When I first graduated college, I worked for an academic out-of-school-time program at a middle school in Henderson, a small town in North Carolina. On a few occasions, when I talked about my interest in improving sex education, my colleagues would say, “That’s good. This county has one of the highest teen pregnancy rates in North Carolina.”
They weren’t kidding.
By the end of that year, Mary, one of our young Latina students, had gotten pregnant. Each time I passed Mary in the hallway and saw her swelling belly, a million “what ifs” would fill my head along with the heavy awareness that the odds were not in her favor. As an English-language learner, Mary already struggled in school; being a teen mom would likely only add to her challenges. Compared to peers who wait to have children, teen mothers are less likely to finish high school and consequently more likely to live in poverty as adults. The children of teen girls also have poorer educational, behavioral, and health outcomes than children with older parents.
Mary’s story highlights the real need we still have in the United States for high-quality teen pregnancy prevention programs. Although the United States has made great strides in lowering teen pregnancy rates – particularly for black girls and even more recently, Hispanic girls – the rates remain too high. In fact, Hispanic girls have the highest teen birth rate in the U.S. In 2013, for every 1,000 Hispanic females between the ages of 15 and 19, roughly 42 of them would end up like Mary and become a teen mom. This rate is more than double that of white females of the same age.
Despite the many factors linked to teen pregnancy, researchers have identified more comprehensive elements that can help prevent teen pregnancy among youth, such as strengthening parent-child relationships and communication, fostering future orientation among youth, and providing developmentally-appropriate reproductive health education and services such as long-acting reversible contraceptives. This research has supported the development of teen pregnancy prevention (TPP) programs. A recent review by the U.S. Department of Health and Human Services (HHS) has identified over 35 TPP program models that have worked to help prevent teen pregnancies, sexually transmitted infections, and/or sexual risk behaviors in at least one evaluation. These program models form the backbone of the national evidence-based TPP grantee program managed by the HHS Office of Adolescent Health (OAH). Since it began in 2010, OAH’s grantees have provided evidence-based and innovative TPP programs to over 1.2 million youth, trained over 7,000 professionals, and established 3,000 local partnerships. Expanding the use of evidence-based TPP programs has the potential to further reduce teen pregnancy rates and positively impact the lives of teens, particularly if we can fine-tune these programs for populations most in need.
Hispanics are an example of such a population. Despite having the highest teen birth rate, a Child Trends review of the literature found a dearth of evaluations of TPP programs for Latinos, particularly those that support young Latino males. After reviewing 142 TPP programs, Child Trends found only 29 had been rigorously evaluated with Latino populations; 23 of those made at least some difference, but only a couple had been specifically designed to be culturally appropriate for Latinos. The lack of evidence-based culturally-relevant programs for Latino youth is troubling considering the rapid growth of the Hispanic population, particularly among youth. Currently, Hispanics make up a little less than a quarter of adolescents. But the U.S. Census Bureau projects that by 2050, nearly one in three youth will be Hispanic.
So what can we do?
Child Trends asked Latino youth and families this question. They found that most Hispanics knew someone affected by teen pregnancy, and consequently, they valued TPP programs. Additionally, while Latino youth and parents understood that being a teen parent could negatively impact their future, most didn’t know how to put prevention in practice. What was particularly difficult for Latino youth and parents, especially if a parent was an immigrant, was how to talk to one another about sex, especially when balancing more traditional values about sexuality and gender with methods of pregnancy prevention. These difficulties often pushed adolescents to ask friends or go to the media, which left them vulnerable to misinformation. When asked what would help, Hispanic parents and youth both said that they wanted TPP programs that bridged these communication gaps and increased awareness. They also stressed that TPP shouldn’t just be about sex education but also help adolescents consider and achieve their educational and career goals.
Happily, some groups are already testing this more holistic approach. In Silver Spring, Md., one OAH grantee has developed and is testing their positive youth development model, Sé tú mismo (Be Yourself), which helps Latino youth connect with their ethnic identity and stay true to themselves. Similarly, Child Trends is developing and testing a new program, El Camino, with Hispanic students in Washington, D.C., that seeks to reduce teen pregnancy and improve graduation rates by working on goal-setting, building relationship skills, providing information about contraception, and supporting academic achievement. Hopefully, these efforts will help ensure that youth like Mary avoid teen pregnancy and instead focus on having a healthy, happy adolescence and a bright future.
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