly greater. These data suggest that affect management techniques might improve the impact of standard skills-based prevention programs for adolescents in therapeutic schools. PMID:23975475
Manaseri, Holly; Uehara, Denise; Roberts, Kelly
The overall extent of evidence-based culturally responsive health education programs targeting ethnic minority groups in Hawai'i is limited. The few that do exist were adapted from models developed with other majority ethnic groups in mind and may not always be appropriate for Native Hawaiian or Pacific Islander youth (Okamoto et al. in J Alcohol Drug Educ 54(1):56-75, 2010; Helm and Baker in J Ethn Cult Divers Soc Work 20(2):131-149, 2011; Po'a-Kekuawela et al. in J Ethn Cult Divers Soc Work 18(3):242-258, 2009). The need for a culturally responsive, evidence-based health curriculum is clear considering the large disparities reported among Hawaiian youth in health, academic achievement, and other identified risk factors. School-based health interventions are an opportunity not only to improve the physical well being of students, but also to increase their ability to learn and succeed in school. The University of Hawai'i at Manoa-Center on Disability Studies (UH-CDS) received a highly competitive grant from the US Office of Adolescent Health to develop a teen pregnancy and sexually transmitted infection (STI) prevention curriculum for Hawai'i middle school youth. The authors will detail a collaborative process that led to a culturally responsive sexual health curriculum for middle school youth designed to meet the rigorous standards of an evidenced-based review and more importantly reduce teen pregnancies and STI transmission.
Nelson, Brenda A.
Describes the Teen Pregnancy Project, which began in Savannah, Georgia, in 1981 as an effort to reduce mortality rates of at-risk infants, and has grown into a multiservice program with many approaches. Stresses the need for a home visitation initiative to reach clients. (SKC)
Backinger, C; Fagan, P; Matthews, E; Grana, R
Data sources:Data were collected from published literature. Searches for adolescent prevention were conducted using PubMed, PsycInfo, and ERIC; and for cessation, PubMed, and two major reviews that span January 1978 to May 2002. PubMed, PsychInfo, and SCCI were searched for young adults from January 1990 to May 2002. Study selection:Data included smoking prevention studies published from January 1990 to May 2002 and conducted in the USA; all identified smoking cessation studies for adolescents. Young adult data were limited to initiation and cessation studies. Data extraction:Extraction of data was by consensus of the authors. Data synthesis:Results of the review are qualitative in nature using a consensus approach of the authors. Conclusions:School based curricula alone have been generally ineffective in the long term in preventing adolescents from initiating tobacco use but are effective when combined with other approaches such as media and smoke-free policies. Prevention research should consider multiple approaches and the social conditions that influence the development of youth problem behaviours including tobacco use. Because youth smoking cessation has been understudied to date, scientifically rigorous adolescent smoking cessation studies need to be conducted with attention to high risk smokers and less than daily smokers. Tobacco prevention and cessation for young adults needs focused attention. Prevention and cessation programmes need to address other tobacco products in addition to cigarettes. PMID:14645940
Schondel, Connie; And Others
Provides survey findings from 54 adolescent hotlines, and presents an organizational case study of an existing peer listening phone program. A brief discussion of the role of professionals is also explored in relation to the use of adolescent volunteers. The case study suggests that volunteering is beneficial to both customers and adolescent…
Jones, Rachel A; Sinn, Natalie; Campbell, Karen J; Hesketh, Kylie; Denney-Wilson, Elizabeth; Morgan, Philip J; Lubans, David R; Magarey, Anthea
Pediatric overweight and obesity continues to be a major public health concern. Once established it is difficult to treat; therefore well-designed and evaluated prevention interventions are vitally important. There is considerable evidence to suggest that obesity prevention initiatives can change children's behaviours and weight status over the short- or medium-term; however, there is far less evidence on which to judge the impact over the longer term. In response to the rise in short- and medium-term obesity prevention studies for children and adolescents over recent years, the Prevention Stream of the Australasian Child and Adolescent Obesity Research Network highlight five points as to why the dearth of obesity prevention studies with long-term follow-up should be urgently addressed. Furthermore, recommendations to strengthen the evidence base and outline key implications for research design in this area and the support required for long-term follow-up studies are detailed.
Griffin, Kenneth W.; Botvin, Gilbert J.
Synopsis Substantial progress has been made in developing prevention programs for adolescent drug abuse. The most effective interventions target salient risk and protective factors at the individual, family, and/or community levels and are guided by relevant psychosocial theories regarding the etiology of substance use and abuse. This article reviews the epidemiology, etiologic risk and protective factors, and evidence-based approaches that have been found to be most effective in preventing adolescent substance use and abuse. Exemplary school and family-based prevention programs for universal (everyone in population), selected (members of at-risk groups), and indicated (at-risk individuals) target populations are reviewed, along with model community-based prevention approaches. Challenges remain in widely disseminating evidence-based prevention programs into schools, families, and communities. PMID:20682218
Wallace, Jacqueline M; Milne, John S; Aitken, Raymond P
Nutritional backgrounds prior to pregnancy may interact with subsequent gestational intake to influence pregnancy outcome, particularly in young, growing adolescents. To investigate this interaction, singleton pregnancies were established in two groups of adolescent sheep of identical age but different initial weight and adiposity score, classified as good (G) and poor (P) body mass index (BMI). Thereafter, ewes were offered either an optimal control (C) intake to maintain adiposity throughout pregnancy, undernourished (UN) to maintain weight at conception but deplete maternal body reserves, or overnourished (ON) to promote rapid maternal growth and adiposity, resulting in a 2 x 3 factorial design. Gestation length was independent of BMI and reduced in ON dams. Average placental and lamb birth weights were influenced by initial BMI (G > P) and gestational intake (C > UN > ON), with the highest incidence of growth restriction in ON groups. Metabolic challenges at two thirds of gestation revealed enhanced insulin insensitivity in ON dams (higher glucose postinsulin challenge and higher insulin postglucose challenge), but nevertheless fetal growth was constrained. Initial colostrum yield, total IgG, and nutrient supply were reduced in ON groups, but these low-birth-weight lambs exhibited rapid catch-up growth to weaning. Thus, both maternal BMI at conception and gestational intake have a profound influence on pregnancy outcome in young, putatively growing adolescent sheep and may have implications for the nutritional management of pregnant adolescent humans.
