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Objective: Despite a decrease in teenage pregnancy rates in the United States in the past decades, teen pregnancy continues to be a considerable health issue. In this paper, we outline the development of our novel peer-based intervention, Get It?, that aims to increase awareness of and self-efficacy to use long-active reversible contraceptives (LARCs) among teenagers., Methods: Peer narrative videos were created from audio recording semi-structured, one-on-one interviews with teenage LARC users. Focus groups of young women 19 years old and younger were conducted to choose the most audience-appropriate videos to be included in the final intervention. Using a thematic content analysis approach, transcripts of the audio recorded focus groups were reviewed and manually coded., Results: The final layout of Get It? included 4 videos that were chosen by participants of the focus groups, as well as supplemental activities that included a basic description of the LARC devices, the ability to anonymously post personal stories about LARCs that can be shared with others, and the opportunity to email the primary investigator questions about LARCs. Thematic analysis of the focus group discussions revealed that when it came to narrative videos, participants desired (1) an authentic narrator, (2) more information on the narrator, and (3) narrators displaying ample emotions., Conclusion: Peer narratives play a vital role in influencing a teenager's perspective on their health status; therefore, understanding what constitutes reliable narration from an online format was critical in the development of a peer-based electronic intervention that informs teenagers of the most effective contraceptive available to them., Competing Interests: Conflicts of Interest The research reported in this publication was supported by the NICHD of the National Institutes of Health, which awarded the primary investigator with 75% salary support. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health., (Copyright © 2023. Published by Elsevier Inc.)

Purpose: The purposes were to determine contraceptive methods pregnant adolescents intend to use postpartum and to understand factors that predispose intention to use less effective birth control than long-acting reversible contraception (LARC)., Methods: Participants were 247 pregnant minority adolescents in a prenatal program. Intention was assessed by asking "Which of the following methods of preventing pregnancy do you intend to use after you deliver?" Multinomial logistic regression analysis was used to determine factors associated with intent to use nonhormonal (NH) contraception (male/female condoms, abstinence, withdrawal and no method) or short-/medium-acting hormonal (SMH) contraception (birth control pill, patch, vaginal ring, injectable medroxyprogesterone acetate) compared with LARC (implant and intrauterine device) postpartum., Results: Twenty-three percent intended to use LARC, 53% an SMH method, and 24% an NH method. Participants who intended to use NH or SMH contraceptive methods over LARC were significantly more likely to believe that LARC is not effective at preventing pregnancy, to report that they do not make decisions to help reach their goals and that partners are not important when making contraceptive decisions. Other important factors were having a mother who was aged >19 years at first birth and had not graduated from high school, not having experienced a prior pregnancy or talked with parents about birth control options, and the perception of having limited financial resources., Conclusions: Distinct profiles of factors associated with intending to use NH or SMH contraceptive methods over LARC postpartum were identified and may inform future interventions to promote the use of LARC to prevent repeat pregnancy., (Copyright © 2015 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

To examine individual, interpersonal, family, and community correlates associated with moderate-to-severe depressive symptoms among pregnant adolescents. A total of 249 primarily African American and Hispanic pregnant adolescents ages 15-18 years were recruited into either an intervention group utilizing Centering Pregnancy prenatal care and case management, or to a comparison group receiving case management only. Moderate-to-severe depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Intervention and comparison groups did not significantly differ on demographic characteristics or depression scores at baseline. A total of 115 (46.1 %) participants met criteria for moderate-to-severe depressive symptoms at entry into the program. Pregnant adolescents who were moderately-to-severely depressed were more likely to be African American, to have reported limited contact with the father of the baby, and to have experienced prior verbal, physical or sexual abuse. Depressed adolescents also experienced high levels of family criticism, low levels of general support, and exposure to community violence. A significant number of pregnant adolescents were affected by depression and other challenges that could affect their health. Comprehensive interventions addressing these challenges and incorporating partners and families are needed.

