Adolescent Health, Medicine and Therapeutics (Oct 2020)
Perspectives on Adolescent Pregnancy Prevention Strategies in the United States: Looking Back, Looking Forward
Abstract
Claire D Brindis,1 Martha J Decker,1,2 Abigail Gutmann-Gonzalez,2 Nancy F Berglas1– 3 1Philip R. Lee Institute for Health Policy Studies, Adolescent and Young Adult Health National Resource Center, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA 94118, USA; 2Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, USA; 3Bixby Center for Global Reproductive Health, University of California, San Francisco, Oakland, CA 94612, USACorrespondence: Claire D BrindisPhilip R. Lee Institute for Health Policy Studies, Adolescent and Young Adult Health National Resource Center, Bixby Center for Global Reproductive Health, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118, USATel +1 (415) 517-4521Email [email protected]: Attempts to solve the “problem of adolescent pregnancy” have long been a focus of national, state, and local efforts in the United States. This review article summarizes trends and strategies around adolescent pregnancy prevention, provides lessons learned and best practices, and presents ideas for future directions. Over the past decades, a wide variety of policy and programmatic interventions have been implemented – including educational efforts, clinical health services, and community-wide coalitions – accompanied by a growing consensus regarding viable solutions. While notable reductions in adolescent pregnancy and childbearing have occurred across all sociodemographic groups, racial/ethnic, geographic, and socioeconomic disparities persist. Many adolescents who most need sexual health information and services are underserved by current programs and policies. A growing understanding of the role of social determinants of health, the impacts of structural racism, and the need for equity and inclusion must inform the next set of interventions and societal commitments to not only ameliorate the occurrence of unintended adolescent pregnancy but also foster healthy adolescent development. Recommendations for future efforts include improving the content, quality, and sustainability of education programs; actively engaging youth in the design of policies, programs, and clinical services; using technology thoughtfully to improve health literacy; expanding access to services through telehealth and other delivery options; and designing programs and policies that recognize and address structural racism, health equity, and inclusion.Keywords: pregnancy in adolescence, sex education, reproductive health services, United States