Saunders, Edward; Sabri, Bushra; Huberman, Barbara; Klaus, T. W.; Davis, Laura
The purpose of this qualitative study was to identify significant external and internal challenges that state organization leaders face in promoting science-based teen pregnancy prevention programs within their states. The state organization administrators were chosen because their organizations were funded by the U.S. Centers for Disease Control…
Wood, Lesley; Hendricks, Farah
Teenage pregnancy among school-going youth is a concern worldwide, but in socially-economically challenged environments it is a result of, and contributory factor to, a complex web of social injustice. In South Africa, most of the school-based prevention interventions to date have been adult-designed and imparted, with the voice of the target…
Sorhaindo, Annik; Mitchell, Kirstin; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Bonell, Chris
Purpose: Evaluation of the Teens & Toddlers (T&T) positive youth development (PYD) and teenage pregnancy prevention programme suggested that the intervention had minimal effectiveness partly due to its unclear theory of change. The purpose of this paper is to examine the lived experiences of young women participating in the programme to…
Mar, Nataliya; Kosowicz, Rebecca; Hook, Karen
We report a case of a 36-year old patient with prior history of thrombosis in a setting of antiphospholipid antibody syndrome (APS) as well as pregnancy-associated catastrophic antiphospholipid syndrome (CAPS), resulting in multi-organ infarction and pregnancy loss. The episode of CAPS occurred while she was receiving antepartum low-dose aspirin and therapeutic-dose enoxaparin. This patient presented again at 6 weeks gestation and ultrasounds were consistent with fetal growth restriction, concerning for placental insufficiency and thrombosis. This time, hydroxychloroquine and monthly intravenous immunoglobulin (IVIG) infusions were added to her prophylaxis regimen, resulting in a successful delivery. Platelet count and antiphospholipid antibody titers were routinely monitored throughout pregnancy as markers of disease activity for APS. Current thromboprophylaxis guidelines do not address therapeutic options to prevent further pregnancy morbidity in women who develop recurrent episodes of thrombosis or CAPS despite receiving adequate anti-thrombotic treatment. Use of hydroxychloroquine and IVIG has been associated with good outcomes in this subset of patients.
Pantoja, Ana Lídia Nauar
Focused on a group of low-income youth in Belém, Pará State, Brazil, this study discusses the issue of adolescent pregnancy and motherhood from a socio-anthropological perspective. Aimed at an understanding of the cultural meanings of this event in this context, the study suggests that for adolescent girls, it does not mean a break with life projects. On the contrary, pregnancy and motherhood are valued to the extent that they produce changes in social status for the girls, in terms of affirmation of projects for social mobility in the future, thus justifying the continuity of studies in the face of difficulties imposed by the situation.
Long, Joann D; Armstrong, Myrna L; Amos, Elizabeth; Shriver, Brent; Roman-Shriver, Carmen; Feng, Du; Harrison, Lanell; Luker, Scott; Nash, Anita; Blevins, Monica Witcher
This pilot study tested the effects of an interactive nutrition education Web site on fruit, vegetable, and fat consumption in minority adolescents genetically at risk for Type 2 diabetes. A one-group nonexperimental pretest, posttest focus group design was used. Twenty-one sixth-grade to eighth-grade junior high adolescents who were minorities volunteered to participate. Participants received 5 hours of Web-based nutrition education over 3 weeks. A significant difference in fat consumption was supported from the computerized dietary assessment. No difference was found in fruit or vegetable consumption. Comparative data indicated a rise in body mass index (BMI) percentile from 88.03 (1999) to 88.40 (2002; boys) and 88.25 (1999) to 91.2 (2002; girls). Focus group responses supported the satisfaction of adolescents in the study with the use of the Web-based intervention for nutrition education. Healthy eating interventions using Web-based nutrition education should be further investigated with adolescents.
Pena, Juan B.; Caine, Eric D.
Among the provisions of the recently signed Garrett Lee Smith Memorial Act, Congress called for the use of screening to detect adolescents who are at risk for suicide. After a review of the literature, 17 studies involving screening instruments and programs were identified. We addressed the question: What do we know about the demonstrated…
Jones, Carolyn E.; Monfils, Marie-H.
Traumatic experiences early in life can contribute to the development of mood and anxiety disorders that manifest during adolescence and young adulthood. In young rats exposed to acute fear or stress, alterations in neural development can lead to enduring behavioral abnormalities. Here, we used a modified extinction intervention…
In an effort to reduce the current epidemic of gun violence among children and adolescents in the United States, this fact sheet presents various approaches to reducing access to and interest in carrying firearms. Suggested approaches to reducing access include: (1) urging parents to turn in their guns to police; (2) repealing anti-gun control…
Lin, Kirk K.; Sandler, Irwin N.; Ayers, Tim S.; Wolchik, Sharlene A.; Luecken, Linda J.
This study examined environmental stress, family, and child variables that differentiate resilient children and adolescents from those with mental health problems following the death of a primary caregiver. The community-based sample included 179 bereaved children ages 8 to 16 years and their surviving caregivers who completed a test battery of…
Byrnes, Hilary F.; Miller, Brenda A.; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Cupp, Pamela K.; Atwood, Katharine A.; Fongkaew, Warunee; Rosati, Michael J.; Chookhare, Warunee
Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = 0.52) in Bangkok, Thailand in a prevention program for adolescent…
Lang, Jason M.; Waterman, Jill; Baker, Bruce L.
Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16…
Wilderness Therapy Programs have recently become a formal alternative treatment for adolescents with emotional and behavioral disorders (Hinkle, 1999; Russell & Hendee, 1999; Russell, Hendee, & Phillips-Miller, 2000; Russell, 2003a, 2003b). Adolescent populations are unique in that traditional forms of psychotherapy, including "talk-therapies,"…
Carter, D M; Felice, M E; Rosoff, J; Zabin, L S; Beilenson, P L; Dannenberg, A L
Despite developments in contraceptive technology and changes in societal norms, adolescent pregnancy remains a key issue for politicians, social scientists, health care providers, and educators. The adolescent's access to contraception and abortion services continues to spark legal debate. The implications of research call for the development of innovative programs to address larger issues, such as poverty and limited access to health care, in the management and prevention of adolescent pregnancies. Clinical interventions, such as school-linked clinics to provide contraception and prenatal care programs to reduce perinatal morbidity, have varied in their approaches and their subsequent success.
... Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panel..., discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panel...
