STUDY AIMS: This qualitative study aims to evaluate the hypothesis that vaccination attitudes, knowledge, and factors of influence differ between pregnant teen and young adults and pregnant adults. The study explores these themes in efforts to offer insight on ways in which vaccine uptake and strategies can be improved. METHODS: Participants that were at least 18 years of age, pregnant, and English or Spanish speaking were recruited from the study sites and interviewed. Qualitative interviews consisted of topics including childhood vaccination importance, adult vaccination importance, vaccine information and trust, influenza vaccination and Tdap vaccination in pregnancy, and COVID vaccination. Data collected from interviews were collaboratively coded and analyzed using content analysis. RESULTS: A total of 13 pregnant teens and young adults and 19 pregnant adults participated. Some topics and questions indicated significant differences that supported the hypothesis and rejected the null that there were no significant differences in vaccine attitudes, knowledge, and influence, between pregnant teens and young adults and pregnant adults. These topics and questions included adult vaccine refusal, knowledge of flu vaccine preventing complications in pregnancy, knowledge of Tdap vaccine during in general, knowledge of maternal Tdap vaccination, knowledge of Tdap vaccine during protecting babies against whooping cough, Public Service Announcement influence, and COVID-19 impact on other vaccines. Compared with adults, teens and young adults were less knowledgeable about some vaccinations, more likely to refuse specific vaccinations, and more likely to say that the COVID pandemic negatively affected their views of vaccinations. Despite these differences, vaccination rates were similar. CONCLUSION: Vaccine attitudes and uptake amongst pregnant teens and young adults did not generally differ in most instances from pregnant adults. However, a huge knowledge gap between the two groups were evident. Despite vaccine adherence with limited knowledge in pregnant teens and young adults, their most trusted sources, like health care providers, should put forth greater efforts to provide teens and young adults with vaccine knowledge through suitable platforms and sources.

Engulfed by the tumultuous 1960s, seventeen-year-old Katherine Dayes conceals her pregnancy from the conservative seaside community of Samphire, her hometown. The novella traces a year in Katherine's life, from her summer of love through a winter stained by blood and moonlight. Throughout the story, Katherine endures the push and pull of a culture torn between tradition, represented by community leader Margaret Blythe, and modernism, embodied by the free spirit Evelyn Partridge. Inspired by the life of an actual eighteenth-century woman, Samphire explores the complexities of the 1960s feminist movement. Using vivid imagery of natural elements, it examines opposing views of sexuality and cultural criticisms that women have faced throughout history. The character-driven narrative seeks to deconstruct societal views of teen pregnancy, motherhood, women's sexuality, and infanticide by exploring the psyche of a young woman caught between cultural perceptions and her personal reality.

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The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the development of implementation and evaluation plans for the newly adopted policy. The theoretical framework was based on the social, cognitive, and behavior change theories. The program logic model served as a framework to monitor its progress. Existing peer-reviewed literature, including research studies, state and national teen pregnancy prevention projects and curriculum, and publicly available statistics, were gathered and reviewed by the project team as background to be used for developing and changing policy at the institutional level. Project monitoring involved tracking processes surrounding policy and practice guideline development and adoption, as well as implementation and evaluation plan development for the adopted policy and whether these processes progressed as the empirically-derived teen pregnancy prevention projects should when changing sex education policy at the organizational level. This project resulted in policy adoption and developing a policy implementation and evaluation plan to be disseminated within a county school system that could decrease teen pregnancy rates and demonstrate positive outcomes.

Why are so many girls becoming pregnant in Brownsville, Texas? I encountered this question as a result of my field work. Teachers, school administrators, community officials, parents, and even students pose this question as part of a local concern over the high birth rate among Brownsville youth. As a response to this concern, I engage with this overarching research question by exploring the sex lives and romantic experiences of young mothering teens in Brownsville, through in-depth interviews and focus group discussions. However, as part of a larger mission of problematizing common misconceptions and misunderstanding regarding Mexican-origin youth and their sex lives, this thesis offers a Chicana feminist/borderlands analysis of what the young women shared concerning their sexual experiences. Through their stories, I situate teen pregnancy as a symptom of a complex web of discourses, practices, social institutions, and ideologies regarding sex, thereby elucidating the socio-cultural factors that make young Mexicanas vulnerable to unprotected sex, and consequently unintended pregnancy in Brownsville, Texas. Throughout this thesis I focus on three social and personal venues that stood out as the most influential sources from which my informants learned and talked about sex: peers, mothers, and boyfriends. Contrary to the culture of silence presumed by the literature, the mothers and peers of the young respondents are quite vocal about sex; in fact, there is strong peer pressure for young women to have sex. However, they are expected to so within the context of a committed, heterosexual relationship in which young women give into male desire. This set of social expectations compels young women to have unprotected sex, but also to engage in unwanted sex. In the final chapter, I suggest how sex education can be improved and tailored to the particular needs of Brownsville youth—that is both women and men. / text

Sexual development and interest in sex is a normal part of adolescent development, but the negative outcomes of unprotected intercourse can result in life changing consequences such as an unplanned pregnancy or a sexually transmitted infection. Although the prevalence of these consequences have improvement over the past decade, the United States still has one of the highest teen pregnancy rates and highest prevalence of youth sexually transmitted infection among developed countries. In this report, the determinants that lead adolescents to engage in sex and fail to use contraceptives are reviewed. With knowledge on what factors contribute to adolescent sexual risk taking behaviors, counseling strategies can be implemented to prevent and intervene, and the school counselor is in a prime setting for delivery. The prevention strategies that are covered in this review are grouped into five categories. They are education, skill building, enhancing student development, involving parents and families, and implementing programs. / text

