Programs and services to prevent pregnancy, childbearing, and poor birth outcomes among adolescents in rural areas of the Southeastern United States

Loda, Frank A.; Speizer, Ilene S.; Martin, Kerry L.; DeClerque Skatrud, Julia; Bennett, Trude A.

doi:10.1016/S1054-139X(97)00048-7

« Previous Next »Journal of Adolescent Health
Volume 21, Issue 3 , Pages 157-166, September 1997

Programs and services to prevent pregnancy, childbearing, and poor birth outcomes among adolescents in rural areas of the Southeastern United States

Frank A. Loda
- Department of Community Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of International Health and Development, Tulane School of Public Health, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, University of North Carolina School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Ilene S. Speizer
- Department of Community Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of International Health and Development, Tulane School of Public Health, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, University of North Carolina School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Kerry L. Martin
- Department of Community Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of International Health and Development, Tulane School of Public Health, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, University of North Carolina School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Julia DeClerque Skatrud
- Department of Community Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of International Health and Development, Tulane School of Public Health, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, University of North Carolina School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Address reprint requests to: Julia DeClerque Skatrud, Dr.P.H., Research Associate, North Carolina Rural Health Research Program, Cecil G. Sheps Center for Health Services Research, CB No. 7590, University of North Carolina, Chapel Hill, NC 27599-7590.
Trude A. Bennett
- Department of Community Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of International Health and Development, Tulane School of Public Health, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, University of North Carolina School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Accepted 6 September 1996.

Purpose:

To illustrate how rural adolescents' needs for pregnancy prevention and improved birth outcomes are currently being addressed, and to suggest strategies for future programs.

Methods:

Local and state-level informants knowledgeable about services to adolescents in the Southeastern United States were identified. Semistructured interviews were used to determine the program start date and time frame, funding sources, target population, participating counties, implementing agency or organization, specific program services, and status of program activities. These programs were categorized by the type of services offered and the population targeted.

Results:

The most common adolescent services in the rural Southeast attempt either to improve life options of youth, reduce sexual activity, or provide prenatal and postnatal care. Unlike urban areas where there are a variety of family planning providers, in the rural Southeast, health departments are the primary source of family planning for adolescents. There are no abortion providers in most rural areas of the Southeast. The majority of rural programs that include adolescents among the population served are developed for all women rather than specifically for adolescents. Programs specific to rural adolescents are described.

Conclusions:

The majority of programs in the rural Southeast address only selected adolescent health issues. Successful interventions require locally supported, multipronged, intensive approaches with consistent messages targeted to high-risk populations. Evaluation tools are needed to determine the effectiveness of each component of prevention programs.

Key Words: Rural health services, Pregnancy in adolescence, Adolescents, Pregnancy prevention, Childbearing, Birth outcomes

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