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Essential components of a mentoring program for pregnant and parenting teens.

Abstract: Research on teen pregnancy and parenthood indicates that teens are unprepared for parenting, and are likely to struggle socially and economically due to limited education and employment opportunities. A formative research study conducted focus groups at an alternative school of choice in an urban school district to explore teen perceptions and beliefs about pregnancy and parenting. This paper reviews the literature and formative research findings describing pregnant and parenting teens' expressed needs for support and mentoring programs. The review explains the essential components of mentoring programs the teens believe would help them become successful young women and good parents.

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Research on teen pregnancy and parenthood indicates that teens are not well prepared for parenting, and are more likely to live in poverty and to interrupt their education than are older mothers (Braithwaite & Taylor, 2001) Also, the overall quality of a young mother's life is greatly compromised in comparison to the lives of young women who wait until they are older to become pregnant. Due to limited employment opportunities, social discrimination, and the challenges of single parenting, many of these young mothers remain marginally functional throughout much of their adult life. Health promotion and public health professionals should seek to hear and understand teen voices and perspectives before attempting to develop signature school and community-based mentoring programs aimed at meeting the needs of this vulnerable population.

A formative research study conducted at New Lives, an alternative school of choice in an urban northeast Texas school district, used focus groups to explore perceptions and beliefs about pregnancy and parenting among teens. The school is considered economically disadvantaged based on the number of enrolled students receiving free and reduced breakfast and lunch. The program enrolled 228 pregnant and parenting teens during the 1999-2000 academic year. The majority of the teens were African American and Hispanic; only one white teen was enrolled. Fifty six adolescents between the ages of 13-18 were randomly selected from the enrollment records and invited to participate in two focus groups. The first group consisted of 36 7th-9th grade girls and the second group consisted of 20 10th-12th grade girls. All of the teens were either pregnant or parenting (Shaw, Doyle, & Rittmayer, 1999).

The focus group interviews were guided by the following research questions (Shaw et al., 1999):

* What are some of the most important things that you want out of life for you and your baby?

* What could prevent you from attaining a high school diploma and what could help you attain one?

* What qualities do you look for in a role model?

* What qualities do you look for in a mentor?

* How could a mentor be of help to you?

* What do you feel is your most important need as a pregnant teen?

* What do you feel is your most important need as a parenting teen?

Data analysis revealed several needs expressed by the pregnant and parenting teens in the New Lives sample. The needs included mentoring, parental guidance and support, spiritual guidance, parenting classes, personal growth and development classes, and peer support groups (Shaw et al., 1999)

These expressed needs should be considered when designing and implementing programs to support and mentor pregnant and parenting teens. Programs that respond to these needs likely will be effective in helping pregnant and parenting teens develop the assets necessary to become successful and productive citizens in society. Furthermore, a review of teen pregnancy and parenting literature confirms that teens have an urgent need for resources that will improve their parenting skills, as well as help to achieve personal goals. These resources increase the likelihood of teen parents becoming successful young adults. This paper provides a) a brief review of the literature on teen pregnancy; b) identification and discussion of the essential components needed for an effective mentoring and support program for pregnant and parenting teens (based on the findings from the New Lives teen pregnancy study and other relevant literature); and c) summary and conclusions.

REVIEW OF LITERATURE ON PREGNANCY STATISTICS AND TRENDS

Approximately one million teens become pregnant each year in the United States, half resulting in live births (Teen Shelter, 2003). While the teenage pregnancy birth rate dropped for the 10th straight year, as of 2002, the United States still had the highest rate of teen pregnancy and births in the western industrialized world (National Center for Health Statistics, n.d.). Texas, has the third highest teen birth rate in the nation; a baby is born to a teen mother every 10 minutes (Adolescent Pregnancy Prevention, 2002). It is estimated that 24,655 girls, ages 13-17, became pregnant in Texas in the year 2000. This represents a decrease of 1,462 pregnancies from 1999. Since 1991, the teen birth rate has declined 26% in Texas. Despite this decline, teen pregnancy still remains a vast problem.

