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Biomedical subjects

L S Zabin

Publications and source records attributed to L S Zabin.

At least 37 records · Page 2Linked to original sources
PubMed1984

A school-, hospital- and university-based adolescent pregnancy prevention program. A cooperative design for service and research.

Based upon prior service and research findings, a program was designed to reduce the incidence of early childbearing among a high-risk, inner-city junior and senior high school population. Combining a strong research design with medical and educational service in a school- and clinic-based program, the project team sought to develop a replicable model the individual components of which could be evaluated against baseline data collected from 1,709 male and female students before the program began. This paper reports levels of sexual activity, contraceptive use and pregnancy in the student population, using data from anonymous, self-administered questionnaires, and outlines the program's objectives and major features. It also suggests variables that can be used in the measurement of program impact.

Adolescent↗
PubMedDate not supplied

Adolescent pregnancy: the clinician's role in intervention.

Adolescent childbearing has adverse sequelae that are intensified when the onset of sexual activity takes place at a particularly early age. A relationship between the onset of sexual activity and the age of maturation has been demonstrated; as the mean age of menarche has become younger, a greater discontinuity has been created between physical development on the one hand and cognitive and emotional development on the other. Initiatives to prevent early sexual initiation and unintended pregnancy must be designed in that context and with an appreciation of normative social pressures. This report reviews research on adolescent development and sexual behavior, including the relationship between maturation and the onset of sexual activity, the timing of pregnancy risk, clinic utilization and reasons for delay in clinic attendance, and clusters of high-risk behaviors. It discusses the role of clinical interventions, suggesting ways in which those who treat adolescents can assist them in acquiring and maintaining protective behaviors.

Adolescent↗
PubMedDate not supplied

Partner effects on a woman's intention to conceive: 'not with this partner'.

CONTEXT: Current definitions of pregnancy intention that are useful at aggregate levels are weak at the individual level. This is especially true in social contexts where childbearing and pregnancy often occur within casual or transient relationships. METHODS: Extensive data on lifetime partnerships and sexual behaviors, including pregnancies and births, from 250 low-income women who had experienced a total of 839 pregnancies are used to explore correlates of intention to conceive, as well as the extent to which women attribute their intentions to a current partnership. RESULTS: Some 57% of reported pregnancies were unintended. Overall, 21% of the women had not wished to conceive at least one of their pregnancies with the partner who impregnated them; that proportion rose to 33% among women who had had only unintended pregnancies. Even among women who had had no unintended pregnancies, 18% had had at least one conception that they had not wanted with their partner at the time of conception. Women were less likely to say they had not wanted to conceive with a particular partner if they were living with that partner than if they were not. The likelihood of not having wanted a pregnancy with a given partner rose with the lifetime number of serious partners. Pregnancies that were not wanted with a particular partner were more than twice as likely to end in abortion as were those that were (33% vs. 14%). CONCLUSIONS: Among these women, the desire to avoid childbearing relates more to the couple involved in the conception than to abstract notions of completed family size. It would therefore be useful to include items pertaining to partner relationships in future studies of pregnancy intention.

Adolescent↗
PubMedDate not supplied

To whom do inner-city minors talk about their pregnancies? Adolescents' communication with parents and parent surrogates.

A study of 334 black, urban teenagers who sought pregnancy tests in two Baltimore clinics in 1985-1986 explored communication between the teenagers and their parents or parent surrogates before the pregnancy test visit and, among those whose test results were positive, before the final pregnancy outcome decision. Of these young women, 66% had discussed the possibility that they were pregnant with a parent (usually the mother) or parent surrogate before the test; an additional 6% had turned to another adult. At a follow-up interview a year later, 91% of those whose test results had been positive reported that they had consulted a parent or parent surrogate before deciding what to do about the pregnancy, and 4% had confided in another adult. The probability that an adolescent would consult a parent before deciding what to do about her pregnancy was higher if she was younger, if she lived with the parent and if she found the parent easy to talk to. A year after the pregnancy test, 88% of the adolescents who had given birth or had had an abortion were satisfied with their pregnancy outcome. Satisfaction was not related to whether the young woman had discussed her decision with a parent. Dissatisfaction was most likely if the parent did not support the final outcome, if someone other than the young woman had made the final decision, or if the final outcome was different from the adolescent's preference at the time of the pregnancy test.

