Introduction
Adolescent pregnancy is a major global issue that affects most young girls. Thus, as a social worker, the focus will be on girls aged 14-19 living in poverty. Apart from being underprivileged, their problem is compounded by early pregnancy. In this case, the target group’s education may be disrupted, and their job prospects may diminish. This can perpetuate the cycle of poverty and exclusion, which can impact their survival and health outcomes.
Pregnancy during adolescence is usually not the result of a deliberate decision. Instead, it is a consequence of a lack of information about sexual and reproductive health and rights. The focus of this 3-tier preventive program is to engage a small group of girls and offer them sex education to enable them to make informed decisions and prevent early pregnancy.
Literature Review
Teenage pregnancy is a grave social problem in today’s society. A report shows that each year, about 21 million girls aged 15-19 become pregnant, of whom approximately 12 million give birth (Maheshwari et al., 2022). Another study by Asmamaw et al. (2023) indicates that 16 million girls aged 10-19 give birth annually, accounting for approximately 11% of total births globally.
In the United States, the teen birth rate has gradually declined over the years. Statistics show that in 2020, the teenage birth rate for ages 15-19 in the country was 15.4 births per 1,000 females, representing an 8% decline from 2019 and a 75% reduction from 1991 (U.S. Department of Health & Human Services, n.d.). Nevertheless, despite this decrease, the prevalence of adolescent pregnancy in the United States remains higher than in other developed nations.
Several factors may contribute to the increase in teen pregnancies and births. Poverty has been cited as a major cause of pregnancy among minors. Research reveals that adolescents from low socioeconomic households have a higher likelihood of becoming pregnant compared to their peers from high-income backgrounds (Asmamaw et al., 2023; Diabelkováet al., 2023). This is because girls from needy families may be involved in transactional sex in an effort to solve their financial woes. Additionally, the lack of parental guidance may lead to early childbearing by depriving young adults of emotional support, validation, and a sense of direction (Maheshwari et al., 2022; Asmamaw et al., 2023).
Similarly, the lack of comprehensive sex education is another cause of teen pregnancies. Without accurate and detailed information about sexual health, healthy relationships, and contraception, teens might engage in risky sexual practices, resulting in early pregnancies. A study by Mark and Wu (2022) shows that the financing of comprehensive sex education by the federal government has decreased county-level teenage births by over 3% in the United States. Thus, the key drivers of adolescent pregnancy are multifaceted.
Teenage pregnancies have severe adverse effects on both the adolescents and their children. In this regard, they cause high fatality rates for the mothers and the newborns. Research indicates that more than one million infants born to adolescent girls die before they reach one year (Asmamaw et al., 2023).
Additionally, approximately 70,000 teen girls die annually either during pregnancy or childbirth (Asmamaw et al., 2023). As a result, adolescent pregnancy has been cited as a leading contributor to newborn and maternal deaths. Furthermore, early pregnancy predisposes young girls to several health complications, including pregnancy-induced hypertension, preeclampsia, sexually transmitted infections, postpartum depression, and anemia (Maheshwari et al., 2022). Hence, teen pregnancies pose a threat to the health of the minors and the neonates.
Early pregnancies can lead to poor academic results and school dropout. Young mothers may be unable to balance caring for their children and studying, resulting in poor grades (Maheshwari et al., 2022; Otegbayo et al., 2023). Additionally, societal stigmatization and ridicule from their peers might affect their ability to concentrate on their studies, prompting some to drop out of school.
A report shows that only 50% of adolescent mothers graduate from high school by age 22 (Centers for Disease Control and Prevention, 2021). Low academic achievements and education levels increase the risk of unemployment for teen mothers, resulting in poverty, emotional distress, and substance abuse (Asmamaw et al., 2023). Therefore, early pregnancies might negatively impact the youths’ future success.
Identification and Recruitment
The recruitment will target girls with a higher risk of pregnancy, including those who are sexually active and adolescents. In this case, school-based programs, such as sex education and counseling classes, will be utilized to identify prospective participants. Confidentiality will be maintained throughout the recruitment process to help the girls feel comfortable sharing their experiences. The selection process of the target group will be based on various criteria.
The first condition for inclusion is that participants should be male and 14 to 19 years old, because the program is for first- and second-year students. Secondly, the adolescents should be high school students and interested in teenage pregnancy prevention. Thirdly, the subjects must show their commitment to regularly attending after-school sessions, which will be conducted until 5 o’clock on school days. These measures will ensure that suitable candidates are recruited for the program.
For this preventive program to be organized, key considerations include obtaining parental consent for participation. For this reason, a consent form will be written and signed by interested students or their legal guardians, especially if they are under the legal age, to participate. Additionally, the social worker must speak with the principal to obtain permission to keep the girls after 3 o’clock and to be granted access to the facility or room.
The school administration will also provide information about students who use school busing, excluding them from the program unless they have a way to get home. However, when sessions are held during school hours, another key stakeholder will be teachers. Liaising with them can secure their buy-in to let me pull a student out of class. All these strategies can improve the enrollment process and ensure compliance with legal requirements.
