Teen Pregnancy is a concern in many countries. In this paper a teen is defined as a male or female between the ages of 14-20. Of the Western industrialized nations, the United States has one of the highest teen birth rates. In the United States approximately 905,000 teens become impregnated each year: 9. 4% of our youth population. Of this group an estimated 78% of pregnancies were unintended and in 40% of the cases the teen was under the age of 20. Although the number of teen pregnancies has decreased from 1 million, the statistics support the continuation of efforts to reduce these rates.
The high number of adolescent births in our country is more than just an isolated problem, it is a problem that reaches across our entire culture. Nearly two thirds of America’s high school population is sexually active by the time they graduate. We need not focus solely on the teens that become pregnant; we need to focus on our youths’ sexual patterns as a whole. How Trends are Monitored To monitor the trends in our population relating to the rates of teen pregnancy, five major surveys are used: the National Survey of Family Growth (NSFG), the National Survey of Adolescent Males (NASM), the Youth Risk Behavior Survey (YRBS), the National Longitudinal Study of Adolescent Health (Add Health), and the National Health Institute Survey (NHIS).
The results of a variety of surveys are used in order to lower high or low skewed results. NSFG is not limited to the teen population. It provides detailed info on fertility related behavior among a nationally representative household sample of woman/girls ages 15-44 (Santelli, Duberstien, Abma, Sucoff & Resnick, 2000). The sample population for this survey is extracted from all 50 states.
The survey is conducted face-to-face in a private setting with trained interviewers. Both parental and adolescent sexual perspectives are reflected in this survey. NSAM is the male counterpart to the teenage sub-sample of NSFG. The results of the survey are reflective of the national population of males ages 15-19. Like NSFG, the survey is conducted in a similar face-to-face interview. There is more emphasis, in this survey, on sexually transmitted diseases and HIV. Both YRBS and Add Health are surveys conducted using a nationally representative sample of students.
The YRBS is designed to reflect the national population of both male and female students in both public and private schools grades 9-12. The YRBS surveys a broad range of youth health behaviors and is administered through a paper and pencil questionnaire in the classroom. Add Health surveys a nationally representative sample of youth grades 7-12. Add health was designed to examine the antecedents of health-related behaviors emphasizing the social contexts of which they occurred under. The NHIS was used in conjunction with the YRBS surveys to provide data relating to the socioeconomic aspect of sexual behavior in youth.
The surveys reflect national percentages for families with adolescents ages 14- 17 and were completed by the household adult. Family income, adult educational attainment, family structure, marital status, and race/ethnicity were elements reflected in the results of the survey. Each element Significance of Survey Results The demographics of our youth population as it relates to sexual behavior, is also a key element to consider when forming programs to reduce risky sexual behavior in adolescents. By demographics I am referring to parent-child relationship, peer influence, ethnicity, education, socioeconomic status, and religion.
By comparing the results of NHIS with that of YRBS the effects of socioeconomic status on youth sexual behavior. Socioeconomic status was surveyed in its impact on five different sexual behaviors: ever having sex, sexual intercourse in the past three months, multiple partners in the past three months, condom use at time of last sexual experience by either partner, and oral contraceptive use at last sexual encounter by either partner (Santelli, Lowry, Berner & Robin 2000). The four elements used to determine socioeconomic status were each separated into four classes.
Income was divided into a family income of less than $20,000 per year, $20,000-$34,999 per year, $35,000-$49,000, and $50,000 or more dollars earned per year. Parental education was determined by the adult with the highest level of education in the household. Educational status was defined as less than a high school degree, high school graduate, some college, or a college graduate. The four subcategories of family structure included living with both parents, living with mother, living with father, or other. Race was defined as White non- Hispanic, Black non-Hispanic, Hispanic or other (Santelli, 2000).
Of the five sexual behaviors assessed, through the conjoined efforts of the YRBS and the NHIS, parental education, family structure, and ace/ethnicity had the strongest influence on the youth ever partaking in sexual intercourse. Parental education and family structure were related to the initiation of intercourse for each gender. Among females family structure was also significant in predicting oral contraception use. When the elements of parental education, family income, and family structure were adjusted for a control sample, it had little impact on the relationship between sexual behavior and race/ethnicity.
