J I Dolgan | PubMed Health

PubMed1997

The effect of monetary incentives and peer support groups on repeat adolescent pregnancies. A randomized trial of the Dollar-a-Day Program.

OBJECTIVES: To test the hypotheses that (1) a monetary incentive promotes peer-support group participation; and (2) peer-support group participation decreases repeat adolescent pregnancies. DESIGN: Two-year, prospective, randomized controlled trial. SETTING: Denver, Colo. PARTICIPANTS: A total of 286 primiparous girls younger than 18 years, whose infants were younger than 5 months. INTERVENTION: Participants were randomized to 4 interventions: monetary incentive and peer-support group, peer-support group only, monetary incentive only, or no intervention. MAIN OUTCOME MEASURES: Consistency of participation in planned intervention and repeat pregnancy. RESULTS: Participation in interventions was generally low. Hypothesis 1 was supported: 58% of those offered a monetary incentive participated in the peer-support groups, compared with 9% of those who were not offered the incentive. Hypothesis 2 was rejected: the peer-support group experience failed to prevent repeat pregnancies. The incidence of second pregnancies at 6 months (9%, 22/248), at 12 months (20%, 49/248), at 18 months (29%, 72/248), and at 24 months (39%, 97/248) following delivery did not vary significantly in relation to intervention strategy. Background sociodemographic characteristics significantly affected the timing of subsequent conceptions but not intervention participation. CONCLUSION: A monetary incentive draws adolescent mothers to sites where they can discuss the costs and benefits of contraception and conception with knowledgeable adults and supportive peers. These discussions do not prevent repeat pregnancies. Further studies are needed to determine if an intervention that produces substantive changes in the daily living environment will eliminate the sexual practices that are responsible for the high rate of repeat pregnancy in this population.

Adolescent↗

PubMed1990

Depression in children.

The field of child and adolescent affective disorders is relatively new and very challenging for research and clinical practice. A definite clinical entity of depression exists in significant numbers of children and adolescents. Signs and symptoms are different from those seen in adults and vary with different age levels. The syndrome must be recognized as early as possible to prevent a chronic illness from developing. Depression can cause serious difficulty in academic life because of its effects on concentration. Depression can affect relations with peers and, if acting out behavior ensues, can lead to serious delinquent behavior, sexual promiscuity, pregnancy, and substance abuse. Depression can also lead to suicide. Depression is often the common denominator in delinquency, promiscuity, teen pregnancy, to say nothing of alcohol and drug abuse. Adolescents often find substances on the street to "medicate" their own depression. When depression in children and adolescents is not properly identified, evaluated, and treated, it can lead to lifelong depression, antisocial behavior, and substance abuse. When depressed children receive appropriate therapy, the results can be rewarding. As one patient commented, "Every day was cloudy and gray. It always rained. Now I see some sun coming out."

Child↗