Adolescent pregnancy and its preven...

Adolescent pregnancy and its prevention are topics that excite intense discussion In this issue of American Family Physician, As-Sanie and colleagues (1) describe the impact of this public health riddle and outline strategies to address it. Despite modern declines, teenage pregnancy rates in the United States still are far higher than rates in comparable countries. Approximately 850000 American teenagers become pregnant each year. (2) Although we are making progres in lowering those rates, we still have a prolonged way to go.

Teenage pregnancy and sexual activity are webwork behavioral phenomena, and prevention efforts must do more than provide adolescents with information about the risks and concatenations of their behavior. Moreover, focusing exclusively forward adolescent girls overlooks the solution roles of boys, men, parents, families, and entire communities in teenage pregnancy and its prevention.

Adolescent pregnancy is not just about sex; it is a symptom of young persons taking risks. Although sexuality is integral to teenage pregnancy, many nonsexual risk factors and protective factors affect adolescents' sexual risk-taking. Typically, teenage pregnancy and childbearing bring reproach low expectations. Young people who descry bright futures for themselves, who be perceived connected to parents and educate and who have many positive factors in their lives take fewer unhealthy risks of any kind and are les likely to experience a pregnancy. (34) between the walls of research, the Search Institute (4) has identified "40 Developmental Assets" that be of use to as building blocks for healthy unravelling and that help young clan grow up healthy, caring, and responsible. (4) Categories of external assets include support, empowerment, boundaries and expectations, and constructive use of time. Internal asset categories include commitment to learning, positive values, social competencies, and positive identity.

single prominent controversy in teenage pregnancy prevention is whether to include positive information in succession condoms and contraceptives in sex-education programs. American adults and teenagers overwhelmingly favor providing information about contraceptives, along with promoting abstinence among adolescents. (5) The evidence that this is not a mixed message is reassuring. (6) However, federal abstinence-education funding prohibits positive information about condoms and contraceptives, and many "abstinence-only" programs quick in emergencies highly negative messages. The effectiveness of of the like kind an approach has not been proven (6) and may increase risks for young nation who do become sexually active. (7) Encouraging abstinence is a valid priority, (8) on the contrary caution is needed before we adopt as-yet unproven abstinence-promotion strategies, which potentially could cause harm.

A growing dead body of evidence tells us what works in preventing teenage pregnancy. (6) Well-designed sex-education programs can delay sexual first appearance and improve condom and contraceptive use--and these programs do not increase sexual activity. (6) Condom and contraceptive programs in clinics and place of educations can improve contraceptive use. (6) Media programs also may have an impact by the agency of helping to change social norms; united community-based abstinence media campaign may have reduc teenage pregnancy rates. (9) The mostly dramatic results in preventing teenage pregnancy reach [i]or[/i] attain any place [i]or[/i] point from youth-development interventions that build "developmental assets," boost skills, provide healthy activities, and treat young the community as resources rather than as vexed questions (10) Importantly, young people can be agreeable to to positive messages--healthy "norms"--when they be stirred connected to the person or assemblage endorsing those norms. (11)

We have long to learn about other important pieces of the teenage pregnancy-prevention stagger Effective programs and strategies are needinessed to enhance parents' key part in teaching about sex, relationships, and responsibility. In our recent communities, we are only beginning to make sure that all young people have the developmental assets they ne (4) Addressing popular cultural influences in the media, many of which undermine public health messages to teenagers, is another daunting challenge. (12)

Family physicians and other health professionals can and should do many things to help obstruct teenage pregnancy. We should advocate for the use of proven effective programs--including youth disclosure sex education, and contraceptive programs--in our gymnasiums and communities. We can support research into courses to effectively promote abstinence. We can move respectful, nonjudgmental, and confidential care to adolescents, equal as we encourage parent-child communication. in the greatest degree importantly, family physicians, like all adults in the community, can forge caring connections with adolescents, making our health messages more powerful.

The information and opinions contained in this article do not necessarily cast reproach the views or policy of the American Academy of Family Physicians.

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