An evaluation of California's Adolescent Sibling Pregnancy Prevention Program.
Much evidence has documented the disproportionately dis·pro·por·tion·ate
Out of proportion, as in size, shape, or amount.
dispro·por high rates of adolescent pregnancy adolescent pregnancy See Teenage pregnancy. and childbearing child·bear·ing
Pregnancy and parturition.
childbearing adj. and early sexual activity among the siblings siblings npl (formal) → frères et sœurs mpl (de mêmes parents) of pregnant and parenting teenagers. (1) Concern over this problem led to the creation of the California California (kăl'ĭfôr`nyə), most populous state in the United States, located in the Far West; bordered by Oregon (N), Nevada and, across the Colorado River, Arizona (E), Mexico (S), and the Pacific Ocean (W). Adolescent ad·o·les·cent
Of, relating to, or undergoing adolescence.
A young person who has undergone puberty but who has not reached full maturity; a teenager. Sibling sibling /sib·ling/ (sib´ling) any of two or more offspring of the same parents; a brother or sister.
n. Pregnancy Prevention Program (ASPPP) in 1996. The program is delivered to the brothers and sisters of pregnant and parenting teenagers at 44 nonprofit A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive.
Nonprofits are also called not-for-profit corporations. Nonprofit corporations are created according to state law. social service agencies, community-based organizations, school districts and county health departments across California. * Each program site provides a unique combination of services, including individual case management, academic guidance, training in decision-making decision-making,
n the process of coming to a conclusion or making a judgment.
n a type of informal decision-making that combines clinical expertise, patient concerns, and evidence gathered from skills, job placement, self-esteem self-esteem
Sense of personal worth and ability that is fundamental to an individual's identity. Family relationships during childhood are believed to play a crucial role in its development. enhancement, and contraceptive contraceptive /con·tra·cep·tive/ (-sep´tiv)
1. diminishing the likelihood of or preventing conception.
2. an agent that so acts. and sexuality education. To date, the program has served approximately 6,000 youths. (2)
This article presents the results of an evaluation that had two goals. First, we sought to determine whether program participants showed more favorable fa·vor·a·ble
1. Advantageous; helpful: favorable winds.
2. Encouraging; propitious: a favorable diagnosis.
3. outcomes than comparison youths at the conclusion of the nine-month evaluation. We assessed many outcomes, including the incidence of problem behaviors known to be risk factors for teenage pregnancy teenage pregnancy Adolescent pregnancy, teen pregnancy Social medicine Pregnancy by a ♀, age 13 to 19; TP is usually understood to occur in a ♀ who has not completed her core education–secondary school, has few or no marketable skills, is , adolescents' perceived likelihood that they would engage in pregnancy-related behaviors; and rates of first intercourse INTERCOURSE. Communication; commerce; connexion by reciprocal dealings between persons or nations, as by interchange of commodities, treaties, contracts, or letters. , contraceptive use and pregnancy. Second, we examined whether positive outcomes were related to the content area of services received, their mode of delivery and the dosage dosage /dos·age/ (do´saj) the determination and regulation of the size, frequency, and number of doses.
1. Administration of a therapeutic agent in prescribed amounts. of the intervention A procedure used in a lawsuit by which the court allows a third person who was not originally a party to the suit to become a party, by joining with either the plaintiff or the defendant. . The findings from these analyses will highlight which services were most effective at preventing pregnancy in this high-risk high-risk adjective Referring to an ↑ risk of suffering from a particular condition Infectious disease Referring to an ↑ risk for exposure to blood-borne pathogens, which occurs with blood bank technicians, dental professionals, dialysis unit population.
At the initiation of the evaluation, in May 1997, approximately 3,300 youths were participating in ASPPP. (3) Because of logistic lo·gis·tic also lo·gis·ti·cal
1. Of or relating to symbolic logic.
2. Of or relating to logistics.
[Medieval Latin logisticus, of calculation and time constraints In law, time constraints are placed on certain actions and filings in the interest of speedy justice, and additionally to prevent the evasion of the ends of justice by waiting until a matter is moot. , only a subset A group of commands or functions that do not include all the capabilities of the original specification. Software or hardware components designed for the subset will also work with the original. of active program sites were included in the evaluation. The 16 ASPPP program sites selected to participate in the evaluation ([dagger]) were serving 1,011 clients at the time, or 31% of all clients statewide.
In our selection of program sites to be included in the evaluation, we targeted those sites that would be most representative in terms of geographic region of California, area of residence (urban or rural), and clients' age and race or ethnicity ethnicity Vox populi Racial status–ie, African American, Asian, Caucasian, Hispanic . This effort was partially successful. Although the client gender composition at the selected sites was identical to that of clients served statewide (60% female and 40% male), the 16 evaluation sites were more likely than ASPPP sites overall to be located in an urban area and to serve Hispanics and clients who were younger than the average. Finally, we could not base our selection of evaluation sites on their record of services delivered, because most program sites were still developing their service profiles at the time.
The evaluation involved a group of current participants in ASPPP and a comparison group of youths not in the program. Eligibility criteria for participation in the evaluation (as either a program client or a member of the comparison group) were being aged 11-17 years and three months; having never been pregnant or caused a pregnancy; and having a biological teenage sibling (full or half) who was pregnant or parenting and enrolled in California's Adolescent Family Life Program or Cal-Learn Program. ** The adolescents in the program group needed to be currently enrolled in ASPPP. Youths eligible for ASPPP were often identified through providers' existing caseloads, since most service providers were familiar with the families and siblings of the teenagers already enrolled in their programs.
Youths who participated in the evaluation as part of the comparison group could never have been enrolled in ASPPP, and neither could any of their siblings. Comparison youths were recruited from the waiting lists at the 16 evaluation sites or by outreach Outreach is an effort by an organization or group to connect its ideas or practices to the efforts of other organizations, groups, specific audiences or the general public. , often conducted through a satellite agency of the main ASPPP office.
We expected to enroll equivalent numbers of program clients and comparison youths at each site. (The average number of clients served per site was 63; the range, 20-195.) However, some sites could not meet this expectation because of financial and personnel constraints CONSTRAINTS - A language for solving constraints using value inference.
["CONSTRAINTS: A Language for Expressing Almost-Hierarchical Descriptions", G.J. Sussman et al, Artif Intell 14(1):1-39 (Aug 1980)]. . For example, two sites did not enroll any comparison youths, and two enrolled only a negligible This article or section is written like a personal reflection or and may require .
Please [ improve this article] by rewriting this article or section in an . number (i.e., two or three individuals).
Overall, 1,594 youths were enrolled in the evaluation: 1,011 program clients and 583 comparison youths. Enrollment for the evaluation took approximately 20 months (May 1997 to December 1998). Posttest post·test
A test given after a lesson or a period of instruction to determine what the students have learned. data were collected nine months after enrollment. Usable USable is a special idea contest to transfer US American ideas into practice in Germany. USable is initiated by the German Körber-Stiftung (foundation Körber). It is doted with 150,000 Euro and awarded every two years. posttest information was obtained for 1,271 adolescents, or 80% of those originally enrolled.
Similar proportions of program clients and comparison youths completed a posttest questionnaire (81% and 77%, respectively; [chi-square chi-square (ki´skwar) see under distribution and test.
n. ]=3.7, p<.06). The proportion successfully followed up was comparable for females (81%) and males (77%), and for youths of different races or ethnicities (Hispanics, 81%; blacks, 73%; whites, 76%; and other, 79%). Moreover, the likelihood of completing the posttest questionnaire was not related to several background characteristics, including age, receipt of financial assistance and family size.
The evaluation data reflect only those youths who provided complete pretest pre·test
a. A preliminary test administered to determine a student's baseline knowledge or preparedness for an educational experience or course of study.
b. A test taken for practice.
2. and posttest information. Contrasting the background characteristics of program and comparison youths indicated significant differences by several demographic factors, including age and race or ethnicity. We used two procedures to make the two groups more comparable in terms of both their characteristics and sample size. First, we eliminated all participants from the four sites that provided only three or fewer comparison youths (N=95); thus, the total unweighted sample for analysis from the remaining 12 sites was 1,176, or 731 program clients and 445 comparison youths. Second, we weighted the comparison group data within four sites that provided fewer comparison youths than program youths, but left the data unweighted from the remaining eight evaluation sites; weighting brought the final sample of comparison youths to 735.
