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Example 1: Hillsboro Healthy Teens: Preventing Teen Pregnancy In School & Home

NAMING THE ISSUE/ PROBLEM/ GOAL TO BE ADDRESSED

JUSTIFY THE PRIORITY ISSUE(S)/PROBLEM(S)/GOAL(S) TO BE ADDRESSED:

Teen pregnancy is a serious problem in Hillsboro. In our community, 7.6 in 100 girls between the ages of 15-19 becomes pregnant - which is more than 50% higher than the national average (51 per 1000 15-19 year-olds). Young women who become pregnant as teens are less likely to complete high school, and more likely to have to depend on assistance in order to meet their new family's needs. They have decreased future earning potential and are more likely to live in poverty. Their children are more likely to have childhood health problems, perform poorly at school, be abused or neglected, and less likely to be economically and socially successful as adults. As having a child in your teens may result in a diminished quality of life for both the mother and her children, we want to decrease the number of teenagers in our community who are having babies.

STATE THE ISSUE/PROBLEM/GOAL TO BE ADDRESSED:

The problem is that too many teenagers are having babies.

REVIEW THE NAMING AND FRAMING OF THE ISSUE/PROBLEM/ GOAL:

In order to avoid framing the problem in terms of a specific solution ("Teenagers are getting pregnant because our society does not value or promote abstinence" or "Teenagers are getting pregnant because they are not educated in the use of and provided with contraceptives"), the label for the problem referred to the root condition or concern of the Hillsboro Healthy Teens Initiative - too many young girls are becoming pregnant. We avoided framing the problem in terms of a lack of abstinence or a lack of contraceptive access in order to reduce conflict over means. Both may be viable ways to intervene in addressing the problem. However, framing the problem as "too many children are having children" helps potential opponents (over the means) find common ground in the desired outcome.

ANALYZING THE ISSUE 

Ask questions about the issue/problem/goal to identify key behaviors and actors and their consequences:

Behaviors (and actors) that contribute to the problem of too many pregnancies among teenagers include:

  • Youth- initiating early sexual activity, not using contraceptive
  • Parents and guardians- not monitoring/supervising their children's whereabouts
  • Service and health care providers- not offering counseling, sexual health information and skills, contraceptives
  • School system - lacks comprehensive sexual education curricula and engaging after school activities, failing to decrease drop out rates
  • Media - portrayal of casual unprotected sex as norm

This analysis suggests that a comprehensive intervention in which many behaviors are modified may be the most effective way to bring about change in the rates of teenage pregnancy in our community.

A variety of people are affected by the problem of too many teenagers having babies.

They include:

  • The teens themselves (who may be unable to complete high school or hold a full time job due to child care responsibilities, be forced to live on assistance to meet their family's needs, and suffer a decline in physical and emotional health),
  • The children of teens (who are more likely to have childhood health problems, perform poorly in school, and suffer neglect and abuse),
  • Parents and guardians (who may avoid conflict by not addressing their children's behavior),
  • The human services and health care system (who may become further overburdened or not have the resources to respond to the needs of teen parents),
  • The school system (who may be unwilling to devote resources to prevent teen pregnancy for political or economic reasons), and
  • The media (who may lose some of their constituency if they change their programming).

The impact of teens becoming parents goes far beyond the impact on their own development. It affects the development of their children and increases the probability that the cycle will be repeated. With fewer and fewer support systems and resources to help teens overcome the obstacles inherent in raising a child, prevention of teen pregnancies is of paramount importance in our community.

ANALYZE  "ROOT" CAUSES OF THE ISSUE OR PROBLEM TO IDENTIFY THE CONDITIONS/BEHAVIORS AND MIGHT CONTRIBUTE TO IMPROVEMENT. (BUT WHT? ANALYSIS):

The problem is that "Too many teenagers are having babies"

  • "But, why?" Because they are becoming sexually active too early; because they do not have access to or know how to use contraceptives; because they have no future plans; because they are uninvolved in alternative activities.
  • "But, why?" (Choosing one possible reason: Because they do not have access to or know how to use contraceptives)
  • Because they are not taught about contraceptives by their parents or during sexual education classes.
  • "But, why?" Because their parents and the school system may believe that talking about preventing pregnancy is equivalent to giving teenagers permission to have sex, which they do not want them to do.
  • "But, why?" Because they are uncomfortable recognizing the sexual development of their children and they are afraid of the repercussions for their future.

Based on this analysis of root causes, we can identify some specific conditions/behaviors and related interventions that might contribute to improvement. These include:

  • Too little information about the possible negative consequences of teenage sexual activity (e.g., pregnancy, STD's and HIV) (provide information through public service announcements on popular radio stations and in teen magazines
  • Lack of skills in refusing peer pressure to engage in sexual activity (training in assertiveness skills in schools and youth organizations)
  • Too few positive consequences for not engaging in sexual activity (promote peer support through influential youth networks based in school and faith communities)
  • Poor access to contraceptives (provide discrete, inexpensive ways for teens to get contraceptives and educational material and create a hotline to answer questions)
  • Few alternative activities for youth (sponsor after-school art and recreational activities at local community centers, churches, and on school grounds)
  • Perceived lack of future achievement (link teenagers with mentors to build self-esteem, provide educational and job opportunities, encourage career goals)

IDENTIFY RESTRAINING AND DRIVING FORCES (CONDUCT A FORCE FIELD ANALYSIS)

  • Forces keeping the situation the same may include 1) people feeling as if they are unable to change teen behavior "Teens will be teens", 2) too little media coverage about the problem and how it effects both teenager and the greater community, 3) the belief that unless its your child, it doesn't concern you, 4) fears that addressing teenage sexuality will encourage it
  • Forces that are causing things to change may include 1) growing awareness of how the problem is linked to other societal issues (spread of STD's, number of children in poverty, lack of living wage jobs for unskilled workers), 2) the increasing visibility of teenage mothers in the community, 3) the widespread debate about child welfare reform

Each of these forces point suggest points of intervention to promote a prevention oriented initiative.

SEE RELATIONSHIPS AMONG THE ISSUE/PROBLEM/GOAL:

Our priority issue is teenage pregnancy. We know that having a child as a teenager can be detrimental to the health and welfare of both the mother and the child. The problem of teenage pregnancy is intricately interlaced with issues of poverty, lack of self-esteem, changing and confusing sexual mores and messages, growing gaps of communication between children and parents, the difficult transition from childhood and adulthood, and the feelings of many children that they have no bright future. Seeing the interrelationships among a variety of youth issues suggests the value of a comprehensive approach that connects with the work of those concerned about the health and development of all youth.