Teen Pregnancy Prevention
Ivenise A. Butts, Damilola Oloyede, Lanita Harvey, Linda Lennon, and Eucharia Nwachukwu
Stratford University
NSG 420-COMMUNITY CLINICAL
Dr. Sybilla Myers
APRIL 16, 2022
Teen Pregnancy Prevention
Teen Pregnancies occur in girls under 20 years, usually between the ages of 15 to 19 years. They can also occur in girls as young as 10 years, depending on the development of their reproductive systems. It is essential to prevent teenage pregnancy because of its psychological, physical, and economic risks. Parents, caregivers, and guardians concerned about the increasing number of early pregnancies have identified the need to prevent teenage pregnancy. There has been an outcry in the community because these cases are rampant and affect society. The need has been identified by observing the trends and cases of early pregnancy in the community. Moreover, studies have been done, and some gaps have been identified, such as lack of awareness, thus justifying the need for teenage pregnancy prevention programs. According to a study by Kantor et al. (2020), most US voters support the provision of sex education in high schools to prevent teen pregnancy. Most studies indicate that teen pregnancy is a reality in the contemporary world. Such cases are on the rise due to social media influence, urbanization, and modern technology (Panting et al., 2019). Preventing teen pregnancy is therefore of utmost importance.
To perfectly deal with the problem, it is vital to understand the group affected and critically analyze the health teaching needs of the group. One of the primary causes of teenage pregnancy is the lack of information by teens regarding reproductive health. In a study by Panting et al. (2019), low awareness of sexual and reproductive health has been identified as one of the causes of teen pregnancy. The study suggests that effective health education can help prevent teenage pregnancy. Moreover, this group, the teens, also experience family and social pressure that makes them vulnerable to early pregnancy. Teenage pregnancy programs have been effective in reducing teenage pregnancies. For example, the teen birth rate in the Maryland community dropped by 76% between 1991 and 2020 (Maryland data, n.d). In 2020, there were 2431 teen births recorded. 72% of these were recorded in teens aged 18-19. The teen pregnancy rate, which is a record of all pregnancies, including those that did not result in a birth, has fallen by 67% (Maryland data, n.d). Since there are still cases of teenage pregnancies being recorded in the State, it is crucial to find ways to reduce these cases.
One of the best ways to reduce the occurrence of teen pregnancy is to make teenage pregnancy prevention programs effective. According to Panting et al. (2019), a proper understanding of social risk factors such as low awareness, dysfunctional family relationships, besides alcohol and drug abuse can make the prevention programs effective. This reality can be achieved by assessing the needs of the young people to tailor the programs accordingly. For instance, according to the World Health Organization (WHO), some girls get pregnant because they cannot refuse coaxed or unwanted sex. Therefore, training programs must be personalized towards educating the teens about their rights and actions they can take in such situations. Good evidence of a program tailored toward the teens’ needs is the My Journey sexual health curriculum which is culturally attuned to meet the Northern Plains Native American youths’ needs (Kenyon et al., 2019). The program’s success has been due to its tailored approach to addressing the target community’s cultural disparity.
However, the conveyance of the message is also critical as it should employ teaching methods that are young-people-oriented. Studies show that teens tend to be shy. Unless suitable teaching methods are applied, they cannot discuss their challenges or even accept the presented information (Kenyon et al., 2019). Moreover, according to Ercan-Demirel & Ulas-Taraf (2021), it is hard to talk to teenagers due to their confrontational, disruptive, and unfocused behavior, mainly attributed to their young age, psychosocial development, and peer pressure. For example, most people will find their behaviors such as rolling of eyes to be disrespectful and rude. Therefore, it is essential to break the boundaries and gap that separates them from the adults to be on level ground before passing the information. One possible reason why most teens still suffer the predicament of early pregnancy despite the effort put by parents and society is attributed to the ineffectiveness of communication. Hence, it is essential to be patient with them, win their trust and respect, listen to their concerns without judging them, and establish a boundary of how they should behave. These approaches have shown great success when dealing with teens.