In both the program and the comparison groups, the majority of youths were Hispanic Hispanic Multiculture A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race Social medicine Any of 17 major Latino subcultures, concentrated in California, Texas, Chicago, Miam, NY, and elsewhere , from economically disadvantaged This article or section may contain original research or unverified claims.
Please help Wikipedia by adding references. See the for details.
This article has been tagged since September 2007. families and urban residents; they were, on average, nearly 14 years old (Table 1, page 63). Program clients differed significantly from comparison youths on several background variables, however. For example, a significantly higher proportion of program than comparison youths were Hispanic (77% vs. 71%) and spoke Spanish Spanish, river, c.150 mi (240 km) long, issuing from Spanish Lake, S Ont., Canada, NW of Sudbury, and flowing generally S through Biskotasi and Agnew lakes to Lake Huron opposite Manitoulin island. There are several hydroelectric stations on the river. at home (59% vs. 46%). The proportion of youths whose family was receiving aid at the time was significantly higher among comparison youths (75% vs. 66%), as was the mean grade completed by the youths' mother (9.8 vs. 9.3) and the adolescents' current grade (8.3 vs. 8.1).
Program participants and comparison youths had equivalent numbers of brothers (mean, 1.9--not shown) and sisters (2.8). Moreover, youths from both the program and the comparison groups had an equivalent number of sisters who had been pregnant during adolescence adolescence, time of life from onset of puberty to full adulthood. The exact period of adolescence, which varies from person to person, falls approximately between the ages 12 and 20 and encompasses both physiological and psychological changes. (mean, 1.3) and of brothers who had fathered a child as a teenager Teenager
See also Adolescence.
high-school senior has problems with girls and his father. [Am. Drama: O’Neill Ah, Wilderness! in Sobel, 15]
teenaged film character of the 1940s. [Am. (mean, 0.2). (Overall, 73% of the full evaluation sample had one sister who had been pregnant or given birth, 16% had two such sisters and 6% had three or more; 11% overall had one brother who had fathered a child during adolescence and 5% had two or more.)
Forty-nine percent of evaluation participants lived in the Central Valley region of California, 27% in Los Angeles Los Angeles (lôs ăn`jələs, lŏs, ăn`jəlēz'), city (1990 pop. 3,485,398), seat of Los Angeles co., S Calif.; inc. 1850. County and the surrounding sur·round
tr.v. sur·round·ed, sur·round·ing, sur·rounds
1. To extend on all sides of simultaneously; encircle.
2. To enclose or confine on all sides so as to bar escape or outside communication.
n. coastal counties, 13% in Southern California Southern California, also colloquially known as SoCal, is the southern portion of the U.S. state of California. Centered on the cities of Los Angeles and San Diego, Southern California is home to nearly 24 million people and is the nation's second most populated region, , 6% in the San Francisco Bay area “Bay Area” redirects here. For other uses, see Bay Area (disambiguation).
The San Francisco Bay Area, colloquially known as the Bay Area or The Bay and 5% in Northern California Northern California, sometimes referred to as NorCal, is the northern portion of the U.S. state of California. The region contains the San Francisco Bay Area, the state capital, Sacramento; as well as the substantial natural beauty of the redwood forests, the northern . These proportions roughly correspond to the geographic distribution of all clients served by the program.
Survey Procedures and Measures
At enrollment, all participants were interviewed about their family background and completed a 59-item self-administered questionnaire, at their home or the program agency office. The survey instrument was expanded slightly and administered nine months later as a posttest. Program and comparison adolescents completed identical forms at pretest and posttest. Five percent completed their interview and questionnaire in Spanish; these adolescents did not differ on any indicator from those who responded in English. Although program clients were not paid for taking part in the evaluation, comparison youths received a $5 gift certificate for filling out the pretest questionnaire and a $10 gift certificate for completing the posttest form. All respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. (and their parents or guardians) provided written informed consent to participate.
The questionnaire assessed several outcomes relevant to the program, including the incidence of pregnancy, measures of sexual and contraceptive behavior, and variables thought to mediate MEDIATE, POWERS. Those incident to primary powers, given by a principal to his agent. For example, the general authority given to collect, receive and pay debts due by or to the principal is a primary power. adolescent sexual and fertility-related behavior. (4) The survey had a grade-2.5 reading level and an ease of readability read·a·ble
1. Easily read; legible: a readable typeface.
2. Pleasurable or interesting to read: a readable story. score of 87 (out of 100). The mean alpha coefficient coefficient /co·ef·fi·cient/ (ko?ah-fish´int)
1. an expression of the change or effect produced by variation in certain factors, or of the ratio between two different quantities.
2. of scales assessed at both points in time was .78, and all scales had an alpha greater than .68, indicating acceptable internal consistency In statistics and research, internal consistency is a measure based on the correlations between different items on the same test (or the same subscale on a larger test). It measures whether several items that propose to measure the same general construct produce similar scores. . *** For items yielding response scores, increasing scores mean higher frequency, greater perceived likelihood and more consistency. For measures that combined more than one item, the resulting score represents an average of the items.
The 30 questionnaire items considered in the evaluation fell into the following categories:
* Parent-youth communication (two). These items measured how frequently adolescents talked in the last three months with a parent or other adult relative about contraception contraception: see birth control.
Birth control by prevention of conception or impregnation. The most common method is sterilization. The most effective temporary methods are nearly 99% effective if used consistently and correctly. and pressures to have sex (scale, 1-4).
* Perceived likelihood of having sex (four). These items assessed youths' likelihood that they would have sex during the next year, while still in high school, while still a teenager and before marriage (scale, 1-5).
* Perceived likelihood of remaining abstinent (two). At posttest only, adolescents were asked how sure they were that they would remain abstinent during the next year and how likely they were to wait until they were older to have sex (scale, 1-5). All participants were asked these questions, regardless of their sexual experience. The responses thus indicate intentions of secondary abstinence abstinence: see fasting; temperance movements. among sexually experienced youths.
* Perceived likelihood of early parenting (four). These gauged participants' likelihood of becoming a parent during the next year, while still in high school, while still a teenager and before marriage (scale, 1-5).
* Perceived likelihood of contraceptive use (two). These asked about the likelihood that a respondent In Equity practice, the party who answers a bill or other proceeding in equity. The party against whom an appeal or motion, an application for a court order, is instituted and who is required to answer in order to protect his or her interests. and his or her partner would use any contraceptive and, specifically, a condom 1. condom - The protective plastic bag that accompanies 3.5-inch microfloppy diskettes. Rarely, also used of (paper) disk envelopes. Unlike the write protect tab, the condom (when left on) not only impedes the practice of SEX but has also been shown to have a high failure , if they were to have sexual intercourse sexual intercourse
or coitus or copulation
Act in which the male reproductive organ enters the female reproductive tract (see reproductive system). (scale, 1-5).
* Truancy (two). Respondents were questioned on how frequently in the last three months they had cut a class and had cut a whole day of school (scale, 0-4).
* Drug or alcohol use (four). Participants were asked how many times during the last three months they had smoked cigarettes; drunk beer, wine or liquor liquor /li·quor/ (lik´er) (li´kwor) pl. liquors, liquo´res [L.]
1. a liquid, especially an aqueous solution containing a medicinal substance.
2. ; smoked marijuana marijuana or marihuana, drug obtained from the flowering tops, stems, and leaves of the hemp plant, Cannabis sativa (see hemp) or C. indica; the latter species can withstand colder climates. ; and used drugs other than marijuana, such as crack cocaine (scale, 0-4).
* Gang activity (one). This item asked how often during the last three months the adolescent had been part of a gang or gang activity (scale, 0-4).
