The Effects of Resilience and Social Influences on Preventing Repeat Adolescent Pregnancies in Parenting Adolescent Mothers

Holness, Nola

doi:10.25148/etd.fi14040804

Cited by 4 publications

(4 citation statements)

References 107 publications

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“…This model, proposed by Porter and Holness,37,38 has four central concepts: the adolescent, pregnancy, recoil-rebound interactions and resilience. The external influences of family, peers, school, church and community, though incorporated, are not major concepts within this theory.…”

Section: Resilience-recoil-rebound Theorymentioning

confidence: 99%

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Whitaker¹,

Hendry

Aslam

et al. 2016

Health Technol Assess

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BackgroundThe UK has one of the highest rates of teenage pregnancies in Western Europe. One-fifth of these are repeat pregnancies. Unintended conceptions can cause substantial emotional, psychological and educational harm to teenagers, often with enduring implications for life chances. Babies of teenage mothers have increased mortality and are at a significantly increased risk of poverty, educational underachievement and unemployment later in life, with associated costs to society. It is important to identify effective, cost-effective and acceptable interventions.ObjectivesTo identify who is at the greatest risk of repeat unintended pregnancies; which interventions are effective and cost-effective; and what the barriers to and facilitators of the uptake of these interventions are.Data sourcesWe conducted a multistreamed, mixed-methods systematic review informed by service user and provider consultation to examine worldwide peer-reviewed evidence and UK-generated grey literature to find and evaluate interventions to reduce repeat unintended teenage pregnancies. We searched the following electronic databases: MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database), EMBASE (Excerpta Medicadatabase), British Nursing Index, Educational Resources Information Center, Sociological Abstracts, Applied Social Sciences Index and Abstracts, BiblioMap (the Evidence for Policy and Practice Information and Co-ordinating Centre register of health promotion and public health research), Social Sciences Citation Index (supported by Web of Knowledge), Research Papers in Economics, EconLit (American Economic Association’s electronic bibliography), OpenGrey, Scopus, Scirus, Social Care Online, National Research Register, National Institute for Health Research Clinical Research Network Portfolio and Index to THESES. Searches were conducted in May 2013 and updated in June 2014. In addition, we conducted a systematic search of Google (Google Inc., Mountain View, CA, USA) in January 2014. Database searches were guided by an advisory group of stakeholders.Review methodsTo address the topic’s complexities, we used a structured, innovative and iterative approach combining methods tailored to each evidence stream. Quantitative data (effectiveness, cost-effectiveness, risk factors and effect modifiers) were synthesised with reference to Cochrane guidelines for evaluating evidence on public health interventions. Qualitative evidence addressing facilitators of and barriers to the uptake of interventions, experience and acceptability of interventions was synthesised thematically. We applied the principles of realist synthesis to uncover theories and mechanisms underpinning interventions (what works, for whom and in what context). Finally, we conducted an overarching narrative of synthesis of evidence and gathered service user feedback.ResultsWe identified 8664 documents initially, and 816 in repeat searches. We filtered these to 12 randomised controlled trials (RCTs), four quasi-RCTs, 10 qualitative studies and 53 other quantitative studies published between 1996 and 2012. None of the RCTs was based in the UK. The RCTs evaluated an emergency contraception programme and psychosocial interventions. We found no evidence for effectiveness with regard to condom use, contraceptive use or rates of unprotected sex or use of birth control. Our primary outcome was repeat conception rate: the event rate was 132 of 308 (43%) in the intervention group versus 140 of 289 (48%) for the control goup, with a non-significant risk ratio (RR) of 0.92 [95% confidence interval (CI) 0.78 to 1.08]. Four studies reported subsequent birth rates: 29 of 237 (12%) events for the intervention arm versus 46 out of 224 (21%) for the control arm, with a RR of 0.60 (95% CI 0.39 to 0.93). Many repeat conceptions occurred in the context of poverty, low expectations and aspirations, and negligible opportunities. Service user feedback suggested that there were specific motivations for many repeat conceptions, for example to replace loss or to please a partner. Realist synthesis highlighted that context, motivation, planning for the future and letting young women take control with connectedness and tailoring provide a conceptual framework for future research.LimitationsIncluded studies rarely characterised adolescent pregnancy as intended or unintended, that is interventions to reduce repeat conceptions rarely addressed whether or not pregnancies were intended. Furthermore, interventions were often not clearly defined, had multiple aims and did not indicate which elements were intended to address which aims. Nearly all of the studies were conducted in the USA and focused largely on African American or Hispanic and Latina American populations.ConclusionsWe found no evidence to indicate that existing interventions to reduce repeat teenage pregnancy were effective; however, subsequent births were reduced by home-based interventions. Qualitative and realist evidence helped to explain gaps in intervention design that should be addressed. More theory-based, rigorously evaluated programmes need to be developed to reduce repeat teenage pregnancy in the UK.Study registrationThis study is registered as PROSPERO CRD42012003168. Cochrane registration number: i=fertility/0068.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Resilience-recoil-rebound Theorymentioning

confidence: 99%

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Whitaker¹,

Hendry

Aslam

et al. 2016

Health Technol Assess

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“…Therefore, adolescents could be promoted to use contraception and mentally prepared to practice safe sex. Typically, young people are fully developed in their sexual identity by this stage (19).They may also live independently from their families and may take on adult responsibilities and roles (20). Late adolescents are able to understand the consequences of current actions and are very concerned about their future, career goals, and often consider desirable potential spouses or life-partner related to the transition to the adult role (19,21).…”

