Teen Pregnancy and Sexually Transmitted Disease Prevention
Teen Pregnancy and Sexually Transmitted Disease Prevention
The proposed public health leadership theory was developed to identify public health interventions that can address risky sexual behavior in teenagers, which is associated with teen pregnancy and sexually transmitted disease (STD) prevalence in teenagers. The risk factors contributing to risky sexual behaviors in the teenage population and the interventions public health leaders can use to address those factors are presented in Figure 1.
Figure 1. Public health leadership theory on interventions for addressing risk factors associated with risky sexual behaviors in teenagers.
Teen sex behaviors can be influenced by their socioeconomic status, contraception access, sex education, and parenting practices used by their parents. Most teenagers engage in risky sexual behavior, which means they do not use contraception during intercourse, even if they change partners regularly. Consequently, they are at an increased risk for teen pregnancy and STD infections. Risky sexual behavior has been associated with low socioeconomic status, lack of access to contraception, ineffective sex education, and poor communication with parents on sex-related topics (Hadley, Chandra-Mouli, & Ingham, 2016; Partington, Steber, Blair, & Cisler, 2009; Lederman & Mian, 2003). In order to address the four factors associated with teen pregnancy and STD risks, public health leaders need to use a multifaceted approach to solve this public health issue by using their influence to affect community-level factors and by delivering education teenagers and their parents.
According to Yphantides, Escoboza, and Macchione (2015), influence is one of the essential attributes of public health leaders, who have the “influence to drive change – they are able to communicate their vision and win others over to embrace and implement it” (p. 1). In order to achieve a wide-spread change, leaders need to be able to involve a wider community on a local, state, or even national level. More importantly, education alone does not address the association between socioeconomic status or contraception access and sex behaviors in the teenage population. It was established in the literature review that poverty and lack of access to contraceptives are risk factors for teenage pregnancy and STD, so a public health leader needs to address those factors by advocating for policy changes and conducting community-based campaigns with local partner organizations. The purpose of those activities is to develop public policies and conduct community interventions targeted at helping disadvantaged teen populations recognize and avoid risky sex behaviors. Some examples of such activities can include building a dedicated support infrastructure for youth at risk of risky sex behavior and improved access to contraception for adolescents (Hadley et al., 2016).
Community-based education can address ineffective sex education and parenting factors associated with risky sexual behaviors in teenagers. Public education interventions for preventing teen pregnancies and STD infections should be tailored based on the needs of the community, but all interventions should include an outreach program. A community outreach program is needed to include all teenagers and parents in sex education, regardless of their socioeconomic status. The interventions reported in the current literature usually conduct sex and relationship education in school, but advice, educational materials, and correspondence from local leadership to adolescents do not need to be restricted to a specific setting (Hadley et al., 2016). Sex education outside of school settings is important because disadvantaged teens may attend schools that do not have the resources required to deliver adequate sex education, so community health centers or similar institutions could be utilized for conducting community outreach and sex education programs.
Various programs have been developed to prevent STDs and pregnancies among adolescents, such as the Parent-Adolescent Relationship Education Program (Lederman & Mian, 2003) or the Students Together Against Negative Decisions intervention (Smith et al., 2000). Regardless of the educational program used, which can change based on the needs of the community, public health leaders should always follow two principles. First, in order to improve public health delivery, “education should be structured to reinforce a collaborative approach” (Yphantides et al., 2015, p. 2). Therefore, even though public health leaders take on the roles of sexual health educators, they must also recognize parents and teenagers as their equal partners working towards a common goal to improve public health among teenagers. Second, leaders should take a personal approach to sex education when working with parents, teens, or both parties simultaneously. Even though some long-distance interventions proved to be successful, face-to-face interventions are the most successful because they build a personal relationship between the educators and learners (Pendelton et al., 2008). Face-to-face interventions also allow interventionists to understand their audience better so that they can design and implement an individual approach to sex education based on their needs.
The implementation of the proposed theory can have important implications for practice. First, most studies focused on evaluating one intervention, such as teen-parent education programs (Lederman & Mian, 2003), but this theory proposes a holistic approach for addressing both individual and social factors that contribute to teen pregnancy and STD rates. A similar intervention that used a multifaceted approach was conducted in the United Kingdom, and the evaluation of that approach found that conception, maternity, and abortion rates have been declining since its implementation (Hadley et al., 2016). However, that type of national-level intervention demands a lot of resources to provide dedicated support and education to adolescents and their parents, whereas the proposed theory can be scaled and adapted based on the needs and resources of each community and its members.
References
Hadley, A., Chandra-Mouli, V., & Ingham, R. (2016). Implementing the United Kingdom Government's 10-year teenage pregnancy strategy for England (1999–2010): applicable lessons for other countries. Journal of Adolescent Health, 59(1), 68-74.
Lederman, R. P., & Mian, T. S. (2003). The parent-adolescent relationship education (PARE) program: A curriculum for prevention of STDs and pregnancy in middle school youth. Behavioral Medicine, 29(1), 33-41.
Partington, S. N., Steber, D. L., Blair, K. A., & Cisler, R. A. (2009). Second births to teenage mothers: Risk factors for low birth weight and preterm birth. Perspectives on Sexual and Reproductive Health, 41(2), 101-109.
Pendleton, S. M., Stanton, B., Cottrell, L. A., Marshall, S., Pack, R., Burns, J., & Cole, M. (2008). Teens in the twenty-first century still prefer people over machines: Importance of intervention delivery style in adolescent HIV/STD prevention. Journal of HIV/AIDS Prevention in Children & Youth, 8(2), 95-115.
Smith, M. U., Dane, F. C., Archer, M. E., Devereaux, R. S., & Katner, H. P. (2000). Students together against negative decisions (STAND): Evaluation of a school-based sexual risk reduction intervention in the rural south. AIDS Education and Prevention, 12(1), 49-70.
Yphantides, N., Escoboza, S., & Macchione, N. (2015). Leadership in public health: New competencies for the future. Frontiers in Public Health, 3, 1-3.
