Introduction
Like any other major health issue, teen pregnancy has been widely studied in medical research. Most previous studies aimed to examine the risk factors for teen pregnancy, as well as what possible interventions might reduce risky sexual behaviors in adolescents, which are the primary reason for pregnancy at a young age. This stage of the project will provide a summary of previous research studies that targeted the issue of teen pregnancy and propose a detailed methodology for the current study.
Literature Review
Understanding the extent and results of previous research on the topic is an essential part of planning the methodology for a new research study. There are two primary strands of research which target the issue of adolescent pregnancy. First, a large body of research focuses on the risk factors and socioeconomic determinants of teen pregnancy. Exploration of research findings in this area will help choose and justify the target sample for the study. Secondly, many researchers attempted to study the effectiveness of various interventions on the incidence of teen pregnancy. Examining the approaches and interventions used in previous studies will aid in determining the intervention of interest for the new research.
Risk Factors
The vast majority of researchers agree that in developed countries, such as the United States, teen pregnancy is tightly linked to socioeconomic disparities. For example, a longitudinal study by McCall, Bhattacharya, Okpo, and Macfarlane (2015) aimed to review the social determinants of teenage pregnancy in the United Kingdom between 1950 and 2010. The researchers found that high incidence of teenage pregnancy was negatively associated with socioeconomic status (McCall et al., 2015).
For instance, in areas with high deprivation, characterized by unemployment, low social class, and overcrowding, the occurrence of teenage pregnancy was significantly higher than in more affluent regions (McCall et al., 2015). Rates of crime, access to services, health, and education were also considered to be among the key determinants of low socioeconomic conditions leading to a higher risk for teenage pregnancy (McCall et al., 2015).
Overall, the study showed a significant correlation between socioeconomic settings and the incidence of teen pregnancy, which indicates that teenage girls living in neighborhoods with high unemployment, increasing crime rates, and low overall access to healthcare are at a higher risk of getting pregnant than those living in better socioeconomic settings. The impact of social disparities on teenage pregnancy was also examined by Penman-Aguilar, Carter, Snead, and Kourtis (2013).
The researcher effectively summarized the findings of previous research studies on the topic. The researchers found sound evidence that teenage pregnancy was linked to negative socioeconomic status indicators, including unemployment, low household income and education, low-opportunity communities, and poor living conditions (Penman-Aguilar et al., 2013). The study confirms previous suggestions, thus forming an appropriate basis for choosing the sampling methodology for the present research.
Interventions
In order to decide on the methodology for the research study, it is also crucial to overview the current perspectives on interventions to identify any potential gaps or opportunities for further research. One of the key interventions for preventing teenage pregnancy that is widely studied in medical research is the provision of no-cost contraception. Due to the strong influence of socioeconomic disadvantages on teenage pregnancy rates, providing no-cost contraception is considered to be effective, as many teens from disadvantaged backgrounds cannot afford to buy contraception. One of the recent studies that examined the provision of no-cost contraception is the research by Secura et al. (2014).
The researchers designed the Contraceptive CHOICE Project aiming to provide long-acting reversible contraception (LARC) to teens living in St. Louis region. An analysis of pregnancy, birth, and abortion rates was performed 2 or 3 years after the provision of LARC (Secura et al., 2014). The study showed that the proposed intervention was successful in reducing the incidence of pregnancy, birth, and abortion in the target population. For instance, the mean pregnancy rate among the CHOICE project cohort between 2008 and 2013 was 34.0 per 1000 teens, whereas the 2008 national pregnancy rate among sexually experienced U.S. teens was 158.5 (Secura et al., 2014).
A significant decline was also evident in birth and abortion rates, which declined to 19.4 and 9.7, respectively, compared to 2008 national rates of 94.0 and 41.5 (Secura et al., 2014). Another popular approach to reducing teenage pregnancy is the promotion of abstinence through educational interventions (Lindberg, Santelli, & Desai, 2016). However, most studies showed no evidence of abstinence as an effective method of preventing or reducing teenage pregnancy (Lindberg et al., 2016).
Among educational interventions aimed at reducing teenage pregnancy, comprehensive sexual education is considered to be more effective. For instance, according to Lavin and Cox (2012), “Programs that use a comprehensive approach and include correct information about contraceptives in addition to promoting delay of sexual activity are more effective than abstinence-only programs” (p. 463).