Kindt, Karlijn C M; Kleinjan, Marloes; Janssens, Jan M A M; Scholte, Ron H J
As restructuring a negative cognitive style is a central skill taught in many depression prevention programs, we tested whether a universal prevention program evoked a change in negative cognitive style in adolescents. In addition, we examined distinct developmental trajectories of negative cognitive styles and assessed whether research condition (intervention versus control) predicted these trajectories. Young adolescents (n = 1343; Mean age = 13.4 years; SD = 0.77; 52.3% girls) were randomly allocated to a cognitive behavioral therapy (CBT)-based depression prevention program or a care as usual control condition. A negative cognitive style was assessed at baseline, post-treatment and 6- and 12-months follow-up. Adolescents who received the intervention did not differ in their negative cognitive style from the control group at any time-point. We found four distinctive trajectories of negative cognitive style: normative, increasing, decreasing and stable high, which were not predicted by intervention condition and were not moderated by gender. Yet, the results revealed a trend, which indicated that adolescents who followed the program tended to show an increasing than a normative developmental pattern. We concluded that the CBT-based depression prevention program did not reduce or prevent an increase in negative cognitive style.
Greydanus, D E; Railsback, L D
This article reviews the difficult but complex subject of abortion in adolescents. Methods of abortion are outlined and additional aspects are presented: psychological effects, counseling issues, and legal parameters. It is our conclusion that intense efforts should be aimed at education of youth about sexuality and prevention of pregnancy, utilizing appropriate contraceptive services. When confronted with a youth having an unwanted pregnancy, all legal options need to be carefully explored: delivery, adoption, or abortion. The decision belongs to the youth and important individuals in her environment. Understanding developmental aspects of adolescence will help the clinician deal with the pregnant teenagers. If abortion is selected, a first trimester procedure is best. Finally, physicians are urged to be aware of the specific, ever changing legal dynamics concerning this subject which are present in their states. Abortion is a phenomenon which has become an emotional but undeniably important aspect of adolescent sexuality and adolescent health care, in this country and around the world.
Valizadeh, Leila; Hosseini, Fahimeh Alsadat; Zamanzadeh, Vahid; Heidarnezhad, Fatemeh; Jasemi, Madineh; Lankarani, Kamran Bagheri
Background: Prerequisite for management of a chronic disease involves knowledge about its complications and their prevention. Hemophilia in adolescents influences all the aspects of their lives and thier performance. Objectives: The present study aimed to determine the performance of Iranian hemophilic adolescents in prevention of disease complications. Patients and Methods: In this descriptive-analytical study, 108 adolescents with hemophilia were selected through convenience sampling. Their performance in preventing the complications of hemophilia was evaluated by sending a semi-structured questionnaire to their addresses throughout Iran. Then, the data was analysed using the Statistical Package for Social Sciences (SPSS) software (v. 13) and descriptive and interferential statistics were used. Results: Overall, 32.1% of the participants controlled bleeding during the 1st hour. Inaccessibility of coagulation products was mainly responsible for inhibiting timely and proper bleeding control. In order to relieve bleeding associated pain, only 39.0% of the adolescents used analgesics. On the other hand, 19.8% of the subjects used nonpharmacological methods to relieve pain. The majority of the adolescents did not participate in sport activities (65.4%) others allocated less than 5 hours a week to physical activities (70.5%). In addition, the participants did not have favorable dietary patterns, exercise habits, and dental care. The results showed a significant relationship between the adolescents’ preventive practice with coagulation disorders and utilization of pharmacological pain relief methods. Also, significant relationships were found between severity of the disease; participating in physical activities, number of hours of physical activities; and disease complications. Conclusions: Iranian adolescents did not exhibit favorable practices towards complication prevention. PMID:26600702
Haffner, Debra W.
Due to indiscriminate experimentation with drugs and sex, teens are increasingly at risk of contracting AIDS. Goals of prevention include reducing the panic and misinformation surrounding the disease, helping teenagers delay sexual intercourse, ensuring condom use, and preventing I.V. drug use. AIDS prevention as a shared responsibility includes…
Erickson, P I
The conclusion of this quantitative and qualitative evaluation of 350 mothers delivering at Women's Hospital in East Los Angeles and recruited between April 1989 and December 1990 was that basic ethnographic research on teenage sexual and reproductive behavior is needed. Target groups of Hispanics, for instance, may not be homogenous and may require multiple strategies. New interventions should accommodate the effects of poverty, the influence of significant others, and the cultural meaning of relationships, pregnancy, childbearing, contraceptive use, and gender roles. Concern focused on the notion that limited program effects can be considered trivial. The point was made that bilingual mothers who had been in the US for some time and desired upward socioeconomic mobility were helped by the program. Also, the program developed referral resources in child care, school programs, employment, housing, emergency aid, and services for physical and sexual abuse. Additional funding was able to provide part-time work experiences in the clinic for a few of the teenagers, which provided more social support, solid work experience, and incentives. Through the use of qualitative data, counselors were able to prioritize teenage needs and thus supply needed food and housing before contraception. Qualitative data also helped to distinguish several different groups of Hispanics: those recent immigrants who wanted to be wives and mothers; bilingual adolescents desiring economic advancement; throw-away kids involved with drugs and gangs; and Central American teenagers who fled war-torn countries and desired a better life. There were pressing needs related to poverty and social circumstances that interfered with family planning program implementation. Recognition of the different lifestyles helped to direct services in appropriate ways. The statistical demographic profiles were presented and indicated that these teenage obstetric persons had significant social, economic, and medical
Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Spitznagel, Edward L.; Schootman, Mario; Cottler, Linda B.; Bierut, Laura Jean
