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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Kristin Anderson Moore, Ph.D. Selma Caal, Ph.D. Lina Guzman, Ph.D. Jennifer Manlove, Ph.D. Karen Walker, Ph.D April 2nd, 2014

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Reducing Poverty by Reducing Teen Pregnancy

Hispanics are the largest racial/ethnic minority group in U.S. High levels of child and family poverty, and high school dropout Hispanic teen birth rates are also high One way to reduce poverty is to reduce teen pregnancy Especially if pregnancy delays are accompanied by increases in educational attainment Few Teen Pregnancy Prevention programs have been designed for Hispanics
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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

The Challenges to Hispanic Teen Pregnancy Prevention

Hispanic teen birth rates, although falling, continue to be high Sexual activity among Hispanic teens is similar to white and black teens But their use of contraception is lower and less consistent And few TPP programs have been designed for Hispanics

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

What We Did

National Data & Program Review


Understand reproductive health behaviors among Hispanics in the U.S. Understand the causes and consequences of Hispanic teen childbearing Identify programs that are effective in preventing teen pregnancy What strategies work? How should programs be implemented?

Field Work & Program Development


Focus groups with Hispanic teens and interviews with Hispanic parents of teens Interviews with program developers and providers

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Key Findings

Hispanic Teens and Parents Want to Avoid Teen Pregnancy


Contrary to stereotypes, the majority of Hispanic teens report that they do not want to get pregnant. They want to: Enjoy being young Finish school Have careers Get married Have kids after completing these goals But, once pregnant, they tend to be happier with their condition compared with white and black youth
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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Better Alignment of Intentions and Behaviors is Needed


Hispanics are less likely to use: Any contraception at first sex Any contraception at last sex Condoms consistently But there is reason to be optimistic Among females, Hispanic teens ages 15-19 are more likely to have used IUDs and injectable contraceptives While Hispanics use of long-acting reversible contraceptives (LARCs) is promising, they are not being reached early enough Older Hispanic teens were more likely to have used the IUD or injectable contraceptives, but many of them get the IUD after they have had a birth
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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Relationships with Parents, Partners and Friends Matter


Hispanic teens are less comfortable discussing teen pregnancy with their parents than are other teens Partners do not communicate easily about pregnancy and its prevention

Teens who think their peers are sexually active are more likely to become so themselves
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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

What We Know and Dont Know About Pregnancy Prevention Programs for Hispanics

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What Do We Know about Teen Pregnancy Prevention Programs for Hispanics?


Few programs have large samples of Hispanics Most were school-based, some community-based and clinicbased Programs are similar toor the same asthose offered to teens of other ethnic/racial backgrounds Some well-known programs have not been evaluated with large Hispanic populations (e.g., Teen Outreach Program) Program strategies Often interactive and include a mix of knowledge building, and psycho-social or behavioral skills building Some incorporated innovative components: parent involvement/homework, peer education, technology
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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Effectiveness of Current Programs

Most programs showed impacts on knowledge, attitudes, and communication (but fewer impacts on behaviors) Both middle and high school interventions delayed sex But only high school programs showed impacts on contraception Community- and clinic-based programs also showed impacts Few measured contraceptive use other than condoms
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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

What Dont We Know about Program Components and Implementation?


We dont know: Which program components are critical Programs that showed impacts often had the same components as programs that did not show impacts
What are the independent effects of individual components Most measure cumulative effects of all components
How long programs should be or how often they should meet Both short-term and longer-term programs are effective

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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

What Did We Learn about the Implementation of Programs with Hispanic Populations?
Many program providers continued to adapt program even those using programs modified for Latinos Modifications didnt go deep enough Didnt address the needs of specific populations Added components of healthy relationships, acculturation, older partners, etc. Warm, engaging, bi-lingual and bi-cultural staff are key for: Recruitment of teens and parents Engagement and retention Delivery Latino parents readily provide permission Glad to see children getting right information

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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Implications for TPP Programs for Hispanics


Our findings suggest developing a program approach that:
1. 2. 3. 4. 5. 6. Helps adolescents align sexual and contraceptive behaviors with educational goals Highlights relationships and communication with parents, peers, and partners Includes comprehensive information on sex and contraception, with a particular focus on long-acting reversible contraceptives (LARCs) Incorporates culturally relevant content and activities to better engage and retain teens Includes interactive activities, role-playing and skill building Involves key partners: Partner with schools that provide strong educational supports Consider partnering with schools that have health centers

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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

Promising starting points:


Teens and parents are eager to talk to one another TPP programs share common goals with parents Programs that include both educational goals as well as TPP may be especially appealing to parents Parents and teens have positive attitudes toward contraception, especially condoms and oral contraception (pills) Translate attitudes towards behaviors

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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy

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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy Jennifer Manlove and Lina Guzman

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Contact information: Jennifer Manlove jmanlove@childtrends.org 240-223-9262 Lina Guzman lguzman@childtrends.orrg 240-223-9206

www.childtrends.org Twitter/childtrends www.facebook.com/childtrends


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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy Jennifer Manlove and Lina Guzman