The health teaching needs that should be addressed to prevent teen pregnancy include STDs prevention, birth control, safe sex, and avoiding unintended pregnancy. According to Kantor et al. (2019), most adults in the USA, including parents, agree that high school sexual education programs should focus on abstinence, STDs, and contraception. Arguably, one might challenge such content or dismiss it as promiscuous or even direct permission for teens to have sex. However, in reality, most teens think and talk about sex; hence it is imperative to address their needs. Furthermore, the conversation about having sex should be independent of a parent’s or guardian’s belief about whether the teen is having sex or not. The US federal government is spending much money to fund programs such as Teen Pregnancy Prevention (TPP) because teen pregnancy is a reality that should not be downplayed (Kantor et al. 2019). Therefore, there is a need to explore possible solutions to prevent teenage pregnancy for the benefit of the teenagers and the community.
The health teaching need is to educate the teens because they are directly affected by this issue. Teens need to be taught that abstinence is the safest and best way to deal with the issue since it is not associated with any side effects. However, since this might not be realized with most teens owing to the influence of their peers and media, it is also vital to teach them about birth control and the use of condoms. These options should be seen as safe to prevent unwanted pregnancy and STDs. The teaching should not apply to only one gender, the girls. The message should also target the teen boys because they are also at risk, and the fact that they do not become pregnant does not mean they are not at risk. Moreover, boys’ safety from unprotected sex extends to girls because some pregnancy results from teen boy-girl relationships. There is also a need for sex counseling, especially when dealing with a sexually active teen. A professional counselor can help teenagers practice responsible sexual behavior and debunk misconceptions about sex. A well-designed program leads to a better outcome. A good example is the Personal Responsibility Education Program (PREP), which the federal government also funds. This program is supported by most Americans regardless of their political divide because they equip the teen with the relevant sexual information to make sound decisions (Kantor et al. 2019). Therefore, having a program that meets the intended need and is implemented perfectly is vital because it is beneficial to the students and society and approved and supported by the larger population.
Readiness Assessment
Readiness
Assessing readiness means getting the teenagers to be open-minded and develop the willingness to understand the topic’s contents. Assessing readiness will play an integral role in identifying knowledge gaps before presenting the case to them. This is important in determining how the teaching plan will focus on addressing these gaps, which will enable them to understand the new concepts and boost their confidence, thus influencing their success (Dembo and Lundell, 2009). Assessing readiness will be done through lectures where various questions regarding contraceptive use among the teenagers will be raised, and their feedback gathered. Another way to determine their enthusiasm will be by giving them assignments on a particular topic. The attitudes used in responding to the questions will assist in deciding if organizing a program on the issue will be relevant.
Motivation
Assessing the learning motivation will use two bases of inspiration: pre-training motivation and pre-training self-efficacy. Pre-training will involve determining the desire of the teenagers in attendance to learn the contents of the program before they can initially attend the program. The pre-training focus on analyzing the ability of the training program to affect the transfer and learning of the training. This will help identify whether the teens have what it takes to learn the factors influencing contraceptive use among individuals in their age group. Identifying their capacity is essential because if they do not have the right motivation to pursue the subject at hand, they may fail to engage in the training actively. Therefore, they will not be able to improve their knowledge and skills concerning diversity.
Similarly, unmotivated teens will be less likely to transfer their skills and knowledge to other teens who did not attend the session. Pre-training self-efficacy will involve the extent of the teenagers’ belief that they are in a position to learn and effectively apply the program’s content in real life. Here, if the trainees strongly think that they have what it takes to master skills and knowledge from the training, they will be able to devote themselves to learning, enhance their understanding and utilize the knowledge (Schunk and Meece, 2006). This is important in understanding how contraceptives can effectively use contraceptives to prevent early pregnancy.