A significant result of the survey was the implication that income did not show a significant relation to any sexual behavior. Although in 1988, 56% of teen births occurred to young women that were considered poor, community structure is a more prominent factor in these statistics. Determining the family oriented antecedents is necessary in designing programs to impact youth sexual behavior in a positive way. Although Socioeconomic status played a large role in helping to determine some predictors of youth sexual risk behavior, race also plays an important role in sexual perspectives.
Rates of adolescent birth, pregnancy, and STD infection are higher among racial and ethnic minority groups. Nationally reported rates for gonorrhea is 31 times higher in African American adolescents than in White adolescents. Birth rates among teens ages 15-17 are 3. 2 times higher among African Americans as well. These rates relate also to the cultural perspectives of the teen. In a study conducted by Smith and Barney, 1995, African American teen mothers viewed pregnancy during adolescence as normal and acceptable.
They felt that pregnancy introduced a feeling of significance and meaning and provided hope for the future. Although this could be attributed to community structure, the teens still failed to realize the impact of hildbearing at such a young age. How to Deal With This Problem “Despite the alarming statistics of youth pregnancy rates there is no federal mandate to teach sex education in public schools and less than half of all public schools in this country offer information on how to obtain birth control” (Starkman & Rajani, 2002, p. 313).
Many efforts to reduce teen pregnancy have focused on teenagers’ sexual beliefs, attitudes, skills, and behaviors and how they influenced contraception and reproductive health services. However, they have lacked ant long-term effect on youth risk behavior. In order to reduce the rates of teen pregnancy efforts to prevent pregnancy and reduce the spread of STDs must move beyond the health care system to involve parents, schools, and communities. The Role of the Healthcare Community Calista Roy described a model for nursing based on the concept of adaptation.
There are five major concepts of nursing explicated in her model: the person, the goal of nursing, nursing activities, health, and the environment. The person is viewed as having four different modes of adaptation: physiologic, self-concept, role function, and interdependence modes. Roy’s model is concerned with the internal and external environmental stimuli affecting the development and behavior of the person. Roy’s model is written pertaining to the person as an individual client. Her model can easily be applied to family groups or communities as well.
In Roy’s Adaptation Model (1970, 1976), the person is described as a bio-psycho-social being in constant interaction with a changing environment and having four modes of adaptation: physiologic, self concept, function, and interdependence. Roy describes the person as having a zone surrounding his variable level of adaptation. Stimuli that fall within this zone will result in a positive response or adaptation. Stimuli which falls outside of this zone will result in a negative response or maladaptation.
Roy describes the environment as being both internal and external. Roy describes health as being a state of successful positive adaptation to stimuli from the environment. The goal of nursing, in Roy’s model is to promote positive adaptation in each of the four adaptive modes of the person. The nursing process, as defined in Roy’s Adaptation Model consists of six steps: First level assessment, Second level assessment, Problem Identification, Goal Setting, Intervention, and Evaluation (Roy ).
Roy’s Adaptation Model for nursing is based on the concepts of the person adapting to his changing environment. The role of nursing in the model is to facilitate the person in this adaptation protecting the persons’ integrity. The model can be applied to the individual client, the family group, or the community (Roy, ). Roy’s model, being prescriptive in nature, is concerned with the values, goals, patiency of the recipient, and intervention. In Roy’s Adaptation Model the basic assumptions link the concepts of man, nvironment, health, and nursing together completely.
The Adaptation Model by Roy is generalizable enough to be applied to practice, research, and education. Through application of Roy’s model we can determine the ways in which it is appropriate to help teens deal with the issue if pregnancy. Through supporting the teen and providing support in the areas such as providing of information, counseling, and genuine moral concern the nurse can have impact the teens perspective and attitude towards sexual behavior, pregnancy, and contraception. The nurse should begin by identifying options available to the atient.
Also by providing information of the consequences of the teens actions can help in reducing the likely hood a teen will become impregnated. Conclusion In finding solutions to prevent teen pregnancy we must work in coalition with healthcare providers, teachers, school administrators, and politicians. Communities must also address the many antecedents that lead to the occurrence of a teen pregnancy. The standard of teaching abstinence only needs to be modified. A patchwork of programs within a community may be the only effective process to impact statistics.