* Sexual behavior sexual behavior A person's sexual practices–ie, whether he/she engages in heterosexual or homosexual activity. See Sex life, Sexual life. (three). Youths were asked whether they had ever had voluntary vaginal vag·i·nal
1. Of or relating to the vagina.
2. Relating to or resembling a sheath.
pertaining to the vagina, the tunica vaginalis testis, or to any sheath. intercourse (0=no, 1=yes). (The questionnaire specified voluntary intercourse to distinguish between willful Intentional; not accidental; voluntary; designed.
There is no precise definition of the term willful because its meaning largely depends on the context in which it appears. and coerced pregnancy risk behavior.) Sexually experienced respondents also indicated how often they had had intercourse in the last three months and their total number of sexual partners.
* Contraceptive behavior (three). Sexually experienced youths were asked how consistently they had practiced contraception (scale, 1-5); what method they had used most often; and whether they had used a method at last intercourse (0=no, 1=yes).
* Pregnancy and sexually transmitted disease sexually transmitted disease (STD) or venereal disease, term for infections acquired mainly through sexual contact. Five diseases were traditionally known as venereal diseases: gonorrhea, syphilis, and the less common granuloma inguinale, (STD (Subscriber Trunk Dialing) Long distance dialing outside of the U.S. that does not require operator intervention. STD prefix codes are required and billing is based on call units, which are a fixed amount of money in the currency of that country. ) history (three). All respondents were asked whether they had ever been pregnant or impregnated im·preg·nate
tr.v. im·preg·nat·ed, im·preg·nat·ing, im·preg·nates
1. To make pregnant; inseminate.
2. To fertilize (an ovum, for example).
3. anyone (0=no and 1=yes); their age at that time; and whether they had ever had an STD.
At pretest, young women in the program and comparison groups were similar on all indicators except the perceived likelihood of contraceptive use (Table 2). Males in the comparison group were significantly more certain than male program clients that they would have sex in the near future and had recently been truant significantly less often; those who were sexually experienced had used contraceptives more consistently. Once we entered controls for the youths' grade level, however, all of these differences--among females as well as males--lost statistical significance.
Description of Services
No specific program services were required of providers, other than at least one face-to-face contact with every client every month. Program personnel were expected to implement a variety of services, to prevent pregnancy and related risk behaviors. **** Two sample programs, which are profiled in the appendix (page 70), provide a sense of what services may be involved.
The evaluation involved monitoring the services that program clients received at all of the sites. Providers were required to note the following at every client encounter: duration of service (dosage); service mode, or how it was delivered (i.e., case management, group activity, one-on-one mentoring, individual counseling, formal therapy, video or other means); and service domain, or broad content area (i.e., community service or recreational activity, psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects.
Involving aspects of both social and psychological behavior. skills, job skills or school issues, and sexuality and health issues).
On average, program clients received 18.4 hours of services over the evaluation period Evaluation period
The time interval over which funds assess a money manager's performance. (range, 45 minutes to more than 95 hours), or approximately two hours per month. To simplify our analysis of service impact, we reduced the 16 possible service domain categories to four on the basis of services that are related or typically delivered together. Thus, over the nine-month evaluation, clients received an average of seven hours of services devoted to improving their psychosocial skills, five hours of sexuality and health education, and four hours each of community service or recreational activities and help with school and job issues (Table 3, page 65).
Clients received, on average, 11 hours of individual services and seven hours of group activities over the evaluation period. (We excluded from the analysis services that included showing videos and "other" modes of delivery, because of the small number of service hours involved.) The number of group service hours correlated cor·re·late
v. cor·re·lat·ed, cor·re·lat·ing, cor·re·lates
1. To put or bring into causal, complementary, parallel, or reciprocal relation.
2. minimally with the number of one-on-one hours (r=.12); thus, these measures appear to be assessing separate aspects of service delivery.
Compared with males, females received significantly more total service hours (20.1 vs. 15, p<.001) and participated in significantly more hours of one-on-one services (12.4 vs. 7.9); however, the number of hours of group activities did not differ by gender. The mode of service delivery did not vary by clients' race or ethnicity, but one-on-one services were positively correlated with age (r=.15), whereas group activities were negatively associated with age (r=-.11). Thus, older clients were likely to receive many hours of individual services, whereas younger clients were likely to receive services within a group.
Receipt of Nonprogram Services
At the posttest interview, we asked all evaluation participants if, in the past nine months, they had received any nonprogram services, such as through school, church or synagogue synagogue (sĭn`əgŏg) [Gr.,=assembly], in Judaism, a place of assembly for worship, education, and communal affairs. The origins of the institution are unclear. One tradition dates it to the Babylonian exile of the 6th cent. B.C. ; organizations such as the Girl Scouts Girl Scouts, recreational and service organization founded (1912) in Savannah, Ga., by Mrs. Juliette Gordon Low (1860–1927). It was originally modeled after the Boy Scouts and Girl Guides, organizations created in Great Britain by Sir Robert Baden-Powell during or Boy Scouts Boy Scouts, organization of boys 11 to 17 years old, founded (1907) in Great Britain by Sir Robert (later Lord) Baden-Powell. It was incorporated in 1910 in the United States, where its appearance was connected with earlier organizations—the Sons of Daniel ; or a community center or agency (e.g., Boys' and Girls' Clubs). We also asked that respondents specify which of the following seven domains best described those services: sexuality education, drug and alcohol use prevention, contraception, violence prevention and gang activity, communication with parents, STDs (including HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. and AIDS) and how to handle peer pressure.
A significantly higher proportion of comparison adolescents than of program youths received any nonprogram services (63% vs. 50%; [chi square chi square (kī),
n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] =24.61, p<.001). Relative to program clients, comparison youths also received other services in a higher average number of topic areas (2.9 vs. 2.2; t=4.56, p<.001). Because these services address key pregnancy prevention issues, we used the receipt of supplemental services (summed across the seven topic domains) as a statistical control in the analyses comparing clients and nonprogram youths, and as an independent variable in interaction with group status (program or comparison) in other analyses.
Analytic an·a·lyt·ic or an·a·lyt·i·cal
1. Of or relating to analysis or analytics.
2. Expert in or using analysis, especially one who thinks in a logical manner.
3. Psychoanalytic. Procedures
To contrast the program and comparison groups, we calculated change scores for the outcome variables from pretest to posttest-that is, the measure's value assessed at posttest, minus the value assessed at pretest. A positive change score indicates an increase in that variable from pretest to posttest, and a negative change score indicates a decrease.
We then contrasted these change scores by group, using analysis of covariance Covariance
A measure of the degree to which returns on two risky assets move in tandem. A positive covariance means that asset returns move together. A negative covariance means returns vary inversely. tests when the dependent variables were continuous and we needed to statistically control for a variety of factors (e.g., extent of nonprogram services and differences in the adolescents' background characteristics at pretest). We used logistic regressions In statistics, logistic regression is a regression model for binomially distributed response/dependent variables. It is useful for modeling the probability of an event occurring as a function of other factors. when the outcome variables were categorical That which is unqualified or unconditional.
A categorical imperative is a rule, command, or moral obligation that is absolutely and universally binding.
Categorical is also used to describe programs limited to or designed for certain classes of people. rather than scales or scores (such as the proportions who first had sex during the evaluation period, who experienced or caused a pregnancy, who used contraceptives at last sex and who had an STD). When change scores were unavailable because data were collected at only one point (e.g., abstinence intentions were assessed at posttest only), we compared the posttest scores of program clients and comparison youths, using analysis of covariance or logistic regression, depending on the coding of the variable. All the analyses controlled for the cumulative number of domains of nonprogram services received and for background characteristics that differed significantly by group at intake (i.e., grade level, ethnicity, language spoken at home, family's receipt of financial assistance and mother's educational level). We conducted separate analyses for males and females, both to discern dis·cern
v. dis·cerned, dis·cern·ing, dis·cerns
1. To perceive with the eyes or intellect; detect.
2. To recognize or comprehend mentally.
3. gender-specific program effects and because male and female program participants received different levels and types of services. We present F values and odds ratios only for variables that were significant.
