Raising Awareness to Reduce Teenage Pregnancy in Health Promotion - Research Paper Example

Raising Awareness to Reduce Teenage Pregnancy in Health Promotion ID Number Total Number of Words: 2,717 The incidence of teenage pregnancy in England and around the world is high. Therefore, health promoters should focus on developing new ways on how to educate and encourage the teenagers to avoid getting involved in early sexual activities. This report tackled not only the health, socio-economic, and psychological impact of teenage pregnancy but also highlighted several strategies on how to create public awareness on this issue. Table of Contents Abstract ……………………………………………………………………………………. 2 Table of Contents ………………………………………………………………………….. 3 1. Introduction / Background of the Research Topic ………………………………… 4 2. Literature Search Strategy ………………………………………………………… 4 3. Literature Review ………………………………………………………………….. 5 3.1 Social, Economic, and Environmental Factors Causing Teenage Pregnancy ……………………………………………………… 5 3.2 Adverse Effects of Teenage Pregnancy …………………………………. 6 3.2.1 Health Consequences ……………………………………….. 7 3.2.2 Socio-Economic Consequences …………………………….. 7 3.2.3 Psychological Impact ……………………………………….. 7 3.3 Common Strategies Used in Reducing Teenage Pregnancy …………….. 8 3.3.1 Importance of Creating Public Awareness …………….......... 8 3.3.1.1 Applicable Health Promotion Theories and Models in Creating Public Awareness ………… 9 3.3.1.1.1 Social Learning Theory ……….. 9 3.3.1.1.2 Health Belief Model …………... 10 3.3.1.2 Necessary Skills in Creating Public Awareness . 10 3.3.2 Mediating Health Promotion through Partnership …………... 11 3.4 Strategies in Place to Reduce Teenage Pregnancy ..…………………….. 12 4. Discussion, Conclusion and Recommendations ……………..…………………….. 12 References ………………………………………………………………………………… 14 - 19 Chapter 1 – Introduction / Background of the Research Topic Teenage pregnancy is defined as “a situation where girls become pregnant when they have not reached legal adulthood” (Cherry, Byers and Dillon, 2009, p. 376). Accounting for 11% of the total births worldwide, the World Health Organization (WHO) reported that approximately 16 million young girls between the age of 15 to 19 are expected to give birth annually (WHO, 2014). In England, the estimated number of teenage pregnancy among girls below 18 years of age decreased from 31,051 in 2011 down to 27,834 in 2012 (Office for National Statistics, 2012). Even though the number of teenage pregnancy in England fell down by 10% between 2011 to 2012 (Office for National Statistics, 2012), the number of girls who get themselves pregnant at a very young age remains high. The adverse health and socio-economic consequences of teenage pregnancy can affect both the mother and child throughout the lifespan (Ruedinger and Cox, 2012). In response to high rates of teenage pregnancy, this study will focus on developing and creating new ideas on how to further improve the competencies of health promotion practitioners. Furthermore, in the process of going through this research study, data presented in this report can be useful in the future development of the National Occupation Standards used in the practice of Public Health. Chapter 2 – Literature Search Strategy When conducting a search for literature review, the term “inclusion criteria” is referring to the researchers’ desired results based on the articles pre-selected from the databases of MEDLINE, PubMed, and ScienceDirect (Offredy and Vickers, 2010, p. 58). Based on the “inclusion criteria”, the researcher will be able to easy choose and select the most relevant academic textbooks and peer-reviewed journals that will be considered in this study (Card, 2012, p. 38). Applicable to this study, a significant part of the “inclusion criteria” include all academic books and peer-reviewed journals that have been published between the years 2009 to 2014. Within the specified publication date, the topic of the peer-reviewed journals should pertain to the socio-economic and health consequences of teenage pregnancy, external factors that can trigger the high rates of teenage pregnancy, the common strategies used in reducing teenage pregnancy, the importance of creating public awareness, mediating health promotion through partnership, and specific health promotion theories and models that are applicable to the need to create public awareness. Therefore, the following search terms were used in the process of locating relevant peer-reviewed journals for this study: (1) teenage pregnancy; (2) consequences teenage pregnancy; (3) factors affecting teenage pregnancy; (4) strategy reduce teenage pregnancy; (5) teenage pregnancy public awareness; and (5) teenage pregnancy health promotion partnership. Chapter 3 – Literature Review 3.1 Social, Economic, and Environmental Factors