Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
To view the funding opportunity announcement for a description, visit the following web link. https://www.grants.gov/web/grants/view-opportunity.html?oppId=54258.
Tools that were used during the project to support capacity building are available on the CDC website. https://www.cdc.gov/teenpregnancy/projects-initiatives/communitywide.html.
To view the funding opportunity announcement for a description, visit the following web link.
https://www.grants.gov/web/grants/view-opportunity.html?oppId=271309.
To view the funding opportunity announcement for a description, visit the following web link.
https://www.grants.gov/web/grants/view-opportunity.html?oppId=274991.
References
Chinman, M., Acosta, J., Ebener, P., Malone, P. S., & Slaughter, M. E. (2016). Can implementation support help community-based settings better deliver evidence-based sexual health promotion programs? A randomized trial of Getting To Outcomes®. Implementation Science, 11(1), 78.
Downs, J. S., Murray, P. J., Bruine de Bruin, W., Penrose, J., Palmgren, C., & Fischhoff, B. (2004). Interactive video behavioral intervention to reduce adolescent females’ STD risk: A randomized controlled trial. Social Science & Medicine, 59(8), 1561–1572.
Finley, C., Suellentrop, K., Griesse, R., House, L. D., & Brittain, A. (2018). Stakeholder education for community-wide health initiatives: A focus on teen pregnancy prevention. Health Promotion Practice, 19(1), 38–50.
Fowler, C. I., Gable, J., Wang, J., & Lasater, B. (2016). Family planning annual report: 2015 national summary. Research Triangle Park, NC: RTI International.
Fowler, C. I., Gable, J., Wang, J., & Lasater, B. (2017). Family planning annual report: 2016 national summary. Research Triangle Park, NC: RTI International.
Fowler, C. I., Lloyd, S., Gable, J., Wang, J., & McClure, E. (2012). Family planning annual report: 2011 national summary. Research Triangle Park, NC: RTI International.
Fuller, T. R., White, C. P., Chu, J., Dean, D., Clemmons, N., Chaparro, C., & King, P. (2018). Social determinants and teen pregnancy prevention: Exploring the role of nontraditional partnerships. Health Promotion Practice, 19(1), 23–30.
Goesling, B., Colman, S., Trenholm, C., Terzian, M., & Moore, K. (2014). Programs to reduce teen pregnancy, sexually transmitted infections, and associated sexual risk behaviors: A systematic review. Journal of Adolescent Health, 54(5), 499–507.
Hallum-Montes, R., Middleton, D., Schlanger, K., & Romero, L. (2016). Barriers and Facilitators to Health Center Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Services. Journal of Adolescent Health, 58(3), 276–283. https://doi.org/10.1016/j.jadohealth.2015.11.002
Hoffman, S. D. (2008). Kids having kids: Economic costs and social consequences of teen pregnancy. Washington, DC: The Urban Institute Press.
Huberman, B., Klaus, T., & Davis, L. (2014). Strategies guided by best practice for community mobilization. . Retrieved from Washington, DC
JSI Research & Training Institute, Inc. (2016). Working with diverse communities: Strategies guided by best practice. Retrieved from http://rhey.jsi.com/wp-content/uploads/2016/04/WDC-Strategies-for-StrategiesGuided-by-Best-Practice-final-.pdf
Kegler, M. C., Steckler, A., McLeroy, K., & Malek, S. H. (1998). Factors that contribute to effective community health promotion coalitions: A study of 10 project ASSIST coalitions in North Carolina. Health Education & Behavior, 25(3), 338–353.
Kramer, J. S., Philliber, S., Brindis, C. D., Kamin, S. L., Chadwick, A. E., & Revels, M. L. (2005). Coalition models: lessons learned from the CDC’s Community Coalition Partnership Programs for the Prevention of Teen Pregnancy. Journal of Adolescent Health, 37.
Lesesne, C. A., Lewis, K. M., Fisher, D., House, L. D., Mueller, T., Fuller, T. R., Brittain, A., & Wandersman, A. (2016). Promoting science-based approaches to teen pregnancy prevention using getting to outcomes for teen pregnancy prevention (PSBA-GTO). Centers for Disease Control and Prevention.
