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Abstract Despite the fact that the incidents of teen pregnancy has been on a steady decline since1991 (CDC, 2011), they still remains too high. Each year teen pregnancy resulting in live births is responsible for the initiation of a cycle of poverty that ends up costing the United States over $40 billion in family aid to teen families. This figure accounts for subsidies provided in the form of cash, medical, housing and food assistance for the more than 1 million teens that give birth annually. Whats more alarming than the figures for live births to teen mothers is the alarmingly high pregnancy rates. In fact, the pregnancy rate for teens is more than three times that of live births. This poses a significant social problem that has spanned generations and is extremely problematic especially in light of the fact that teen pregnancy is entirely preventable through the use of contraception as well as abstinence. Within my practice I generally see approximately 10 to 15 pregnant teens annually. This figure is but a small proportion of the teens seen in my school-based clinic, however, one teen pregnancy is one too many. In addition to this, my clinic only sees a small percentage of the teens enrolled in my site that become pregnant. Many of the pregnant teens seek medical attention from outside clinics. Keeping this in mind, the impact is one that lasts a lifetime and has implications for future generations. The impact is seen in all aspects of life and can include a life of poverty, low earning potential and poor education. In order to examine the factors that contribute to teen pregnancy, I intend to conduct a retrospective study utilizing the data from patient charts within a five-year period. In examining the data I will include measures such as the socioeconomic status of the teens family, parental education, parental marital status and the age of conception (with the first child) for the pregnant

YOUTH FIT FOR LIFE PROTOCOL

teens mother. In examining these factors I will be able to design an intervention that takes these factors into consideration.

EVIDENCE SUMMARY TABLE Citation Smith, D.M. & Elander, J. (2006). The effect of area and family deprivation on risk factors for teenage pregnancy among13-15year-old girls. Psychology, Health & Medicine, 11(4), 399-410. Research Methods/Design 2 X 2 Factorial Design using a sample of 201 girls residing in deprived areas and affluent areas in the UK. 128 resided in the deprived areas and 73 in the more affluent areas. The level of evidence aligns with Level B evidence based on the AHA Levels of Evidence for research. The research method used by the researchers was systematic review of 10 research studies that aligns with Level A evidence based on the AHA Levels of Evidence for research. Results The results of this study indicated that both area and family deprivation contributed to early sexual activity and has implications for early pregnancy. Investigators Conclusions The researchers were able to conclude that young girls who resided in more affluent areas were expected to achieve more and as a result got pregnant less frequently than girls living in poorer areas. Significance to Your Project This body of research is significant to my project because it illustrates that socioeconomic status could be a contributor to teen pregnancy

Acharya, D.R., Bhattarai, R., Poobalan, A., van Teijlingen, E.R. & Chapman, G. (2010). Factors associated with teenage pregnancy in South Asia: A systematic review. Health Science Journal, 4(1), 3-13.

The researchers indicated that SES, low educational attainment and cultural as well as family structure were identified as risk factors for teen pregnancy.

In South Asia general socioeconomic factors are associate with teen pregnancy, however, more studies need to be done in order to determine the influence of the individual components of socioeconomic status.

This body of research is significant to my project because it illustrated that elements of socioeconomic status as well as low educational attainment and family structure determine the likelihood of a teen becoming pregnant.

TEENAGE PREGNANCY: FACTORS AND INFLUENCES

Research Citation Methods/Design Smith, D.M. & Roberts, B. Semi-structured (2011). Social inequalities interviews that and young pregnancy: the aligned with Level causal attributions of young B evidence based parents in London, UK. on the AHA Levels Health Place, 17(5), 1054- of Evidence for 1060. research.

Secor-Turner, M., Sieving, R. & Garwick, A. (2011). Social messages, social context, and sexual health: voices of urban African American youth.

Individual interviews with 20 African-American young women. The level of evidence aligns with Level B evidence based on the AHA Levels of Evidence.

Results The findings of the study indicated that the parental relationship with the teen, access to education and career alternatives along with the acceptance of pregnancy contributed most to whether a teen would become pregnant. The findings of the study indicated that there were five general themes relative to teen pregnancy. The themes included age of first sexual encounter, social context and messages sent by becoming sexually active and the decision to become pregnant

Investigators Conclusions The study authors concluded that further study needs to be done in order to determine a more precise contribution of the study factors.

Significance to Your Project These findings are important to my project because the findings did indicate that SES played a part in influencing teenage pregnancy.

The study authors concluded that there was an extremely complex relationship between the age of first sexual encounter, social context and messages sent by becoming sexually active and the decision to become pregnant.

The findings are important to me because I do intend examine the factors that contribute to teen pregnancy. This study identified some of these factors.

TEENAGE PREGNANCY: FACTORS AND INFLUENCES

Citation East, P.L., Reyes, B.T. & Horn, E.J. (2007). Association between adolescent pregnancy and a family history of teenage births. Perspectives on Sexual and Reproductive Health, 39(2), 108-115.

Research Methods/Design The research method used by the researchers was Logitic regression analyses using a sample of 127 Latino and Black adolescent females. The level of evidence aligns with Level B evidence based on the AHA Levels of Evidence.