We next ran additional analyses of covariance and logistic regressions that tested for interactions between group status (comparison vs. program) and additional services received (many vs. few or none). We based our categorization on the median number of domains in which males and females received additional services. Thus, for young women, "few or no outside services" was defined as having received nonprogram services in two or fewer topic areas, whereas "many" corresponded to three or more. Among young men, those who received no outside services were categorized cat·e·go·rize
tr.v. cat·e·go·rized, cat·e·go·riz·ing, cat·e·go·riz·es
To put into a category or categories; classify.
cat as having received "few or no outside services," whereas the receipt of outside services in one or more areas corresponded to "many." These analyses controlled for the same background variables as the original analyses.
To examine whether positive outcomes were related to the receipt of specific services, we computed Pearson-listwise correlations between the hours of service received in the four service domains and the two service modes and the program outcomes. Correlations were computed first for all program clients (statistically controlling for youths' gender and age) and then separately for each gender (statistically controlling for age). The correlations by gender highlight which services may be particularly effective for males and for females.
Overall, participation in the sibling pregnancy prevention program appears to have been associated with positive outcomes, especially among females. For example, program females' truancy frequency score declined from pretest to posttest, while it rose among nonprogram females (Table 4); program participants scored significantly higher than comparison females on their abstinence intentions score at posttest. Moreover, a significantly lower proportion of program than of comparison females first had sex over the nine-month period (7% vs. 16%) and experienced a pregnancy in that interval (4% vs. 7%). Results of the logistic regressions performed with these data (not shown) show that the odds of initiating sexual activity over the evaluation period were significantly elevated among comparison females relative to program females (odds ratio, 1.5; 95% confidence interval confidence interval,
n a statistical device used to determine the range within which an acceptable datum would fall. Confidence intervals are usually expressed in percentages, typically 95% or 99%. , 1.09-1.94), and the odds of becoming pregnant were significantly higher among comparison than program females (odds ratio, 1.6; 95% confidence interval, 1.07-2.52).
Only one significant difference emerged between program and comparison males at posttest: Males enrolled in the program increased their consistency of contraceptive use from pretest to posttest, while comparison males used contraceptives less consistently over time.
Effects of Nonprogram Services
When we tested for interactions between group status (program or comparison) and the receipt of nonprogram services, two significant interaction effects emerged for each gender (Table 5). Among program males, those who received nonprogram services in one domain or more had more definite intentions of abstaining from sex than those who received no outside services at all. All other interactions centered on the comparison group. Comparison group males who received many outside services experienced greater declines in their frequency of gang activities from pretest to posttest than did those who received no supplemental services. Similarly, among comparison females, those who received many outside services perceived sex in the near future to be significantly less likely to occur, and used drugs and alcohol less frequently, than females who received relatively few nonprogram services.
Effects of Type and Mode of Services
Our assessment of whether the receipt of services in specific domains was associated with changes in program outcomes revealed many significant correlations, both among program clients overall and among male and female participants separately. Because of the relatively large sample size and the large number of correlations computed, we focus on those that were highly significant.
At p<.01 or higher, the receipt of an increasing number of hours of school and job-related services was correlated with reductions in the frequency of skipped classes over time among males and with more consistent contraceptive use over time among females (Table 6, page 68). More hours of sexuality or health education were related to declines from pretest to posttest in the perceived likelihood of early parenting among all program clients (and among males separately), but also to decreases in males' perceived likelihood of remaining abstinent.
The receipt of psychosocial services was positively related to contraceptive use at most recent sex among all program clients. Psychosocial services were also correlated with reduced truancy among males but with increased truancy among females, and with a reduced perceived likelihood of early parenting among females. The number of hours of community and recreational activities was associated only with males' more definite intentions to be abstinent.
Services delivered in a one-on-one context were related to reductions in adolescents' perceived likelihood of early parenting among all program clients (and males and females separately), as well as to declines in gang activity among all program clients and in truancy among males. Finally, services delivered in a group setting were related to greater certainty of contraceptive use among all program clients (and among females separately), and to a greater certainty among males that they would remain abstinent. The receipt of group services also was correlated with a delay in sexual debut among males.
Even at p<.05, negative associations emerged between content area and delivery modes and measures of sexual activity (for all clients), measures of truancy (for males) and measures of intentions of early parenting (for females). We found positive correlations Noun 1. positive correlation - a correlation in which large values of one variable are associated with large values of the other and small with small; the correlation coefficient is between 0 and +1
direct correlation at p<.05 between content area and contraceptive use at last sex (for females) and between content area and contraceptive intentions and sexual initiation (for females), as well as a positive correlation between one-on-one service delivery and contraceptive use at last sex (for all clients).
DISCUSSION AND CONCLUSIONS
Our results suggest that participation in ASPPP was associated with several favorable outcomes, particularly among female clients. Most notable was the significantly lower pregnancy rate among program females than comparison females (4% vs. 7%). This difference translates to a 43% reduction in pregnancy. Applying such a potential decrease to all 3,600 young women who have been served by ASPPP to date (5) could have a meaningful impact on rates of teenage pregnancies and births in California, and mean far lower costs for services for pregnant and parenting teenagers throughout the state. Certainly, ASPPP and other special programs that systematically focus prevention efforts on high-risk individuals hold great promise for continuing the trend toward lower teenage birthrates in the country; such programs should be considered an integral component of any national pregnancy prevention policy.
Very few males overall reported impregnating a partner over the evaluation period, so there were no differences in these rates by group. These negligible rates of causing a pregnancy may reflect a variety of factors, such as the low overall rates of fatherhood among young men in this age-group. For example, the Youth Risk Behavior Surveillance Survey found that only 4% of males in grades 9-12 had caused a pregnancy. (6) Additionally, the presumably pre·sum·a·ble
That can be presumed or taken for granted; reasonable as a supposition: presumable causes of the disaster. young female partners of these males (who averaged 14 years of age) may be less likely than older women to have informed their partner of a pregnancy. Moreover, these young men may be less likely than older men to admit to themselves that they had gotten someone pregnant and thus be less likely to report it.
Significantly lower proportions of program than of comparison females first had sex during the evaluation period. This difference is a key indicator of success. Young age at sexual onset is a known risk factor for teenage pregnancy; thus, if program services can delay sexual initiation, pregnancy will be avoided or at least delayed.
When contrasted with females in the comparison group, program females were more certain, at posttest, that they would remain abstinent Further, program females cut classes less frequently from pretest to posttest, whereas females in the comparison group increased their frequency of truant behavior over this period. Among males, only one significant difference emerged between program clients and comparison youths: ASPPP males used contraceptives more consistently from pretest to posttest, whereas those in the comparison group used contraceptives less consistently over that period. All of these differences were in the desired direction and are key measures of program success.
The effects of the receipt of nonprogram services were only nominal among program participants, but were more important among comparison youths. These findings illustrate that benefits accrue To increase; to augment; to come to by way of increase; to be added as an increase, profit, or damage. Acquired; falling due; made or executed; matured; occurred; received; vested; was created; was incurred. for youths who are not part of an organized state program, but who receive many services in diverse community settings. In these cases, a "saturation saturation, of an organic compound
saturation, of an organic compound, condition occurring when its molecules contain no double or triple bonds and thus cannot undergo addition reactions. " of services across multiple contexts likely reinforces the prevention message and helps forge forge
Open furnace for heating metal ore and metal for working and forming, or a workshop containing forge hearths and related equipment. From earliest times, smiths (see smithing) heated iron in forges and formed it by hammering on an anvil. social norms that shun Shun
In Chinese mythology, one of the three legendary emperors, along with Yao and Da Yu, of the golden age of antiquity (c. 23rd century BC), singled out by Confucius as models of integrity and virtue. risky and unhealthy behaviors. (7) Thus, although comparison youths did not necessarily fare better overall than program youths, those who received many community services fared better than those who received minimal or no community services in terms of females' reductions in frequency of drug and alcohol use and perceived likelihood of sex, and in males' reductions in gang activity.
Our study also identified types of services that were especially effective in enhancing positive outcomes. The receipt of group services was correlated with delayed sexual debut among males, and services that strengthen psychosocial skills were correlated with increased contraceptive use among sexually active youths.