Lesesne, C. A., Lewis, K. M., White, C. P., Green, D. C., Duffy, J. L., & Wandersman, A. (2008). Promoting science-based approaches to teen pregnancy prevention: Proactively engaging the three systems of the interactive systems framework. American Journal of Community Psychology, 41(3–4), 379–392.
Lewis, K. M., Lesesne, C. A., Zahniser, S. C., Wilson, M. M., Desiderio, G., & Wandersman, A. (2012). Developing a prevention synthesis and translation system to promote science-based approaches to teen pregnancy, HIV and STI prevention. American Journal of Community Psychology, 30.
Martin, J. A., Hamilton, B. E., Osterman, M. J., Driscoll, A., & Drake, P. (2018). Births: Final data for 2016. National Vital Statistics Reports, 67(1).
Mueller, T., Tevendale, H. D., Fuller, T. R., House, L. D., Romero, L. M., Brittain, A., & Varanasi, B. (2017). Teen pregnancy prevention: Implementation of a multicomponent. Community-Wide Approach. Journal of Adolescent Health, 60(3S), S9–S17.
O’Uhuru, D. J., Santiago, V., Murray, L. E., Travers, M., & Bedell, J. F. (2017). Bronx teens connection’s clinic linkage model: Connecting youth to quality sexual and reproductive health care. Journal of Adolescent Health, 60(3S), S38–S44.
Perper, K., Peterson, K., & Manlove, J. (2010). Diploma attainment among teen mothers. Child Trends Fact Sheet.
Plastino, K., Quinlan, J., Todd, J., & Tevendale, H. D. (2017). Stakeholder education and community mobilization garner support for sex education. Journal of Adolescent Health, 60(3S),
Romero, L. M., Middleton, D., Mueller, T., Avellino, L., & Hallum-Montes, R. (2015). Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services. Journal of Adolescent Health, 57(5), 488–495. https://doi.org/10.1016/j.jadohealth.2015.07.013
Romero, L. M., Olaiya, O., Hallum-Montes, R., Varanasi, B., Mueller, T., House, L. D., & Middleton, D. (2017). Efforts to increase implementation of evidence-based clinical practices to improve adolescent-friendly reproductive health services. Journal of Adolescent Health, 60(3S), S30–S37.
Romero, L. M., Pazol, K., Warner, L., Cox, S., Kroelinger, C., Besera, G., Barfield, W. (2016). Reduced disparities in birth rates among teens aged 15–19 years—United States, 2006–2007 and 2013–2014. Retrieved from
Santelli, J. S., Lindberg, L. D., Finer, L. B., & Singh, S. (2007). Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use. American Journal of Public Health, 97(1), 150–156.
Saunders, E. J. (2018). Mobilizing communities in support of teen pregnancy prevention: “communitywide initiatives” findings. Health Promotion Practice, 19(1), 16–22.
Sotolongo, J., House, L. D., Swanson, S., & Davis, S. E. (2017). Integrated community strategies for linking youth to adolescent reproductive health services: A case study. Journal of Adolescent Health, 60(3S), S45–S50.
Tevendale, H. D., Condron, D. S., Garraza, L. G., House, L. D., Romero, L. M., Brooks, M. A., & Walrath, C. (2017). Practical approaches to evaluating progress and outcomes in community-wide teen pregnancy prevention initiatives. Journal of Adolescent Health, 60(3S), S63–S68.
Travers, M., O’Uhuru, D., Mueller, T., & Bedell, J. (2019). Implementing adolescent sexual and reproductive health clinical best practice in the Bronx, New York. Journal of Adolescent Health, 64(3), 376–381.
Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., & Saul, J. (2008). Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. American Journal of Community Psychology, 41(3–4), 171–181.
Funding
This publication is made possible by cooperative agreement 5U58DP002887-04 from the Centers for Disease Control and Prevention (CDC) through a partnership with the US Department of Health and Human Services (HHS) Office of Adolescent Health (OAH). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Office of Adolescent Health, or the Centers for Disease Control and Prevention, US Department of Health and Human Services.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interests.
Disclaimer
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
House, L.D., Tevendale, H., Brittain, A. et al. Implementation of Community-Wide Initiatives Designed to Reduce Teen Pregnancy: Measuring Progress in a 5-Year Project in 10 Communities. Sex Res Soc Policy 19, 496–508 (2022). https://doi.org/10.1007/s13178-021-00565-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13178-021-00565-y