Objective: The present study examined the associations between initiation and intensity of substance use and with sexual experience with and without a history of teenage pregnancy. Method: Participants were high school females (weighted n = 3,451) who participated in the 1999–2003 Youth Risk Behavior Surveillance System, a cross-sectional, nationally representative survey. Multinomial multivariable logistic regression was used to assess the likelihood of being sexually experienced (but never pregnant) and teenage pregnancy (reference group: never had sexual intercourse) as a function of age at substance use initiation (i.e., age 12 or younger, 13–14 years of age, and age 15 or older) and intensity of substance use (i.e., nonuser, experimental/ new or nondaily, nonexperimental/daily user) for alcohol, cigarettes, and marijuana, while controlling for race/ethnicity, metropolitan location, symptoms of depression, and illegal drug availability at school. Results: A major finding of our study is that substance use behaviors across each substance (alcohol, cigarettes, and marijuana) independently contributed to an increased risk in sexual intercourse experience with and without a history of teenage pregnancy (vs. nonsexually experienced females). A dose-response relationship was also observed between an increased likelihood of a teenage pregnancy and marijuana behaviors. Furthermore, the risk for teenage pregnancy was compounded for daily cigarette smokers who initiated use at age 12 or younger. Conclusions: Screening substance use behaviors can help to identify girls who may benefit from pregnancy prevention strategies. Targeting cigarette and marijuana behaviors as early as age 12 or younger may provide an added benefit. Prevention strategies should also consider the role of race above and beyond substance use behaviors. PMID:21388592
Black, Maureen M.; Hager, Erin; Le, Katherine; Anliker, Jean; Arteaga, S. Sonia; DiClemente, Carlo; Gittelsohn, Joel; Levy, Lauren; Magder, Laurence; Papas, Mia; Shebl, Fatma; Snitker, Soren; Treuth, Margarita S.; Wang, Yan
Objective To evaluate a 12-session home and community-based health promotion/obesity prevention program (Challenge!) on changes in BMI, body composition, physical activity (PA), and diet. Methods 235 African-American adolescents (11–16 yrs, 38% overweight/obese) were recruited from low-income urban communities. Baseline measures included weight, height, body composition (dual-energy x-ray absorptiometry (DEXA) and bioelectrical impedance), physical activity (PA) (accelerometry), and diet (food frequency). PA was measured by time in play-equivalent physical activity (PEPA≥1800 activity counts/min). Participants were randomized into a home- and community-based health promotion/obesity prevention controlled trial, anchored in social cognitive theory and involving motivational interviewing techniques, and delivered by college-enrolled, African-American mentors. Control adolescents did not receive the intervention or a mentor. Post-intervention (10 mos) and delayed follow-up (24 mos) evaluations were conducted. Longitudinal analyses using random mixed effects models and generalized estimating equations (GEE) examined direct and moderated effects of time, gender, and baseline BMI category on changes at both follow-ups. Results Retention was 76% (178/235) over 2 years; overweight/obese status declined 5.3% among intervention adolescents and increased 11.3% among control adolescents (χ2=5.8, p=0.02, GEE). Among males, but not females, fat free mass was significantly higher among intervention members at both follow-up evaluations. PA effects were moderated by baseline BMI category; among adolescents ≥ 85th percentile, control adolescents averaged 25.5 min less daily activity than intervention adolescents (p=0.018) at the 10-mo, but not the 24-mo follow-up. Intervention adolescents declined significantly more in snack and dessert consumption than control adolescents (p=0.045). Conclusion A 12-session, home-and community-based intervention, based on social cognitive
Kuntsche, Sandra; Kuntsche, Emmanuel
Despite the increasing relevance of peers, parents remain important socializing agents for their adolescent children and are therefore promising agents for inclusion in prevention or intervention programs. This systematic review provides an overview of the effectiveness of parent-based programs in preventing, curbing or reducing substance use (i.e. alcohol, tobacco and cannabis) among 10 to 18-year-olds. The databases PubMed, PsychInfo, Eric and Google Scholar were used to identify randomized trials published within the past 12years evaluating effects on adolescent substance use. Of the 653 identified in the first screening, 39 publications dealing with 13 programs were included. Results reveal desirable effects of parenting measures such as rule-setting, monitoring and parent-child communication. There was also some evidence in terms of preventing, curbing or reducing adolescent substance use. However, this appears to depend particularly on the age group of the adolescents in question, the kind of parents included and the intensity of the program. To conclude, the results of this systematic review underline the importance of including parents in programs aiming to impede initiation of substance use or curb or reduce already existing substance use in adolescence.
Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia
Preventing adolescent pregnancy is a national research priority that has had limited success. In the present study, the authors examined whether Multidimensional Treatment Foster Care (MTFC) relative to intervention services as usual (group care [GC]) decreased pregnancy rates among juvenile justice girls mandated to out-of-home care. Girls (13-17…
Pepper, Jessica K.; McRee, Annie-Laurie; Gilkey, Melissa B.
Purpose Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that may serve as a “gateway” to tobacco use by adolescents. Use of e-cigarettes by U.S. adolescents rose from 3% in 2011 to 7% in 2012. We sought to describe healthcare providers’ awareness of e-cigarettes and to assess their comfort with and attitudes toward discussing e-cigarettes with adolescent patients and their parents. Methods A statewide sample (n = 561) of Minnesota healthcare providers (46% family medicine physicians, 20% pediatricians, and 34% nurse practitioners) who treat adolescents completed an online survey in April 2013. Results Nearly all providers (92%) were aware of e-cigarettes, and 11% reported having treated an adolescent patient who had used them. The most frequently cited sources of information about e-cigarettes were patients, news stories, and advertisements, rather than professional sources. Providers expressed considerable concern that e-cigarettes could be a gateway to tobacco use but had moderately low levels of knowledge about and comfort discussing e-cigarettes with adolescent patients and their parents. Compared with pediatricians and nurse practitioners, family medicine physicians reported knowing more about e-cigarettes and being more comfortable discussing them with patients (both p < .05). Nearly all respondents (92%) wanted to learn more about e-cigarettes. Conclusions Healthcare providers who treat adolescents may need to incorporate screening and counseling about e-cigarettes into routine preventive services, particularly if the prevalence of use continues to increase in this population. Education about e-cigarettes could help providers deliver comprehensive preventive services to adolescents at risk of tobacco use. PMID:24332394
Skeith, Leslie; Carrier, Marc; Kaaja, Risto; Martinelli, Ida; Petroff, David; Schleußner, Ekkehard; Laskin, Carl A; Rodger, Marc A
We performed a meta-analysis of randomized controlled trials comparing low-molecular-weight heparin (LMWH) vs no LMWH in women with inherited thrombophilia and prior late (≥10 weeks) or recurrent early (<10 weeks) pregnancy loss. Eight trials and 483 patients met our inclusion criteria. There was no significant difference in livebirth rates with the use of LMWH compared with no LMWH (relative risk, 0.81; 95% confidence interval, 0.55-1.19;P= .28), suggesting no benefit of LMWH in preventing recurrent pregnancy loss in women with inherited thrombophilia.
