Place Matters: Youth Perspectives on Teen Pregnancy & Their Environment

Recent data show that birth rates among teenagers in the United States (US) are at a record low. However, the US has higher teen pregnancy and birth rates when compared with other developed nations. While increasing access to youth-friendly health care, contraception, and evidence-based interventions (EBIs) have contributed to this historic low, many community risk factors continue to influence youth sexual risk-taking behavior.

In 2010, the Centers for Disease Control and Prevention (CDC) in partnership with the Office of Assistant Secretary for Health Offices of Adolescent Health (OAH) and Population Affairs (OPA) funded nine state– and community-based organizations in high need communities as part of the Teen Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives. These initiatives are tailored to the specific communities, yet all employ common strategies such as increasing access to EBIs and sexual and reproductive health services. In addition, these initiatives engage stakeholders, and mobilize community members to take action to facilitate the change (in both behaviors and systems) necessary to reduce teen pregnancy. JSI Research & Training Institute, Inc. (JSI) is one of five national organizations funded to provide training and technical assistance to the nine grantees and focuses on the “Working with Diverse Communities” component. This is an essential component of the initiative which aims to raise awareness of the relationship between teen pregnancy and social determinants of health, help partners identify determinants that are feasible to change, and ultimately integrate a “social determinants approach” into all of their teen pregnancy prevention efforts.

In 2014, JSI collaborated with Youth Leadership Teams (YLT) from the City of Hartford Teen Pregnancy Prevention Initiative and Massachusetts Alliance on Teen Pregnancy’s Youth First initiative to create a video presenting teens’ perspectives on the unique contexts where they live, learn, work, and play and the influence these community factors have on teen pregnancy. JSI designed this video to be used with a diverse audience (e.g., youth, parents, evidence-based intervention (EBI) facilitators, school staff, healthcare providers, and community members). As a video companion tool, JSI developed a discussion guide designed to engage two main audiences around the social determinants of teen pregnancy - adults who serve youth EBI facilitators and youth. Questions in each section of the guide are broken down by the main themes YLT members address in the video: (1) what their community and family mean to them; (2) the challenges they face; (3) recommendations as to how their communities can better support them; and (4) their hopes and dreams. 

The aim of this video and discussion guide is to raise awareness about community context influencing teen pregnancy, encourage communities to incorporate a social determinants of health approach to teen pregnancy prevention, and suggest six concrete actions to mobilize viewers in reducing risks and enhancing protective factors in their communities.