Monday, December 13, 2010

Preventing Teen Pregnancy: The Failure of Sex Education and The StayTeen Campaign – Laura Pierce

For being one of the world’s most advanced countries, the fact that the United States also has one of the highest rates of teenage pregnancy is not something to be taken lightly. A country that is completely industrialized, with some of the most advanced technology and some of the most educated young people should not also have such a high rate of unplanned pregnancy and sexually transmitted infections. Not only is pregnancy and sexually transmitted infections completely preventable in everyway, but this prevention is also safe and relatively easy. It is not a lack of education or resources that has caused this high statistic, every junior high age child knows about sex and the consequences it ensues. The fact is that “as of 2002, one-third of teens had not received any formal instruction about contraception” (9) meaning we have the resources to teach, they have an understanding of the material but the education does not happen, therefore the contraception available to them is either not used correctly or not used at all because of the lack of understanding its significance. The simple fact that around one out of three girls will become pregnant at least once in their teenage years (11) should be enough incentive for a change in the way our country looks at sexual education.
That is not to say there are not programs available whose effort it is to decrease this statistic. The resources are out there and accessible, but what needs to be implicated is the programs into the correct areas in need. While there is much debate over abstinence versus safe sexual education the issue continues to be; a vast majority of teenagers are going to take part in sexual relations no matter what they were taught in school. Currently, teens aged 18-19 make up 68% of all teen pregnancy (13) and these are teens that have passed the point of zero education. The great debate may center around moral standards, religious practice or parental insecurity but no matter the adult issues, it is still the teenagers who end up engaging in unsafe sexual activity no matter what they are taught. What is good is that the majority of our youth is taught something about sexual education by early middle school. The issue is how the education progresses. In some cases they have very little to none further information provided, especially when it comes to contraceptive use, with the thought that explaining the correct contraceptive methods encourages sexual behavior at a younger age. There are no statistics that outright prove this thought and with teen curiosity it seems to be a safer environment if correct contraceptive use is explained. One of the major indicators of teenage pregnancy is both socioeconomic standing and racial status. Hispanic and non-Hispanic Blacks have considerably higher chances of becoming pregnant as a teen (3). Because of this significant risk differential, it is important to provide pregnancy prevention programs that are catered towards this specific population.
When considering some of the most prominent and popular teen pregnancy campaigns, we can look at both The Candies Foundation (6) and as some of the most recognized and well regarded. The Candies Foundation uses the support of celebrities to bring recognition to prevention of teenage pregnancy while focuses more on providing information for curious teens. (1). At first glance StayTeen seems to provide a curious adolescent with a variety of information ranging from relationship advice to contraceptive options. The site sponsors games about the myths and truths commonly mistaken about sexual activity. It provides links to topical pregnancy television shows such as 16 and Pregnant (14) and The Secret Life of the American Teenager (15) in order to put the consequences of unprotected sex into view. The site explain the only truly one hundred percent measure to ensure you do not become pregnant is abstinence, but with the same token does not in no means suggest this is the moral thing to do. With its various public service announcements and pregnancy, sex and relationship statistics the site is both parent and teen friendly and at first glace StayTeen appears as an ideal teen pregnancy prevention campaign. With further examination and contextual consideration StayTeen is a campaign that can only really influence a small, easily swayed population, whose risk of teenage pregnancy low. This is a campaign put in place to influence adolescents across the country and instead achieves little influence and merely provides enhancing education to those who need it least.