According to the Lifeline Family Center in Florida, the majority of teens who give birth before 18 years of age are less likely to complete high school (Lifeline Family Center, n.d.). Teen parents who do not finish high school are at a disadvantage in the job market and are more likely to raise their children in poverty. These parents are also more likely to give birth to low-birth-weight infants. Additionally, the children of teen parents are more likely to experience other problems such as mental retardation, blindness, deafness, mental illnesses, cerebral palsy, high infant death syndrome rates, and low self-esteem. Eighty percent of pregnant and parenting teens between the ages of 13 and 19 receive governmental assistance (Adolescent Pregnancy Prevention, 2002). In addition, some of the issues that children of teen parents encounter are likelihood of repeating a grade, increased possibility of incarceration for males, and increased chances of becoming teen mothers themselves (females). Horwitz, Klerman, Kuo, & Jekel (1991) reported a 20-year follow-up study of Black American teen mothers which revealed that decreasing social isolation was a factor that determined their long-term success. A committee report from the American Academy of Pediatrics (2001) indicated that social support correlates positively with improved outcomes for adolescent mothers.

ESSENTIAL COMPONENTS OF A MENTORING SUPPORT PROGRAM MENTORSHIP

Mentorship is one of the most important components of programs designed to exemplify wellness and encourage teens to become productive and responsible members of society. A mentor is called upon to lead and guide by relating lessons learned through past experiences or knowledge gained in a particular area of interest (Shawet al., 1999). Funk & Wagnall's dictionary defines a mentor as "a person who is charged with the instruction and guidance of another or a private teacher" (Landau, 1986, p. 406). According to Johnson & Ridley (2004), "mentorships are dynamic, reciprocal, personal relationships in which a more experienced person (mentor) acts as a guide, role model, teacher, and sponsor of a less experienced person" (p. xv.).

In the New Lives study (Shaw et al., 1999), teens who participated in the focus groups indicated that pregnant and parenting teens want to be involved in developing the criteria for selecting mentors. The New Lives teens expressed several reasons for needing a mentor. These reasons included having someone with whom to talk, having someone with whom to confide without the fear of being judged or penalized for past actions; having one-on-one guidance from someone who has experienced pregnancy as a teen, having someone who can provide realistic advice to help the teens become successful parents, and having someone to provide positive suggestions on how to reach their own goals and dreams. Due to the social and emotional challenges associated with teenage pregnancy, establishing criteria for mentors in a program of such importance requires careful planning to ensure compatibility between the mentor and mentee.

A review of the literature and the findings from the New Lives teen pregnancy study support the idea that researchers, service providers, and other community health planners should consider specific criteria for selecting mentors (Kelly, Bobo, McLachlan, Avery, & Burge, 2006; Shaw et al., 1999). These criteria should include, but are not limited to, financial stability as evidenced by six months of consistent and verifiable employment with current employer, six months of established and verifiable residency, same gender as the audience to be served, required attendance at mentoring classes designed for the particular program, willingness to sign a confidentiality agreement; a minimum of 25 years of age, meet the predetermined requirements established for a criminal check; and three personal references.

The Friends for Teen Moms teen parent mentoring program in the Denver metropolitan area provides an example of a program that utilizes this type of eligibility criteria (Friends for Youths, 2003). The program requests and reviews a potential mentor's driving records, personal references, family background, interests, maturity levels, and hobbies. Most important, mentors should have a desire to work with pregnant and parenting teens. Qualified mentors can provide great assistance in helping girls to transition from teen life to motherhood and to become successful individuals in society. Mentors are indispensable in assisting pregnant and parenting teens in locating and utilizing community resources (Human Sciences Outreach, 2003). There should be policies and procedures in place that outline the expected responsibilities of a mentor, such as how often mentors and teens should interact and the types of mentoring activities that support programs goals and objectives.

Additional policies and procedures can be adapted from prevention programs such as the New Jersey chapter of the National Committee for the Prevention of Child Abuse. This program requires mentors, who were once teen mothers, to meet with students often, encourage them to stay in school and to help them with personal issues (UMDNJ Healthstate, 1999). Also, the Friends for Teen Morns program extends opportunities for the mentors and teens to participate in extracurricular activities and events such as cultural events and family outings (Friends for Youths, 2003).