Study Objective: To assess oral contraceptive pill (OCP) continuation rates and factors associated with OCP continuation in young women., Design: A 12-month retrospective cohort study by chart review of 226 young women seen for an initial clinic visit., Setting: Urban hospital-based family planning clinic., Participants: Predominantly African-American, sexually active young women, 12 to 21 years of age (median age, 17.2 years)., Main Outcome Measures: Scheduled OCP-appointment-keeping rates, pregnancy rates, and associated factors were compared between OCP-compliant and -noncompliant groups., Results: The OCP-appointment-keeping rate declined dramatically over 1 year, from 29% at the 3-month visit to 9% at the 12-month visit. Almost half seeking a postpartum visit checkup (PPVup) did not return after the initial clinic visit. Overall, a higher OCP-appointment-keeping rate was noted in those seeking OCPs vs. PPVup at the initial visit; P < .05 for 12-month visit. There was no difference in the pregnancy rates between OCP-compliant and -noncompliant groups. School enrollment and nulliparity was significantly associated with OCP compliance until the 6-month visit (P < .05)., Conclusion: In an urban hospital based clinic, the OCP continuation rate after the initial visit was poor. Continuation of OCPs may be anticipated by type of services sought at an initial visit. Methods to improve OCP continuation in this setting should be implemented.

A study examining the health and behavioral consequences of child abuse was conducted among 263 parenting and 257 never-pregnant teens attending a reproductive health clinic. Both groups of teens identified the following major consequences: suicide, prostitution, school drop-out, crime and substance abuse. However, only parenting teens expressed interest in prevention programs that would address these consequences. Traditional child abuse prevention programs are focused on parenting issues and rarely address health and behavioral consequences of abuse. These health and behavioral consequences of abuse may make adolescents vulnerable to abuse their own children as well as interfere with their psychosocial development. Therefore, the authors recommend integrating health and behavioral issues into child abuse prevention programs.

Factors affecting the drinking patterns of 183 pregnant, African-American, Hispanic, and White adolescents were investigated, including the influence of peers, sexual partners, family members, and mentors. Among participants who drank alcohol prior to their pregnancies, 87% quit or cut back on their drinking behaviors. Those adolescents who lived in environments where their partners, peers, and relatives were drinking and using drugs were more likely to have consumed alcohol in the previous month, while adolescents who identified mentors and/or parents who provided high levels of support were less likely to have consumed alcohol. Finally, distinct patterns of both drinking and life circumstances among the African-American, Hispanic, White adolescents were revealed. The implications of these findings for future research and intervention with pregnant adolescents are discussed.

The present study described the effectiveness of using an educational program for self-detection of premature labor in a group of forty-one indigent pregnant adolescents. Twenty-one of these teens self-detected premature labor and received appropriate medical intervention; only four had low birthweight infants and three delivered before 37 weeks. The overall results showed a significant use of the program and a high success to failure rate for those who received medical intervention. The cost-effectiveness and usefulness of this protocol in improving medical outcome for indigent teens are discussed.

To help physicians provide supportive information to pregnant teens, 146 pregnant adolescents and 46 physicians completed self-administered questionnaires about prenatal and infant care. Teens placed great importance on knowing about prenatal and parenting behaviors. Teens and physicians generally attached similar importance to concerns across all items (p less than 0.45). Both groups considered similar items extremely important, with the exception of birth control, which was more frequently rated extremely important by physicians (p less than 0.001). However, physicians reported differences between the importance they attached and the importance they thought teens would attack to items (p less than 0.001). Physicians did not accurately estimate the importance teens would attribute to 23 of the 24 items (p less than 0.001), and they anticipated that the teens would attach significantly less importance to items than the teens actually attached. Psychosocial concerns, which physicians anticipated would be considered most important, were often minimized by teens. Responses were not significantly associated with physician age, sex, or level of training, thus suggesting the need to address patient information concerns at all levels of professional education.

The diverse factors associated with sexuality among adolescents and the specific issues related to contraception in this developmentally diverse group result in complexity in policy formation. The future of an adolescent may be determined solely on the basis of access to supportive physical and emotional services funded by public and private sector monies. The purpose of this paper is to briefly present contemporary and social policies regarding pregnant adolescent health care. Suggestions as to how these policies can be translated into public adolescent health models are provided. The strategies will be related to primary and secondary public policy interventions.