A few unexpected findings emerged in which program services were correlated with an unfavorable outcome. For example, the receipt of sexuality or health education was correlated with less certainty of remaining abstinent among males and with recent sexual debut among females (at p<.05). The most plausible interpretation may be that males with little intention of being abstinent and females who had only recently started having sex were specifically targeted to receive many hours of sexuality or health education. The finding of a positive correlation between training in psychosocial skills and females' frequency of truancy most likely reflects the same kind of tailoring of service to need (i.e., females who often cut classes were targeted to receive many hours of psychosocial services).
That the correlation between psychosocial services and truancy was in the opposite direction among males is puzzling puz·zle
v. puz·zled, puz·zling, puz·zles
1. To baffle or confuse mentally by presenting or being a difficult problem or matter.
2. . One possible explanation is that service providers were more reactive reactive /re·ac·tive/ (re-ak´tiv) characterized by reaction; readily responsive to a stimulus.
1. Tending to be responsive or to react to a stimulus.
2. (and less proactive) with female clients than with male clients. ***** Alternatively, these results may reveal that different services work differently for each gender. In any case, repeated assessments of measures throughout the evaluation period would have been useful to verify (1) To prove the correctness of data.
(2) In data entry operations, to compare the keystrokes of a second operator with the data entered by the first operator to ensure that the data were typed in accurately. See validate. these conjectures This is an incomplete list of mathematical conjectures. They are divided into four sections, according to their status in 2007.
The variability in the number of service hours that clients received is also noteworthy. Although the total amount of services received averaged 18 hours over the evaluation period, it ranged from 45 minutes to 95 hours. Moreover, the number of hours received in each service domain and mode varied by clients' gender and age. These findings of variations by client characteristics suggest that providers did not deliver services in a vacuum, but focused on the needs and characteristics of each client. An approach based on individual needs can be a sound and successful pregnancy prevention strategy, particularly because different factors likely influence the pregnancy-related risk behaviors of older and younger adolescents and of male and female adolescents, (8) The different levels of service offered and the individually tailored nature of service delivery are important components of this program and should be considered in its replication In database management, the ability to keep distributed databases synchronized by routinely copying the entire database or subsets of the database to other servers in the network.
There are various replication methods. .
Several potential limitations of this study should be mentioned. First, the evaluation period--nine months--was relatively short. Most clients participate in the program for a longer period (sometimes a year or more), so the changes captured here likely underestimate what most clients ultimately experience. A longer study period may uncover long-term effects that are not yet evident among these fairly young adolescents (i.e., 14 years old, on average). Unrealized benefits may include impacts on rates of high school graduation Graduation is the action of receiving or conferring an academic degree or the associated ceremony. The date of event is often called degree day. The event itself is also called commencement, convocation or invocation. and college attendance, and reductions in pregnancy rates in the middle and later teenage years, when most adolescent pregnancies occur. (9) Of course, program effects may also decay The reduction of strength of a signal or charge.
decay - [Nuclear physics] An automatic conversion which is applied to most array-valued expressions in C; they "decay into" pointer-valued expressions pointing to the array's first element. over time.
Second, individuals were not randomly assigned as·sign
tr.v. as·signed, as·sign·ing, as·signs
1. To set apart for a particular purpose; designate: assigned a day for the inspection.
2. to program and comparison groups, so the adolescents who were recruited into the program might have had a different pregnancy risk than those who made up the comparison group. To avoid this potential bias, randomization randomization (ranˈ·d·m would have been preferable. Third, the evaluation sample was predominantly pre·dom·i·nant
1. Having greatest ascendancy, importance, influence, authority, or force. See Synonyms at dominant.
2. Hispanic. Different outcomes might have resulted if the program had served a different population; thus, caution should be exercised when generalizing beyond the evaluation sample.
A definite strength of the evaluation, however, is that all participants had siblings who had been pregnant or had been a parent. (Since program and comparison youths had equivalent numbers of these siblings, the known higher risk associated with having many such siblings was not an issue. (10)) Thus, all participants were at very high risk of early sexual activity and pregnancy, and of problem behaviors such as alcohol and drug use. (11) The risks for this population likely derive from the adolescent's family background (e.g., having permissive permissive adj. 1) referring to any act which is allowed by court order, legal procedure, or agreement. 2) tolerant or allowing of others' behavior, suggesting contrary to others' standards.
PERMISSIVE. parents) and environment (e.g., neighborhood conditions of poverty, lack of job opportunities and community norms that accept early and unwed parenting unwed parent Social medicine A person who is not married at the time of delivering a child ). A sibling's pregnancy and parenthood may also affect these youths. For example, an adolescent may model the behavior of a sister who gave birth, the adolescent's mother may be less available to monitor her children, and family stress and financial hardship may increase when a teenager has become pregnant or given birth. (12) Any changes in attitudes and behaviors that occurred from pretest to posttest among these sibling clients should, therefore, be considered within this context.
In summary, California's special sibling program was effective at reducing the pregnancy rate and several pregnancy-related risk behaviors in this high-risk sample. Targeting intervention efforts at high-risk youths has been a recommended approach to teenage pregnancy prevention. (13) Although such specially targeted programs are certainly a challenge to implement, they hold great promise for significantly lowering rates of teenage pregnancy and births.
Appendix--Description of Two Sample ASPPP Programs
Stand Tall and Achieve Responsibility (STAR)
* Site. County of Santa Cruz Santa Cruz, city, United States
Santa Cruz (săn`tə krz), city (1990 pop. 49,040), seat of Santa Cruz co., W Calif., on the north shore of Monterey Bay; inc. 1866. Health Services health services Managed care The benefits covered under a health contract Agency.
* Stated goals. To support teenagers in delaying childbearing; help youths do well in school; and help youths be physically healthy.
* Underlying objectives. That youths see themselves as important and valued persons; have a positive, optimistic op·ti·mist
1. One who usually expects a favorable outcome.
2. A believer in philosophical optimism.
op life outlook; have healthy and positive goals and expectations; develop trusted, positive relationships with caring adults; and enjoy themselves and have fun. Utilizes a youth development approach.
* Strategies. In areas of sex and contraception--counsel about abstinence and contraception; provide access to quality reproductive health Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene care; take clients to a health or medical clinic, if needed; provide rewards for not having sex or for being responsible about using contraceptives; and incorporate goal-setting concepts. In schooling and job skills--connect clients with tutors and help with homework; help with writing and typing school reports; take clients to the library to do research; help students deal with teachers and connect with school counselor A school counselor is a counselor and educator who works in schools, and have historically been referred to as "guidance counselors" or "educational counselors," although "Professional School Counselor" is now the preferred term. ; help clients prepare a resume; advocate at expulsion EXPULSION. The act of depriving a member of a body politic, corporate, or of a society, of his right of membership therein, by the vote of such body or society, for some violation of hi's. and court hearings; and meet with teachers and principal. In the areas of health and general well-being--make appointments and take youths to doctor, dentist dentist /den·tist/ (den´tist) a person with a degree in dentistry and authorized to practice dentistry.
A person who is trained and licensed to practice dentistry. , optometrist optometrist /op·tom·e·trist/ (op-tom´e-trist) a specialist in optometry.
A medical professional who examines and tests the eyes for disease and treats visual disorders by prescribing corrective , sports exams and vaccine vaccine
Preparation containing either killed or weakened live microorganisms or their toxins, introduced by mouth, by injection, or by nasal spray to stimulate production of antibodies against an infectious agent. updates; sign up clients for medical insurance; provide access to sports teams, games and swimming program at local high school; help teenagers recognize media pressure for fashion and thinness; educate clients about healthy eating and exercise; and go on field trips and engage in group activities to strengthen social skills and competence in new situations.
* Program structure. Throughout the first year of operation, one full-time program staff person for a 35-client caseload case·load
The number of cases handled in a given period, as by an attorney or by a clinic or social services agency.
* Program successes after one year of operation. No pregnancies; no STDs; extremely low program dropout (1) On magnetic media, a bit that has lost its strength due to a surface defect or recording malfunction. If the bit is in an audio or video file, it might be detected by the error correction circuitry and either corrected or not, but if not, it is often not noticed by the human rate; and more than 50% attendance on field trips and outings.
