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

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, 2014Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#1Reducing Poverty byReducing Teen PregnancyHispanics are the largest racial/ethnic minority group in U.S.High levels of child and family poverty, and high school dropoutHispanic teen birth rates are also highOne way to reduce poverty is to reduce teen pregnancyEspecially if pregnancy delays are accompanied by increases in educational attainmentFew Teen Pregnancy Prevention programs have been designed for Hispanics

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 highSexual activity among Hispanic teens is similar to white and black teensBut their use of contraception is lower and less consistentAnd few TPP programs have been designed for Hispanics

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#3What We Did

#Lizy, can you fix this so this is a nice transition slide?

LM: Addressed.

Lizy: Can you add a picture here as well as in the other transition slide?

Jen: Do you think that we shd just delete this slide? It is not adding anything.4National 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 pregnancyWhat strategies work?How should programs be implemented?

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

Field Work & Program Development

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#5Key Findings

#IntentionsSex and ContraceptionHispanic teens are less likely than white teens to have used the pill, but more likely to have used IUDs or injectables. Older Hispanic teens were much more likely to have used the IUD or injectable, but many of them get the IUD after they have had a birthAlignment of Intentions and BehaviorsRelationships and Open CommunicationEducationFew ProgramsImplementation6Hispanic Teens and Parents Want to Avoid Teen PregnancyContrary to stereotypes, the majority of Hispanic teens report that they do not want to get pregnant. They want to: Enjoy being youngFinish schoolHave careersGet marriedHave kids after completing these goalsBut, once pregnant, they tend to be happier with their condition compared with white and black youthReducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Note here the ideal age at first birth reported by teens and parents7Better Alignment of Intentions and Behaviors is Needed

Hispanics are less likely to use:Any contraception at first sexAny contraception at last sexCondoms consistentlyBut there is reason to be optimisticAmong females, Hispanic teens ages 15-19 are more likely to have used IUDs and injectable contraceptivesWhile Hispanics use of long-acting reversible contraceptives (LARCs) is promising, they are not being reached early enoughOlder 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

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#LM: Added in bars from old slide 15

Jen: Lets stick to the any use at 1st and last sex and less likely to use condoms . We can then stick to the ever use of hrmonals in the next slide. Jen: Is there anything new from the NSFG analysis that we did that we cld add to this slide. 8Relationships with Parents, Partners and Friends MatterHispanic 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

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#9What We Know and Dont Know About Pregnancy Prevention Programs for Hispanics

#IntentionsSex and ContraceptionHispanic teens are less likely than white teens to have used the pill, but more likely to have used IUDs or injectables. Older Hispanic teens were much more likely to have used the IUD or injectable, but many of them get the IUD after they have had a birthAlignment of Intentions and BehaviorsRelationships and Open CommunicationEducationFew ProgramsImplementation10What Do We Know about Teen Pregnancy Prevention Programs for Hispanics? Few programs have large samples of HispanicsMost were school-based, some community-based and clinic-basedPrograms are similar toor the same asthose offered to teens of other ethnic/racial backgroundsSome 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 buildingSome incorporated innovative components: parent involvement/homework, peer education, technology

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Effectiveness of Current ProgramsMost programs showed impacts on knowledge, attitudes, and communication (but fewer impacts on behaviors)Both middle and high school interventions delayed sexBut only high school programs showed impacts on contraceptionCommunity- and clinic-based programs also showed impactsFew measured contraceptive use other than condoms

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Programs tend to be successful at increasing knowledge, even if they are not successful at changing behaviorThe research shows that positive communication is key, yet programs do not measure communicationWithout knowing about other contraceptive use besides condoms, it is difficult to know about the healthy habits of teens12What Dont We Know about Program Components and Implementation? We dont know:Which program components are criticalPrograms that showed impacts often had the same components as programs that did not show impacts

What are the independent effects of individual componentsMost measure cumulative effects of all components

How long programs should be or how often they should meetBoth short-term and longer-term programs are effective

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Be tentative: We are finding that13What Did We Learn about the Implementation of Programs with Hispanic Populations?Many program providers continued to adapt program even those using programs modified for LatinosModifications didnt go deep enoughDidnt address the needs of specific populationsAdded components of healthy relationships, acculturation, older partners, etc. Warm, engaging, bi-lingual and bi-cultural staff are key for:Recruitment of teens and parentsEngagement and retentionDeliveryLatino parents readily provide permission Glad to see children getting right informationReducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Be tentative: We are finding that14Implications for TPP Programs for HispanicsOur findings suggest developing a program approach that:

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 teensIncludes interactive activities, role-playing and skill building Involves key partners:Partner with schools that provide strong educational supportsConsider partnering with schools that have health centers

Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Promising starting points:Teens and parents are eager to talk to one anotherTPP programs share common goals with parentsPrograms that include both educational goals as well as TPP may be especially appealing to parentsParents and teens have positive attitudes toward contraception, especially condoms and oral contraception (pills) Translate attitudes towards behaviorsReducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty Strategy#Both adolescents and parents want Latino teens to avoid teen pregnancy. This fact may act as a catalyst for practitioners in teen pregnancy prevention programs to begin conversations with Latino families and engage them in efforts to address the teen pregnancy problem. Adolescents and parents generally have positive attitudes about condom use; these attitudes can be leveraged to launch discussions about safe sex, the full spectrum of birth control options, misconceptions and fears about different contraceptive methods, and the

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Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty StrategyJennifer Manlove and Lina Guzman#17Contact information: Jennifer Manlove jmanlove@childtrends.org 240-223-9262Lina Guzman lguzman@childtrends.orrg 240-223-9206

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www.childtrends.org Reducing Teen Childbearing among Hispanics: An Innovative Anti-Poverty StrategyJennifer Manlove and Lina Guzman#18