Hurd, Noelle M; Valerio, Melissa A; Garcia, Nicole M; Scott, Anthony A
This study examined the effectiveness of an adapted 4-session HIV prevention program. Participants included 490 adolescents who participated in either the 8- or the adapted 4-session HIVEd program. Analyses to identify mean changes in HIV-related knowledge, attitudes, self-efficacy, and behavioral intentions between participants in either the 4- (n = 274) or 8-session (n = 216) programs were completed. Findings indicate participants in both programs had positive changes at post interview across all study outcomes. No significant differences in changes between participants in the 4- and 8-session programs were found except that male adolescents in the 4-session program had significantly higher mean changes in condom knowledge (p < .01). The adaptation of the 8-session HIVEd program was undertaken to better reach and accommodate the needs of a high risk incarcerated adolescent population. Findings demonstrate that HIV prevention interventions for high risk populations may be successfully adapted and condensed when based on rigorously evaluated and theoretically driven programs.
Garmy, Pernilla; Jakobsson, Ulf; Carlsson, Katarina Steen; Berg, Agneta; Clausson, Eva K.
The aim of this pilot study was to evaluate the implementation of a universal school-based cognitive behavioral program whose target is to prevent depressive symptoms in adolescents. The study had a quasi-experimental design with pretest, posttest, and a 1-year follow-up and provides an illustrative calculation for the implementation costs of the…
Shaibu, Sheila; Holsten, Joanna E.; Stettler, Nicolas; Maruapula, Segametsi D.; Jackson, Jose C.; Malete, Leapetswe; Mokone, George; Wrotniak, Brian H.; Compher, Charlene W.
The study's objectives were to gain school personnel's (1) perceptions on diet, physical activity, body size, and obesity, (2) description of school food and physical activity practices, and (3) recommendations for programs to prevent adolescent obesity. The study took place in six junior secondary schools of varying socioeconomic status in…
Gonzalez-Guarda, Rosa Maria; Guerra, Jessica E.; Cummings, Amanda A.; Pino, Karen; Becerra, Maria M.
The purpose of this study is to evaluate the preliminary efficacy of a dating violence (DV) prevention program for Cuban American adolescents ("JOVEN"/YOUTH: "Juntos Opuestos a la Violence Entre Novios"/Together Against Dating Violence). A randomized-controlled experimental design with a delayed condition was used to evaluate…
The Yellow Ribbon Suicide Prevention Program has gained national and international recognition for its school- and community-based activities. After the introduction of Yellow Ribbon to a Denver-area high school, staff and adolescents were surveyed to determine if help-seeking behavior had increased. Using a prepost intervention design, staff at…
Mauriello, Leanne M.; Driskell, Mary Margaret H.; Sherman, Karen J.; Johnson, Sara S.; Prochaska, Janice M.; Prochaska, James O.
This article describes the development and pilot testing of a computer-based, multiple-behavior obesity prevention program for adolescents. Using the Transtheoretical Model as a framework, this intervention offers individualized feedback based on readiness to engage in physical activity, to consume fruits and vegetables, and to limit television…
Martsolf, Donna S.; Colbert, Crystal; Draucker, Claire B.
Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne's…
Tapia, Maria I.; Schwartz, Seth J.; Prado, Guillermo; Lopez, Barbara; Pantin, Hilda
Objective: The objective of the present article is to review and discuss Familias Unidas, an empirically supported, family-based, culturally specific drug abuse and HIV prevention intervention for Hispanic immigrant adolescents and their families. Method: The authors focus on engagement and retention as well as on intervention delivery.…
Tze, Virginia M. C.; Li, Johnson C.-H.; Pei, Jacqueline
Substance abuse, especially among adolescents, has long been an important issue in society. In light of the adverse impact of substance abuse, scholars, educators, and policy-makers have proposed different approaches to prevent and reduce such abuse. This paper investigates the effectiveness of the two prominent approaches--educational and…
Karki, Suyen; Pietila, Anna-Maija; Lansimies-Antikainen, Helena; Varjoranta, Pirjo; Pirskanen, Marjatta; Laukkanen, Eila
The aim of this systematic review is to describe and evaluate the effects of interventions used for preventing or reducing substance use among adolescents under 18 years of age. Studies (N = 27) available in CINAHL and PubMed from 2007 to 2010 were included. Results showed that family-based interventions and combined interventions have significant…
Mitchell, D. R., Ed.
Presented are nine papers given at a New Zealand symposium on the prevention and treatment of delinquent/antisocial behavior in children and adolescents. Major theories such as the cultural deviance theory are noted in the introduction by D.R. Mitchell. J. E. Ritchie defines delinquency as law breaking, critiques delinquency research, and offers a…
Vist, Natalya V.
This article focuses on such a highly relevant subject as the prevention and correction of deviant behavior in the adolescent environment. The study revealed the main vectors for the development of the modern science of deviant behavior, identified the main causes of deviations and carried out a comparative analysis of the work on the prevention…
Allensworth, Diane DeMuth; Bradley, Beverly
Investigates the use of school nurses to deliver the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS) in collaboration with school and community professionals. Examines GAPS' components and related critical issues (identifying students for screening, screening students, triage, interdisciplinary and interagency…
Corrigan, Matthew J.; Loneck, Barry; Videka, Lynn; Brown, M. Craig
The field of substance abuse prevention has evolved towards a risk and protective factor paradigm in explaining the onset and escalation of adolescent substance use. This framework for understanding the problem has been developed and employed by researchers at the University of Washington, under Doctors Hawkins and Catalano, to assess communities…
Schwinn, Traci Marie; Hopkins, Jessica Elizabeth; Schinke, Steven Paul
Objectives: Girls' rates of drug use have met up with and, in some instances, surpassed boys' rates. Although girls and boys share risk and protective factors associated with drug use, girls also have gender-specific risks. Interventions to prevent girls' drug use must be tailored to address the dynamics of female adolescence. Methods: One such…
Schinke, Steven P.; Schwinn, Traci M.; Hursh, Hilary A.