Causing Teenage Pregnancy Members of the family can affect not only the personal experiences of each child within the environment but also their attitude, values, and behaviour (Copping, Campbell and Muncer, 2013). Among the few characteristics of parenting styles include: (1) parent-teen communication; (2) parental warmth and care; (3) parental monitoring; and (4) permissiveness among others (Donenberg, Emerson and Mackesy-Amiti, 2011; Belsky et al., 2010). In general, the quality of parenting style is significant in terms of predicting the risk for teenage pregnancy and exposure to risky sexual behaviour (Hoskins and Simons, 2014; Donenberg, Emerson and Mackesy-Amiti, 2011; Belsky et al., 2010). Teenage pregnancy can also be an end-result of peer-pressure (Elkiington, Bauermeister and Zimmerman, 2010). In most cases, children who were raised by their parents using authoritative parenting are less likely to engage themselves in “risk-taking” behaviours caused by the influence of their friends (Kogan et al., 2010). To be effective in preventing teenage pregnancy, Hoskins and Simons (2014) explained that it is necessary to combine the use of a strict parental control with a high levels of parental warmth and care. Likewise, several other studies also highlighted the importance of parental warmth in reducing the risk of teenage pregnancy (Kan et al., 2010). Contrary to good parenting, Kogan et al. (2010) revealed that teenagers with a poor relationship with their parents are more likely to explore early sexual experience. As explained by Komro, Flay and Biglan (2011), poverty can make people experience behavioural, emotional, and mental disorders. In most cases, behavioural and emotional disorders contribute to the increased risks wherein girls would engage themselves in risky sexual behaviour (Seth et al., 2012). On top of the child’s family background and peer pressure, the observational research study that was conducted by Penman-Aguilar et al. (2013) revealed that various socio-economic factors such as underemployment, low levels of socio-economic status, low income, low educational attainment, neighbourhood disadvantage, and income inequality can also contribute to the increasing number of teenage pregnancy. 3.2 Adverse Effects of Teenage Pregnancy 3.2.1 Health Consequences There are quite a lot of health considerations when it comes to teenage pregnancy. First of all, teenage pregnancy is strongly related to “poor maternal and child health outcomes” (Coall, Dickins and Nettle, 2012, p. 167). Likewise, the practice of unprotected sexual behaviour can also increase your girls’ risks of becoming infected with sexually transmitted infections like Chlamydia, Gonorrhea, and HIV among others (Kogan et al., 2010; Mogler, 2008, p. 11). Single parenting can cause young girls to suffer from excessive physical and emotional stress caused by inadequate food sources, job and financial insecurity, and unsafe neighbourhoods (Broussard, 2010). Since most teenage girls are not prepared to raise their own children, a lot of them end up having an abortion which could result to other more complicated long-term issues such as psychological or mental health imbalances and the increased risks of infertility (Wiebe et al., 2014). 3.2.2 Socio-Economic Consequences Specifically the socio-economic consequences of teenage pregnancy are rampant not only in England but also across the world. Since young girls who undergoes teenage pregnancy were either forced to drop out from school (The National Campaign, 2010) or has a negative engagement in schools (Kogan et al., 2010), this group of young individuals are most likely to have low levels of academic achievements and more problems when it comes to gaining access to a more promising career in the future (Penman-Aguilar et al., 2013). Due to the fact that most young girls who got pregnant during their teenage years were not able to complete their studies further explains why most teenage mothers are most likely to experience poverty in life (Penman-Aguilar et al., 2013). 3.2.3 Psychological Impact Due to the fact that teenage mothers are unprepared for serious obligations in life or previous abortion, a lot of them would experience a much higher level of depression (Pinheiro et al., 2012; Mollborn and Morningstar, 2009) as well as panic disorder (Pinheiro et al., 2012). Furthermore, the research findings in the cross-sectional study that was conducted by Pinheiro et al. (2012) revealed that 43 out of 828 or 4.94% of the total research participants are at risk of having suicidal behaviour whereas 7.4% of the total research participants have shown signs of lifetime suicidal attempts because of teenage pregnancy. 