Abortion, Legal↗
PubMedDate not supplied

When urban adolescents choose abortion: effects on education, psychological status and subsequent pregnancy.

A group of 360 black teenage women of similar socioeconomic background who sought pregnancy tests from two Baltimore family planning providers was followed for two years to determine if those who obtained abortions were adversely affected by their abortion experience. After two years, the young women who had terminated their pregnancies were far more likely to have graduated from high school or to still be in school and at the appropriate grade level than were those who had decided to carry their pregnancy to term or those whose pregnancy test had been negative. Those who had obtained an abortion were also better off economically than were those in the other two groups after two years. An analysis of psychological stress showed that those who terminated their pregnancy had experience no greater levels of stress or anxiety than had the other teenagers at the time of the pregnancy test, and they were no more likely to have psychological problems two years later. The teenagers who had obtained abortions were also less likely than the other two groups to experience a subsequent pregnancy during the following two years and were slightly more likely to practice contraception. Thus, two years after their abortions, the young women who had chosen to terminate an unwanted pregnancy were doing as well as (and usually better than) those who had had a baby or who had not been pregnant.

Abortion, Induced↗
PubMedDate not supplied

Users of reproductive health clinic services in a school pregnancy prevention program.

Although the potential of school-based programs in the prevention of adolescent pregnancy is well recognized, few have been evaluated. This paper describes the use of a reproductive health care clinic associated with a school pregnancy prevention program which had demonstrated success. The program operated in one junior and one senior high school in a large city during the 3 school years from 1981 to 1984. Three facets of the 818 users of the program clinic are explored: who enrolled in the clinic, why they enrolled and what contraceptive methods they received, and their continuation with the clinic. Chi-square analysis and Student's t-tests were used to test for significant differences between the two school and sex groups. Life table and regression techniques were employed to examine clinic continuation. The main findings are teens of both sexes used the clinic, and junior high males used it in surprisingly large numbers; there were no major school or sex differences in the characteristics of those who enrolled; most students enrolled to obtain a contraceptive method; although many females served by the clinic had previously used another family planning clinic, the majority of them had unmet needs; the rate of clinic continuation was high; and certain factors contributed to clinic continuation. These findings suggest that a clinic in a school-linked setting can successfully attract students to use its services and it may offer certain advantages for reaching sexually active teens in search of contraceptive protection.

Adolescent↗
PubMedDate not supplied

The Baltimore pregnancy prevention program for urban teenagers. II. What did it cost?

An experimental pregnancy prevention program for junior and senior high school students consisted of classroom lectures, informal discussion groups and individual counseling in the schools and group education, individual counseling and reproductive health care in a nearby clinic. The structure of the program allowed for extensive individual counseling for students who desired it, and the reported costs are thus considered generous. School-based services utilized 40 percent of a total three-year budget of $409,250, and clinic services, 60 percent. The average cost per student served was $122, with the average per female student almost four times that per male and the average per senior high student more than twice that per junior high student. Students who utilized more expensive types of services, such as individual counseling and medical services in the clinic, also used other program offerings more frequently. Services to students who attended only class lectures cost an average of $13.20 to deliver, while students who utilized all services cost the program an average of $546 each.

Adolescent↗
PubMedDate not supplied

The Baltimore pregnancy prevention program for urban teenagers. I. How did it work?

Two teams, each consisting of a social worker and a nurse, delivered the bulk of services in an experimental pregnancy prevention program for junior and senior high school students that combined school and clinic components. In-school components were classroom presentations, informal discussion groups and individual counseling; clinic services consisted of group education, individual counseling and reproductive health care. Eight-five percent of the total student enrollment had contact with at least one component of the program. More males than females were among the 15 percent with no contact. When estimates of chronic absenteeism are taken into account, the program is believed to have reached all students in regular attendance. Approximately 22 percent of staff-student contacts occurred in the classroom, and the remaining 78 percent were voluntary on the part of the student. About 68 percent of contacts occurred within the school, with small group discussions especially popular--they represented 41 percent of all contacts. The proportion of contacts that occurred in the clinic was highest among senior high females (46 percent) and lowest among senior high males (12 percent).

