Sexual Attitudes of Young Women of Different Backgrounds - Teen Pregnancy - Research Proposal Example

Teen Pregnancy Objectives The purpose of this study is to chalk out an effective plan to reduce teenage pregnancies. The study will encompass qualitative as well as quantitative methods of assessment of factors associated with teenage pregnancy, and will involve teenagers in the early to late adolescence period. The ultimate aim of the work to be undertaken in the context of pregnancies in teenage women will be to integrate the various factors to understand how they interact with one another and to determine the factors (for example, socioeconomic, educational, and family environment) which could significantly contribute to preventing teenage pregnancies. Measurement of health literacy will be an essential part of this study since girls as young as 13 years old will also form subjects of this study. The research outcome will potentially be useful to gain insight into various aspects of teenage sexual health that will lead to potentially better intervention strategies to bring about a reduction in teenage conception. Rationale for the study Teenage pregnancy rates in the United States are among the highest within the developed countries. Although the rates have dipped a little in the past few years, they are still significantly higher than in the early 1970s, and, therefore, deemed an urgent national problem. Even with the easy availability of contraceptives and the increased use of the same, the use is inconsistent and often not enough to counter the increase in teen sexual activity. In addition to the financial burden teenage pregnancies inflict on the young mothers and their families, the nation’s taxpayers have to bear the brunt of it, too. Teenage girls are inadequately equipped – physiologically and psychologically - to undertake parenthood. Apart from the higher infant mortality rates observed for babies born to teens, the teenage mothers normally lack the maturity and the skills to bring up a child. The negative effects of teen pregnancies on the children born to teenage mothers are no less worrisome. Those children, in all probability, will grow up in poverty with all the associated woes including health problems, child abuse and neglect, failure in studies, and delinquency. Thus, teen pregnancies are rightly viewed as a serious national problem by a majority of Americans which need to be tackled on various levels. This study proposes to make an attempt to objectively assess the various options available to bring about a decline in teenage pregnancy. Review of the Literature According to a UNICEF report, the United States tops the table of teenage pregnancy rates among 28 of the world’s richest nations with a teenage birth rate of 52.1 which is more than double the European average (Unicef-IRC Report, 2001). At the other end of the table are countries such as Korea, Japan, Switzerland, the Netherlands, and Sweden having a rate of less than seven births per 1000 teenagers. According to the report, these countries have been more successful in preparing their younger population to handle contemporary lifestyles. The report says these countries have made “successful efforts to prepare their young people to cope with a more sexualized society”. Medical literature generally classifies teenage pregnancy as a societal problem. However, the perspective of teenagers themselves might be different. In a study that looked at the attitudes of young people from advantaged backgrounds in comparison to those from disadvantaged backgrounds towards teenage pregnancy, Jewell et al. (2000) found clear differences in the two groups in their attitude to teenage pregnancy, and, especially with the way the groups saw their future. Early motherhood was not an option for the privileged; having a career, university, money and personal development were more important for them. The authors also observed that, in general, the under-privileged group had less knowledge about contraception. Interestingly, a major source of information for all women was other young women with the information so obtained being mostly inadequate. The types of services which have been considered effective include pre-conception advice and support, easy access to contraception, and improved information on risky behavior especially pertaining to pregnancy. Sex education would appear to be an effective approach for preventing unintended teenage pregnancy. Researchers led by Pamela Kohler at the University of Washington support comprehensive sex education having found that teens who receive comprehensive sex education are 60 percent less likely to get pregnant or inseminate someone pregnant than those who receive no sex education at all (Kohler et al., 2008). On the other hand, the subjects in Jewell et al’s study were of the view that sex education was “too biological and did not explain enough about contraception or the emotions involved in sexual relationships and pregnancy.” (2000). A study conducted in the UK to evaluate the correlation between teenage mothers and social exclusion revealed that most mothers felt that the sex education they had received both in school and at home had been inadequate (Wiggins et al., 2007). Kohler et al. (2008), found