3.3 Common Strategies Used in Reducing Teenage Pregnancy 3.3.1 Importance of Creating Public Awareness Health promotion is defined as “the science and art of helping people change their lifestyle to move toward a state of optimal health” (ODonnell, 2002, p. 49). In most cases, health promotion is considered as one way of creating public awareness concerning the adverse health, socio-economic, and mental health consequences of teenage pregnancy. In line with this, Wamoyi et al. (2013) mentioned that the active implementation of adolescent sexual and reproductive health interventions is effective in terms of improving the teenagers’ knowledge on various sexual and reproductive health issues and effectively reduces their personal desire and engagement in sexual risk behaviours. There are several ways in which health promoters can effectively create public awareness within the public and private school settings. Based on the cross-sectional study that was conducted by Melaku, Berhane and Reda (2014), the mere act of discussing issues on sexual and reproductive health with peers and parents are among the few independent predictors for contraceptive awareness. For this reason, it is essential to include sexual and reproductive health issues in the school curriculum or promote in-school intervention (Coleman et al., 2013; Wamoyi et al., 2013). Client-centred and empowerment can improve the health promoters’ ability to create effective public awareness on issues related to teenage pregnancy. In line with this, Koelen and van den Ban (2004, p. 140) explained that empowerment in health promotion is all about giving people the power to control over improving their own health. On the other hand, client-centred is all about staying focus on the main concerns and wellbeing of the teenagers (Antai-Otong, 2007, p. 101). With these in mind, one of the best strategies that will enable health promoters to empower teenagers to manage their own individual health is to develop a two-way communication between the teenagers and the health promoters (Noyes and Savin, 2012). Through the use of an interactive and shared decision-making process (Antai-Otong, 2007, p. 102), the health promoters can help the teenage girls improve their ability to protect themselves from unwanted pregnancy. 3.3.1.1 Applicable Health Promotion Theories and Models in Creating Public Awareness 3.3.1.1.1 Social Learning Theory Commonly used in most school’s health promotion programmes, the social learning theory focuses on observing people’s attitude and behaviour (Gottwald and Goodman-Brown, 2012, p. 102; Hernandez, 2011, p. 108). In line with this, Gottwald and Goodman-Brown (2012, p. 102) explained that learning can occur by closely observing the interaction between a person and the environment. In other words, the social learning theory highlights the importance of cognitive learning process which commonly takes place within the social and environmental context. Specifically the concept of social learning theory has been widely used in the health promotional intervention for young individuals (Delgado, 2009, p. 112). Therefore, health promoters who choose to adopt the use of the social learning theory should focus on analyzing not only “personal factors” such as attitude, self-efficacy, expectations, behavioural capacity, self-control, emotional coping, and values but also the relationship between environmental factors and the development of behaviour (Hernandez, 2011, pp. 108 – 109). For example, using the social learning theory, health promoters should first ask themselves whether or not a specific school supports the need to extend health prevention on teenage pregnancy before they bother sharing some important knowledge and sexual information to the students. Likewise, it is also necessary to ask themselves how the school administrator would react if the health promoter would approach them regarding teenage pregnancy prevention programme. 3.3.1.1.2 Health Belief Model Similar to social learning theory, the health belief model has also been widely used in health-related topics (Rankin, Stallings and London, 2005, p. 31). Likewise, the health belief model is also very much applicable in “health-related decision making” (Green and Tones, 2010, p. 119). Unlike the social learning theory, Rankin, Stallings and London (2005, p. 31) explained that the health belief model was designed to focus more on analyzing a more complex relationship between health behaviour, motivation, and the expected health outcome. The health belief model seem to be more promising than the use of the social learning theory simply because the use of the health belief model was designed to have the capacity to prevent the risks of negative health consequences or outcomes (Green and Tones, 2010, p. 120; Rankin, Stallings and London, 2005, p. 31). For this reason, it is strongly advisable for health promoters to adopt with the use of health belief model in case they wish to reduce the risks of teenage pregnancy. 