Adolescent↗
PubMedDate not supplied

The risk of adolescent pregnancy in the first months of intercourse.

Because of early age at initiation of intercourse and associated nonuse of contraception, half of first premarital pregnancies to teens occur in the first six months after they begin coitus; one-fifth occur in the first month. Programs to prevent adolescent pregnancy will not succeed unless they reach young people before they begin sexual activity.

Actuarial Analysis↗
PubMedDate not supplied

Adolescent sexual attitudes and behavior: are they consistent?

Relationships between sexual attitudes and behavior among adolescents were studied in data collected by self-administered questionnaires from approximately 3,500 junior and senior high school students attending four inner-city schools during 1981-1982. An analysis of the results by sex, race and age found that 83 percent of sexually experienced adolescents cite a best age for first intercourse that is older than the age at which they themselves experienced that event, and 43 percent of them report a best age for first coitus older than their current age. In addition, 88 percent of young women who have had a baby say the best age at which to have a first birth is older than the age at which they first became mothers. Thirty-nine percent of the women and 32 percent of the men say that they believe premarital sex is wrong. Among those who are virgins, the proportions are much higher. However, even among those who have had intercourse, approximately 25 percent of both sexes say they believe sex before marriage is wrong. Women desire stronger relationships before having intercourse than do men, and women claim to have had a stronger relationship with their last sexual partner. Very few teenagers believe neither partner is responsible for pregnancy prevention, which tends to be viewed as a joint responsibility. Those who see it as a shared responsibility are slightly more likely than those who assign the responsibility to one or the other partner to have used a method at last intercourse, and they are considerably more likely to have used a method than are those who believe contraception is neither partner's responsibility.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Sex, contraception and parenthood: experience and attitudes among urban black young men.

Eighty-seven percent of black adolescent males attending an inner-city junior high school and senior high school in Baltimore report that they have had sexual intercourse. Eighty percent of the sexually experienced teenagers have used a contraceptive method--and 60 percent used one at last intercourse. Contraceptive practice is characterized by heavy reliance on male methods: Of those using a method at last intercourse, 41 percent relied on the condom; 15 percent, on withdrawal; and 14 percent, on a combination of male and female methods. Use of female methods alone (mostly the pill) accounted for 28 percent of contraceptive practice at last intercourse. Nine-tenths of the teenagers have heard of the pill and condom, but far smaller majorities have heard of the IUD and diaphragm (about three-fifths each). In general, this population regards the condom as comparable in effectiveness to the pill. More than two-fifths of those recognizing these methods believe the pill--and the condom--to be "very good" at preventing pregnancy, and one-fifth believe that about the IUD and diaphragm. Nearly four in 10 mistakenly believe that they need a parent's permission to attend a birth control clinic, while slightly more than half think they need permission to buy nonprescription contraceptives in a drugstore . Although nearly nine in 10 respondents recognize that boys share a responsibility for preventing pregnancy when they have sex, more than half are willing to tolerate unprotected coitus. Most wish to delay parenthood until their early 20s, but many of these adolescents appear to hold attitudes conducive to out-of- wedlock conception.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

When children have children: the teen pregnancy predicament.

Despite developments in contraceptive technology and changes in societal norms, adolescent pregnancy remains a key issue for politicians, social scientists, health care providers, and educators. The adolescent's access to contraception and abortion services continues to spark legal debate. The implications of research call for the development of innovative programs to address larger issues, such as poverty and limited access to health care, in the management and prevention of adolescent pregnancies. Clinical interventions, such as school-linked clinics to provide contraception and prenatal care programs to reduce perinatal morbidity, have varied in their approaches and their subsequent success.

Abortion, Induced↗