Mixed Messages: Findings from a Needs Assessment of Teen Pregnancy Prevention in Central Texas

Background. Nearly 46% of Texas high school students report having ever had sexual intercourse and 47.1% reported not using a condom at last sexual intercourse.  In the Central Texas area, the most recent county-level data for teen pregnancy shows a rate of 33.6 per 1,000 females ages 10 to 19.  In order to understand teen pregnancy in the Central Texas Area, a community based collaboration, the Healthy Youth Partnership, conducted a needs assessment to determine the types of services that are available to teens, how accessible services are, and what barriers teens and their families encounter when trying to access services.

Methods. Youth-serving professionals who were members of the community collaborative guided the design and data collection for the needs assessment in consultation with a university based researcher.  Mixed methods were used to triangulate data collected through multiple sources.  Using purposive sampling, a convenient sample was recruited to participate in 16 separate focus groups.  Focus group participants included 36 teens, 16 teen mothers, 4 teen fathers, and 20 parents of teenagers.  Surveys were also administered to professionals in the Central Texas community via listserves, conferences and word of mouth. Surveys were completed by 38 teachers, 83 youth-serving professionals, and 13 medical providers. Descriptive statistics were produced for quantitative data.  Qualitative data was analyzed using conventional content analysis.

Results. Findings from the needs assessment highlight barriers to pregnancy prevention in the Central Texas Community.  Teens cited barriers to safer sex practices, including access and misinformation about birth control, embarrassment when purchasing condoms and the restriction requiring them to get parental consent to access reproductive services, which is the case outside of Title X clinics in Texas. Our teen parent participants cited additional barriers to receiving services such as their age (being under the age of 18 and having minor status), waitlists for childcare, and little to no guidance from service providers. Concerns over preventing a second pregnancy were cited as a result of teen parents no longer being able to afford birth control because funding had been cut from their clinic or service provider. Parent participants emphasized the need for parent-child communication around sex, but the level of comfort and confidence in talking about sex varied, which was also found among our provider participants as well. Participants also suggested this sex education be provided earlier, at younger ages. Teens recommended peer-led sex education while teen parents offered to share their experiences of teen parenting with other teens.

Implications. Overall, the model used in this needs assessment is a useful tool for communities. Specific to teen pregnancy prevention, teens, teen parents, and parents recommended increased, open, and honest communication about sex in their communities by providing comprehensive sex education that includes contraception methods and raises awareness of available sexual and reproductive health resources for teens in the community. Both state and local policies should shift to provide evidence-based sex education.