The Health Belief Model and Its Use on
The Health Belief Model is defined as “a conceptual framework that describes a person’s health behavior as an expression of health benefits” (8). It is a way for an individual to balance the risks and benefits of a particular behavior or activity they are going to take part in. The Health Belief Model is used to create and adopt a variety of public health campaigns with a focus on changing an individuals behavior why explaining to them the implications of that behavior. There may be some public health concerns that can be rationalized and with a certain planned technique a program can be put into place that successfully helps individuals change their negative behavior. These campaigns do not deal with teenagers. Adolescents are not only rarely rational but negative behaviors they may partake in become all the more appealing once a figure of authority condemns the behavior. When it comes to sexual activities, the sheer amount of controversy surrounding the issue makes it almost immediately appealing to mischievous adolescents. Therefore when the adolescent in question is considering the behavior the perceived risks and benefits are skewed because of the greater want to take part in the activity.
This conundrum is only enhanced by the StayTeen website with numerous examples of parental opinion and advice to talk with parents or older adults before engaging in sexual activity of any kind. When a program uses rational means such as parental advice to make an impression on an irrational population the opposite effect may happen. This phenomena is most easily explained when considering Psychological Reactance Theory (16). When having a parental figure express the cessation of a behavior, an adolescent perceives their freedom being threatened. If they are not encouraged, or even allowed to partake in a particular activity, nine times out of ten the teen will want to make their own decision, reclaim their freedom and just for the heck of it do the exact activity they were encouraged not to. If a teen is told to postpone from any and all sexual activity, they no longer have the freedom to choose for themselves and are more likely to oppose the advice they are given (3). Taking this theory into consideration it is easy to understand the general failure of abstinence only programs. While StayTeen does not advocate only abstinence there is still a considerable amount of strong suggestions on the decisions teens should make in reference to their sexual activity. These suggestions do not come from peers but from a separate disconnected source that teens cannot directly relate to. The concept of familiarity is lost and the message the site sets out to make becomes weak.

The Misguided Message of
The familiarity the StayTeen website brings is severely lacking. This website should be geared towards the population in need, the population with the highest teen pregnancy issues, the population educated least about safety and sexual activity. This population is usually on the lower side of the socioeconomic scale and greatly diverse. These adolescents may have little parental, or adult of any kind, guidance, or parental misguidance leaving them to fend for themselves in dealing with the tough issues of sex and pregnancy. This population knows about sex. People they know are having it, their friends are talking about it, their teachers may even mention a thing or too about it. What is greatly overlooked is how accurate the information they are getting is.
One out of five adolescent males believe there is less chance of pregnancy if you have sex standing up. Only 79% of eighteen to nineteen year olds are taught the importance of using birth control, and on top of that only 55% were shown the correct usage of a condom (3). StayTeen disproves many of these mistaken statistics, which is beneficial, but it is catered towards a younger audience that does not necessarily even know the facts about sex, much less the myths. The statistics provided do not come with real life examples, they are just numbers on a page with no context and can be seen as completely irrelevant. StayTeen tries to compensate for this by adding links to the sites containing teenage pregnancy television shows; 16 and Pregnant and The Secret Life of an American Teenager (14 & 15). The issue with relating to The Secret Life of an American Teenager is the fictionality it presents. The television show starts off addressing a complicated situation involving a pregnant high school student but loses its relevance when it portrays only a white suburban middle class family. (15) Pregnancy rates aside, this family’s situation is not applicable to much of the country. It may try and illustrate the struggles of a pregnant teen, but this teen also has not only the emotional support of her family and parents but also the financial. The fact is this fictional situation can be considered a best case scenario for some teenage mothers, in some cases completely out of reach. 16 and Pregnant on the other hand takes a completely different view of the situation.
A documentary style show, the teenagers featured are from a variety of backgrounds dealing with an array of issues along with their unplanned pregnancy. (14) These are stories of real life, with adolescent parents struggling to finish high school, find jobs, and care for a newborn. 16 and Pregnant achieves a drastic illustration of the consequences of teenage pregnancy and may be an extremely effect means of scaring adolescents into safe sexual practices. The show is also gaining some public backlash in the media, with claims of teenage girls purposely getting pregnant in order to get on the show and make some money. While this is an unavoidable risk of such a show, it also demonstrates the lack of full understanding the youth has of such a drastic situation. While watching the show they may understand how hard life has become for those featured but optimistic bias takes over and they presume they could handle the situation.