In a review of past studies on educational interventions and sex education for teenagers, Lavin and Cox (2012) found that comprehensive interventions showed statistically significant results in reducing risky behaviors that result in sexually-transmitted diseases and unintended pregnancy. The researchers also found that developing an educational program which is specific to the culture and context of the intended audience can increase its effectiveness (Lavin & Cox, 2012). Overall, there is a strong body of evidence suggesting that educational interventions can help to promote safe sex behaviors in sexually active adolescents.
Methodology
The review of the prior literature on the subject indicated several important points that must be addressed as part of the current project. First of all, there are socioeconomic disparities which are significantly linked to the occurrence of teenage pregnancy. Therefore, it would be useful to focus on the populations where the issue is most pressing, as this would help to lower the overall rate of teen pregnancies.
Secondly, educational interventions were found to be effective in reducing the incidence of teenage pregnancy and promoting safe sex practices. Educational interventions require less time and resources than other methods, which is why it would be useful to test them in the current research. Thirdly, it is crucial to ensure that the education program targets a specific population in a comprehensive manner (Lavin & Cox, 2012). Therefore, taking into account the socioeconomic factors affecting the target audience and including all available information in the educational program is essential to achieve success.
Finally, due to large amounts of previous research on the subject, it is important to offer a new perspective on the issue of teenage pregnancy. Most of the studies use quantitative methodology and analyze the results of the intervention by reviewing teen pregnancy rates in two to five years. However, very few recent studies have analyzed the problem and the proposed intervention from the target audience’s perspective. Evaluating respondents’ opinions on the intervention and its usefulness could offer a valuable insight into improving educational interventions used to remedy the issue.
Therefore, the current research will use a mixed methodology with surveys as the primary method of data collection. The surveys will also be supplemented by semi-structured interviews with a smaller sample of the participants to indicate any areas of the intervention that need improvement. The main sample size for the intervention should be no less than 30 participants, whereas interviews will be conducted with at least ten women from the main sample. Such design would provide the necessary insight, while at the same time ensuring sufficient coverage.
Participants will be chosen using purposive sampling and based on several characteristics, such as race (black or Latino), sex (female), age (14-17), reported sexual activity, and low socioeconomic status, determined by low reported household income and residency in neighborhoods with high crime and low health rates. These selection criteria will allow targeting teenagers who are at a high risk of teenage pregnancy.
The intervention will involve a 1.5-2 hour talk with groups of five or six participants on the subject of safe sex practices and contraception. Additionally, participants will be provided with information on the possible sources of no-cost medical aid, such as local Planned Parenthood clinics. Questionnaires will be analyzed using percentiles, which will be useful in comparing the responses and viewing common trends, while interviews will be analyzed using thematic content analysis methods. The results of the research will be presented both in tables and text form.
Overall, the research will aim to offer an insight into the teenagers’ perspective on educational interventions used to prevent teenage pregnancy. The results of this study could potentially be used to improve educational interventions aimed at similar audiences, thus helping to alleviate the issue of teenage pregnancy in the United States.
References
Lavin, C., & Cox, J. E. (2012). Teen pregnancy prevention: Current perspectives. Current Opinion in Pediatrics, 24(4), 462-469.
Lindberg, L., Santelli, J., & Desai, S. (2016). Understanding the decline in adolescent fertility in the United States, 2007–2012. Journal of Adolescent Health, 59(5), 577-583.
McCall, S. J., Bhattacharya, S., Okpo, E., & Macfarlane, G. J. (2015). Evaluating the social determinants of teenage pregnancy: A temporal analysis using a UK obstetric database from 1950 to 2010. Journal of Epidemiology and Community Health, 69(1), 49-54.
Penman-Aguilar, A., Carter, M., Snead, M. C., & Kourtis, A. P. (2013). Socioeconomic disadvantage as a social determinant of teen childbearing in the US. Public Health Reports, 128(2), 5-22.
Secura, G. M., Madden, T., McNicholas, C., Mullersman, J., Buckel, C. M., Zhao, Q., & Peipert, J. F. (2014). Provision of no-cost, long-acting contraception and teenage pregnancy. New England Journal of Medicine, 371(14), 1316-1323.