San Bernardino San Bernardino, city, United States
San Bernardino (săn bûr'nədē`nō), city (1990 pop. 164,164), seat of San Bernardino co., S Calif., at the foot of the San Bernardino Mts.; inc. 1854. County Siblings Program
* Site. County of San Bernardino Department of Public Health.
* Stated goals. To prevent pregnancy; promote healthy lifestyles; and inspire and empower empower verb To encourage or provide a person with the means or information to become involved in solving his/her own problems young people and their families toward self-discovery, positive personal growth, goal attainment and self-sufficiency.
* Strategies. Sibling groups meet bimonthly bi·month·ly
1. Happening every two months.
2. Happening twice a month; semimonthly.
1. Once every two months.
2. Twice a month; semimonthly.
n. pl. to participate in sports, visit museums and historical places, visit colleges or vocational schools, and participate in sociocultural so·ci·o·cul·tur·al
Of or involving both social and cultural factors.
soci·o·cul events and volunteer activities. Each event is structured and developed with specific goals and objectives to build youths' self-esteem and internal strengths by exposing them to opportunities that increase their skills in decision-making, problem-solving, goal-setting and communication. Program staff identify and build on existing strengths and accomplishments, provide a sense of belonging, and advocate, educate and counsel when needed.
* Program structure. In the first year of operation, three social workers and two public health nurses provided case management for approximately 200 youths.
* Program successes after the first year of operation. Program attendance has resulted in reductions in rates of teenage pregnancies and truancy. Eighty-seven percent of program participants are enrolled in school and attend regularly.
TABLE 1. Percentage distributions and means reflecting selected background characteristics at enrollment of participants in the Adolescent Sibling Pregnancy Prevention Program and comparison youths, California, 1997-1998 Characteristic Program Comparison (N=731) (N=735) % DISTRIBUTIONS Race/ethnicity Hispanic 77.0 71.4 * Black 9.5 11.3 White 8.1 8.6 Other 5.4 8.6 Speaks Spanish at home Yes 59.0 46.0 *** No 41.0 54.0 Family currently receives aid ([dagger]) Yes 66.2 75.1 * No 20.4 18.2 No response 13.4 6.7 Area of residence Urban 71.0 66.9 Suburban 12.0 15.0 Rural 17.0 18.1 Gender Female 59.0 59.0 Male 41.0 41.0 Mother currently married Yes 52.0 48.0 No 48.0 52.0 Two-parent household Yes 52.9 51.0 No 47.1 49.0 Total 100.0 100.0 MEANS Current grade ([double dagger]) 8.1 8.3 * Age 13.5 13.6 Mother's last grade complete 9.3 9.8 ** Mother's age at first birth 19.1 19.2 * Groups differ significantly at p<.05. ** Groups differ significantly at p<.01. *** Groups differ significantly at p<.001. ([dagger]) Denotes any kind of government assistance. ([double dagger]) For the 1% of adolescents who were no longer in school, the last grade attended was considered in the calculation of the mean. Note: Comparison group N is weighted. (Unweighted N was 445.) TABLE 2. Means and percentage distributions reflecting evaluation outcomes assessed at pretest among program and comparison youths, by gender Outcome Females Program Com- (N=432) parison (N=430) MEANS Parent-youth communi- cation (scale, 1-4) ([dagger]) 2.0 2.0 Perceived likelihood of having sex (scale, 1-5) ([double dagger]) 2.0 2.0 Perceived likelihood of early parenting (scale, 1-5) ([double dagger]) 1.6 1.6 Perceived likelihood of contraceptive use (scale, 1-5) ([double dagger]) 4.5 4.7 * Truancy (scale, 0-4) ([section]) 0.8 0.7 Drug/alcohol use (scale, 0-4) ([section]) 0.5 0.5 Gang activities (scale, 0-4) ([section]) 0.1 0.2 No. of times had sex in last 3 mos. (range, 1-35) ([dagger][dagger]) 3.1 3.0 Lifetime no. of partners (range, 1-20) ([dagger][dagger]) 1.9 2.2 Consistency of contra- ceptive use in last 3 mos. (scale, 1-5) ([dagger][dagger]),([double dagger][double dagger]) 4.0 3.7 % DISTRIBUTIONS Ever had sex No 82.6 84.2 Yes 13.9 15.6 No response 3.5 0.2 Used contraceptive at last sex ([dagger][dagger]) No 15.0 11.6 Yes 71.7 55.1 No response 13.3 33.3 Ever had an STD ([dagger][dagger]) No 90.0 72.5 Yes 10.0 11.6 No response 0.0 15.9 Total 100.0 100.0 Outcome Males Program Com- (N=299) parison (N=305) MEANS Parent-youth communi- cation (scale, 1-4) ([dagger]) 1.8 1.7 Perceived likelihood of having sex (scale, 1-5) ([double dagger]) 2.5 2.8 * Perceived likelihood of early parenting (scale, 1-5) ([double dagger]) 1.8 1.8 Perceived likelihood of contraceptive use (scale, 1-5) ([double dagger]) 4.4 4.4 Truancy (scale, 0-4) ([section]) 0.8 0.6 * Drug/alcohol use (scale, 0-4) ([section]) 0.5 0.5 Gang activities (scale, 0-4) ([section]) 0.2 0.2 No. of times had sex in last 3 mos. (range, 1-35) ([dagger][dagger]) 2.6 2.8 Lifetime no. of partners (range, 1-20) ([dagger][dagger]) 3.5 3.0 Consistency of contra- ceptive use in last 3 mos. (scale, 1-5) ([dagger][dagger]),([double dagger][double dagger]) 3.4 4.1 * % DISTRIBUTIONS Ever had sex No 84.0 82.6 Yes 12.7 14.8 No response 3.3 2.6 Used contraceptive at last sex ([dagger][dagger]) No 18.0 20.0 Yes 56.4 62.2 No response 25.6 17.8 Ever had an STD ([dagger][dagger]) No 94.9 100.0 Yes 0.0 0.0 No response 5.1 0.0 Total 100.0 100.0 * Within gender, program group differs significantly from comparison group at p<.05. None of the differences retained significance, however, after grade level was controlled for. ([dagger]) Score of frequency of parent-youth communication in last three months, where 1=never, 2=once, 3=2-3 times and 4=more than three times. ([double dagger]) Higher scores on the scale indicate increasing certainty that event asked about will occur, where 1=sure it will not happen, 2=probably will not happen, 3=not sure, 4=probably will happen and 5=sure it will happen. ([section]) Score of frequency of outcome in the last three months, where 0=never, 1=once, 2=2-3 times, 3=4-10 times and 4=more than 10 times. When outcomes were assessed through more than one item, score is the average across all items. ([dagger][dagger]) Based on sexually experienced respondents only. ([double dagger][double dagger]) Consistency score, where 1=never, 2=rarely, 3=sometimes, 4=most of the time and 5=always. Note: All scores and contrasts included weighted data for the comparison group. TABLE 3. Mean number of hours (and standard deviations) of services received, by service domain and mode Service domain and mode Mean DOMAIN Psychosocial 6.5 (7.3) Dealing with peer pressure 1.1 (1.7) Decision-making skills 0.9 (1.1) Life skills 0.7 (1.8) Stress/anger management 0.7 (1.0) Gang prevention 0.6 (1.0) Self-esteem 1.5 (2.4) Relationship with parents 1.0 (1.4) Sexuality/health 4.5 (5.0) Sexuality education 0.9 (1.1) HIV/AIDS education 0.8 (1.1) STD (non-HIV) education 0.9 (1.2) Contraceptive education and services 0.9 (1.1) Abstinence education 1.0 (1.1) Activities 3.8 (4.1) Community service 0.3 (0.9) Recreation 3.5 (3.9) School/job 3.5 (4.0) School issues 2.7 (3.3) Job skills 0.9 (1.1) MODE One-on-one 10.6 (11.5) Group 7.4 (10.1) Note: The 16 service domains were grouped into four overarching service categories for ease of analysis. TABLE 4. Changes in scores from pretest to posttest, percentages of youths engaging in selected behaviors during the evaluation period and outcomes assessed at posttest only, by group and gender Outcome Females Program Comparison Changes in scores Parent-youth communication .07 .28 Perceived likelihood of having sex .12 .22 Perceived likelihood of early parenting .06 .15 Perceived likelihood of contraceptive use .09 -.04 Truancy -.12 .18 ** Drug/alcohol use -.09 -.08 Gang activities -.09 -.09 Consistency of contraceptive user -.39 .14 Percentages over evaluation period Had first sex 7.4 16.0 ** Became pregnant/caused a