Mentors must be models of wellness that can encourage the development of habits such as conflict resolution, discernment, and good decisionmaking skills. These mentors should be included in the planning and implementation phases of programs designed to assist pregnant and parenting teens. Most successful programs include all of their stakeholders in program planning.

PARENTAL GUIDANCE AND SUPPORT

Parental guidance and support are critical components of a teenager's life. The way teenagers are viewed by their parents can greatly influence their behavior. Pamela Grace (1997), a clinical psychologist, interviewed poor inner-city pregnant teenagers ages of 12-19 years. She concluded that teenage girls may be vulnerable to placing undue value on a dating relationship if they do not receive adequate emotional nurturance from their own families. According to Grace, when teens perceive that they lack attention from their parents or sense that they are unloved, they seek love and attention from other sources. These sources are not always positive. When teenagers seek out other avenues to fill a void in their lives, the consequences can be drastic and sometimes deadly. Many female teens lack parental love at home, especially that of a father figure. This deficit may lead them to participate in high-risk sexual activity, seeking male attention and acceptance. This high-risk behavior plays a large and significant role in teenage pregnancy. Results from the New Lives study (Shaw et al., 1999) suggested that a declining relationship between a teenage girl and her parents will often result in greater reliance on her relationship with her boyfriend. As this relationship grows, the girl attempts to cement the relationship and begin a new family by becoming pregnant.

Consequently, successful mentoring programs must include a component designed to encourage parental support and involvement in their teen's lives. However, this may not be an option for some of teens. Hence, it becomes important to extend parental role models to include individuals such as godparents, Big Sisters, or extended family members.

COMMUNICATION WORKSHOPS/SKILLS TRAINING

Communication is a vital part of any relationship. This is a fundamental component of parental guidance and support that should be addressed in a mentoring program for pregnant and parenting teens (Hoppe, Le, & Cunningham, 2000). According to Grace (1997), there are many disconnections in the lines of communication between parents and their teens. Parents need to build two-way communication by getting their teens to share their feelings. In turn, parents learn what their teens are thinking. Teens have voiced that they want their parents to listen and to not always judge; to be open, empathetic, and willing to share their own personal experiences; to openly talk about issues such as sex, drugs, alcohol, and school; to initiate dialogue and interaction through probing and giving advice; to spend more time with them; and to engage in specific activities to improve communication in the relationship (Hoppe et al., 2000; Shaw et al., 1999). Parents should be encouraged to articulate their own values for living and behavior and to teach them in the home. They should also emphasize the importance of respect between children and parents (Kay, 1995).

ROLES/RESPONSIBILITIES OF THE PARENTS OF PREGNANT/PARENTING TEENS (EDUCATION & TRAINING)

Once the proper lines of communication are established, parents may need assistance in coping with their teen's pregnancy. Mentoring programs for pregnant and parenting teens can offer joint counseling sessions for parents and their pregnant teens. These sessions offer teens the opportunity to let their parents know how they may have contributed to the teen's high-risk behavior. Parents can begin to offer more positive support and guidance once they are aware of the influences that contributed to this behavior. During these sessions, teens and parents are able to conduct joint problem-solving and work through situations together. Joint counseling can lead to improved relationships between the parents and the teens.

As a support person and mentor, parents need to learn how to encourage their children to become better parents and avoid making the same mistakes that they made as parents. Parents can also encourage their pregnant and parenting teens to develop open relationships with their own children, and to advise them to start positive communication practices while their children are young. Parents should offer support and guidance to their teens by accompanying them to doctor's visits and assisting them in maintaining a healthy lifestyle that will benefit both the pregnant teen and their unborn child. Parents should also continuously encourage their teens to stay in school by offering support such as providing childcare, assisting them with school assignments, and providing financial assistance when necessary, even as they are teaching their teens to become self-sufficient (Relationship Repair Shop, 2003).

