141st APHA Annual Meeting

In This section

288088
California hot spots study: An innovative mixed-methods approach to neighborhood level factors affecting teenage pregnancy

Tuesday, November 5, 2013 : 9:18 AM - 9:30 AM

Sarah Isquick, BS , Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Mara Decker, DrPH , Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Leah Maddock, MPH , Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Abigail Arons, MPH , Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Diana Lara, MD, MS. , Teen Pregnancy Prevention Program, Institute for Health Policy Studies, San Francisco, CA
Claire Brindis, Dr. P.H, M.P.H. , University of California, San Francisco, Bixby Center for Global Reproductive Health /PRL Institute for Health Policy Studies, San Francisco, CA
During the past twenty years, teen birth rates have declined at the national and state levels. However, significant disparities in teen birth rates remain at the county and sub-county levels among communities with similar demographic characteristics. We used an innovative mixed-methods approach to explore the role that neighborhood traits may play in teen pregnancy. We selected medical service study areas (MSSAs), which are contiguous census tracts, as the geographic unit of analysis. Using GIS mapping, we geo-located teen births that occurred during 2009 and 2010 by MSSA. We used population-level data to calculate teen birth rates for each of the 541 MSSAs in California, and calculated rate changes for each MSSA between 2004–05 and 2009–10. We selected ten MSSAs with significantly elevated or declining teen birth rates for further qualitative study. We conducted semi-structured interviews with adult stakeholders (n=94), and single-sex focus groups with male and female youth ages 13–18 (n=186, 60% female), including a brief quantitative survey. Adult stakeholders interviewed included religious leaders, health educators, clinicians, teachers, politicians, and law enforcement personnel, among others. Focus group and interview topics included neighborhood physical and social attributes, resources and socioeconomic opportunities for youth, attitudes about teenage pregnancy, and access to reproductive health services. Data were analyzed in Atlas.ti using a grounded theory approach. A mixed-methods approach for sample selection and data analysis — incorporating GIS mapping, purposive sampling and in-depth qualitative data collection with youth and adults — can help to identify neighborhood factors for future interventions and resource allocation.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss strengths and challenges of mixed-method data collection. Describe benefits and challenges of selecting diverse samples of adult and youth community members. Identify how using different levels of geographic units of analysis may mask or reveal health disparities in a given population. Discuss limitations of estimating and comparing data across time. This abstract is submitted as part of a pre-arranged panel entitled, "The California Hot Spots Study: Insights into neighborhood-level factors associated with teenage pregnancy."

Keywords: Adolescents, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed the study protocol and methodology and collected data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.