Intervention research is essential to help Hispanic American adolescents avoid drug use. This article describes an intervention research program aimed at preventing drug use among these youths. Grounded in salient epidemiological data, the program is informed by bicultural competence, social learning, and motivational interviewing theories. The…
Rissel, Christopher; And Others
Surveys of adolescent alcohol abuse prevention task force members found that members who were more satisfied with the task force and lived in the community less time spent more time on task force work. Satisfaction was greater for those who perceived more personal and community influence on the task force. (SM)
Nitza, Amy; Chilisa, Bagele; Makwinja-Morara, Veronica
This article describes a small group intervention for HIV/AIDS prevention among adolescent girls in Botswana. The psychoeducational group model is designed to empower girls to overcome the gender inequality that puts women at increased risk of HIV infection in the country. Group goals include heightening group members' awareness of the influence…
Background Adolescent pregnancies are a common phenomenon that can have both positive and negative consequences. The rights framework allows us to explore adolescent pregnancies not just as isolated events, but in relation to girls' sexual and reproductive freedom and their entitlement to a system of health protection that includes both health services and the so called social determinants of health. The aim of this study was to explore policy makers' and service providers' discourses concerning adolescent pregnancies, and discuss the consequences that those discourses have for the exercise of girls' sexual and reproductive rights' in the province of Orellana, located in the amazon basin of Ecuador. Methods We held six focus-group discussions and eleven in-depth interviews with 41 Orellana's service providers and policy makers. Interviews were transcribed and analyzed using discourse analysis, specifically looking for interpretative repertoires. Results Four interpretative repertoires emerged from the interviews. The first repertoire identified was "sex is not for fun" and reflected a moralistic construction of girls' sexual and reproductive health that emphasized abstinence, and sent contradictory messages regarding contraceptive use. The second repertoire -"gendered sexuality and parenthood"-constructed women as sexually uninterested and responsible mothers, while men were constructed as sexually driven and unreliable. The third repertoire was "professionalizing adolescent pregnancies" and lead to patronizing attitudes towards adolescents and disregard of the importance of non-medical expertise. The final repertoire -"idealization of traditional family"-constructed family as the proper space for the raising of adolescents while at the same time acknowledging that sexual abuse and violence within families was common. Conclusions Providers' and policy makers' repertoires determined the areas that the array of sexual and reproductive health services should include
Rink, Elizabeth; FourStar, Kris; Medicine Elk, Jarrett; Dick, Rebecca; Jewett, Lacey; Gesink, Dionne
The Fort Peck Sexual Health Project: A Contextual Analysis of Native American Men is a community-based participatory research (CBPR) project that explores the extent to which knowledge, attitudes, and beliefs about sex, intimate relationships, and mental health influence sexual and reproductive health. For the purpose of this study, the influence of age, fatherhood, and mental health factors related to historical trauma and loss on young American Indian (AI) men's intention to use birth control was examined. In-depth interviews were conducted with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21 years. Thirty-eight percent of the young men reported having children. The young men reported experiences of historical trauma during their lifetime as well as emotional responses due to historical losses. Ninety-five percent reported that it was very important that they use some form of birth control to prevent their partner from getting pregnant within the next year. Logistic regression analysis indicated that, as age increased, young men were less likely to use birth control to prevent pregnancy. The young men who reported feelings of loss due to experiences related to historical trauma and loss were more likely to use birth control. Findings from this study suggest that public health efforts to educate AI men about planned pregnancies and the use of birth control may be most effective in adolescence. Public health programs that address mental health concerns such as the emotional responses due to historical losses may assist young AI men in their decision to use birth control.
Paxton, Georgia A; Teale, Glyn R; Nowson, Caryl A; Mason, Rebecca S; McGrath, John J; Thompson, Melanie J; Siafarikas, Aris; Rodda, Christine P; Munns, Craig F
• The recommended level for serum 25-hydroxyvitamin D (25(OH)D) in infants, children, adolescents and during pregnancy and lactation is ≥ 50 nmol/L. This level may need to be 10-20 nmol/L higher at the end of summer to maintain levels ≥ 50 nmol/L over winter and spring. • Sunlight is the most important source of vitamin D. The US recommended dietary allowance for vitamin D is 600 IU daily in children aged over 12 months and during pregnancy and lactation, assuming minimal sun exposure. • Risk factors for low vitamin D are: lack of skin exposure to sunlight, dark skin, southerly latitude, conditions affecting vitamin D metabolism and storage (including obesity) and, for infants, being born to a mother with low vitamin D and exclusive breastfeeding combined with at least one other risk factor. • Targeted measurement of 25(OH)D levels is recommended for infants, children and adolescents with at least one risk factor for low vitamin D and for pregnant women with at least one risk factor for low vitamin D at the first antenatal visit. • Vitamin D deficiency can be treated with daily low-dose vitamin D supplements, although barriers to adherence have been identified. High-dose intermittent vitamin D can be used in children and adolescents. Treatment should be paired with health education and advice about sensible sun exposure. Infants at risk of low vitamin D should be supplemented with 400 IU vitamin D₃ daily for at least the first year of life. • There is increasing evidence of an association between low vitamin D and a range of non-bone health outcomes, however there is a lack of data from robust randomised controlled trials of vitamin D supplementation.
Smith, Jennifer L.; Skinner, S. Rachel; Fenwick, Jennifer
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…
Yampolskaya, Svetlana; Brown, Eric C.; Greenbaum, Paul E.
This 7-year study examined the consequences of early pregnancy and parenting for girls with serious emotional disturbances (SED) and risk factors identified with teenage pregnancy. Risk factors that were examined included sociodemographic characteristics, psychological characteristics, and psychopathology. The 109 participants in the study were…
Power, Thomas G.; Bindler, Ruth C.; Goetz, Summer; Daratha, Kenneth B.
Background: Obesity is a significant health problem among today's youth; however, most school-based prevention programs in this area have had limited success. Focus groups were conducted with seventh- to eighth-grade students, parents, and teachers to provide insight into the development of a comprehensive program for the prevention of adolescent…
Kershaw, Trace S.; Ethier, Kathleen A.; Milan, Stephanie; Lewis, Jessica B.; Niccolai, Linda M.; Meade, Christina; Ickovics, Jeannette R.
Risky sexual behavior can lead to pregnancy, sexually transmitted diseases (STDs), and human immunodeficiency virus (HIV). Our study of 300 adolescent females takes an integrative approach by incorporating these multiple outcomes to assess the influence of risk perceptions on sexual behavior by (1) identifying subgroups of perceived susceptibility…
Goldenberg, Shira M; Silverman, Jay G; Engstrom, David; Bojorquez-Chapela, Ietza; Usita, Paula; Rolón, María Luisa; Strathdee, Steffanie A
Coerced and adolescent sex industry involvement are linked to serious health and social consequences, including enhanced risk of HIV infection. Using ethnographic fieldwork, including interviews with 30 female sex workers with a history of coerced or adolescent sex industry involvement, we describe contextual factors influencing vulnerability to coerced and adolescent sex industry entry and their impacts on HIV risk and prevention. Early gender-based violence and economic vulnerability perpetuated vulnerability to coercion and adolescent sex exchange, while HIV risk mitigation capacities improved with increased age, control over working conditions, and experience. Structural interventions addressing gender-based violence, economic factors, and HIV prevention among all females who exchange sex are needed.