Northern Arizona women of childbearing age are at disproportionately higher risk for poverty and persistent health disparities in maternal risk factors and maternal child health outcomes. Preconception care is a lifespan and population-based approach to providing health promotion activities to women of childbearing age to improve the health of women, their families, and communities. The county's Reproductive Health Program offers comprehensive reproductive and preconception healthcare to underserved women and men throughout the county without regard for ability to pay, serving as a critical safety net for this vulnerable population. A formative evaluation was performed using the CDC's Framework for Program Evaluation in Public Health and retrospective chart review to assess program implementation. In 2010, 1,561 patients received care over 2,575 visits; the majority of patients (69.4%) were women of childbearing age (females 15-44). Most patients (92.9%) were ≤ 150% FPL, and uninsured (77.8%). Program patients were racially/ethnically diverse, with nearly half identifying themselves as White (48.8%), followed by Hispanic (35.3%), and American Indian/Alaskan Native (11.6%). Program reach was limited. Comprehensive medical and social risk assessment and health promotion activities were consistent with evidence-based recommendations. More than 3,400 STI and pap screenings were performed, with identification of 178 abnormal results at the primary program site. One hundred forty-five females had a positive pregnancy test at the primary program site, one-third (33.1%) to teens. For women of childbearing age not trying to become pregnant (98%), a range of family planning methods were provided, which most commonly included oral contraception (36.9%), followed by condoms (15.4%), and Depo-Provera injection (12.6%). More than 10% of low-income females 15-44 received referrals for further medical care not provided with program. Logistic regression analysis revealed program visits associated with a decreased risk of unplanned pregnancy, though this was not significant (OR 0.87, 95% CI 0.59-1.29, p>0.05). In conclusion, this program provided evidence-based preconception care to underserved women of childbearing age, though reach was limited. Additional studies are recommended to explore patient needs and barriers to improve reach and tailor services. Development of a community advisory council is recommended to guide program activities.

The United States has one of the highest teen pregnancy rates among developed countries and ranks third overall in rates of teen pregnancy out of thirty countries in the Organization for Economic Cooperative Development, OECD (UNICEF, 2007). However, as a country we are spending an enormous amount of money on teen pregnancy prevention programs. For example, the Office of Adolescent Health has implemented grant funding opportunities for teen pregnancy prevention programs and provides approximately $105 million to states to design these programs. These programs include personal responsibility education and abstinence only education (http://www.hhs.gov/ash/oah/oah-initiatives/tpp). If we are spending this much on these programs, why do we still have one of the highest teen pregnancy rates among developed countries? Based on what we have learned from current prevention efforts, the goal of this dissertation is two-fold, to introduce alternative theoretical approaches for prevention design and test determinants and protective factors of sexual risk-taking in adolescence. To obtain these goals, this dissertation was written using the three paper option that contains a theoretical paper and two empirical papers that test hypotheses of determinants of sexual risk-taking in adolescence and possible factors that protect youth from engaging in sexual risk-taking, such as school-wide communication and sexual education. The theoretical paper introduces alternative theoretical approaches to not only target individual behavior that may be risky, but also target the contextual constraints in which teens are operating. The empirical papers analyze possible determinants and protective factors for sexual risk-taking in youth.

Road Going Home follows the life of four women of the same family: grandmother, granddaughter, her mother, and her aunt. Mother Karen leaves home at sixteen because she's pregnant, afraid of disappointing parents Ruth and Nelson. Her sister Lacy is just a child when she leaves. Karen has always wanted to leave home because her small town feels suffocating. At the opening of the novel, Karen has moved into a commune in central Virginia. Her father kidnaps granddaughter Dylan in hopes of bringing his family back together. However, the result is the family growing more apart from one another. Thematically, the novel seeks to answer what happens to families when they run away from one another. How do we come back together again? And how do we rebuild those close ties that we once lost?

In the U.S., the Latino youth population is large and growing rapidly and many Latino youth are sexually active. These relatively high rates of sexual activity are concerning because Latino boys and girls, compared to other youth, have the lowest rate of contraceptive use and high rates of sexually transmitted infections (STI’s) and teen pregnancy. Thus, the need for greater attention to factors that influence Latino adolescent sexual health such as sexual risk behavior and attitudes is imperative. An understudied area with respect to Latino youth sexual behavior is the role that an adolescent’s perception of his/her body has on sexual risk attitudes and behaviors and the possible moderating role of cultural factors. To address this gap in the literature, this study obtained data from one hundred and fifty Latino adolescents who completed a survey that assessed sexual risk attitudes and intentions, body image, ethnic identity, and acculturation. Results indicated that both weight concerns and shape concerns were marginally positively associated with more positive attitudes towards condoms among females and with less positive attitudes towards condoms among males. Gender did not moderate relations when examining attitudes towards pregnancy and intentions as outcome variables. At lower levels of Anglo acculturation, negative body image was associated with less sexual risk attitudes among females whereas positive body image was associated with higher risk attitudes towards pregnancy among males. At low levels of Mexican Orientation, more positive attitudes towards condoms were associated with negative body image among males. Results indicated that none of the interactions of participant’s ethnic identity score with the three body image variables were significant in predicting sexual risk attitudes or intentions for either females or males. The findings shed light on the role of body image and cultural factors on sexual risk attitudes and intentions among Latino adolescents.