The Threat of Optimistic Bias and the Need for StayTeen to Encourage More Vigorous Education
For this age group optimistic bias spans a variety of issues. Starting with the fact that many adolescents do not believe statistics apply to them. They see the number of teens who experience unplanned pregnancy or sexually transmitted infections and may even know a friend or too that has experienced such a situation but still maintain an illusion of invincibility. Especially as teens age towards eighteen and nineteen, they may not have become sexually active at a young age so there can be a bias towards feeling as though there is no need to worry about pregnancy. This optimistic bias may even continue to an understanding of the risk of pregnancy but a misconception of how difficult and life changing this pregnancy could be. In many cases teens are sexually active with someone they trust and love and could see themselves marrying. It takes away an edge of the pregnancy threat, if you can consider that they could technically be pregnant with this person at a later time in life, why would it be so bad for such a thing to happen sooner? (3). It has almost become “yes, I could can pregnant but I can handle that”, while teens in this situation may have a stronger hold on reality, the statistics of teen parents who finish high school or go to college suggest otherwise. StayTeen does not stretch to educate any situation such as this. The site has forums and blogs with contributions from teen parents and health professionals but neither situation stresses the severity that a situation can have. The site contains videos with messages such as “if I got pregnant I couldn’t go to an amusement park or hula hoop with my friends” (1) and for adolescents to see these they may immediately disregard them and therefore disregard the site as a whole. This consequently can diminish the accounts of actual teen parents, it can make the entire site less relevant and more of a joke that generalizes pregnancy as a whole. No matter the amount of sexual education teens are exposed to the impact of optimistic bias has the capability of weakening any public health program.

In order to fully exploit a public health campaign in preventing teenage pregnancy it is important to lessen the impact of optimistic bias as much as possible. The basis of the StayTeen program tries to accomplish this with a variety of statistics explaining the dangers of sexual activity and unsafe sex practices. Where StayTeen fails is the amount of information they provide and the lack of meaningful real life examples provided. In order to create a new intervention program it is necessary to tale a note from The Candies Foundation. (3). The Candies Foundation has prominent celebrities speaking on their behalf in order to convey their message. These celebrities range from actors and actresses to singers and songwriters, all of who have an association with the adolescent population. A model figure that teens already look up to conveying a necessary public health message has much more impact on this impressionable age group.
What a new intervention needs is to take this celebrity aspect of The Candies Foundation and taking it one step further. At the moment the Candies Foundation has these celebrities expressing the need to practice safe sexual activity, to think about the situation before you take part in it, by illustrating the consequences that could ensue if you do not. The campaign becomes more of a lecture of what not to do, than a way for teens to relate and comprehend the full extent of the situation. This new intervention will take these celebrities and instead have them explain real stories of when they were adolescents. By making their lives seem more real and accessible, and their stories similar to what teens may be experiencing themselves, this campaign can accomplish not only education but also a lasting impression. Celebrities can play a major role is effecting at risk populations. A teen is much more likely to respond positively towards a celebrity they admire and think of as cool, than a teacher or parent they deal with regularly. To implement a program involving celebrities explaining the risks of unsafe sexual activity accompanied with their own past experiences can help teens not only understand the true risk they’re at but also help them see they are not alone. To fully accomplish this the intervention needs to work on getting ride of the taboo surrounding sexual activity.
In the United States discussing sexual activity, with teenagers especially, is regarded as something almost to private to talk about. With a high percentage of Christianity deeming premarital sexual activity as immoral, a taboo has been in place in publicly discussing sex. In the context of impressionable adolescents this taboo is all the more apparent, for fear of any encouragement to engage in immoral behaviors. While one sole intervention could in no means change this entire taboo, an effort to more discussion of sexual activity, with teens especially, can slowly encourage a more socially acceptable situation. There is the worry that adolescents cannot handle such significant topics and discussions or they will automatically be encouraged to engage in them once they are mentioned but we tend to disregard how smart teens truly are. StayTeen needs to become more public. The fear of negatively impacting teens needs to become discounted. If StayTeen had more than a few tame public service announcements and an interactive website and expanded to intense full-length commercials and advertisements in schools it could grab people’s attention. A campaign that not only expresses statistics but also demonstrates real life situations with the honest significance they truly are, could be taken seriously by even the most opposing adolescents. The Truth About Sex is a proposed intervention that could accomplish all of this.
Beginning with celebrity endorsements, The Truth About Sex, would have a variety of commercials expressing the true statistics about sexual activity and safe sex. Myths would be countered and the strict facts would be told. These celebrities would then delve further into the issues, expressing their past experiences and how they dealt with them. By becoming more human and coming in on a level that adolescents completely understand, what these celebrities have to say is no longer seen as a lecture. Adolescents do not need a lecture or to be talked down to, they need facts and situations presented in a way they can relate and understand and physiological reactance will most likely not occur.
Now that their idol and favorite musician is talking about how they understood sex as a teen these teens consider making their own positive decisions because a “cool” person showed them it would be okay. They can still become a rockstar at age twenty-one and use a condom. They in fact have a greater chance of becoming a rockstar at age twenty-one because they use a condom, and finish school, and not have to worry about a child. This program is neither encouraging nor disapproving of sexual activity. It is a program to help adolescents understand sexual activity better. A program that stresses the facts that some teens, not matter what they are taught or the morals they value, are going to have sex as teens. With the intense range of hormones teens experience it is natural to be curious about such things and there will always be teens who are experimenting. The Truth About Sex campaign is not about individualizing safe sexual activity, it is about effecting the entire teenage population.
The intervention is meant to be conducive to all at risk populations. By taking the initiative to educate in a relatable way, the Truth About Sex campaign will stress protection always but try to avoid telling teens what behaviors to engage in. The use of statistics is important but not the means to scare teens into protection. It is the real life situations and people who explain their real consequences and regrets that can have the most impact on this generation. Once they fully understand these consequences it is about stressing the fact about contraception and they correct uses of all birth control in order to deter the consequences of unprotected sexual activity. By making contraception available and less of a taboo, there is a higher likelihood teens will use it. The Truth About Sex campaign is just that, it’s the truth, not just the facts about contraception and the statistics about unplanned pregnancy and sexually transmitted infections, but it’s the truth that some teens are going to engage in sexual activity no matter what. It’s a campaign that understands the reality of the situation and hopes to prepare adolescents for anything.

