In 2016, South Carolina ranked 15 out of 50 states for highest teen births (CDC, 2018). The audience of need is teens ages 15-19 years old in Spartanburg, South Carolina. There are many negative effects associated with teen pregnancies. Teen mothers are less likely to finish high school; more likely to rely on public assistance; more likely to live in low socioeconomic housing; and more likely to have children who have low education, behavioral, and health outcomes over their lives (HHS, 2016). This literature the prevalence of teen birth and sexual behavior; effects of teen pregnancies; and solution strategies to reduce the number of teen pregnancies in Spartanburg, South Carolina.
Prevalence of Teen Birth and Sexual Behavior
There are many factors that contribute to teens risky sexual behaviors leading to pregnancy, including lack of reproductive health education, lack of awareness of risks of sexual behavior, and socioeconomic status.
Despite the decline in teen pregnancy, the United States teen pregnancy rates are higher than other countries (Guttmacher Institute, 2015.) Based on the 2015 Youth Risk Behavior Surveillance (YRBS) data, found that 41.2% high school students (9th grade to 12th grade) reported being sexual active (Kann et al., 2016). Sexual activity was higher at rural and urban counties. Twenty-one percent of high school students who had sexual intercourse reported usage of drugs or alcohol before the sexual act (Kann et al., 2016). Nationally 11.5% of high school students reported they had four or more sexual partners (Kann et al., 2016). These statistics differed between ethnic groups with Hispanic and African American populations being highest.
Herrman and Waterhouse (2011) completed a qualitative study on socioeconomic status, family structure, and teen pregnancy. Through their study, they found a relationship between socioeconomic status and family structure regarding teen pregnancy outlook. The findings suggest that adolescent that live in low socioeconomic neighborhoods and adolescents with a parent or sibling who went through teen pregnancy had a more positive connotation on teen pregnancy. In contrast, majority of the individuals had a negative connotation than neutral connotation towards teen pregnancy. Herrman and Waterhouse emphasized the important of evaluating prevention strategies based on the insights of teens and building teen pregnancy prevention strategies based on socioeconomic status.
Cavazos-Rehg et al. (2013) investigated the attitudes among teenage girls from ages 15 to 18 years old. Sixteen percent of the teens who admitted to being sexually active reported that “they would be pleased if they became pregnant” (Cavazos-Rehg, 2013). There was a relationship between the parent’s education level, ethnic/racial status and attitudes of having a pleased attitude about pregnancy. “Teens who had previous discussion about sexual health and contraception with their parents were less likely to have the attitude of being pleased about teen pregnancy” (Cavazos-Rehg, 2013). “Teens who had not had previous discussion about sexual health, prior pregnancy, and teens who had not yet discussed sexual health topics were more likely to have a pleased attitude toward teen pregnancy” (Cavazos-Rehg, 2013).
Effects of Teen Birth
Childbearing and caretaking for any individual can be difficult. Sleepless nights, arranging child care, and making doctor’s appointments can be tough. Children of adolescent mothers have a higher chance to drop out of high school or have a lower school achievement, give birth as a teenager, have more health issues, be incarcerated at some time during adolescence, and face unemployment as a young adult (CDC, 2018). Moreover, adolescent parenthood is associated with many mental health problems, including depression, substance abuse, and posttraumatic stress (Hodgkinson et al., 2014). Hodgkinson, Beers, Southammakosane, and Lewin (2014) found that adolescent mothers had significantly higher rates of depression than non-pregnant peers with estimated rates of 16% to 44% (p. 115). However, lifetime prevalence of major depression in all women is 5% to 20% (Hodgkinson et al., 2014, p. 115). Mental health interventions targeting adolescent mothers are rare. They suggested building strong relationships with primary care physician to have better screening of psychological and emotional well-being. With the recognized relationship, there can be better referrals to other needed organizations, including home visiting programs and schools.
Prevention Strategies
There are preventative measures that are already in place to help reduce the likelihood of teen pregnancy, but there are not many programs or organizations in Spartanburg, South Carolina. There needs to be better communication between parents and child. A strong relationship and open communication about reproductive health, sexual behavior, contraceptives, and sexual transmitted diseases is one way to reduce risky sexual behavior and teen pregnancy. Cavazos-Rehg et al. suggested discussing the prospective loss of education and financial opportunities associated with teen pregnancy. They felt a different approach should be used for low socioeconomic and minority groups until there was elimination of the barrier of education and economic opportunities.
Generation Z is highly involved with technology and social media. Galloway, Duffy, Dixon, and Fuller (2017) completed a qualitative study to understand the African American and Hispanic teen population in South Carolina regarding their perception of access to reproductive health services, contraception knowledge, and preference for finding health information. The study found that teens value social media and television advertisements to learn about health information. Teens value privacy. Galloway et al. suggest the use for teen-only clinics and social media prevention platforms. In addition, Jones, Eathington, Baldwin, and Sipsma (2014) examined the impact of educating adolescents and young adults about risky sexual behavior through social media and text messaging outlets. The study found that social media and text messaging increased the knowledge preventing sexual transmitted diseases.
Many systematic reviews have been completed to evaluate the effective. Goesling, Colman, Trenholm, Terzian, and Moore (2014) reviewed 88 studies from 1989 to 2011 and found that teen pregnancy and sexual transmitted disease prevention programs were effective. Teens spend majority of their day at school. Involving prevention programs into school courses is an effective way to educate teens. Hoyt and Broom (2002) examined school based teen pregnancy prevention programs. A few school based programs had success with delaying the onset of sexual activity and increasing contraception use by sexually active teens; other school based programs helped change attitudes toward sexual behavior and increased knowledge about reproduction (Hoyt & Broom, 2002). Researchers suggested school based prevention programs led by the school nurse.
Gap Analysis
While there are a few organizations in Spartanburg, SC that address teen sexual behavior and teen pregnancy, most of the programs are non-profit organizations. Teens are not able to have access to the information unless they attend the meetings by the organization. Since teens value privacy, there is a sense of “invasion of privacy” with talking about sexual health. Many teens do not open up about the topic due to feeling of embarrassment and/or peer pressure. In addition, teens are less likely to tell their parents and other adults about their interest in learning about sexual health. There needs to be more implementation of sexual health in Spartanburg County schools. The limitations with involving schools is that schools and district levels have frequent staff changes.
Conclusions
Teen pregnancy prevention programs have had great success. Implementation of sexual health will help educate teens and give a sense of privacy away from parents. There will be a need to build and maintain relationships with school districts. Schools can offer a class for life skills which features sexual education learning. The class will discuss teen pregnancy prevention, HIV/STD prevention, and sexual behavior. The class can be taught by the school nurse and the educator of the school’s choice.
In addition, launching a teen only clinic will allow teens to have privacy and learn about reproductive health. The clinic will have a friendly, understanding staff. The clinic will focus on reducing sexual behaviors; giving out evidence-based material that is age and cultural appropriate; use social learning; appropriate length to allow individuals to complete activities to learn about sexual health; provide information about the risks of unprotected sex and methods of avoiding unprotected sex; address social pressures related to sex; and provide communication methods to refuse, negotiate, and make other decisions (Hoyt & Broom, 2002).