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In 2013, South Carolina implemented a multi-year program providing support services for pregnant and parenting teens. Local lead sites were responsible for coordinating service delivery in partnership with other multidisciplinary community-based organizations. We used social network theory and analyses (SNA) to examine changes in partnerships over time. Using two-stage purposeful sampling, we identified three lead sites and their self-reported community partners. We administered two web-based surveys grounded in social network theory that included questions about partnership relationships and organizational characteristics. We calculated selected whole-network measures (size, cohesion, equity, diversity). Following the Year 1 surveys, we reviewed our findings with the lead sites and suggested opportunities to strengthen their respective partnerships. Following the Year 3 surveys, we observed changes across the networks. Survey response rates were 91.5% (43/47) in Year 1 and 68.2% (45/66) in Year 3. By Year 3, the average network size increased from 15.6 to 20.3 organizations. By Year 3, one lead site doubled its measure of network cohesion (connectedness); another lead site doubled in size (capacity). A third lead site, highly dense in Year 1, increased in size but decreased in cohesion by Year 3. Innovative use of SNA findings can help community partnerships identify gaps in capacity or services and organizations needed to fulfill program aims. SNA findings can also improve partnership function by identifying opportunities to improve connectedness or reduce redundancies in program work. The ability of lead sites to strategically reconfigure partnerships can be important to program success and sustainability.

This study investigated the relatic~mship between social support networks and their effects on sexual behavior during adolescence. The PSS-Fr and the PSS-Fa (Prociando & Heller, 1983) were used to establish the participants' overall perception of their social support networks from their friends and from their family. The Healthy Oakland Teen Survey (Ekstrand et al., 1996) was used to measure the perceived prevalence of risk behaviors among friends of the adolescents, attitudes regarding sexually active students, sexual behavior, and social networks. The predicted result of the experiment was that the strength of an adolescent's social support network would be a predictor for teenage pregnancy. A relationship was found between family support and the number of sexual partners.

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The purpose of this study was to determine if there are differences in birth weight of infants, tobacco use during pregnancy, and Apgar scores of infants between pregnant adolescents who successfully complete a healthy pregnancy curriculum and those who do not and to further examine the adolescent mothers' perceptions of the major concepts included in a healthy pregnancy curriculum. The study involved the collection and analysis of retrospective data to determine differences in birth weight of infants, tobacco use during pregnancy, and Apgar scores of infants. Additionally, a questionnaire, focus group discussions, and follow-up interviews were conducted with former students of the healthy pregnancy curriculum to examine the adolescent mothers' perceptions of the major concepts in the healthy pregnancy curriculum. The participants answered questions regarding how important they thought each major concept is for inclusion in the healthy pregnancy curriculum, how much they learned about each major concept, and how helpful that information was in their own experiences. Analyses of the data did not show statistical differences between adolescents who successfully completed a healthy pregnancy curriculum and those who did not complete a healthy pregnancy curriculum regarding differences in birth weight of infants, tobacco use during pregnancy, and Apgar scores of infants. These findings of non-significance may be due to the small number of participants (n=50), non-participants (n=149), and the limited duration of the study data (1999 to 2003). A larger population over a longer period of time might yield different results. The findings from the qualitative data provided by the seven former students suggest that pregnant adolescents who successfully complete the class perceive the components of the healthy pregnancy curriculum as valuable and important. Topics that were indicated as particularly important were The Birth Process, Nutrition, Decision Making, and Family Planning. Participants further indicated changes in their attitudes for all ten topics and changes in behaviors in the areas of Human Reproduction, Nutrition, Health-Care Practices, Environmental Effects on the Unborn Baby, and Decision Making.

