Puerto Rican teens' views on teen pregnancy and birth: Their voices can guide public health nursing practice

Background: Teen pregnancy and births are a complex public health problem and grave concern. Although Massachusetts has the third lowest teen birth rate in the nation, a closer examination reveals a disturbing and persistent trend in Holyoke, MA – teen birth rates have been consistently the highest in the state for over two decades. Holyoke represents a vulnerable community where 54% of families with children under 18 years living below the poverty level and nearly 45% of the population are Puerto Rican.

Methods: The Ecological Model of Health Behavior provided the framework for a qualitative study examining Puerto Rican teens' perceptions of teen pregnancy and birth in Holyoke. A series of eight focus groups were used to gather data from male and female high school students.

Findings: The findings indicate that Puerto Rican teens in Holyoke regard: teen pregnancy as unintentional and a problem with negative outcomes, sexual and reproductive health education as a necessity for all teens and pre-teens, and social factors as either contributing to or preventing teen pregnancy. Most importantly, teens' want their voices heard.

Conclusions: The problem of teen pregnancy and birth requires a comprehensive approach. Interventions focused solely on individuals are not likely to have powerful or sustained effects. Public health nurses are in a position to build collaborative teams on the local level and develop combinations of public health interventions addressing individual, intrapersonal, community and societal levels for risk reduction and effective behavior change in vulnerable communities.