pregnancy 3.7 6.5 * Posttest measures Perceived likelihood of abstaining from sex (scale, 1-5) 4.3 4.0 * No. of times had sex in last 3 mos. ([dagger]) 6.5 3.9 Consistency of contraceptive use in last 9 mos. (scale, 1-5) ([dagger]) 3.5 3.7 % used contraceptive at last sex ([dagger]) 77.4 55.8 No. of partners in last 9 mos. ([dagger]) 1.5 1.7 % had an STD in last 9 mos. ([dagger]) 6.8 9.3 Outcome Males Program Comparison Changes in scores Parent-youth communication .08 .13 Perceived likelihood of having sex .26 -.04 Perceived likelihood of early parenting .06 -.07 Perceived likelihood of contraceptive use .07 .17 Truancy -.04 .02 Drug/alcohol use -.08 -.04 Gang activities -.06 -.18 Consistency of contraceptive user .38 -.18 ** Percentages over evaluation period Had first sex 11.7 11.5 Became pregnant/caused a pregnancy 0.7 1.3 Posttest measures Perceived likelihood of abstaining from sex (scale, 1-5) 3.8 3.9 No. of times had sex in last 3 mos. ([dagger]) 4.2 3.7 Consistency of contraceptive use in last 9 mos. (scale, 1-5) ([dagger]) 4.0 4.0 % used contraceptive at last sex ([dagger]) 59.2 53.3 No. of partners in last 9 mos. ([dagger]) 2.0 2.0 % had an STD in last 9 mos. ([dagger]) 1.4 0.0 * Within gender, program youths differed significantly from comparison youths at p<.05. ** Within gender, program youths differed significantly from comparison youths at p<.01. ([dagger]) Based on sexually experienced respondents only. Notes: Analyses of covariance (ANCOVA) included weighted data for the comparison group and controlled for cumulative receipt of nonprogram services and background characteristics that differed significantly at intake. Among females, ANCOVA produced F values of 7.09 (df=1 and 639) for significant difference between program and comparison youths in change in truancy, and 4.68 (df=1 and 662) for significant difference in perceived likelihood of abstaining at posttest. Among males, F value was 7.18 (df=1 and 57) for significant difference between program and comparison youths in change in consistency of contraceptive use from pretest to posttest. TABLE 5. Means for selected outcomes, by number of non-program services received, according to gender and group Outcome Many ([dagger]) Few or none ([double dagger]) MALES Posttest likelihood of abstinence Program ** 4.02 3.64 Comparison 3.94 3.91 F=8.55 (df=-1 and 426) Change in frequency of gang activities Program -.01 -.11 Comparison ** -.20 -.12 F=7.21 (df=-1 and 426) FEMALES Change in perceived likelihood of sex Program .09 .14 Comparison * .12 .36 F=3.93 (df=-1 and 666) Change in frequency of drug/alcohol use Program -.09 -.09 Comparison *** -.27 .05 F=10.40 (df=1 and 637) * Within gender and group, difference by receipt of nonprogram services is significant at p<.05. ** Within gender and group, difference by receipt of nonprogram services is significant at p<.01. *** Within gender and group, difference by receipt of nonprogram services is significant at p<.001. ([dagger]) Defined as receipt of nonprogram services in one or more topic areas for males and in three or more for females. ([double dagger]) Defined as receipt of no nonprogram services for males and of nonprogram services in two or fewer topic areas for females. Note: The F values are for the group by nonprogram services interaction. TABLE 6. Significant correlation coefficients from analyses assessing the relationship between service domain and mode of delivery and evaluation outcomes, by gender Gender and outcome Domain School/ Sexuality/ job health All Likelihood of early parenting ns -.11 *** Likelihood of contraceptive use ns ns Gang activities ns ns Frequency of sex in last 3 mos. ([dagger]) -.11 * -.09 * Used contraceptive at last sex, ([dagger]),([double dagger]) ns ns Males Likelihood of abstaining ([double dagger]) ns -.16 ** Likelihood of early parenting ns -.16 ** Truancy -.21 *** -.12 * Had first sex since pretest ns ns Females Likelihood of early parenting ns -.11 * Likelihood of contraceptive use .11 * .10 * Truancy ns ns Had first sex since pretest ns .12 * Consistency of contraceptive use since pretest, ([dagger]),([double dagger]) 28 ** ns Used contraceptive at last sex, ([dagger]),([double dagger]) ns 23 * Gender and outcome Domain Psycho- Activities social All Likelihood of early parenting ns ns Likelihood of contraceptive use ns ns Gang activities ns ns Frequency of sex in last 3 mos. ([dagger]) ns ns Used contraceptive at last sex, ([dagger]),([double dagger]) 20 * ns Males Likelihood of abstaining ([double dagger]) ns .25 *** Likelihood of early parenting ns ns Truancy -.18 ** ns Had first sex since pretest ns ns Females Likelihood of early parenting -.15 ** ns Likelihood of contraceptive use ns ns Truancy .13 ** ns Had first sex since pretest ns ns Consistency of contraceptive use since pretest, ([dagger]),([double dagger]) ns ns Used contraceptive at last sex, ([dagger]),([double dagger]) 23 * ns Gender and outcome Mode of delivery One-on- Group one All Likelihood of early parenting -.12 *** ns Likelihood of contraceptive use ns .10 ** Gang activities -.09** ns Frequency of sex in last 3 mos. ([dagger]) ns ns Used contraceptive at last sex, ([dagger]),([double dagger]) .16 * ns Males Likelihood of abstaining ([double dagger]) ns .14 ** Likelihood of early parenting -.14 ** ns Truancy -.22 *** -.12 * Had first sex since pretest ns -.17 ** Females Likelihood of early parenting -.14 ** ns Likelihood of contraceptive use ns .14 ** Truancy ns ns Had first sex since pretest ns ns Consistency of contraceptive use since pretest, ([dagger]),([double dagger]) ns ns Used contraceptive at last sex, ([dagger]),([double dagger]) ns ns * p<.05. ** p<0.01. *** p<0.001. ([dagger]) Based on sexually experienced respondents only. ([double dagger]) Assessed at posttest only (not a change score). Notes: Outcomes are change scores unless otherwise noted. Tests for correlations among all clients statistically controlled for youth's age and gender, and those conducted for males and females separately statistically controlled for age. ns = not significant.
The data presented here were collected as part of contract 96-27072 between the California Department of Health Services Department of Health Services may refer to:
DOHS Department of Occupational Health & Safety
DOHS Defense Officers Housing Society ) and the University of California, San Diego UCSD is consistently ranked among the top ten public universities for undergraduate education in the United States by U.S. News & World Report. It is a Public Ivy.  For graduate studies, most of UCSD's Ph.D. , with grant support from the Office of the Assistant Secretary for Planning and Evaluation and the David and Lucile Packard Foundation David and Lucile Packard Foundation, private philanthropic institution that funds nonprofit organizations. It was founded in 1964 by David Packard (1912–96), co-founder of Hewlett-Packard Co., and his wife Lucile (1914–87). . The authors appreciate the hard work and dedicated efforts of the 16 California Adolescent Family Life Program agencies that participated in the evaluation, and thank Terrence Smith and Fran Katsuranis of DOHS for their support and comments on a previous draft.
* Program sites are contracted through the Maternal MATERNAL. That which belongs to, or comes from the mother: as, maternal authority, maternal relation, maternal estate, maternal line. Vide Line. and Child Health Branch of California's Department of Health Services on a noncompeting basis.
([dagger]) A 17th program site was originally selected to participate in the evaluation, but that agency had to temporarily discontinue dis·con·tin·ue
v. dis·con·tin·ued, dis·con·tin·u·ing, dis·con·tin·ues
1. To stop doing or providing (something); end or abandon: service provision (because its administrative offices were relocating at the time), so it was excluded from the study.
