Teen Pregnancy Robin Killingsworth HCS/465 June 16, 2014 University of Phoenix Running head: TEEN PREGNANCY 1 TEEN PREGNANCY 2 Teen Pregnancy The problem at hand is the issue of teen pregnancy. Teens are young people who have just joined adulthood. The issue seems to be more prevalent in the rural areas. Sexual activities by the teenagers are on the rise this result to young girls getting pregnant. This issue is a big problem to the nursing practitioners in these rural communities; this challenge is intensified by presence of barriers to open discussions concerning teen pregnancy for instance , many rural southern communities social and cultural aspects discourage the open discussions on safe sexual practices it’s like a taboo (Weiss, 2012). The problem is important for healthcare administrators to study for cases of teen pregnancy are associated with increased infant and maternal risk complications and hardships, this settles more on costs related handling such situations. These teens are forced to drop out of school , lead marriages that break easily and in many situation they lead a life of poverty .this affects both the infant and the teen whose skills and ability to bring up a baby are insignificant in case where a concerned grown up does not intervene. Understanding how to handle those situations and challenges will increase the efficiency on service provision units dealing with teen children especially girls at the rural community health centers. Research purpose The purpose of this research was to analyze the essays written by high school students to gain insight concerning teen pregnancy rate in the rural community. This will help to establish the contributing factors to the problem of teen pregnancy eliminate barriers to successful discussions on teen pregnancy issue and implement appropriate interventions to manage teen pregnancy problems within the rural communities (Weiss, 2012). Research question Research question is one which is concise, focused and clear that surrounds the whole research. In this research, the research question was; is teen pregnancy a problem in our community? Hypotheses This is a statement that gives predictions of an experiment or research based on speculations on the expected outcome, based on the research problem. The following hypotheses can be formulated. • Why is teen pregnancy problem to our community? • Why is the teen pregnancy problem more prevalent in rural communities? • Rural communities’ teens are the most vulnerable in teen pregnancy issue. • Teen pregnancy education and contraceptive use promotion will ease the burden of teen pregnancy among the rural communities. Study variables Variables are aspects within the experiment that will be measured to show any change. We have dependent variable which is measured during the experiment. The independent variable shows any change that occurred .it affects the dependent variable. Dependent variable is pregnancy which the independent variabl ...

1. Teen Pregnancy
Robin Killingsworth
HCS/465
June 16, 2014
University of Phoenix
Running head: TEEN PREGNANCY
1
TEEN PREGNANCY
2
Teen Pregnancy
The problem at hand is the issue of teen pregnancy. Teens are
young people who have just joined adulthood. The issue seems
to be more prevalent in the rural areas. Sexual activities by the
teenagers are on the rise this result to young girls getting
pregnant. This issue is a big problem to the nursing
practitioners in these rural communities; this challenge is
intensified by presence of barriers to open discussions
concerning teen pregnancy for instance , many rural southern
communities social and cultural aspects discourage the open
discussions on safe sexual practices it’s like a taboo (Weiss,
2012). The problem is important for healthcare administrators to
study for cases of teen pregnancy are associated with increased

2. infant and maternal risk complications and hardships, this
settles more on costs related handling such situations. These
teens are forced to drop out of school , lead marriages that
break easily and in many situation they lead a life of poverty
.this affects both the infant and the teen whose skills and ability
to bring up a baby are insignificant in case where a concerned
grown up does not intervene. Understanding how to handle
those situations and challenges will increase the efficiency on
service provision units dealing with teen children especially
girls at the rural community health centers.
Research purpose
The purpose of this research was to analyze the essays written
by high school students to gain insight concerning teen
pregnancy rate in the rural community. This will help to
establish the contributing factors to the problem of teen
pregnancy eliminate barriers to successful discussions on teen
pregnancy issue and implement appropriate interventions to
manage teen pregnancy problems within the rural communities
(Weiss, 2012).
Research question
Research question is one which is concise, focused and clear
that surrounds the whole research. In this research, the research
question was; is teen pregnancy a problem in our community?
Hypotheses
This is a statement that gives predictions of an experiment or
research based on speculations on the expected outcome, based
on the research problem. The following hypotheses can be
formulated.
• Why is teen pregnancy problem to our community?
• Why is the teen pregnancy problem more prevalent in rural
communities?
• Rural communities’ teens are the most vulnerable in teen
pregnancy issue.
• Teen pregnancy education and contraceptive use promotion
will ease the burden of teen pregnancy among the rural

3. communities.
Study variables
Variables are aspects within the experiment that will be
measured to show any change. We have dependent variable
which is measured during the experiment. The independent
variable shows any change that occurred .it affects the
dependent variable. Dependent variable is pregnancy which the
independent variable is age of the adolescent
Conceptual framework
This shows a conception or model of what is to be studied to
show why things are the way they seem to be to attract a
research. This helps to describe a tentative phenomenon that the
researcher has shown interest upon; this will guide to achieve
the research purpose. . The conceptual framework guided the
study by starting with determination of data sources and its
analysis by the software max qualitative data analysis. The
analysis results were stated generally and latter for the teen
pregnancy which was the point of interest. The problem and the
reasons behind were stated and a proposed prevention like
promotion of discussion concerning safe sexual practices was
agreed as mitigations for the problem.
Literature review
This help to gain prior knowledge to be able to understand the
problem under study, its background and latest trends. The
literature review in this contest was supportive to this study
needs in that it, gives a general overview of the teen pregnancy
status across the USA annually, it also gives an overview of the
contributors and challenges that healthcare providers dealing
with teenagers and the pregnant teenagers face due to teen
pregnancy concern (Weiss, 2012). With this, an intervention can
be designed for ultimate goal of a research is to establish the
problem and find a solution.