abstinence-only sex education to be quite ineffective. But, according to Santelli et al. (2007), while promotion of abstinence is worthwhile especially among younger teenagers, scientific evidence shows that the abstinence-only approach by itself is incapable of preventing unintended pregnancies among teens. Improved usage of effective contraception has been found to have the greatest impact on reducing conception rates. The decline in pregnancy rates in US women aged 15 to 19 during 1991 to 2000 has been attributed to improvements in contraceptive use including use of condoms, birth control pills, and other techniques (Santelli et al., 2007). Sweden has had for long an admirable tradition of openness and non-judgmental societal attitude to teenage sexuality. Besides, relationship and sexual education imparting information on contraception, STDs, HIV etc. have been part of the school curriculum for over 50 years. Contraceptive services are generally adolescent-oriented and free. All these measures have helped make teenage pregnancies uncommon in Sweden (Edgardh, 2002). Experimental Design This study will adopt a mixed-method approach utilizing both qualitative and quantitative research techniques. Methods of qualitative data collection include: a cognitive task analysis, in depth interviews, and end-user usability testing using thinking aloud protocol. Quantitative data will depict gender and age, Short Test of Functional Health Literacy in Adults (S-TOFHLA), Health Numeracy component of the Functional Health in Adults (TOFHLA), and visual design elements for laboratory value assessment questions. Sampling and Recruitment: The sample (n=100) will consist of young women who have attained menarche, in the age group of 13 to 19 years of age, from a range of social circumstances. At least one-third to a half of the subjects will be from an advantaged background (that is, living in milieu of relatively low levels of poverty and unemployment, with good family income). Subjects will be mixed racial group, comprehension of English being a must for all the subjects. All subjects recruited for this research will be students currently enrolled in school. Due to the limited literacy skills that is expected in the study subjects or at least among the very young subjects, it can be expected that the advice or information imparted to them may not be fully comprehensible to them. Hence, S-TOFHLA and TOFHLA will be administered to all the subjects initially to measure the level of their health literacy and, based on the test results, the information to be communicated to each will be suitably modified, if necessary. Experimental details The subjects will be interviewed by turn and advised in groups of no more than 10 persons, once in 2 months for a period of 18 months. The topics of discussion will include physiology of human reproduction simplified (in video), contraception and safe sex, advantages of abstinence and postponement of sexual activity, and abortion and its pros and cons. After each session, the subjects will be encouraged to discuss their views orally as well as in writing. Selected peers will be recruited to interact with the subjects to discuss the listed topics as well as to elicit information regarding the sexual history in the intervening period since the last meeting. Data recording and Evaluation Detailed notes will be made of discussions and findings after the participant observation. Exhaustive interviews as per a checklist of topics including the family background/financial circumstance of the subject, details of friends and boyfriends, sexual health, contraceptive use, career plans and, if appropriate, details of pregnancies and children will be audio tape-recorded and will also be fully transcribed. A series of multivariate analyses of the various factors will be done to evaluate the outcome vis a vis increase or reduction in teenage pregnancy. This study will potentially provide an insight into the sexual attitudes of young women of different backgrounds. At the same time, it is expected to endow the subjects with a more holistic understanding of the role played by sex, contraception and pregnancy in their lives. This knowledge will, hopefully, lead to safer sexual practices and reduced teenage pregnancies. References Edgardh, K. 2002. Adolescent sexual health in Sweden. Sex Transm Infect., 78: 352-356. Jewell, D., Tacchi, J. & Donovan, J. 2000. Teenage pregnancy: whose problem is it? Family Practice 17: 522–528. Accessed 29 November 2009 http://fampra.oxfordjournals.org/cgi/content/full/17/6/522 Kohler, P.K., Manhart, L.E. & Lafferty, W.E. 2008. Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health 42: 344-351. Santelli, JS. , Lindberg, LD. , Finer LB., and Singh, S. 2007. Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use. American Journal of Public Health 97: 150-156 Unicef-IRC Report, 2001. “A League Table of Teenage Births in Rich Nations”, Innocenti Report Card, 3. Accessed 30 November 2009 http://www.unicef-irc.org/cgi-bin/unicef/Lunga.sql?ProductID=328 Wiggins, M., Oakley, A., Sawtell, M., et al. 2007. Teenage parenthood and social exclusion: a multi-method study. Accessed 28 November 2009 www.ioe.ac.uk/ssru/reports/teenagepregnancyandsocialexclusion.pdf Read More