3.3.1.2 Necessary Skills in Creating Public Awareness Among the few necessary skills needed in creating public awareness include: (1) communication skills such as active listening, oral, verbal, and non-verbal cues used in communications; (2) leadership skills such as empowerment. Instead of using multiple theories and conceptual frameworks, the literacy in health and public awareness on teenage pregnancy is highly dependent on how teenagers would use and understand health-related information that they receive from health promoters (Pleasant, McKinney and Rikard, 2011). For this reason, the use of effective communication skills plays a significant role in creating public awareness. Building intersectoral partnership is essential part of preventing teenage pregnancy (Macpherson, 2013; Basch, 2011; Jones and Barry, 2011). In line with this, Jones and Barry (2011) mentioned that leadership is one of the most important predictors of intersectoral partnership. Likewise, the use of effective leadership skills is necessary in terms of enabling the health promoters increase youth engagement in the programme (Crooks et al., 2010). Therefore, health promoters should also acquire the necessary leadership skills in order for them to have a strong influence on their target audiences and other related organizations (Goodwin, 2006, p. 6). For instance, the use of transformational leadership style is effective in terms of building trust and creating a shared vision within the team (Heuston and Wolf, 2011). Furthermore, the use of transformational leadership style is effective in terms of empowerment and motivation (Curtis and OConnell, 2011). 3.2.3 Mediating Health Promotion through Partnership Majority of the teenage girls can be found in schools. Therefore, health promoters should be able to promote health by mediating partnership with sexual health clinics, schools, teachers, and school nurses (Macpherson, 2013; Basch, 2011). In the process of building good working relationship with a group of sexual health clinic staff, schools’ dean, teachers, and school nurses, it will be much easier for the health promoters to play their role in reducing the cases of teenage pregnancy through the United Kingdom (Basch, 2011). 3.4 Strategies in Place to Reduce Teenage Pregnancy Creating public awareness by teaching sex education in schools is being practice not only in England but also in different countries worldwide (Jennings, Howard and Perotte, 2014; Duffy et al., 2013; Coleman et al., 2013; Wamoyi et al., 2013). For instance, throughout the United States, the government is promoting “abstinence-only education” to reduce teenage pregnancy (Stanger-Hall and Hall, 2011). In UK, NICE and NHS set a universal guidelines for healthcare professionals on how to prevent teenage pregnancies (Hairon, 2007; Walkers and Mackenzie, n.d.). Among the teenage pregnancy prevention programmes in UK include: (1) sex and relationship education; (2) contraceptive services; (3) abstinence education; (4) condom distribution schemes; (5) involving parents; (6) peer education; and (7) youth development programmes (Dennison, 2004). Chapter 4 – Discussion, Conclusion and Recommendations Teenage pregnancy can be avoided through health promotion programmes. Even though teaching sex education in schools is being practice in different countries worldwide (Jennings, Howard and Perotte, 2014; Duffy et al., 2013; Wamoyi et al., 2013), Duffy et al. (2013) pointed out that some teachers in Year 5 and 6 do not have enough confidence to teach students about sexual and reproductive issues related to menstruation sexual intercourse, or wet dreams. Therefore, to increase the success rate of create public health awareness on teenage pregnancy in school, it is essential for health promoters to work together with the school teachers. Likewise, it is also essential for the school teachers to undergo a comprehensive training program in order to improve their knowledge and confidence level when it comes to teaching high school students about sexual education (Jennings, Howard and Perotte, 2014). Aside from effective communication and leadership skills, health promoters should also have necessary skills in research, assessment, planning, implementation, and evaluation. To be able to gain access to new information, health promoters should have good skills in research. When it comes to performing health promotion in different environment and organizations, health promoters should learn how to assess the situation. In case the process of extending teenage pregnancy prevention program is possible, health promoters should immediately plan on what to teach and share with their target audiences. 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