Herzog, Thaddeus A.; Black, David S.; Zaman, Adnin; Riggs, Nathaniel R.; Sussman, Steve
Adolescence is marked by several key development-related changes, including neurocognitive changes. Cognitive abilities associated with self-regulation are not fully developed until late adolescence or early adulthood whereas tendencies to take risks and seek thrilling and novel experience seem to increase significantly throughout this phase, resulting in a discrepancy between increased susceptibility to poor regulation and lower ability to exercise self-control. Increased vulnerability to drug use initiation, maintenance, and dependence during adolescence may be explained based on this imbalance in the self-regulation system. In this paper, we highlight the relevance of schools as a setting for delivering adolescent drug use prevention programs that are based on recent findings from neuroscience concerning adolescent brain development. We discuss evidence from school-based as well as laboratory research that suggests that suitable training may improve adolescents’ executive brain functions that underlie self-regulation abilities and, as a result, help prevent drug use and abuse. We note that considerable further research is needed in order (1) to determine that self-regulation training has effects at the neurocognitive level and (2) to effectively incorporate self-regulation training based on neuropsychological models into school-based programming. PMID:23408284
Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: 1) current definitions of childhood and adolescent overweight and obesity; 2) demography of childhood and adolescent obesity both in the US and globally; 3) current topics in the physiology of fat and obesity; 4) psychosocial correlates of childhood and adolescent overweight and obesity; 5) the three major obesity-related behaviors, i.e. dietary intake, physical activity and sleep; 6) genes components of childhood and adolescent obesity; 7) environment and childhood and adolescent obesity; and 8) progress in interventions to prevent and treat childhood obesity. The article concludes with recommendations for future research, including the need for large-scale, high dose and long-term interventions that take into account the complex nature of the problem. PMID:21625328
Gould, Madelyn S; Twisk, Jos WR; Kerkhof, Ad JFM; Koot, Hans M
Background Face-to-face gatekeeper training can be an effective strategy in the enhancement of gatekeepers’ knowledge and self-efficacy in adolescent suicide prevention. However, barriers related to access (eg, time, resources) may hamper participation in face-to-face training sessions. The transition to a Web-based setting could address obstacles associated with face-to-face gatekeeper training. Although Web-based suicide prevention training targeting adolescents exists, so far no randomized controlled trials (RCTs) have been conducted to investigate their efficacy. Objective This RCT study investigated the efficacy of a Web-based adolescent suicide prevention program entitled Mental Health Online, which aimed to improve the knowledge and self-confidence of gatekeepers working with adolescents (12-20 years old). The program consisted of 8 short e-learning modules each capturing an important aspect of the process of early recognition, guidance, and referral of suicidal adolescents, alongside additional information on the topic of (adolescent) suicide prevention. Methods A total of 190 gatekeepers (ages 21 to 62 years) participated in this study and were randomized to either the experimental group or waitlist control group. The intervention was not masked. Participants from both groups completed 3 Web-based assessments (pretest, posttest, and 3-month follow-up). The outcome measures of this study were actual knowledge, and participants’ ratings of perceived knowledge and perceived self-confidence using questionnaires developed specifically for this study. Results The actual knowledge, perceived knowledge, and perceived self-confidence of gatekeepers in the experimental group improved significantly compared to those in the waitlist control group at posttest, and the effects remained significant at 3-month follow-up. The overall effect sizes were 0.76, 1.20, and 1.02, respectively, across assessments. Conclusions The findings of this study indicate that Web
James, E Angel; Rashid, Moira
In the United States, unintended pregnancy is a serious health, social, and economic concern. However, the existing prevention policies have proven ineffective at decreasing the rate of unintended pregnancy at a national level. This lack of effective national prevention policy is better understood when viewed through the lens of a policy theory that incorporates an understanding of social construction and its effects on policy development. Through the application of one such policy theory, this article explores how the social construction of fertile women in the United States affects previous and recently enacted unintended pregnancy prevention policies.
Foshee, Vangie A; Dixon, Kimberly S; Ennett, Susan T; Moracco, Kathryn E; Bowling, J Michael; Chang, Ling-Yin; Moss, Jennifer L
Adolescents exposed to domestic violence are at increased risk of dating abuse, yet no evaluated dating abuse prevention programs have been designed specifically for this high-risk population. This article describes the process of adapting Families for Safe Dates (FSD), an evidenced-based universal dating abuse prevention program, to this high-risk population, including conducting 12 focus groups and 107 interviews with the target audience. FSD includes six booklets of dating abuse prevention information, and activities for parents and adolescents to do together at home. We adapted FSD for mothers who were victims of domestic violence, but who no longer lived with the abuser, to do with their adolescents who had been exposed to the violence. Through the adaptation process, we learned that families liked the program structure and valued being offered the program and that some of our initial assumptions about this population were incorrect. We identified practices and beliefs of mother victims and attributes of these adolescents that might increase their risk of dating abuse that we had not previously considered. In addition, we learned that some of the content of the original program generated negative family interactions for some. The findings demonstrate the utility of using a careful process to adapt evidence-based interventions (EBIs) to cultural sub-groups, particularly the importance of obtaining feedback on the program from the target audience. Others can follow this process to adapt EBIs to groups other than the ones for which the original EBI was designed.
Muehlenkamp, Jennifer J; Walsh, Barent W; McDade, Moira
Non-suicidal self-injury (NSSI) continues to be a problem among youth and there is a great need for programming aimed at reducing NSSI in adolescents. The signs of self-injury program is the first known NSSI school-based prevention program for adolescents that attempts to increase knowledge, improve help-seeking attitudes and behaviors, and decrease acts of NSSI. A total of five schools implemented the program in selected classrooms (n = 274 adolescents; 51.5% female, mean age = 16.07 years) that consisted of predominantly Caucasian (73%) adolescents. Researchers collected pre-post evaluation surveys of the program and feasibility interviews were conducted with the school guidance personnel who ran the program. Results indicated the prevention program did not produce iatrogenic effects, increased accurate knowledge and improved help-seeking attitudes and intentions among students. No significant changes were found in regards to self-reported formal help-seeking actions. Feasibility responses indicate the program is user-friendly and well received by school personnel. The data offer preliminary evidence that the program may be an effective prevention program for schools.
