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Reliability of self-reported contraceptive use and sexual behaviors among adolescent girls.

This study examines two issues relevant to adolescents' self-reported sexual and contraceptive use behaviors: reliability of partner-referent reports versus 3 and 6 month reports, and test-retest reliability of reports completed over a 2 week period. Data are from 196 13 to 18 year old girls recruited into this study while they south reproductive care from health clinics in a metropolitan area. All participants reported having had sexual intercourse during the past 6 months. Twice over a 2 week interval, participants completed the same paper and pencil surveys. The survey presented questions about sexual behavior and contraceptive use using 3 sequential frames of reference: within the past 6 months, within the past 3 months, and by specific sexual partners in the past 6 months. Findings demonstrate that adolescent girls can reliably report sexual behavior and contraceptive use over a 6 month interval. Study findings have implications for future research utilizing adolescents' self-reported sexual and contraceptive use behaviors.

Adolescent↗

Vulnerable adolescent mothers' perceptions of maternal role and HIV risk.

Pregnant adolescents and young mothers living in Los Angeles County are vulnerable to acquiring HIV/AIDS through sexual transmission because they lack the resources, social status, and power to protect themselves. In this article we describe adolescent mothers' (n = 76) responses to an HIV prevention program. The design of the study was based in ethnography, the anthropological tradition of qualitative research. Many of the pregnant teens and young mothers described how the experience of becoming a mother helped empower them to improve their lives. Yet efforts to decrease risky sexual behavior were overshadowed by more immediate concerns and by relationship issues of gender and power and of trust.

Adolescent↗

Improving pre- and postmenarcheal 12-year-old girls' attitudes toward menstruation.

Adolescence is a time of rapid changes, including risk for unwanted pregnancies and sexually transmitted infections. Education may improve understanding and attitudes toward menstruation among adolescents thus increasing their awareness of risks and enabling them to protect themselves accordingly. To investigate effects of education on attitudes, two interventions were compared in 345 12-year-old girls. The new, active intervention given to premenarcheal girls just before menarche resulted in improvements in attitudes toward menstruation compared with standard intervention. Thus, just before menarche girls should be offered education modeled after the active intervention. The education must be concrete and based on multisensory learning.

Adolescent↗

Weight gain on the combined pill--is it real?

Britain has one of the highest teenage pregnancy rates in Western Europe at 8.8 per 1000 live births. Adolescents are very preoccupied with body image and fear weight gain with use of the combined oral contraceptive (COC) pill. Compliance with contraception continues to be a major issue. Is there a real evidence of weight gain? Or are there discrepancies between adolescent perceptions of weight gain with COC use and available scientific evidence? We carried out a comprehensive literature search and did not find evidence for the purported weight gain with use of low dose COCs. Adolescents need reassurance by gynaecologists, general practitioners, family planning doctors and mass media to remove such misperceptions. This will contribute in some way to reduce the high unintended pregnancy rates.

Adolescent↗

Adolescent girls' personal experience with Baby Think It Over infant simulator.

PURPOSE: To explore adolescent girls' personal experience with an infant simulator that had to be cared for over a period of 1 to 2 weeks. STUDY DESIGN AND METHODS: This qualitative study employed the phenomenological approach and utilized Colaizzi's method of analysis. Participants were nine adolescent high school girls who were interviewed and audiotaped. Interview data were coded using NUD*IST 4 software. RESULTS: Three themes emerged from the data. They were (1) a parenting journey incorporating intellectual, emotive, and physical faculties; (2) recognizing the illusionary nature of previously held ideas about parenting an infant; and (3) offering counsel based on the BTIO experience. CLINICAL IMPLICATIONS: The new perspectives gained by the participants about parenting a newborn infant differed markedly from the romantic fantasies they held prior to the experience. The teens started thinking more seriously about the consequences of sexual activity. Used for 1 to 2 weeks, in conjunction with budgeting exercises and provocative small-group discussions, the BTIO shows promise as an effective tool in helping to modify unrealistic and idealized teen views of adolescent pregnancy and parenting.

