Introduction

Community-wide initiatives (CWI) to prevent teen pregnancy were implemented in 10 communities in the USA. The CWI supported the implementation of evidence-based teen pregnancy interventions (EBIs) and implementation of best practices for adolescent reproductive health care. Implementation was supported through mobilizing communities, educating stakeholders, and strategies to promote health equity.

Methods

We assessed indicators of progress of the CWI for the following five project components (data collected from 2010 to 2015): community mobilization, stakeholder education, working with diverse communities, evidence-based interventions, and increasing access to clinical services and the potential contributions of training and technical assistance.

Results

Communities engaged multiple stakeholder groups to contribute to planning, community outreach and education, and partnership development and used multiple dissemination methods to share information on adolescent reproductive health needs and teen pregnancy prevention strategies. The amount of training and technical assistance from state- and community-based organizations was associated with increased numbers of youth receiving EBIs and increased provision of contraceptives. The number of health centers implementing best practices for adolescent reproductive health services increased; conducting sexual health assessments, offering hormonal contraception or IUD, and offering quick start of IUDs were associated with increases in long-acting reversible contraception utilization.

Conclusions

These findings demonstrate that scaled prevention efforts can occur with adequate support including training and technical assistance and community awareness and engagement in the process.

Policy Implications

The findings raise important questions for understanding what factors contribute to successful community-wide implementation of EBIs and health center best practices for contraceptive access and whether these lead to reductions in teen pregnancies in highly impacted communities.

中文翻译：

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旨在减少青少年怀孕的社区范围举措的实施：衡量 10 个社区的 5 年项目进展情况

介绍

美国 10 个社区实施了预防青少年怀孕的社区倡议 (CWI)。CWI 支持实施基于证据的青少年怀孕干预措施 (EBI) 和实施青少年生殖保健最佳实践。通过动员社区、教育利益相关者和促进健康公平的战略来支持实施。

方法

我们评估了 CWI 以下五个项目组成部分的进展指标（2010 年至 2015 年收集的数据）：社区动员、利益相关者教育、与不同社区合作、循证干预措施、增加获得临床服务的机会以及潜在贡献培训和技术援助。

结果

社区让多个利益攸关方团体参与规划、社区外展和教育以及伙伴关系发展，并使用多种传播方法分享有关青少年生殖健康需求和青少年怀孕预防策略的信息。国家和社区组织提供的培训和技术援助的数量与接受 EBI 的青年人数的增加以及避孕药具供应的增加有关。实施青少年生殖健康服务最佳做法的保健中心数量有所增加；进行性健康评估、提供激素避孕或宫内节育器以及快速启动宫内节育器与长效可逆避孕药使用率的增加有关。

结论

这些发现表明，只要有足够的支持，包括培训和技术援助以及社区意识和参与，就可以开展大规模的预防工作。

政策影响

研究结果提出了重要问题，需要了解哪些因素有助于在社区范围内成功实施 EBI 和卫生中心避孕药具最佳做法，以及这些因素是否会减少受影响严重的社区中的青少年怀孕率。