After analyzing the two aspects of motivation to learn, the teaching plan will integrate ideas that will make learners feel that they are in control of the environment, will enable the trainer to identify the areas that are exiting them the most and identify measures that they will use to engage them more. Also, it will ensure that the trainer can focus on what is relevant to the teens regarding contraceptive use.
Experiential Background
The experiential background will involve determining the learners’ previous knowledge about the topic. The study will involve high school teenagers, and therefore this means that they have substantial knowledge about contraceptives and their uses from their lower grade classes. Thus, the program will focus on determining the amount of information regarding the issue by asking them questions. Later on, the program will focus on extending the topic to increase their knowledge on the issue and clear any myths they may have on the subject.
Current status
The program involves teenagers aged between thirteen and eighteen years old as the target group. The current intellectual level is high school which means they know quite a lot about contraceptive use among teens.
Interests/potential barriers
The main barriers that will limit the program’s efficacy include the availability of myths about contraceptives and their usage, which may limit the ability of the teenagers to attend the training sessions. Another reason is that many teenagers tend to be overwhelmed by shyness about contraceptive issues, so they will refrain from responding to the topic.
Community/Group Diagnoses
Deficient Knowledge
Adolescents have deficient knowledge of pregnancy risk and prevention related to a lack of information about contraceptives, evidenced by an increase in adolescent pregnancies. Durham (2018) indicated that unplanned pregnancies have long-term negative consequences for both the adolescent mom and their child, such as poverty, contracting sexually transmitted infections (STIs), inability to finish school, and increasing the chance of having comorbidities like hypertension and diabetes. In addition, children born to adolescent mothers are at a greater risk of developing health problems such as respiratory distress syndrome, intracardiac hemorrhage, visual abnormalities, behavioral difficulties, digestive complications, or death (Durham, 2018, p. 10). Although abstinence is the best way to prevent pregnancy, various contraceptive methods can reduce the risk of unplanned pregnancy, including intrauterine devices, hormonal methods (oral, implant, Injection, patch, and ring), Barrier Methods (diaphragm, sponge, condoms, and spermicide), and fertility awareness-based methods.
Risk for STIs
These aggregates are also at risk of STIs related to having unprotected sex, as evidenced by adolescent pregnancy and STI rates. The lack of abstinence or condom use leads to unplanned pregnancies and an increased risk of contracting STIs. According to AHC Media (2021), nearly twenty-nine percent of adolescents were diagnosed with HIV for the first time during pregnancy (p. 1). Emily Murphy, MD, mentioned that there were comparable rates of unplanned pregnancy in previous investigations of HIV-negative teenagers (as cited by AHC Media, 2021, p. 1). Practicing abstinence is the best measure to preventing pregnancy and exposure to STIs. If abstinence is not maintained, condom usage can decrease the risk of STIs and pregnancy.
Teaching Objectives
Fertility awareness-based methods
Knowing the monthly ovulation cycle will assist in preventing pregnancy. The Centers for Disease Control and Prevention [CDC] (2022) recommends that to prevent pregnancy, do not have intercourse during the fertile days or use a barrier method of contraception (para. 16). The CDC explained that the number of fertile days, infertile days, and least fertility are all elements of the fertility pattern. In addition, those with a regular menstrual cycle will have nine or more fertile days during the month (CDC, 2022, para. 16). The failure rates of these methods range from two to twenty-three percent (CDC, 2022, para. 16).
An effortless way for people to track their ovulation cycle is by using cyclebeads. Umutesi (2010) noted that the Cyclebeads necklace is a 32-color-coded bead string containing one red bead, nineteen brown beads, and twelve white beads. In addition, there is a black rubber ring that wraps around a single bead on the necklace to assist with keeping track of the stages of the cycle (Umutesi, 2010, para. 11). According to Umutesi (2010), the method the keeping track of the ovulation cycle is as follows:
- The first day of the menstrual cycle is symbolized by the red bead, which is the day that the menstrual period begins.
- The brown beads represent the days throughout the cycle when getting pregnant is extremely rare.
