Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme

Abstract

Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women. Black and minority ethnic young women perceived that the assessment of their risk was based on stereotyping. Others felt their outgoing character was misinterpreted as signifying risk. To manage these imposed labels, stigma and reputational risks, young women responded to being targeted by adopting strategies, such as distancing, silence and refusal. To limit harmful consequences, programmes could involve prospective participants in determining their need for intervention or introduce programmes for young people at all levels of risk.

The tween years: A systematic literature review for services for children aged 10–13 years

“…A tabulated outcomes summary for 36 studies is presented in Appendix B. A few studies (n ¼ 7) were excluded because rather than looking into the effect or outcome of the program, they looked into the reaction of participants being selected (Sorhaindo et al, 2016) or described the service provided (Bigson et al, 2020;de Vries et al, 2016). Other studies focused on personnel providing the service (Raible et al, 2017), explored the problems facing adolescents (Høie et al, 2017), or uncovered barriers that prevented the initiation of a program designed for tween children (Marttinen et al, 2020).…”

Effectively Communicating About HIV and Other Health Disparities: Findings From a Literature Review and Future Directions

“…One study, identified by the snowball method, was conducted in South Korea (Lee and An, 2016) and described a randomized experiment testing the effects of messages about the controllability of a condition (i.e., individual responsibility for the onset of a condition) and group categorization on perceived stigma. The other study, conducted in the United Kingdom, reported results of interviews conducted to learn about the unintended consequences of an intervention targeting a high-risk group (Sorhaindo et al, 2016).…”

“…Messages need to balance the potential benefits of presenting health disparities information to raise awareness and promote behavior change with the potential harms, such as stereotyping and stigmatization (Institute of Medicine, 2002; Guttman and Salmon, 2004;Coleman and Hatley Major, 2014;Keller et al, 2014). For example, while targeting is used to increase the relevance of messages to a priority audience, presenting information that links a particular high-risk group with a negative health condition (i.e., highlighting health disparities) can stigmatize the priority audience (Guttman and Salmon, 2004;Friedman et al's, 2014) and cause them to perceive messages as reinforcing stereotypes (Sorhaindo et al, 2016). Next, we discuss literature addressing our second RQ on the potential unintended adverse effects of communicating about health disparities, including stigmatization and stereotyping, victim blaming, negative emotional reactions, mistrust of health information, and boomerang effects.…”

Effectiveness of the Strengthening Families Programme in the UK at preventing substance misuse in 10–14 year-olds: a pragmatic randomised controlled trial

“… 13 Targeted interventions may also face difficulties in identifying and recruiting such groups, create barriers to engagement through stigmatisation of potential participants 14 and generate iatrogenic effects through reinforcement and normalisation of harmful norms. 15 16 Targeted interventions, which bring together families with high levels of need, may also present problems in relation to feasibility of delivering activities with fidelity. 17 A distinctive aspect of this trial is that the intervention was implemented using a proportionate universal (PU) approach—combining universal provision but with its intensity/scale varied according to need.…”