According to Kay (1995), teenagers, in general, are not mature, responsible decision-makers in society. A majority of teens are in school, and often lack the patience required to work, go to school, and care for a child. Most teens are not able to obtain meaningful employment due to their youth and lack of education. Therefore, the financial assistance of their parents is greatly needed. Parents can financially assist their teens until they are capable of supporting themselves and their child, locating other positive financial resources, and demonstrating financial responsibility. In order to implement a successful mentoring program for pregnant and parenting teens, parents should be encouraged to support their teens financially while also encouraging them to develop the educational and career plans necessary to achieve their future goals. For those parents who are unable to offer financial support, mentoring programs should seek to collaborate, coordinate, and promote linkages with social service and private sector organizations that support social development of pregnant and parenting teens. A social developer (commonly known as a social worker) can facilitate linkages with organizations that offer financial, education, health and nutrition services, parent education, contraceptive services, child care programs, and spiritual resources.

Emotional support from the parents plays an essential role in the way teens approach parenthood. This support should consist of attending classes with their teens, showing them affection, forgiving them, and offering advice on parenting. Teenagers are generally emotionally unstable during this time period; however, parental or close family relative support and encouragement can be the essential element that carries them through (Lifeline Family Center, n.d.; Yordan, E.E. & Yordan, R.A.,1996).

A review of the literature and results from the New Lives study (Shaw et al., 1999) provide evidence that parental involvement is an essential component of a mentoring and support program for pregnant and parenting teens. If a responsible parent is not available, a close family relative, friend, or Big Sister may be a viable alternative in this major role.

SPIRITUAL GUIDANCE

In New Lives focus group interviews, pregnant and parenting teens expressed a need for spiritual guidance to be incorporated into a support and mentoring program (Shaw et al., 1999). Many of the teens indicated a desire to have a close relationship with God, and wanted their respective churches to love and accept them. Spiritual guidance through church affiliation helps teens to develop a set of beliefs and standards that can make them accountable for their actions and decisions. In addition to assisting in mental and spiritual healing, this form of guidance may help teens to address past issues and hurts, as well as to seek a life's purpose. When teens have no direction or accountability, they have a greater propensity to participate in high-risk behavior that may negatively influence their future (Tennessee Baptist Children's Homes, n.d.).

Dr. Anthony Evans, a Christian theologian, wrote that spiritually grounded teens are generally considered to be better equipped to overcome obstacles such as barriers that may prevent graduation from high school, peer pressure, economic hardships, uninvolved parents, the absence of the teen's child's father, as well as sex, alcohol, drugs, violence, and abortion.

Religion and spirituality also contribute to helping teens learn how to make wiser decisions. The church and the spiritual guidance received there can provide a place of refuge in this time of confusion (Evans, 2003).

There are several types of spiritual or religious institutions that serve pregnant and parenting teens such as churches and urban youth ministries. These organizations offer spiritual guidance and community outreach programs that provide for infants' needs, food, financial assistance, and other types of support during economic hardships. For example, the Lifeline Family Center in Florida offers a positive alternative to abortion, giving the mothers-to-be a sense of hope and a future. The center also prepares teen mothers and their babies to become God-dependent, contributing members of society.

Another institution that provides spiritual guidance for single teenage mothers and their children is Living Waters Ministries in Brentwood, TN. This program aims at healing the hurts of teenage pregnancies, which are often the result of delinquent behavioral patterns developed by of teen mothers (Tennessee Baptist Children's Homes, n.d.). Teen mothers who participate in Living Waters Ministries receive temporary housing, assistance with parenting skills, daycare, and counseling so that they can continue their education while learning to become a successful parent.

A third example of a spiritual guidance ministry is Teen Morns, a community ministry of Youth for Christ. This program attempts to reach teenage mothers in the Rochester, NY area. This pro gram focuses on young girls who will not have support from the father of their child and may not have the support of their own families. Teen Moms operate on the premise that establishing a relationship with God will be an influential factor in breaking the cycle of teens having children (Youth for Christ, n.d.). As these programs indicate, spiritual guidance is another component of effective programs designed for mentoring pregnant and parenting teens. According to spiritual guidance books(Evans, 2003; Perry, 2003), Christian values provide teens with a strong and solid foundation that will enable them to become successful individuals in society as well as successful parents.

