Term Paper: Teen Pregnancy Compared

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[. . .] Overall, education programs by themselves are not effective enough to help prevent pregnancy among African-American teenage girls.

Health clinics and counselors

Community health activists have pointed to the role a clinician could play in helping teenage girls avoid pregnancy and sexually transmitted diseases. This is because clinic visits are confidential. In this setting, a health-care provider is in a unique position to provide both medical care, contraception needs and counseling to the patient. The one-on-one nature of this interaction has the further advantage of ensuring the session is tailored to the patient's unique individual needs (Boekeloo et al. 1999).

Because of its healthcare focus, many of these programs emphasize educating patients about sexual diseases. In one program, for example, a nurse spends 10 to 20 minutes discussing diseases like Chlamydia, complete with illustrated pamphlets. The nurse then teaches the patient how to put a condom on a banana. Role-playing exercises further help teenage girls develop skills to convince their partners to wear condoms (Boekeloo et al. 1999).

These health-care programs have several key advantages over other pregnancy prevention programs. First, the one-on-one nature of the program encourages greater openness for more reserved teens, who may be embarrassed about airing their concerns in group settings. Also, clinicians have more time to devote to the individual needs of their teen patients. Furthermore, though teenage girls are the main targets of many pregnancy-prevention programs, the healthcare programs also help prevent teen pregnancy by educating male adolescents as well.

However, the success of these programs is once again tempered by factors like race and income. Recent budget cuts in social spending have forced many clinics in inner-cities and low-income neighborhoods to close. Since teens in low-income neighborhoods faced a higher risk of teen pregnancy (Harding 2003), the growing scarcity of community clinics is another factor that increases pregnancy among teenagers.

Additionally, clinics in low-income minority neighborhoods were few in number to begin with. The few clinics that did exist were hampered by poor funding. The strained resources only allowed for a skeletal staff and many were not able to give out free contraception.

Additionally, while these programs also provide invaluable services, their effectiveness is also quite limited. First of all, not every area has a clinic to begin with, and many clinics have previously closed. These health-care programs also require much investment on the part of the teen patient in terms of time and patience. Many would not feel comfortable going to such clinics, particularly when they have to work or when they would be recognized by other patients.

Finally, like education programs, health-care programs once again do not address the lack of strong ties between mothers and daughters.

Because of this limited, health-care based approached have only had limited successes in addressing pregnancy among African-American teenage girls.

Service Learning Programs

Service learning programs are another term to describe programs designed to involve teens in civic activities in their communities. Teens could participate in voluntary programs such as tutoring younger children, helping to maintain parks, assisting personnel in clinics and hospitals and working in nursing and retirement homes. Most of the teens participate in the voluntary programs, though others also receive class credit for their services (O'Donnell et al. 2000). Many schools make an extra effort to tie the community activity to current lessons.

Of all intervention programs, these service learning programs show the strongest evidence for reducing teen pregnancy rates while the teens are still enrolled in the program. An evaluation of the effectiveness of these programs in different locations around the country show that active service programs reduced rates of pregnancy or sexual activity among area teenagers (O'Donnell et al. 2000).

One of the earliest service programs was called Teen Outreach Program (TOP), which was instituted in several locations around the country. The TOP programs were conducted with the help of schools. TOP participants spent 46 hours doing various community services, ranging from tutoring to working in nursing homes.

A statistics showed that the program's participants showed lower pregnancy rates during the school year, compared to a control group. As an added benefit, TOP participants also reported lower rates of school failure (O'Donnell et al. 2000).

Researchers have suggested many reasons for the effectiveness of service learning programs. Some posit that the voluntary programs help focus the teenagers into thinking about the future. This is particularly true when the volunteer activities are tailored to students' interests. Thus, those who are interested in teaching are enrolled in tutorial programs. Students interested in carpentry and construction help in sprucing up public facilities or in building wheelchair ramps.

Corollary to this, others have posited that such activities may help keep children interested in school.

The increased focus on academics helps the teenagers to consider the consequences of risky sexual behavior. Others were inspired by the difference they can make in the lives of others. All these factors combine to encourage teens to avoid pregnancy and motivate them to stay in school.

Many of these programs have the added benefit of being privately-funded or using very little public resources. This factor makes these programs much easier to implement, especially in the low-income areas where teen pregnancy rates are the highest.

Another important factor behind the success of volunteer programs is the positive relationships many teens in these programs form with the program facilitators. Many teens have found caring mentors and close friends in their program facilitators. These teens reported that the close relationships have helped them develop self-esteem and made them feel more comfortable relating to their peers and to other adults (O'Donnell et al. 2000).

This last factor has significant implications for the success of such programs among African-American communities and in low-income neighborhoods. In these areas, the lack of a strong relationship with the mother or another parent contributes significantly to teen pregnancy.

Because many low-income and single parents have to work longer hours, many teens grow up feeling alienated and with little parental guidance.

Mentor-relationships could help address this alienation by giving young people a positive role model. Though the bond between mother and child would be difficult to replicate, a strong, positive relationship with a caring adult mentor would help to fill the void.

Youth development programs

Following the adage regarding an ounce of prevention, many programs specifically recruit youth beginning at age 13 and encourage them to participate throughout high school. These programs hold special activities and educational programs five days a week. Many operate during the "risky" hours in between school dismissal and dinner time, the time studies have shown to be the most likely period when risky or criminal behaviors occur.

Youth development programs do not target teen pregnancy per se. Rather, the focus is to curb a host of undesirable behavior ranging from drug use, petty theft and vandalism. The privately funded Children's Aid Society -- Carrera Program, for example, is a long-term intensive program that provides a host of services, from homework help, standardized exam preparation and sex education. Counselors are on hand to provide information on safe sex, reproductive health and other concerns. A "job club" helps participants maintain gainful after-school employment, plan a budget and individual bank accounts. Participants spend an average of 16 hours per month on the program. During summer months, the participants also have the option of enrolling in paid employment programs and participate in seminars and projects to hone their entrepreneurial skills (Philliber et al. 2000).

Though the CAS-Carrera program targets many aspects of a teen's life and does not focus on pregnancy only, this program has shown promising results in reducing teen pregnancy rates.

The pregnancy rate among the teenage girls enrolled in the CAS-Carrera program was less than half, compared to the control group.

These wholistic youth development programs thus show tremendous promise in reducing teen pregnancy rates, not only in general but among African-American and low-income neighborhoods as well.

However, these programs are also hampered by financial concerns. The Philliber et al. (2000) study has shown that the CAS-Carrera programs were only effective in areas where all aspects of the program -- from health education to job training to college preparation assistance -- were fully-implemented. In areas where only parts of the CAS-Carrera programs were implemented due to financial or other resource constraints, the youth development program was less effective.

Youth development programs thus exhibit many of the characteristics that help other pregnancy prevention programs be more or less successful. First, they serve as motivation factors for teens, helping them to focus on their academics and think about their futures. These programs provide teens with knowledge regarding safe sex practices. Programs also help boost a young person's self-esteem, making them less susceptible to peer pressure regarding risky sexual behavior.

However, the sheer amount of time and financial resources needed by CAS-Carrera will make it unrealistic to expect these programs across the country. Because… [END OF PREVIEW]

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