Bridging the Gap: Fertility Timing in the United States, Theoretical Vantage Points, Effective Public Policy, and Prevention Design

Abstract

The United States has one of the highest teen pregnancy rates among developed countries and ranks third overall in rates of teen pregnancy out of thirty countries in the Organization for Economic Cooperative Development, OECD (UNICEF, 2007). However, as a country we are spending an enormous amount of money on teen pregnancy prevention programs. For example, the Office of Adolescent Health has implemented grant funding opportunities for teen pregnancy prevention programs and provides approximately $105 million to states to design these programs. These programs include personal responsibility education and abstinence only education (http://www.hhs.gov/ash/oah/oah-initiatives/tpp). If we are spending this much on these programs, why do we still have one of the highest teen pregnancy rates among developed countries? Based on what we have learned from current prevention efforts, the goal of this dissertation is two-fold, to introduce alternative theoretical approaches for prevention design and test determinants and protective factors of sexual risk-taking in adolescence. To obtain these goals, this dissertation was written using the three paper option that contains a theoretical paper and two empirical papers that test hypotheses of determinants of sexual risk-taking in adolescence and possible factors that protect youth from engaging in sexual risk-taking, such as school-wide communication and sexual education. The theoretical paper introduces alternative theoretical approaches to not only target individual behavior that may be risky, but also target the contextual constraints in which teens are operating. The empirical papers analyze possible determinants and protective factors for sexual risk-taking in youth.