PARENTING CLASSES FOR TEENAGE PARENTS

In the New Life focus groups, pregnant and parenting teens expressed the need for parenting classes to be included in a mentoring program (Shaw et al., 1999). Focus group findings indicated that these classes should address several topics including proper childcare techniques, methods of effective communication between parent and child, how to approach emergency situations, basic information about infant healthcare, and the importance of being a positive role model. According to the Center for Family Partnerships, parenting classes should be designed to help teens address parental issues that will arise, as well as learn how to take care of themselves and their children (UMDNJ, 1999). Parenting classes are designed to help teen parents gain confidence in caring for their children, as well as introducing them to social, healthcare, and other support services for themselves and their children (Friends for Youths, n.d.).

Health education should also be incorporated into teen parenting classes. According to the Center for Family Partnerships, this education should consist of guest speakers and workshops, including a course on CPR and a discussion pertaining to HIV and children (UMDNJ, 1999). Other relevant topics that should be discussed in the classes include the importance of abstinence and safe sex practices; prenatal and post-partum care; personal hygiene; routine doctor visits and immunizations for infants; parenting skill; and ways to model the type of behavior that they would want to see their child exhibit (Relationship Repair Shop, n.d.).

Teen parenting classes are an essential component of mentoring and support programs for pregnant and parenting teens. In many cases, the parenting classes represent the only preparation the teen will receive prior to giving birth, the only positive instruction a teen experiences on how to parent. These classes are an effective and inexpensive method to prepare teens for real life parenting (Relationship Repair Shop, n.d.).

PERSONAL GROWTH AND DEVELOPMENT CLASSES

Persona/development classes are designed to help teens develop good parenting skills and to achieve their personal goals. These types of classes can play an important role in the overall success of a teen mentoring program. Personal development classes are necessary to help teens to identify their inner strengths and to develop action plans to accomplish short and long-term goals (Lifeline Family Center, 2003). The classes should address topics such as financial planning, resume writing, interviewing skills, dressing for success, building self-esteem, preparing for college, conducting a successful job search, and various other topics that will enhance personal growth and the overall development. The Lifeline Family Center is an example of a program that is committed to personal growth and development. The center offers teen mothers a chance to build their self-confidence and maturity through professional counseling, character building, GED preparation and career training until their child's second birthday (Lifeline Family Center, 2003).

Personal growth and development classes provide opportunities to assist pregnant and parenting teens to develop a positive sense of self-worth. Self-esteem plays a major role in America's teenage pregnancy crisis. In an effort to identify the relationship between self-esteem and teenage pregnancy, researchers from the University of Minnesota conducted a survey. This 1997 survey asked local high school students: "What role do you think self-esteem plays in America's teenage pregnancy?" (University of Minnesota, 2003). Some of the responses included low self-esteem equals high teen pregnancy rate; teens desire consistency and love, and if this is not obtained from the parents, some teens believe it is obtainable from a child through motherhood; the lower the self-esteem, the higher the chance a person will seek others' approval by offering themselves; self-esteem is measured by the number of people who love you; and if teenagers have high self-esteem, they will make more positive decisions concerning themselves, teenagers with lower self-esteem will do things that may not be good or healthy because they do not feel that they are worth it (University of Minnesota, n.d.).

In 1996, Dr. Michael Carrera of the Children's Aid Society in New York developed and implemented the Above the Waist program. This teenage mentoring program teaches teens the necessary skills for developing positive self-esteem, and how to become successful individuals in society (Sharell, 1996). Teens who participated in the program were guaranteed admission to college upon completion of the program. According to Dr. Carrera, "self-esteem is caught, not taught" by providing opportunities for teens to experience success. He suggests that if teens feel like they are going some place and something good is going to happen to them, they will learn to avoid high-risk behavior and control impulses (Carrera, 1999)

In the New Lives study (Shaw et al., 1999), pregnant and parenting teen participants revealed that their needs included mentoring, parental guidance and support, spiritual guidance, parenting classes, personal growth and development classes, and peer support groups. These findings indicate that personal growth and development classes are an essential component of successful mentoring and support programs for pregnant and parenting teens.

