Positively pregnant: Pregnancy testing for high risk adolescents in non-traditional locations

Background: While pregnancy is commonly assessed via self-report, adolescents may not report pregnancy accurately or consistently. Incorporating biomarkers such as urine pregnancy testing (UPT) in evaluating community-based interventions has the potential to reduce reporting bias. We sought to determine the acceptability and feasibility of UPT in community settings, and to elicit adolescents' preferred methods for receiving UPT results. Methods: This pilot study involved girls aged 16-20 (n=28) at high risk for unintended pregnancy. In community locations convenient for individual participants (e.g., coffee shops, libraries, fast food restaurants), girls completed a structured qualitative interview about UPT; 19 of 28 (68%) also provided a urine sample for pregnancy testing. Interview questions focused on participants' comfort with UPT in traditional and non-traditional locations and their preferences for receiving results. Interviews were content analyzed to identify common themes. Rapid pregnancy tests were completed on urine samples. Results: Participants commonly noted that other teens would be willing to provide urine samples. Participants reported being most comfortable with UPT in clinic, school, and home settings. However, all participants who provided a urine sample (68%) did so at a non-traditional location (fast food, coffee shop or library). Participants preferred to learn about UPT results by phone or in person. Conclusions: Findings suggest that community-based UPT is both feasible and acceptable among adolescents at high risk of unintended pregnancy. Incorporating an objective biomarker, such as UPT, into community-based interventions extends the use of this technology into non-traditional settings and improves pregnancy measurement.