Conclusion is a campaign with positive efforts. A program that hopes to accomplish a diminishing teen pregnancy rate but is misguided in the expanse of its audience. The facts are presented and it tries to relate with real life stories of teenage pregnancy and relationship issues. What StayTeen lacks The Truth About Sex campaign makes up for. By addressing the issues of the Health Belief Model, Optimistic Bias and the misguided message of StayTeen, this new intervention adds an applicable and real factor that was lacking. With teenage pregnancy rates in the United States still high, a program such as The Truth About Sex needs to be implemented in order to not only decrease the taboo on the inevitable sexual activity of teens and teenage pregnancy, but increase the use of contraception and safe sexual behaviors.


1. StayTeen. The National Campaign to Prevent Teen and Unplanned Pregnancy. 2010
2. Stein, R. U.S. Campaign to Promote Abstinence Begins: Groups are Enlisting Parents in Effort to Lobby for Changes in Sex Education. The Washington Post June 8, 2008.
3. Suellentrop, K. The Odyssey Years: Preventing Teen Pregnancy Amoung Older Teens. The National Campaign to Prevent Teen and Unplanned Pregnancy. September 2010.
4. Parents for Truth. Giving Parents a Voice to Support Abstinence Education. National Abstinence Education Association. 2008.
5. Worth the Wait. Scott & White Worth the Wait Sex Education Program.
6. The Candies Foundation. June 2001.
7. Nebbitt, V., Lombe, M., Sanders-Phillips, K., Stokes, C. Correlates of age at onset of sexual intercourse in African American adolescents living in urban public housing. Journal of healthcare for the poor and underserved 2010; 21(4): 1263-77.
8. Health Belief Model. Medical-Dictionary.
9. Sex and Pregnancy Among Teens: Facts on Sex Education in the United States. Guttmacher Institute. December 2006.
10. Graves, K., Senter, A., Workman, J., Mackey, W. Building Positive Life Skills the Smart Girls Way: Evaluation of a School-Based Sexual Responsibility Program for Adolescent Girls. Health Promotion Practice. 2010 November 4.
11. Teen Pregnancy Statistics. Pregnant Teen Help. November 23, 2010.
12. Teen Pregnancy. Adoption Medial LLC.
13. Albert, B. Teen Birth Decline. Again. For Now. Pregnancy Pause Getting Bloggy about Teen and Unplanned Pregnancy. December 8, 2010.
14. 16 and Pregnant. MTV Networks 2010.
15. The Secret Life of the American Teenager. ABC Family Network 2010.
16. Psychological reactance theory. Psycholopedia.

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