Academic journal article Social Work

Preventing Adolescent Pregnancy: A Review of Programs and Practices

Academic journal article Social Work

Preventing Adolescent Pregnancy: A Review of Programs and Practices

Article excerpt

This article reviews literature on the programs and practices available for the primary prevention of adolescent pregnancy. Using the outcomes from research studies, the review defines some of the "best practices" available for the purpose of guiding practitioners in their selection of programs and interventions. Prevention programs, their major components, and curricula are discussed. Best practices discussed include community-based and school-based clinics, programs offering contraceptive knowledge-building along with comprehensive sex education and skills training, and sex education curricula based on social learning theory and skills training.

Key words: adolescents; practice; pregnancy; prevention

Adolescent pregnancy has become a serious social problem of considerable interest to politicians and the general public. In recent years a spotlight has focused on adolescent pregnancy, and political and social groups from diverse sectors have developed programs aimed at decreasing the rates of pregnancies among adolescents (Franklin, Corcoran, & AyersLopez, 1997). Increasing public interest in reducing adolescent pregnancy rates is based on a concern about the escalation of nonmarital pregnancies and births in recent years (U.S. Department of Health and Human Services, 1995). Births to girls ages 15 to 19 have risen from one-third of all births in 1970 to one-half of all births in the early 1980s and to two-thirds of all births in 1988 (Chilman, 1989). This rise in the adolescent pregnancy rate has occurred in the context of an overall rise in nonmarital pregnancies to women of all ages and follows social trends in child births (Franklin et al., 1997).

Social work practitioners often are called on to intervene with adolescents for the purpose of preventing adolescent pregnancy. Funding organizations and those interested in preventing adolescent pregnancy expect social workers to be able to deliver effective interventions with this population. Adolescent pregnancy prevention programs and interventions, however, number in the hundreds (Kirby, 1989). It is difficult for a practitioner to know which programs or interventions serve as "best practices."

There are several viable ways to determine best practices but for the purposes of this review, best practices is determined not from the opinions, appraisals, or judgments of practitioners or those most familiar with adolescent pregnancy programs, but solely from the outcomes of research studies that have been conducted on those programs. This article reviews research literature on primary prevention programs and practices for adolescent pregnancy prevention with the goal of providing an overview that can guide practitioners in their selection of programs and interventions. Primary prevention programs, their major components, and curricula are discussed.

Adolescent Pregnancy Prevention Programs

Programs for adolescent pregnancy address two broad goals. First are programs that aim to prevent pregnancies, and second are programs that aim to provide support services to pregnant and parenting youths and to remediate the negative consequences of adolescent pregnancy (Hofferth, 1991). Programs also are differentiated between those offering primary prevention, the goal of which is to prevent first pregnancies, and programs offering secondary prevention, in which the goal is to prevent subsequent pregnancies. The latter's focus on the prevention of second pregnancies may occur in programs that provide support services for pregnant or parenting youths. This review, however, involves only primary prevention programs or programs in which the main goal is to prevent first-time pregnancies.

Outcome studies determine the effectiveness of primary prevention pregnancy programs through three main outcome objectives or measures. The first involves changes in sexual knowledge and attitudes. These measures generally assess whether adolescents have increased their knowledge concerning human sexuality or the use of contraceptives. …

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