Section: Introductionmentioning

confidence: 99%

Understanding Sexual Reproductive Health from the perspective of Older Adolescents in Northern Thailand: A Phenomenological study

Leekuan

Kane

Sukwong

et al. 2022

Preprint

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Background: Worldwide, Sexual Reproductive Health (SRH) issues comprise a third of health problems for women aged 15-44. SRH education equips people with knowledge of concepts around sexuality and reproduction, and the attitudes and skills help to make informed decisions to prevent sexual and reproductive ill-health problems, including unplanned pregnancy and HIV/AIDS, and other sexually transmitted infections (STIs). The aim of this study is to explore the experiences of older adolescents relating to SRH, examining their attitudes toward sex and contraception, and to identify the gaps in decision-making to prevent risk-taking behaviour.Methods: A qualitative phenomenological study was undertaken with 30 adolescents aged 18-19, purposively and snowball sampled from a university in Northern Thailand from July 2020 to January 2021. In-depth individual interviews were conducted until data saturation was reached. Data were recorded, transcribed, and analysed in ATLAS.ti version 9, using Modified Interpretative Phenomenological Analysis to identify related themes.Results: Participants revealed five key experiences of SRH related to sex and contraception: Keeping a secret; Seeking Freedom and Love; Having SRH education; Self-protection; Parental acceptance. All findings reflected the value and impact of SRH on the experiences of older adolescents.Conclusions: This study provides detailed knowledge about adolescents’ perspectives of SRH and rights in terms of accessing sexual and reproductive health care and information as well as autonomy in sexual and reproductive decision-making. Gaining SRH education can assist decision-making concerning contraceptive methods for family planning and STI prevention. The study recommends that SRH and rights should be designed responsively and appropriately for female and male adolescents, their families, and society. The inclusion of SRH issues should be informed and advocated healthcare providers, educators, policy makers, and systems to empower adolescents in order to achieve effective SRH education.

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“…Therefore, adolescents could be encouraged and supported to use contraception and prepared emotionally to practice safe sex. Typically, young people are fully developed in their sexual identity by this stage [ 23 ]. They may also live independently from their families and may take on adult responsibilities and roles [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…They may also live independently from their families and may take on adult responsibilities and roles [ 24 ]. Late adolescents are able to understand the consequences of current actions and are often concerned about their future, and career goals, and may be considering desirable potential spouses or life-partners related to transition to the adult role [ 23 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding sexual and reproductive health from the perspective of late adolescents in Northern Thailand: a phenomenological study

et al. 2022

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Background Worldwide, Sexual Reproductive Health (SRH) issues comprise a third of health problems for women aged 15–44. SRH education equips people with knowledge of concepts around sexuality and reproduction, and the skills help to make informed decisions to prevent sexual and reproductive ill-health, including unplanned pregnancy and HIV/AIDS, and other sexually transmitted infections (STIs). The aim of this study was to explore the experiences of late adolescents relating to SRH, examining their attitudes toward sex and contraception, and to identify the gaps in knowledge pertiaing to decision-making around risk-taking behaviour. Methods A qualitative phenomenological study was undertaken with 30 adolescents aged 18–19, purposively and snowball sampled from a university in Northern Thailand. Data collaction took place from July 2020 to January 2021. In-depth individual interviews were conducted until data saturation was reached. Data were recorded, transcribed, and analysed in ATLAS.ti version 9, using Modified Interpretative Phenomenological Analysis to identify pertinent themes. Results Participants revealed five key experiences of SRH related to sex and contraception: Keeping a secret; Seeking Freedom and Love; Having SRH education; Self-protection; Parental acceptance. All findings reflected the value and impact of SRH on the experiences of late adolescents. Conclusions This study provides detailed knowledge about adolescents’ perspectives of SRH and rights in terms of accessing sexual and reproductive health care and information as well as autonomy in sexual and reproductive decision-making. Gaining SRH education can assist decision-making concerning contraceptive methods for family planning and STI prevention. The study recommends that SRH and rights-based education should be designed responsively and appropriately for female and male adolescents, their families, and society. The content of SRH should be informed and advocated by healthcare providers, educators, policy makers, and systems to empower adolescents in order to achieve effective SRH education.

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The Effects of Resilience and Social Influences on Preventing Repeat Adolescent Pregnancies in Parenting Adolescent Mothers

Cited by 4 publications

References 107 publications

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Understanding Sexual Reproductive Health from the perspective of Older Adolescents in Northern Thailand: A Phenomenological study

Understanding sexual and reproductive health from the perspective of late adolescents in Northern Thailand: a phenomenological study

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