PEER SUPPORT

Peer support groups can provide emotional and social support to pregnant and parenting young women, as well as provide a forum for the teens to share positive parenting skills. These groups may also provide opportunities for the teens and guest speakers to offer advice that will help with the challenges of teen parenting. For example, when one teen is feeling down, other teens who have experienced similar situations may be a positive influence and offer words of encouragement (Friends for Youths, n.d.; Valatis & Sword, 2005).

Peers can be positive motivators for overcoming obstacles that are related to teen parenthood. The Center for Family Partnerships encourages high school teen mothers to visit middle school teen mothers and speak to them about the difficulties of being a parent and staying in school. They also share ideas on parenting (UMDNJ, 1999). Valatis & Sword (2005) explored the use of online discussions as a means of obtaining pregnant and parenting adolescents' perspectives regarding needs, capacities, and service delivery issues. The research team reported that the participants expected to meet others, share experiences, and talk to other parenting teens or pregnant teens about their experiences. Participants stated, "You need somebody to talk to that's in the same situation with you, and it's a lot more comforting if you have somebody who's a teen parent than [to] go to talk to an adult." (Valaitis & Sword, 2005, p.466).

With peer support in place, teens learn from each other. Information is more readily received, processed, and acted upon when delivered by peers. Valaitis & Sword, (2005); Shaw, et al., 1999) reported that teens are more apt to accept advice when it comes from another teen than from an older adult or parent.. A peer support group is an essential component of a mentoring program for pregnant and parenting teens.

CONCLUSION

Based on the literature and the results of the New Lives focus group interviews, it is evident that certain components enhance programs designed to help pregnant and parenting teens to experience success as young adult women and parents. These essential components have been briefly described in this paper and should be considered vital to the success of a support and mentoring program for this at-risk teen population. The components in elude mentorship, parental guidance and support, spiritual guidance, parenting classes for teen parents, personal growth and development classes, and peer support groups. If these essential components are an integral part of the mentoring and support program, it is reasonable to expect outcomes that favor a more successful transition from young teen mothers to adult and parent.

Public health and health promotion professionals would do well to be reminded that teen voices and perspectives should be considered when designing programs to meet the needs of this special population. Their viewpoints can be used to help design more effective programs because they reflect the concerns and realities of those individuals (pregnant and parenting teens) who actually experience the challenges and obstacles associated with teenage pregnancy. The best ideas for a new program or best suggestions for improvement of existing programs generally come from the population that is directly affected by the issues the programs are trying to minimize or eliminate.

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Perry, L.E. (2003). How to survive your teen's pregnancy: Practical advice for a Christian family. Dumfries, VA: Chalfont House.

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CHES AREAS

Responsibility IX: Administering Health Education Programs

Competency D: Obtain acceptance and support for programs

Sub-competency 4: Use needs assessment information to advocate for health education programs

Responsibility II: Planning Effective Health Education Programs

Competency B: Develop a logical scope and sequence plan for a health education program

Wilsherl Dennis Rowen, BS, MS is affiliated with the Department of Health Studies in the College of Health Sciences at Texas Woman's University. Mary Shaw-Perry, PhD, CHES is an Associate Professor of Public Health & Health Behavior at Indiana University- Bloomington. Robin Rager, PhD, CHES is an Associate Professor in the Department of Health Studies at Texas Woman's University. Address all correspondence to Mary Shaw-Perry, PhD, CHES, Associate Professor of Public Health and Health Behavior, Indiana University- Bloomington, Department of Applied Health Science, School of Health, Physical Education, and Recreation, 1025 E. 7th Street/ HPER 116, Bloomington, Indiana 47405; PHONE: 812-856-6782; FAX: 812-855-3936; E-MAIL: mdperry@indiana.edu.
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Author:Rager, Robin
Publication:American Journal of Health Studies
Date:Jun 22, 2005
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