The high teen birth rate in Holyoke, Massachusetts is a complex problem. The teen birth rate is over five times the state‘s rate and nearly three times the national rate. Since a majority of these births are to Latinas of Puerto Rican descent it is important to include the perceptions of Puerto Rican teens in approaches to prevent teen pregnancy and reduce the birth rate. Although there is a plethora of research on the topic of teen pregnancy and births, there is scarcity in the area of perceptions held by teens of Puerto Rican descent about teen pregnancy and births, future consequences faced by teen parents, contributing and protective factors of teen pregnancy, and potential preventive interventions. This qualitative study used a series of eight focus groups to gather data and examine perceptions held by Puerto Rican teens living in Holyoke about teen pregnancy and birth. The Ecological Model of Health Behavior provided the theoretical framework. Findings indicate that Puerto Rican teens in Holyoke perceive that: teen pregnancy is largely unintentional and a problem with negative outcomes, a lack of information on sexual health and reproduction contributes to this problem, sexual and reproductive health education should be provided to all teens, social factors may either contribute to or prevent teen pregnancy teens, and they want their ideas heard. These findings suggest that teen pregnancy and birth is a complex public health problem in need of a comprehensive approach recognizing that interventions focused on individuals are not likely to have powerful or sustained effects. Rather a combination of interventions addressing individual, interpersonal, community and societal levels are needed for risk reduction and effective behavior change

Troup County, Georgia has been afflicted with elevated teen pregnancy and subsequent teen pregnancy rates. As a result, Circle of Care was developed to reduce the subsequent teen pregnancy rate within Troup County. Circle of Care works with pregnant and parenting teens and their families to enhance their quality of life. A case manager provides information, education and support to enable the teens to stay in school, prevent subsequent teen pregnancies, and prevent child abuse and neglect. This study evaluates the effectiveness of Circle of Care by determining if intensity and duration of program participation have an impact on achieving the desired outcomes for program participants. The results of this research suggest that Circle of Care is reducing subsequent teen pregnancies, increasing educational attainment and decreasing child abuse and neglect among program participants.

The teen pregnancy rate in the United States has been rapidly and steadily declining across all ethnic groups and races over the past two decades and is now at an all-time low. Most academic studies attribute this decline to increased and consistent use of contraception. Despite this good news, instead of or in addition to focusing on evidence-based advocacy in their prevention efforts, many social institutions, including public health entities and private sector organizations, continue to use representations of teen pregnancy and motherhood that stigmatize young mothers – or construct narratives of failure – as part of their communication interventions. The advent of social media, however, has given young mothers the means to challenge these mainstream representations and create positive social identities – or construct narratives of success. My research focuses on how images used in prevention campaigns construct or resist representations of teen pregnancy. My methodological framework consists of a combination of textual analysis and qualitative interviews with the image-producers. Theories related to language as an important tool for constructing and resisting representations, communication for social change as a rights-based framework and social media as a site to build identity and interject voice in public discourse are also explored and should be of interest to communication for development practitioners.

This dissertation examines the role of nongovernmental public action (NGPA) in the controversial field of adolescent fertility in Buenos Aires (Argentina), Santiago (Chile) and Montevideo (Uruguay). Embracing a comparative perspective the study investigates the modes in which national policy and institutional environments shape the role of civil society organizations and their margins of autonomy vis a vis other powerful actors such as the State and the Catholic church. Forty one organizations whose mission includes the prevention of teenage pregnancy or the support of teenage parents were studied using a multi-method approach to explore cross national similarities and differences. An exhaustive account of national and subnational policies and programs in this field demonstrates the existence of isomorphic trends in the treatment and framing of adolescent reproductive behavior as a critical issue of public policy in each country. Similarly in all three countries women’s rights organizations play a critical role in the legal recognition and enforcement of adolescents’ sexual and reproductive rights while pro-poor organizations are fundamental actors in addressing the specific needs of teenage mothers and their children. However, important cross national differences were found regarding the modes in which NGPA engages with governmental agencies. As distinctive national marks, the study reveals a strong presence of NGOs in the role of rights watchdogs and monitors in Argentina, a strong alliance between central government structures and technical NGOs to confront resistances to reforms in Chile, and the utilization of NGOs as service providers in detriment of their participation in phases of policy design in Uruguay. Although the language of rights has colonized most of the surveyed organizations, adult-centric practices and discourses are still defining the interaction with adolescents. Adolescent’s demands are rarely voiced and only a few organizations favor their engagement in contentious politics and community activism. Nongovernmental autonomy is severely curtailed as a result of the influence of religion, and the lack of state modernization or financial opportunities, in the three countries. On theoretical grounds, the study highlights the importance of public policy as the arena where the potential of civil society can be maximized. / text