Reproductive Health

Eight of 17 YEP grantees focus specifically on the issues of reproductive health, but all grantees develop youth assets that have a general effect to reduce risky behaviors.

The YEP’s effect on reproductive health outcomes can be seen in teen live birth rate data collected across the entire Youth Empowerment Program. Normative live birth data are commonly presented for 15-19 year olds, as the live birth rate is relatively low for 10-14 year olds. Therefore, three grantees who work exclusively with younger students, or males, were excluded from the live birth analysis. Similarly from the remaining YEP grantees, we included only those females who were of high school age in this data set. One additional YEP grantee, the University of Utah, was also excluded because that program works specifically with females who are already teenage mothers, and are therefore at a much higher risk of a second pregnancy. The data from Utah’s YEP in preventing a second teen pregnancy are individually featured after the YEP group data are presented.

Reproductive Health Data

Accordingly, a total of four YEP grantees were eliminated from the analysis, leaving data from 13 YEP grantees who reported on a total of 270 YEP females, ages 15-19. A cumulative rate of live births was calculated and reported in Figure 3-1 as births per 1000 female students across all YEP grantees in order to normalize the data to the standard reporting format. Three normative data sets for 15-19 year olds were identified to which the group data from the grantees could be compared. First, a normative local, city, or reservation rate was computed that includes the number of teen live births matched for ethnicity, race, and location. Second, state-wide ethnic and racial data for teen live birth rates were obtained for each of the states where YEP grantees are located. Third, overall teen live birth rates from all 11 states were obtained that described the rate of births for all teens statewide. The latter normative data includes White, non-Hispanic and Asian teens who have lower teen birth rates, and also includes areas of the state where birth rates are much lower than in the targeted YEP areas.

The data show that the yearly live birth rates in the three normative comparison groups were 6-18 times greater than in YEP females (p < .0001). Thus, compared to teens in any of the three normative groups, the YEP data suggest an important effect in reducing the incidence of teen pregnancy.

Reproductive Health Data

A similar analysis was performed to compare self- or clinic-reported STDs in a total of 653 YEP students. When extrapolated to the most commonly reported format, the rate of STDs in the YEP was only 459 per 100,000 youth. The YEP STD rate was compared to the national STD rates for chlamydia and gonorrhea together, the two most common STDs, in 15-19 year olds (Figure 3-2). Note that the STD rate in Black, non-Hispanic youth is 15 times greater than the rate in YEP students. The rate in Hispanic youth is nearly four times higher than in YEP students. Furthermore, the YEP STD rate is below even that of White, non-Hispanic youth. Thirteen YEP grantees provided STD data for these analyses. Institutions that collectively provided reproductive health data and comparison groups for this analysis were CSU Long Beach, CSU San Marcos, Chicago State University, Columbus State Community College, CUNY–Hunter College, CUNY–Medgar Evers College, Kentucky State University, Marquette University, Oregon Health & Science University, University of Pennsylvania, Tennessee State University, Stone Child College, and the University of Utah.

Success in Reproductive Health at the University of Utah: Latinas Adelante

The “Latinas Adelante: Hispanic Teen Moms” program is hosted by the University of Utah’s College of Social Work. “Latinas Adelante” addresses risky sexual behaviors and their consequences in disadvantaged Hispanic females. Originally, the program targeted 30 at-risk teen mothers, ages 12-17, who enrolled at an alternative school in the inner city of Salt Lake City, UT. At the beginning of Year 3 of its YEP grant, 27 mothers were still enrolled. One hundred percent of the YEP cohort qualify for Head Start and free or reduced lunch indicating the high levels of poverty and the at-risk nature of this population. Latinas Adelante focuses on helping teen Latina mothers “develop healthy lifestyles,” graduate from high school, and continue with post-secondary education. The program provides training in life skills, decision making, problem solving, sex education, nutrition, exercise, substance abuse prevention, and other health topics. A case management approach is employed to individualize each student’s program to their specific needs.

A one-hour life skills training session is provided during each school day, while an after-school program provides tutoring and mentorship by college students, advising, college planning, and family-based programs. The alternative high school provides child care to allow the teen mothers to participate. A four-week summer program offers team building, science enrichment, reading, writing, and career exploration. The participants are introduced to a team of Latina professionals, affiliated with the University of Utah, with most having a doctoral or master’s degree. For many, the program provides the teen mothers with their first exposure to successful Latina role models, demonstrating to these young Latinas that they can achieve academically, complete high school, and seek a college education.

Results From Latinas Adelante

In Salt Lake County, local Hispanic teen mothers have an 18.6% annual rate of repeat pregnancies. By contrast, Latinas Adelante had a repeat pregnancy rate of only 6.6%. Accordingly, the data suggest that YEP programming reduced the incidence of a second pregnancy by roughly two-thirds.

Within Latinas Adelante, the rate of chlamydia as an STD was only 1.6% per year. By contrast, chlamydia is a significant problem among Hispanic females in the Salt Lake area. In 2010, 26% of Hispanic females, ages 12-18, in Salt Lake County had confirmed cases of chlamydia. Thus, the normative chlamydia rate is 16 times higher than in the Latinas Adelante program. For gonorrhea, the County rate in Hispanic female teens is 10.8% per year. By contrast, no cases of gonorrhea have been reported in the Utah YEP cohort. Accordingly, the rates of repeat pregnancies and STDs in Latinas Adelante are only a fraction of the expected rates for age-matched, Hispanic females in the same local area. These early results suggest a positive effect of YEP programming in reproductive health to reduce a second teen pregnancy and STDs.

Finally, the Latinas Adelante program has had a dramatic effect on educational outcomes. Eleven students have reached the high school senior year, and of those, eight or 72.7% have graduated. This rate is in stark contrast to the remaining Hispanic teen mothers at the same school, who were not in Latinas Adelante. Of those 45 non-YEP, Hispanic teen mothers, only seven have graduated — a graduation rate of only 17%. Therefore, the graduation rate is more than four times higher in Latinas Adelante than in non-YEP teen mothers attending the same alternative school. Additionally, six of the eight Latinas Adelante mothers who graduated from high school, or 75%, are currently enrolled in a local community college (see Youth Assets section for more). By contrast, only two of the seven non-YEP teen mothers who graduated at the same alternative school have enrolled in college over the same time frame. In other words, only 28% are in college compared to 75% of the YEP teen mothers. A positive correlation between academic achievement and healthy behaviors has been convincingly shown in youth, and the data from Latinas Adelante is consistent with that conclusion (read the Latinas Adelante story).