** The Adolescent Family Life Program, which is operated through California's Department of Health Services, is designed to enhance the health and social and economic well-being of pregnant and parenting adolescents and their children. Cal-Learn, which is run by the state's Department of Social Services social services
welfare services provided by local authorities or a state agency for people with particular social needs
social services npl → servicios mpl sociales , uses incentives and disincentives to help pregnant and parenting teenagers attend high school and earn a high school diploma A high school diploma is a diploma awarded for the completion of high school. In the United States and Canada, it is considered the minimum education required for government jobs and higher education. An equivalent is the GED. (or its equivalent).
*** Six scales had low internal reliabilities (alpha less than .59) and are not included in the analyses.
**** A copy of the program standards can be obtained from the California Department of Health Services, Maternal and Child Health Branch, at <http://www.mch.dhs.ca.gov/programs/asppp/asppp.htm>.
***** This explanation is supported by the correlation coefficients Correlation Coefficient
A measure that determines the degree to which two variable's movements are associated.
The correlation coefficient is calculated as: between receipt of psychosocial services and truancy at pretest, which were .15 for males but -.01 for females, and thus suggest that truant males were targeted to receive more psychosocial services, but that receipt of psychosocial services was unrelated to females' truancy levels at pretest. The correlations between psychosocial services and truancy at posttest (statistically controlling for pretest levels), however, were -.15 for males and .21 for females, which suggests that an increasing number of hours of psychosocial services over the evaluation was associated with declines in truancy among males, but with increased truancy among females. These pretest and posttest correlations by gender are roughly what would be expected if providers were less proactive with females than with males.
(1.) Cox J, Emans SJ and Bithoney W, Sisters of teen mothers: increased risk for adolescent parenthood, Adolescent and Pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.
Of or relating to pediatrics. Gynecology gynecology (gīn'əkŏl`əjē), branch of medicine specializing in the disorders of the female reproductive system. Modern gynecology deals with menstrual disorders, menopause, infectious disease and maldevelopment of the , 1993, 6(1): 138-142; East PL, Do adolescent pregnancy and childbearing affect younger siblings? Family Planning family planning
Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. Perspectives, 1996, 28(4):148-153; East PL, The younger sisters of childbearing adolescents: their attitudes, expectations, and behaviors, Child Development, 1996, 67(2):267-284; East PL and Felice ME, Pregnancy risk among the younger sisters of pregnant and childbearing adolescents, Journal of Developmental and Behavioral behavioral
pertaining to behavior.
see psychomotor seizure. Pediatrics pediatrics (pēdēă`trĭks), branch of medicine dedicated to the attainment of the best physical, emotional, and social health for infants, children, and young people generally. , 1992, 13(2):128-136; East PL and Jacobson LJ, The younger siblings of teenage mothers: a follow-up of their pregnancy risk, Developmental Psychology developmental psychology
Branch of psychology concerned with changes in cognitive, motivational, psychophysiological, and social functioning that occur throughout the human life span. , 2001, 37(2):254-264; and Friede A et al., Do the sisters of childbearing teenagers have increased rates of childbearing? American Journal of Public Health The American Journal of Public Health (AJPH) is a peer reviewed monthly journal of the American Public Health Association (APHA). The Journal also regularly publishes authoritative editorials and commentaries and serves as a forum for the analysis of health policy. , 1986, 76(10): 1221-1224.
(2.) Adolescent Sibling Pregnancy Prevention Program, <http://www. mch.dhs.ca.gov/programs/asppp/aspppfacts.htm>, accessed Oct. 17, 2002.
(3.) Reynen D, California Department of Health Services, Sacramento, CA, personal communication, May 15, 1997.
(4.) Kirby D, Looking for Looking for
In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. Reasons Why: The Antecedents of Adolescent Sexual Risk-Taking, Pregnancy, and Childbearing, Washington, DC: National Campaign to Prevent Teen Pregnancy, 1999.
(5.) Katsuranis F, California Department of Health Services, Sacramento, CA, personal communication, Oct. 17, 2002.
(6.) Grunbaum JA et al., Youth risk behavior surveillance--United States, 2001, Morbidity and Mortality Weekly Report Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention. The 5 June 1981 issue of the MMWR published the cases of five men in what turned out to be the first report of AIDS. , 2002, 51(SS-4): 1-64.
(7.) Brindis C, Antecedents and consequences: the need for diverse strategies in adolescent pregnancy prevention, in: Lawson A and Rhode DL, eds., The Politics of Pregnancy: Adolescent Sexuality and Public Policy, New Haven New Haven, city (1990 pop. 130,474), New Haven co., S Conn., a port of entry where the Quinnipiac and other small rivers enter Long Island Sound; inc. 1784. Firearms and ammunition, clocks and watches, tools, rubber and paper products, and textiles are among the many , CT: Yale University Yale University, at New Haven, Conn.; coeducational. Chartered as a collegiate school for men in 1701 largely as a result of the efforts of James Pierpont, it opened at Killingworth (now Clinton) in 1702, moved (1707) to Saybrook (now Old Saybrook), and in 1716 was Press, 1993; and Kirby D, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy, Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001.
(8.) Kirby D, 1999, op. cit. (see reference 4); Kowaleski-Jones L and Mott F, Sex, contraception and childbearing among high-risk youth: do different factors influence males and females? Family Planning Perspectives, 1998, 30(4): 163-169; and Mott FL et al., The determinants of first sex by age 14 in a high-risk adolescent population, Family Planning Perspectives, 1996, 28(1): 13-18.
(9.) Alan Guttmacher Alan Frank Guttmacher (1898-1974) was an American physician.
He served as president of Planned Parenthood and vice-president of the American Eugenics Society, founded the Association for the Study of Abortion in 1964, was a member of the Association for Voluntary Institute (AGI (Artificial General Intelligence) A machine intelligence that resembles that of a human being. Considered impossible by many, most artificial intelligence (AI) research, projects and products deal with specific applications such as industrial robots, playing chess, ), Sex and America's Teenagers, New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : AGI, 1994.
(10.) East PL and Kiernan EA, Risks among youths who have multiple sisters who were adolescent parents, Family Planning Perspectives, 2001, 33(2):75-80.
(11.) Cox J, Emans SJ and Bithoney W, 1993, op. cit. (see reference 1); East PL, Do adolescent pregnancy.... 1996, op. cit. (see reference 1); East PL, The younger sisters ..., 1996, op. cit. (see reference 1); East PL and Felice ME, 1992, op. cit. (see reference 1); East PL and Jacobson LJ, 2001, op. cit. (see reference 1); and Friede A et al., 1986, op. cit. (see reference 1).
(12.) East PL, Impact of adolescent childbearing on families and younger siblings: effects that increase younger siblings' risk for early pregnancy early pregnancy Obstetrics First trimester of pregnancy , Applied Developmental Science, 1998, 2(2):62-74; and East PL, The first teenage pregnancy in the family: does it affect mothers' parenting, attitudes, or mother-adolescent communication?Journal of Marriage and the Family, 1999, 61(2):306-319.
(13.) Brindis C, 1993, op. cit. (see reference 7); and Moore KA and Sugland BW, Next Steps and Best Bets: Approaches to Preventing Adolescent Childbearing, second ed., Washington, DC: Child Trends, 1999.
Author contact: email@example.com
Patricia East is research scientist, and Elizabeth Kiernan is program manager, both in the Department of Pediatrics, University of California, San Diego Medical Center. At the time this article was written, Gilberto Chavez was chief of the Maternal and Child Health Branch, California Department of Health Services, Sacramento, CA. He is currently director, Division of Birth Defects birth defects, abnormalities in physical or mental structure or function that are present at birth. They range from minor to seriously deforming or life-threatening. A major defect of some type occurs in approximately 3% of all births. and Developmental Disabilities developmental disabilities (DD),
n.pl the pathologic conditions that have their origin in the embryology and growth and development of an individual. DDs usually appear clinically before 18 years of age. , Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. , Atlanta.