Perceptions associated with pregnancy, including life-expectations, desire for pregnancy and knowledge of the menstrual cycle were assessed in a sample of urban adolescents 13 to 18 years old. Data was obtained from 104 primiparous teens in their second and third trimester of pregnancy. The majority of adolescents, although experiencing an unplanned pregnancy, perceived minimal negative social consequences associated with the pregnancy. Although more than 82% of all teens were aware of where to get birth control, they demonstrated no deep understanding of the menstrual cycle and its relationship to intercourse and only 11% used effective contraception. Of the birth control non-users 74% of the girls reported they did not want to get pregnant. In spite of unprotected coitus, most girls were surprised at conception.

Marital status, contraception, desire for pregnancy, and social support relationships were analyzed by ethnicity for a group of pregnant and postpartum adolescents. Although no significant differences were found among ethnic groups for birth control information and use, the desire for pregnancy, grouped by marital status at conception, was significantly different for Hispanics. Positive evaluations of the life changes associated with pregnancy were found more frequently among Hispanic mothers. Hispanic teen mothers, however, were least likely to understand the menstrual cycle. The role of ethnic background in adolescent fertility behaviour is discussed, and potential clinical applications for more effectively serving sexually active Hispanic adolescents are presented.

This paper reviews several sociologic factors associated with fertility and childbearing among Hispanic teens. The influences of acculturation, patterns of prenatal care and pregnancy outcome among Hispanic adolescents are discussed. Statistics related to birth weight, to onset of prenatal care, and marital status of the mother are also reviewed by age and ethnicity. Suggestions on how to enhance health care access among Hispanic teens are provided.

One hundred and forty-six indigent pregnant adolescents (12 to 18 years of age) were asked to complete a questionnaire concerning their prenatal care priorities (Scale I) and their knowledge of correct perinatal behaviors (Scale II). On Scale I, over 75% of teens considered parenting skills, infant care, and diet extremely important. On Scale II correctly answered items focused on the need to avoid substance abuse and smoking during pregnancy, visit the doctor, and eat balanced meals. The mean number of correct answers, however, was only 11.8 out of a total possible scale of 18 items. Less than 50% correctly answered statements about the effects of weight gain and other health behaviors on risk for high blood pressure and toxemia, safety of laxatives during pregnancy, possibility of becoming pregnant again before resuming menstruation, and the safety of various physical activities. Performance on both knowledge and health priority scales showed correct health information was limited to basic concrete facts. Abstract and technical aspects of health care did not appear to be easily assimilated.

To assess client utilization trends, selected characteristics including some aspects of family planning behavior of adolescent families were examined during the first two years of a Teen Health Clinic's operation. The majority of the girls attending the clinic were 16 years and under, nulliparous, and still living with one or more of their parents. While birth control services were the primary motivation for attendance, 25% of the girls came for a general health examination, information or counseling. Potentially significant problems, including venereal diseases, were found in 20% of the patients. Reproductive health trends and their implication for improving health care delivery and family planning for teenagers are discussed.

One hundred and four indigent, pregnant adolescents were selected to evaluate the effect of a prenatal education curriculum presented in a maternity clinic. Adolescent mothers were visited 6 months postpartum to test which short-term, intermediate, and long-term curriculum content items were accurately and effectively retained. Success of the curriculum was evaluated by a trained social worker in the girls' home to ascertain how these content areas were reflected in the adolescent mother's behavior. Short-term matter-child health-care compliance content showed a high degree of success. Intermediate child-rearing content techniques often did not lead to appropriate behavior six months after the baby was born. Long-term educational and vocational performance content did not demonstrate effective long-term retention. Technical aspects of child-rearing, even when deliberately presented by health educators, did not appear to be easily applied in the extended family setting, and long-term goals seemed inconsistent with the adolescent's behavior.

The future funding needs of perinatal programs for teenagers should motivate adolescent clinics to make creative use of nonprofessional volunteers. When adequately trained and supervised, volunteers can perform meaningful tasks with high-risk teenage patients. In this program, volunteer involvement not only has extended the staff's capacity to counsel effectively and to educate pregnant adolescents but also has augmented the program's effectiveness by providing rewards to reinforce patient compliance with nutrition and weight control. This paper provides some guidelines to medical professional who want to improve the volunteer efforts of other adolescent pregnancy programs. Such perinatal services must begin to capitalize on the resources of the volunteer sector if such programs are to continue and eventually expand to meet the needs of the pregnant teenager.