Abstract
This chapter discusses the role of healthcare leaders in reducing teenage pregnancy and in determining the scope and depth of teenage pregnancy in a community. The chapter examines current behavior change theories and the importance of using evidence-based programming to increase the success of teenage pregnancy prevention programs. The chapter will create the foundation for change and through interface with other chapters will provide a comprehensive picture of teenage pregnancy within a healthcare leadership context.
TopIntroduction
A teenage pregnancy is a life-changing event. It has impact on the young woman, the father of the baby, both families and society at large. Low educational attainment and delayed graduation, life-long lowered income and dependency, decreased access to safe and affordable housing, lower academic scores, misbehavior and inappropriate behaviors (those that demonstrate internalized anger, sadness, need, etc.---such as personal and domestic violence, stealing, low grades) for the child in school can be the result. Often, risk behaviors and their effects cluster to amplify the collateral damage that follows (Shugar, 2012).
As a leader in any health care setting, it is important to recognize that teenage pregnancy also has economic, political, emotional, and spiritual impact on community, state and the nation. As a health care leader, a part of your responsibility is to improve the health of your community. That responsibility includes providing not only medical care, but also ensuring that counseling, financial assistance and education are available to all those impacted by a teen’s pregnancy. The responsibility of the health care leader also extends beyond the walls of the organization to participation in a community’s engagement in the prevention of teenage pregnancy.
Because teenage pregnancy is such a pervasive, persistent, and complex issue it must include changes in the structure and process of how and what health care is available, accessible, affordable, and appropriate to the community need- all of which involve policy decisions within systems and communities, as well as nationally. There is also a need to identify and change risky behaviors into protective behaviors in order to influence behavior in both male and female teenagers, the peers and families that surround the teenager, and at all levels and systems of the community. It is the imperative of the health care organization and its leaders to engage with the community to create an environment where teenage pregnancy decreases, pregnancies that do occur are healthier for both mother and infant, and that teenage parenting results in stable, responsible, and nurturing families.
This chapter will create the foundation for change as well as interface with other chapters in the book. It will explore ways through which a health care leader can assess and determine community need:
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Utilizing the demographics.
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Assessing the attitudes, beliefs and behaviors of teenagers (both male and female) and the adults who surround the teenager at risk.
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Increasing an understanding of community social norms- “beliefs about what others do, and what others think we should do, within some reference group, maintained by social approval and disapproval” (United Nation’s International Children’s Fund, 2017).
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Increasing community will to recognize and change the risky behaviors
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Community collaboration which leads to consensus and strategies to create change that allow and shape the behaviors that can lead to teenage pregnancy (MacQueen, McLellan, Metzer, Kegeles, Strauss, Scotti, Blanchard, and Trotter 2011).
This chapter will discuss current theories about positive health behavior change that can be utilized to address teen pregnancy prevention at the individual, group and population levels. Lastly, this chapter will provide some implications for health care management practice.
Key Terms in this Chapter
Community Need: Using data (qualitative or quantitative) that has been collected about a community (a group of people, people living in a specific geographic area or for a specific problem) defines “the problem.” “Need” that is the difference or what is missing (gap) between what exists as resources and what is needed to alleviate the problem.
Causality: The relationship that exists between two factors and show a cause and effect; one factor that because it occurs causes a second factor to always occur and can be predictive.
Evidence-Based Programs: A program or intervention for an individual, group, or community of people, based on a behavior change theory, repeated with fidelity and rigorously tested. The program or intervention shows a pattern of positive change toward a desired outcome and is likely to predict the same behavior change if implemented.
Assessment: Evaluation, using judgments that will guide decision making or establish competency.
Healthcare Leaders: A person who is the “visionary” for a healthcare organization; on the organizational chart, the first and second tiers are usually leaders; that person who supervises and sets the direction, goals, and objectives, and has fiscal responsibility for the organization.
Community Benefit Requirements: A report that is created in response to federal regulations, that must be submitted annually by healthcare organizations, governing the amount of contribution (monetary or resources) to a community to improve the defined needs of that community in order that the organization retains its non-profit status with the IRS.
Data: Newly created or existing information that is derived from observation or research. It may be data that uses numbers or values (quantitative), or a description of concepts that cannot be counted or measured but is observed and recorded by a trained researcher (qualitative), or is a combination of quantitative and qualitative information.
Behavior Change Theories: A researcher's analysis of observed or measured behavior – how that behavior changes, what caused it to change, and how future behaviors can be predicted and positively changed.