- The white glow-in-the-dark beads reflect the menstrual cycle’s fertile days.
Each day, the rubber ring is sled on a different bead as the menstrual cycle progresses (para. 12). Abstain from sex or utilize another kind of contraception when the rubber ring is moved onto the white beads (Umutesi, 2010, para. 12).
Male and Female Condom Use
The CDC (2022) indicated that a male condom is a device to prevent sperm from entering a woman’s body (para. 13). Latex condoms and synthetic condoms assist in preventing pregnancy and STIs. Condoms made of natural fibers such as lambskin can also assist with preventing pregnancy but do not protect against STIs (CDC, 2022, para. 13). The CDC’s indication for male condoms is for one use only and must be thrown away. In addition, to prevent tearing of the condom, use water-based lubricants only; oil base lubricants increase the risk of the condom tearing (CDC, 2022, para. 13). The probability of failure of use is thirteen percent (CDC, 2022, para. 13). The method used to apply the condom is that it should be placed on the tip penis and then rolled up, not pulled, and ensure to press the tip of the condom to release air. The method used to remove the condom after intercourse, grasp the condom at the base before removing it to prevent spills of the ejaculated fluid and dispose of it in the trash.
The female condom is worn to prevent sperm from entering the body and assist in avoiding STIs. Although the strength and texture of a female condom are thicker than male condoms, water-based lubricant should be used. The female condom may be inserted eight hours prior to sexual activity. The failure rate is twenty-one percent. The method used to insert a female condom, use the thumb and middle finger to squeeze the ring on the enclosed end of the condom and then insert it into the vagina. To ensure that the condom is in place, use the index or middle finger and push it farther until it cannot be pushed anymore, leaving the open end just outside the vaginal entrance. To remove the female condom, gasp and twist the ring and pull gently to prevent leakage of the ejaculated fluid and dispose of it in the trash.
Teaching Plan
Teenage pregnancy has serious ramifications on the affected adolescents. According to the WHO, teenage pregnancy also called adolescent pregnancy takes place when girls under the age of 20 years conceive (Suing, 2019). Various factors can contribute to this social problem. One of the key reasons includes poverty, lack of education, and employment opportunities. Adolescents may want to avoid these pregnancies, however, misconceptions and knowledge gaps on the prevention leave them with few choices. Poor or lack of sexual education among adolescents is another contributing factor leading to an increase in the incidence rates. The selected population, in this case, includes teenagers with involvement from their parents. The teaching plan on teenage pregnancy would be based on key overarching goals. These goals include:
- Provide the targeted population with evidence-based information/programs on teen pregnancy
- Improve the youths with knowledge linkage between prevention programs and availability of community-based services to help this population.
- Provide the stakeholders (parents, teachers, religious societies, and business partners) with evidence-based information on strategies to prevent further escalation of the problems and the role they can play.
- Educate the target population on the consequences of early pregnancy from the vantage points of health, legal, financial, and social parameters.
The above four overarching objectives would be critical in formulating a teaching plan that would be critical in the prevention of incidences of teenage pregnancy. An important consideration when teaching about teenage pregnancy would entail provision and the use of evidence-based information (Suing, 2019). The target community would need to understand some of the broad-based strategies which have been adopted at the community level to prevent teenage pregnancy incidence rates. Most of these programs are initiated at the healthcare and educational centers with most of the parents and teenagers unaware of their existence.
The second goal is linked to the first one. There is a need to understand the linkage between the broad-based strategies which not only target the teenagers with information but provide them with options when they find out about the pregnancy. A good example in the community is Bowie Crofton Pregnancy Clinic which plays a critical role in helping the teenagers move forward once they find out about the pregnancy. Some of the services offered include abortion information, testing, ultrasounds, consultations on various options, and possible referral services.
