Shifting the Paradigm from Teen Pregnancy Prevention to Youth Sexual Health

A smiling young woman holds an apple in one hand and books in the otherWith funding from the Family and Youth Services Bureau’s State Personal Responsibility Education Program, the Oregon Public Health Division’s programs take a holistic view of teen pregnancy prevention. They are focusing on all aspects of youth sexual health and involving as many community partners as they can.

In the past, “Everyone was working to improve outcomes for youth one way or another,” says Jessica Duke, manager for adolescent and school health programs at the Oregon Public Health Division, one of Oregon’s state youth-serving agencies and community partners. “But not everyone was thinking about teen pregnancy prevention.”

To get everyone on the same page, five years ago the state used Title V Maternal and Child Health Block Grant funding to put together the Oregon Youth Sexual Health Plan (PDF, 919KB), complete with a list of outcomes and a logic model. The plan seeks to eliminate sexual health inequities, prevent teen pregnancy and sexually transmitted infections, and empower youth to make thoughtful choices that lead to healthier relationships, better sexual health and less dating violence.

‘An Inclusive Umbrella’

The plan brought a sense of unity to agencies that were getting stuck in debate about whether sex education should only focus on abstinence or be comprehensive, Duke says. “Talking about youth sexual health opened a lot of avenues and made it easier for all the partners to see how they fit into youth sexual health as an inclusive umbrella.”

All agencies receiving federal teen pregnancy prevention funding participate in the Oregon Youth Sexual Health Partnership, the group of partners that collaborated together on the plan. Monthly meetings allow Abstinence Education Grant Program, PREP, and Office of Adolescent Health Teen Pregnancy Prevention grantees, agencies working in sexual violence prevention and community nonprofits interested in school health to stay in sync and identify opportunities for continued collaboration.

“When different [funding] opportunities came out there was a big change from thinking competitively to thinking collaboratively, Duke says. “We had conversations about what we wanted to apply for, what programs, what areas, to maximize benefits for whole state. Writing the plan set the stage to do that more effectively.”

Sexual Health Equity

Vital statistics data covering a decade showed that around one-third of Oregon’s teen pregnancies were among Hispanic girls. So PREP program administrators are using ¡Cuídate!, an evidence-based program designed to reduce HIV and sexual risk among Hispanic youth. In order to incorporate more elements of youth sexual health, they added a session on contraceptives. PREP is implemented in six counties representing rural, urban and suburban areas. Each has high sexually transmitted infection rates, high teen pregnancy rates overall or high birth or pregnancy rates among minority groups, such as Hispanic youth.

Involving Youth

The partnership involved youth in the formative research that went into creating the Oregon Youth Sexual Health Plan. Through three youth action research projects, it become evident that youth wanted to know more than just the mechanics of how to prevent pregnancy.

So, members of the Oregon Youth Sexual Health Partnership collaborated, and continue to collaborate, on how to incorporate youth input into their efforts.  An example is Oregon’s AEGP-funded program “My Future-My Choice”, which emphasizes postponing sexual involvement. The program has a Teen Advisory Board that regularly provides input on keeping My Future-My Choice content relevant to youth.

“As they become adults it is developmentally appropriate for young people to start thinking about their sexuality, but just talking about teen pregnancy prevention is not necessarily youth’s focus. If they are not engaging in sexual activity, they won’t relate. Framing programs around sexual health, rather than pregnancy prevention, makes programs more meaningful to youth,” Duke says.