Significant reduction of repeat teen pregnancy in a comprehensive young parent program.

OBJECTIVE: To describe a comprehensive, multidisciplinary approach to teen mothers and their children that significantly reduces repeat pregnancies. DESIGN: Retrospective review of repeat teen pregnancy data. SETTING: Young Parent Program (YPP) at a university-based health center. PARTICIPANTS: 1386 teen mothers between the ages of 11 and 19 who participated in the YPP for at least three years. INTERVENTION: Comprehensive Care: for both teen mother and her baby, including prenatal and postnatal care, preventive care, reproductive services, mental health, and acute care visits. Family counseling and similar services were also provided to siblings of the teen. CONTINUITY OF CARE: Patients are seen by the same staff and attending physicians on each visit. The treatment team includes physicians, nurses, social worker, nutritionist, and psychologist, all of whom are available to provide care at each visit. Flexible hours: Including evening clinic to allow teens to attend school or work during the day. Financial incentive: Patients with no insurance are given free contraceptives and a "no charge" clinic visit. Extensive contraceptive counseling is provided prior to start of contraceptive use and at every clinic visit. Routine telephone and/or mail reminders of appointments MAIN OUTCOME MEASURE: Rate of repeat teen pregnancy. RESULTS: Only 11(.79%) had repeat pregnancies. Older youth appeared more likely to repeat a pregnancy. CONCLUSION: Comprehensive intervention for teen mothers can be very successful in reducing repeat teen pregnancy in those teens who participate consistently in the program over a period of years.

Risky sex behavior and substance use among young adults.

Many young adults, despite widespread prevention and education efforts that target this age group, engage in behaviors that place them at risk of HIV infection. These behaviors include frequent experimentation with alcohol and other drugs before sex, sexual activity with different partners, and inconsistent safe-sex practices. The combination of these risky behaviors causes increased concern about the spread of HIV among this age group. The study discussed in this article examined the relationship between substance use during adolescence and HIV risk behavior among young adults ages 19 to 21 with and without a college education. Results indicated that increased use of alcohol and marijuana at younger ages is related to riskier sexual activity and increased use of alcohol and marijuana as young adults. Recommendations for interventions are made.

PIP: A mailed survey was conducted to assess the risky sexual behavior and substance abuse among an initial sample of 2071 young adults in Lexington, Kentucky, during the 1987-88 school year. The survey included specific items about peer relations, family attachment, self-esteem, sensation seeking, friends' drug use, impulsivity, physical health, health and mental health utilization, dieting, delinquency, violence, and risky sexual behavior. A total of 952 (400 males and 552 females) respondents were included in the final analysis. The findings indicate that earlier initiation of sexual activity is related to early involvement with drugs. Furthermore, male participants who used alcohol or marijuana at a younger age engaged in riskier sexual behavior than female participants. Female participants were more likely to use condoms regardless of their early substance use patterns; and those who had never experienced sex or who initiated sex later (ages 19 or 20) were less likely to report lifetime or current drug use. This study indicated that there is a relationship between the early occurrence of substance use and riskier sexual behavior. Recognizing the use of alcohol or marijuana during adolescence may raise practitioners' awareness, helping them identify HIV risk behavior among young adults more accurately.

Training school counselors in substance abuse risk reduction techniques for use with children and adolescents.

A training project prepared school counselors for expanded roles in the prevention, early detection, and appropriate referral of students at high risk of substance abuse. The project trained middle and high school counselors to work as facilitators of support groups for students at greatest risk for substance abuse; the results were: 1) greater perceived self-efficacy, comfort, confidence, and competence by counselors as a result of Initial, Experiential, and Concurrent training, and 2) improved ability to use group counseling techniques as a result of training.

Reducing substance abuse risk factors among children through a teacher as facilitator program.

A Teachers as Facilitators (TAF) Program used classroom teachers as leaders of small groups that promoted social, emotional, and academic development of children at high risk of adopting potentially destructive substance abuse patterns. The program was intended to increase participating students' positive socialization experiences and academic achievement by successfully integrating these students into the school's social system. A longer-range goal was to increase students' sense of worth as it affects their attitudes toward relationships with other people and academic demands. Program results were: 1) school personnel were found capable of accurately identifying and referring to the TAF Program children who were at risk of substance usage and in need of assistance; 2) the TAF Program was effective in improving at-risk students' perceived academic self-concept, but was less effective in increasing students' perceived sense of social support; and 3) the program was endorsed by participating teachers, counselors, and administrators.