The teaching plan needs to include parents, local businesses, religious organizations, and institutions of learning. In situations where all these members of the community are unavailable, then it would be important to utilize their representatives. The goal appreciates the need for a community-wide initiative that applies to target population (Suing, 2019). In this case, the teaching plan would include education on key communication strategies which would increase the sensitization on unplanned pregnancies and the key outcomes. The teaching goal provides a realization of the integrated services, key programs, and prevention strategies.
Finally, there is a need to understand some of the consequences of early teenage pregnancy from the dimensions of individual health, legal, financial, and social context. The ramifications of the social problem can affect both the victim and the persons not directly affected. The social burden of teenage pregnancy affects all individuals. As such, there is a need to prevent these consequences by teaching the youths and concerned members about healthy relationships, positive adolescent development, and financial sobriety. Importantly, there is a need to educate the target community on the need for positive parent-child communication skills which can foster futuristic goals formulation and consequent sustenance (Chinman et al. 2016). Importantly, there is a need to ensure that the target population has been educated on life skills. Some of these skills include the setting of SMART goals, facilitation of decision making, communication, interpersonal skills, and overall stress management.
Teaching Strategies
The ultimate goal is to reduce the number of adolescent pregnancies and sexually transmitted diseases. Several programs and teaching methods may be proven effective in order to achieve this goal. Each individual has a different method of learning. However for the teenage population, the following teaching methods and strategies may be most effective in captivating this audience.
- Visual aids such as a power point which provides several bullet points and layout to assist the readers understanding, and to convey the information in a clear concise manner.
- Poster boards are another great teaching method because they may include pictures, and act as another form of visual aid for the learner.
- Videos may work most effectively, especially because many individuals are visual learners and the information is instantly relayed and can be educated through a live video to see examples of instant ramifications or benefits for utilizing proper prevention methods, or not taking precaution and preventions.
- Support groups/Counseling such as a comprehensive sex education program are also a great resource to assist with prevention due to the teenager being able to see, and hear experiences from other peers first hand of teenage pregnancy. Many will deter once hearing the challenges and hardships that is experienced with becoming a teenage parent.
These methods are all interactive, and allows the teen to see and understand first hand effects and benefits of proper use of prevention methods or lack thereof.
Financial Needs
Over the past few decades teenage pregnancy has declined 63%, however it is still a fact that the United States there are the highest pregnancy rates of teenagers. A contributing factor to this is several disparities such as race and ethnicity, and socioeconomic status. (Fisher, et. al., 2019) Due to the age of the this population, teenagers ages of 13-18, it may be difficult financially to obtain contraceptives. Examples of these include condoms, oral contraceptives also known as birth control pills, contraceptive patch, IUD, spermicides, or a contraceptive injection. These prevention measures do cost, and may be payed for with insurance, credit cards, or cash. However, these teenagers are considered minors and in most cases would need an adult or parent to assist with financing these various prevention methods. (Fisher, et. al., 2019)
There are several resources which provide assistance for pregnancy prevention and many programs such as reproductive health services that are available for teenagers to use. For example, after conducting several studies and analyzing much data, city grant-funded project, called the Emergency Contraception Awareness and Access Project was created as a needs assessment to assist in providing reproductive health services to adolescents in schools. When utilized properly, fewer pregnancies, abortions and births cause lower cost to public health systems. (Fisher, et. al., 2019)
References
AHC MEDIA. (2021). Adolescents with HIV Experience High Rates of Unintended Pregnancies. Contraceptive Technology Update, 42(6), 1–4. ISSN: 0274-726X https://b8305ai9s-mp02-y-https-web-s-ebscohost-com.prx-stratford.lirn.net/ehost/pdfviewer/pdfviewer?vid=4&sid=ff51e072-b7b6-405b-a548-dadf5881aa56%40redis.
Centers for Disease Control and Prevention. (2022, January 13). Contraception. Retrieved from https://www.cdc.gov/reproductivehealth/contraception/index.htm.
Chinman, M., Acosta, J. D., Ebener, P. A., Sigel, C., & Keith, J. (2016). Getting to Outcomes® guide for teen pregnancy prevention. RAND.
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