Investigators Results Conclusions The study authors used a Family history of teen family history of teenage pregnancy had births to determine the significant implications relationship between family for whether a teen would history and the likelihood of become pregnant and as a teen becoming pregnant. such, interventions In so doing, they were able should take maternal and to determine that teens who sibling pregnancies into had a mother and at least consideration. one sister who were teen mothers were more likely to be pregnant as teens than teens who did not have a mother or sister who were pregnant as teens.

Significance to Your Project These findings of this study are extremely important to my body of research because it includes contributory factors to teen pregnancy.

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TEENAGE PREGNANCY: FACTORS AND INFLUENCES

Citation Young, T., Turner, J., Denny, G. & Young, M. (2004). Examining external and internal poverty as antecedents of teen pregnancy. American Journal of Health Behavior, 28(4), 361-373.

Research Methods/Design The research method used by the researchers was a longitudinal study that aligns with Level B evidence based on the AHA Levels of Evidence for research.

Investigators Results Conclusions The purpose of the study Since the study subjects was to examine the factors were eight grade that influenced whether a students and the teen would become likelihood of them pregnant. The study becoming pregnant authors identified two depended on both general classes of internal and external contributing factors. Those poverty. The study factors were classified as authors determined that internal and external interventions should poverty. Internal poverty begin prior to the eight included the locus of grade and should include control, the expected measures to instill an educational level and internal locus of control whether the teen was in the student along with confident that he/she will the promotion of graduate from high school. academic achievement The only variable indicating and measures to prevent external poverty was the internal poverty. highest level of education attained by the parent of the teen subject.

Significance to Your Project These findings of this study are extremely important to my body of research because it includes contributory factors to teen pregnancy.

TEENAGE PREGNANCY: FACTORS AND INFLUENCES

Citation Khalili, A. (2005). The Neighborhood Socioeconomic Context and the Outcomes of Adolescent Childbearing in Urban Metropolitan Areas. Sociological Viewpoints, 21, 19-34.

Research Methods/Design The researchers conducted a correlational study to determine the variables that are linked to teenage pregnancy. The level of evidence aligns with Level B evidence based on the AHA Levels of Evidence for research.

Al-Sahab, Heifetz, M., Tamim, H., Bohr, Y & Connolly, J. (2012). Prevalence and characteristics of teen motherhood in Canada. Maternal and Child Health Journal, 16(1), 228-234.

Results The study authors utilized the census data from the 1990 census to identify 89 neighborhoods in the city of Pittsburgh. This was done in order to identify the variables associated with teen pregnancy. In so doing, they were able to determine that poverty, median family income, education and occupation as well as family disruption played a significant role in whether a teen would become pregnant. The researchers The study authors found conducted surveys that socioeconomic and of teen women 15 demographic factors and older. The contributed to whether the level of evidence teen would become aligns with Level pregnant. This contribution B evidence based was directional in that teens on the AHA who reside in low income Levels of Evidence areas were more likely to for research become pregnant as were teens of lower socioeconomic status.

Investigators Conclusions The study authors concluded that poverty, family income and occupation as well as parental education played a significant role in whether a teen became pregnant.

Significance to Your Project These findings of this study are extremely important to my body of research because it includes contributory factors to teen pregnancy.

The study authors concluded that poverty as well as socioeconomic status could be utilized as predictors of pregnancy.

These findings of this study are extremely important to my body of research because it includes contributory factors to teen pregnancy.

TEENAGE PREGNANCY: FACTORS AND INFLUENCES

Research Citation Methods/Design Turner, K.M. (2004). The researchers Young womens views on studied 248 teens teenage motherhood: A [average age 15.6] possible explanation for the using six relationship between socio- discussion groups economic background and and utilized teenage pregnancy content analysis to outcome? Journal of Youth report the results. Studies. 7(2), 221238.

Roberts, S.I., Lewis, R.K. Carmack, C. (2011). Positive youth development among African American Adolescents: Examining single parents as a factor. Journal of Prevention & Intervention in the Community, 39(4), 310329.

The researchers utilize a survey of 462 African American youths in order to establish a correlation between teen pregnancy and single parenthood.

Results The study authors found that the views of teen pregnancy held by teens varied depending on whether the teens were from affluent families or not. The findings indicated that poorer teens were more likely to view themselves as being pregnant in their teen years. The study authors found that high teen pregnancy rates were positively correlated with singleparent households and poverty stricken neighborhood.

Investigators Conclusions The perception of teens relative to pregnancies depends on whether teen pregnancy is acceptable by that group. Moreover teen pregnancies seem to be more acceptable for poorer teens.

Significance to Your Project These findings of this study are extremely important to my body of research because it ties socioeconomic status into the subject.

The study authors concluded that educational level was negatively correlated with teen pregnancy as well as teen sexual activity.

These findings of this study are extremely important to my body of research because it ties family structure

References Centers for Disease and Prevention. (2011). About Teen Pregnancy. Retrieved on January 21, 2012 from http://www.cdc.gov/TeenPregnancy/AboutTeenPreg.htm#PTP1.