Liu, Shangming; Guo, Yuji; Yuan, Qiuhuan; Pan, Yan; Wang, Liyan; Liu, Qian; Wang, Fuwu; Wang, Jingjing; Hao, Aijun
Melatonin, an endogenous neurohormone secreted by the pineal gland, has a variety of physiological functions and neuroprotective effects. However, its protective role on the neural tube defects (NTDs) was not very clear. The aim of this study was to investigate the effects of melatonin on the incidence of NTDs (including anencephaly, encephalocele, and spina bifida) of offspring from diabetic pregnant mice as well as its underlying mechanisms. Pregnant mice were given 10 mg/kg melatonin by daily i.p. injection from embryonic day (E) 0.5 until being killed on E11.5. Here, we showed that melatonin decreased the NTDs (especially exencephaly) rate of embryos exposed to maternal diabetes. Melatonin stimulated proliferation of neural stem cells (NSCs) under hyperglycemic condition through the extracellular regulated protein kinases (ERK) pathway. Furthermore, as a direct free radical scavenger, melatonin decreased apoptosis of NSCs exposed to hyperglycemia. In the light of these findings, it suggests that melatonin supplementation may play an important role in the prevention of neural malformations in diabetic pregnancy.
Pai, Chen-Hsueh; Yen, Ching-Tzu; Chen, Chie-Pein; Yu, I-Shing; Lin, Shu-Wha; Lin, Shu-Rung
Preeclampsia (PE) is a potentially fatal pregnancy-related hypertensive disorder characterized by poor placenta development that can cause fetal growth restriction. PE-associated pathologies, including thrombosis, hypertension, and impaired placental development, may result from imbalances between thromboxane A2 (TXA2) and prostacyclin. Low-dose aspirin, which selectively inhibits TXA2 production, is used to prevent high-risk PE. However, the role of TXA2 in aspirin-mediated protective effects in women with PE is not understood fully. In this study, we examined the role of prostanoids in PE using human samples and an induced PE mouse model. We demonstrated that the administration of salted drinking water (2.7% NaCl) to wild-type mice resulted in elevated placental TXA2 synthase (TXAS) and plasma TXA2, but not prostacyclin, levels, which was also found in our clinical PE placenta samples. The high salt-treated wild-type pregnant mice had shown unchanged maternal body weight, hypertension (MAP increase 15 mmHg), and decreased pup weight (~50%) and size (~24%), but these adverse effects were ameliorated in TXAS knockout (KO) mice. Moreover, increased expression of interleukin-1β and downstream phosphorylated-p38-mitogen-activated protein kinase were concordant with apoptosis induction in the placentas of salt water-treated wild-type mice. These alterations were not observed in TXAS KO mice. Together, our data suggest that TXA2 depletion has anti-PE effects due to the prevention of hypertension and placental damage through downregulation of the interleukin-1β pathway.
Caldwell, Beth; Albert, Chantell; Azeem, Muhammad W; Beck, Susan; Cocoros, David; Cocoros, Trish; Montes, Raquel; Reddy, Bhagya
The current article presents the experiences of three different child- and family-serving programs in the United States that have successfully implemented interventions to prevent the use of restraint and seclusion (R/S) in their respective facilities. The article also provides family and youth perspectives on the impact of and recommendations for preventing R/S. Over the past decade, a significant shift has occurred toward preventing the use of R/S within programs serving children and adolescents. National efforts have included the work of the Building Bridges Initiative, as well as growing interest and support for the implementation of trauma-informed environments of care.
Coskun, Aydin; And Others
Compared records of 572 adolescents who delivered babies in 1 obstetric service with records of 978 older patients. Found no significant differences between groups regarding spontaneous and operative delivery rates or regarding neonatal risk. Findings support view that obstetric outcomes of adolescents are no worse than outcomes for older…
Mays, Darren; Hawkins, Kirsten B.; Tyc, Vida L.; Atkins, Michael B.; Tercyak, Kenneth P.
To guide skin cancer preventive interventions, this study examined correlates of sun safety behaviors in a racial/ethnically diverse sample of 407 adolescents completing a self-report survey at the time of pediatric well-visits. Adolescents regularly practiced few sun safety behaviors, and greater interest in cancer prevention was associated with more sun safety behaviors, ever smoking cigarettes was associated with fewer sun safety behaviors, and non-white minority adolescents practiced fewer sun safety behaviors than non-Hispanic whites. Clinical preventive interventions to increase sun safety practices among adolescents of all racial/ethnic backgrounds could be integrated into general cancer prevention education, including combining skin cancer prevention and anti-smoking counseling. PMID:26269134
Mays, Darren; Hawkins, Kirsten B; Tyc, Vida L; Atkins, Michael B; Tercyak, Kenneth P
To guide skin cancer preventive interventions, this study examined correlates of sun safety behaviors in a racially and ethnically diverse sample of 407 adolescents completing a self-report survey at the time of their pediatric wellness visit. Adolescents regularly practiced few sun safety behaviors, and greater interest in cancer prevention was associated with more sun safety behaviors, ever smoking cigarettes was associated with fewer sun safety behaviors, and nonwhite minority adolescents practiced fewer sun safety behaviors than non-Hispanic whites. Clinical preventive interventions to increase sun safety practices among adolescents of all racial and ethnic backgrounds could be integrated into general cancer prevention education, including combining skin cancer prevention with antismoking counseling.
Schinke, Steven P.; Orlandi, Mario A.
The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic adolescents. Emphasizing culturally sensitive prevention strategies, the authors describe an intervention for these adolescents that combines skills-based and interactive computer approaches. PMID:20589223
Schinke, Steven P; Orlandi, Mario A
The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic adolescents. Emphasizing culturally sensitive prevention strategies, the authors describe an intervention for these adolescents that combines skills-based and interactive computer approaches.
Thupayagale-Tshweneagae, G; Mokomane, Z
The purpose of this paper is to raise an argument that inclusiveness will lessen the pain of losing a parent among adolescents orphaned by AIDS and as a result, prevent future mental health problems that may occur because of inappropriate grieving and maladaptive coping strategies. Participation of adolescents orphaned by AIDS in decisions pertaining to their parents' illnesses and funeral arrangements, for example, may shorten the grieving process and allow for closure. The paper draws data from focus group discussions that were held with 15 adolescents orphaned by AIDS in urban South Africa. The focus group discussions that were structured around four themes: grieving patterns; coping strategies; experience with loss; and expectations. The results of the study demonstrate inclusiveness as an overarching factor in the healing process. The concept is thus a strong recommendation for mental health practice and further study.