Promoting Adolescent Sexual Health: A Community Needs Assessment

Background: This needs assessment is part of a partnership with four community agencies that resulted in a $4.9 million grant ($987,500 a year for five years) from the U.S. Department of Health and Human Services Office of Adolescent Health to reduce teen pregnancy. The target population for this project is teenagers ages 10 to 19 that reside in one of five zip codes with extraordinarily high teen birth rates (84.2 to 112.9 per 1000 girls), exceeding the 26.5 per 1000 girls national rate by more than 300%. While this city's teen birth rate is very high at 50.5 births per 1000 girls, the five target areas teen birth rates are much more alarming: 112.9 per 1000; 108.4 per 1000; 96.5 per 1000; 90.4 per 1000; and 84.2 per 1000.

Methods: Data for the needs assessment were collected via focus groups and surveys.  Focus groups were conducted in all target zip codes. The participants are predominantly female (70% female; 30% male) and Hispanic (60% Hispanic; 40% Black). Forty-four parents and 32 teens participated in focus groups. Focus groups were held at social service agencies that serve at-risk youth and adults in these communities. Focus groups with teens addressed their sexual health and opinions regarding teen pregnancy prevention in their community. Focus groups with parents elicited concerns about communicating with their teens about sex.  In addition, 20 medical providers, 45 educators, 36 service providers completed online surveys. Seventy-one teens completed surveys. Teens who participated in focus groups were asked to complete a survey before the focus group started.  The remaining teen surveys were completed at community agencies.  Participants were recruited via fliers, direct contact of community agencies, and direct emails to educators, service and medical providers

Results: Qualitative analysis revealed five themes: the need for comprehensive sexual education, parent education and support programs, increased linkages to services, greater focus on career training and future goals, and promoting healthy relationships. Findings suggest that teens face tremendous barriers in accessing contraception and obtaining adequate information about contraception use. 85% of educators, 92% of medical providers, and 93% of service providers surveyed felt that the lack of education about contraceptives use puts teens at greatest risk of unintended teen pregnancy. Several service providers reported that teens are not accessing their services due to lack of knowledge. Findings also suggest that parents need more information and support to discuss sexual health with their teenagers. An overwhelming majority reported low self-efficacy in discussing sex with their teens.

Conclusion and Implications: It is imperative that health professionals and social work practitioners recognize the importance of including parents in teen pregnancy prevention. Social workers can help parents learn effective strategies to discuss sexual health with their children. In addition, more funding is necessary to mobilize and engage communities to implement innovative teen pregnancy prevention tailored to the target community’s needs. Teens need access to contraception and comprehensive sex education in their communities.  These barriers must be addressed in order to have a sustaining community wide impact on teen pregnancy.