Staff and parents will be involved in the program to ensure the girls receive support and guidance beyond the sessions. For example, parent-teacher meetings will be organized to discuss the program’s progress and address any concerns or questions that participants may have. Parents will also be provided with resources such as brochures and videos that offer information on sexual health and parenting. Additionally, staff members will be involved and provided with training and resources to support the girls and promote healthy behaviors.
Anticipated Outcomes and Intervention
Since this is a preventive exercise, a lot of cognitive behavioral therapy (CBT) will be conducted to ensure young girls understand how to make informed decisions. Research has demonstrated that CBT is effective in managing behavior-related issues among teenagers, including drug abuse, anxiety, and stress-based disorders (Nakao et al., 2021). According to Feld et al. (2021), adolescents with co-occurring depression and stress symptoms are more susceptible to unintended pregnancy compared to those without. In this case, mental health plays a significant role in early pregnancy because those under stress are more likely to engage in risky sexual encounters, have inconsistent contraceptive use, or even fail to consume birth control medications (Feld et al., 2021).
Although no available research directly shows the efficacy of CBT in preventing teenage pregnancy, evidence has proved that it can help develop healthy coping mechanisms against peer influences, increase self-esteem, lower anxiety and depression, which can act as a buffer against engaging in unhealthy sexual behaviors (Sneddonet al., 2020; Nakao et al., 2021). For these reasons, CBT can equip the target group with the knowledge to make rational choices concerning relationships and sexual matters.
The main objective of this preventive measure is to help participants learn how to establish healthy relationships over the 8 to 12 weeks during which the program will be conducted. The overarching plan not only entails addressing the dynamics of positive romantic relationships but also includes instilling skills to enable them to handle peer influences, stress, and depression, which may catalyze early unprotected sex and unplanned pregnancy. Some of the mediations will include teaching safe sex, understanding consent, and stress coping skills, as well as resilience against depression and peer pressure (Keperling et al., 2017). The students will also be guided on how they can identify stress factors that can drive them to engage in unsafe sexual activities.
The program’s success will be evaluated through pre- and post-tests administered to the participants. The entry assessments will enable the social worker to determine the respondents’ initial attitudes and understanding concerning a healthy relationship and their ability to manage sexual advances and depression triggers. The subjects will then be provided with practical tools to deal with their mental health issues. These may include teaching them mindfulness exercises and open dialogues to manage stress, and encouraging them to seek professional assistance from school professionals. The post-test will measure any shifts in attitude, knowledge, and coping mechanisms. The outcome of the CBT model will be assessed through a focus group. This will provide a platform for participants to empower each other.
Conclusion
This preventive program aims to promote knowledge concerning healthy relationships, responsible sexual behavior, and strategies for handling cognitive issues. By focusing on these components, the program is intended to make a positive impact not only on students but also on the school environment as a whole. Each participant is expected to become more conscious and develop new decision-making attitudes to manage relationships or sexual behavior. The program intends to provide a follow-up or a continuous effort by parents, teachers, and school counselors to eradicate the problem. This can facilitate discussions surrounding healthy relationships and safe sexual behaviors, which could reduce teenage pregnancy and strengthen the impact of the program after its termination.
References
Asmamaw, D. B., Tafere, T. Z., & Negash, W. D. (2023). Prevalence of teenage pregnancy and its associated factors in high fertility Sub-Saharan Africa countries: A multilevel analysis. BMC Women’s Health, 23(1), 1-10.
Centers for Disease Control and Prevention. (2021). About teen pregnancy.
Diabelková, J., Rimárová, K., Dorko, E., Urdzík, P., Houžvičková, A., & Argalášová, Ľ. (2023). Adolescent pregnancy outcomes and risk factors. International Journal of Environmental Research and Public Health, 20(5), 1-10.
Feld, H., Barnhart, S., Wiggins, A. T., & Ashford, K. (2021). Social support reduces the risk of unintended pregnancy in a low-income population. Public Health Nursing, 38(5), 801–809.
Keperling, J. P., Reinke, W. M., Marchese, D., & Ialongo, N. (2017). Group interventions in schools: A guide for practitioners. Guilford Press.
Maheshwari, M. V., Khalid, N., Patel, P. D., Alghareeb, R., & Hussain, A. (2022). Maternal and neonatal outcomes of adolescent pregnancy: A narrative review. Cureus, 14(6), 1-10.
Mark, N. D., & Wu, L. L. (2022). More comprehensive sex education reduced teen births: Quasi-experimental evidence. Proceedings of the National Academy of Sciences, 119(8), 1-6.
Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine, 15(1), 1-4.
Otegbayo, B. E., Omar, N., Danaee, M., Mohajer, S., & Aghamohamadi, N. (2023). Impact of individual and environmental factors on academic performance of pregnant adolescent. BMC Women’s Health, 23(1), 1-10.
Sneddon, H., Gojkovic Grimshaw, D., Livingstone, N., & Macdonald, G. (2020). Cognitive-behavioural therapy (CBT) interventions for young people aged 10 to 18 with harmful sexual behaviour. The Cochrane Database of Systematic Reviews, 6(6), 1-61.
U.S. Department of Health & Human Services. (n.d.). Trends in teen pregnancy and childbearing.