Adolescent↗

Pregnant adolescents' perspectives of pregnancy.

PURPOSE: To gain a clearer understanding of teens' perspectives on pregnancy and parenting. DESIGN Descriptive qualitative study using grounded theory. METHODS: The sample was comprised of 20 pregnant 15- to 19-year-old teens in the second or third trimester of pregnancy who planned to keep their child. A taped interview of each participant was performed either in the school the teen was attending or in the privacy of her home. Data were analyzed using the constant comparative method. Interviews were compared with each other to confirm/disconfirm emerging themes. RESULTS: The comparison of the data from the 20 interviews resulted in themes clearly describing the teens' perceptions of the changes related to pregnancy, how they managed these changes, and their views on mothering. Three major themes emerged: "The pregnant me--unexpected changes," "Transformed relationships," and "Envisioning mothering." CLINICAL IMPLICATIONS: Nurses caring for pregnant adolescents who have made the decision to keep their babies should carefully assess each individual's strengths, weaknesses, hopes, and goals prior to developing a plan of care. Identifying the teens' living situations and support from family, father of the baby, and/or friends and recognizing and building upon the strengths the teens bring to the pregnancy may influence the pregnancy's outcome. Encouraging attendance and participation in programs specifically designed for pregnant adolescents and adolescent parents may be a helpful strategy for these teens.

Adolescent↗

Fear of inability to conceive in pregnant adolescents.

OBJECTIVE: To estimate the demographic and health history differences between pregnant adolescents who had fears that they would not be able to conceive and those without these fears. METHODS: Three hundred pregnant adolescents presenting for their first prenatal visit participated in a cohort study that addressed attitudes about pregnancy. All participants were aged younger than 20 years and gave informed consent. The outcome of interest was a positive response to the question "Did you have any fears that you wouldn't be able to get pregnant?" Independent measures included health history and demographic variables. RESULTS: Among participants, 42% stated they had fears about not being able to conceive. The total sample included 20% 12-15 year olds, 39% 16-17 year olds and 41% 18-19 year-olds. There was no statistically significant difference in fear of not being able to conceive by maternal age, reported sexually transmitted disease rates, or age at first intercourse. More adolescents who expressed fear of infertility had a previous spontaneous abortion, previous pelvic examination, and were sexually active for a longer period of time compared with those without this fear. CONCLUSION: A large proportion of pregnant adolescents in this study expressed fear that they would not be able to conceive. Understanding the basis of the fear is critical to appreciating its association with current and future adolescent pregnancy and contraceptive use. LEVEL OF EVIDENCE: III.

Adolescent↗

Variation in teenage mothers' experiences of child care and other components of welfare reform: selection processes and developmental consequences.

Developmental evaluations of the current wave of welfare reform programs present challenges with regard to (1) assessing child outcomes; (2) accounting for heterogeneity among low-income families in both baseline characteristics and involvement in self-sufficiency activities and supports, and (3) development of alternatives to experimental approaches to causal inference. This study (N = 1,079) addresses these challenges by examining effects on 4- to 6-year-old children of different patterns of child care, self-sufficiency activities, and other service utilization indicators among experimental-group mothers in a 16-site welfare reform program. Outcomes in areas of cognitive ability and behavior problems were investigated. The study identified seven subgroups of participants engaging in different patterns of service utilization and activity involvement. A two-stage simultaneous equation methodology was used to account for selection, and effects on child cognitive ability of participation in specific patterns of services and activities were found. For example, children of mothers characterized by high levels of involvement in center-based child care, education, and job training showed higher levels of cognitive ability than children of mothers in groups characterized by high involvement in center-based care and education, or center-based care and job training. In addition, children of mothers in groups with high levels of involvement in any of these activities showed higher levels of cognitive ability than those with low levels of involvement. The bulk of selection effects occurred through site-level differences, rather than family-level socio-economic status or maternal depression indicators. Implications for welfare reform program and policy concerns are discussed.

Adolescent↗