4. Study design
The study design in this research study is a systematic review
where a full survey on the main theme is done from given
relevant sources, either published or unpublished but it is of
high quality content; is evidence based. Each study is assessed
and findings are noted. This has little bias influence. For the
research study 250 teenager were selected as the study sample
from rural south Florida community (Weiss, 2012). The study
was conducted within a school organization within the time
period of English classes.
References
Weiss, J. A. (2012, November). Who Will Listen? Rural Teen
Pregnancy Reflections. , 8(10), 1-7.

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Document 1 of 1
Who Will Listen? Rural Teen Pregnancy Reflections
Author: Weiss, Josie A
ProQuest document link
Abstract: Nurse practitioners, especially those who work with
adolescents in rural communities, are often
frustrated in their efforts to discourage teen pregnancy. Though
the rates of teen pregnancy rates are higher in
rural communities, barriers often inhibit open conversations
about prevention. Rural high school students were
asked to discuss the question, "Is teen pregnancy a problem in
our community?" The participants
acknowledged pregnancy and sexual activity prevalence and
discussed consequences, causes, and prevention
strategies. These findings could help decrease the resistance
that providers often face when initiating
conversations with teens and their parents about sexual issues,
especially pregnancy consequences and
prevention methods.
Links: Check Document Availability
Full text: Approximately 750,000 US teens become pregnant
annually, and many do not finish high school, are

6. single parents, and live in poverty.1,2 Teen pregnancy often
results in hardships for teen mothers, their children,
and communities.1,3 Nurse practitioners who provide care to
adolescents, especially those in school-based
clinics and rural communities, address these realities almost
daily. Although NPs are well aware of evidence-
based strategies to discourage early pregnancy, many parents
resist discussing and promoting them to their
teens. Knowing the perspectives of teens regarding pregnancy
could break down barriers that inhibit prevention
strategies. The purpose of this research was to analyze essays
written by high school students to gain insight
about the high teen-pregnancy rate in their rural community.
Significance
Teen pregnancies present increased infant and maternal risks of
complications and hardships, often at
significant cost. Adolescent mothers are less likely to graduate
from high school and attend college, less likely
to marry and remain in stable relationships, and more likely to
live in poverty. 4,5 Teen fathers have a persistently
decreased income that results in US tax revenue losses of $1.7
billion annually.6
Children often pay the greatest price for teen pregnancy. These
children are more likely to be premature and/or
at low birth weight, increasing their risks for hyperactivity,
blindness, deafness, chronic respiratory problems,
infant death, and mental retardation. 3 Rates of abuse and
neglect are higher for children of teen parents, and
these children are 50% more likely to repeat a grade in school,
perform lower on standardized tests, and drop
out of school.3 Sons of teen mothers are 13% more likely to go
to prison than sons of older mothers.1
Florida ranks 6th in the nation for the highest rate of teen
births,2 and rural counties have the highest rates in the
state. The county where this research was conducted ranks 9th
of 66 in teen births, nearly double the state rate.

7. 7 Teen pregnancy contributes to lower educational and
socioeconomic and higher poverty levels of rural
counties. Compared to state rates, this county has lower average
incomes ($18,375/state: $26,503),
educational levels (69% high school grads/state: 85%), and
higher poverty (22% below poverty level/state:
15%). 8
Social, cultural, and religious influences in many rural Southern
communities often discourage public education
about safe sexual practices. Appreciating the perspectives of
teens could help remove some of these barriers.
This research is based on the Theory of Adolescent Sexual
Decision Making (TASDM) (Figure 1 ), which evolved
from 2 grounded theories.9-11 According to this theory,
adolescents live in risk-promoting environments. Some
adolescents normalize risky sexual behaviors, say "yes" to
sexual opportunities, and make high-risk choices.
Other teens see beyond the immediate appeal of their risk-
promoting environments, avoid exposure to risky
http://search.proquest.com/docview/1507211795?accountid=458
http://linksource.ebsco.com/linking.aspx?sid=ProQ:healthcompl
eteshell&fmt=journal&genre=article&issn=15554155&volume=
8&issue=10&date=2012-11-
01&spage=804&title=The%20Journal%20for%20Nurse%20Pract
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itle=The%20Journal%20for%20Nurse%20Practitioners&btitle=
&id=doi:10.1016/j.nurpra.2012.02.028
situations, and make low-risk choices. This research was
conducted through the lens of this theory to gain
insight into rural risk-promoting environments and adolescent
sexual decision making.
Methods

8. Data Source and Analysis
The prevalence of teen pregnancy and lack of prevention
initiatives is a concern to many educators and health
care providers in the rural south Florida community where this
research was conducted. A timed writing
exercise was given to 125 10th grade students (53 males, 72
females)--ages 15 (30 males, 42 females), 16 (16
males, 27 females), and 17 (3 males, 3 females) (4 males
omitted their age)--to help them prepare for state
examinations. This assignment took place during English
classes with no prior intervention. The students were
directed to handwrite essays during class discussing whether
teen pregnancy was a problem in their
community. The essays were not graded and submitted to their
teacher anonymously except for gender and
age. After teacher and administrative review and approval and
institutional review board approval, the essays
were analyzed by the researcher.
The handwritten essays were transcribed, then compared and
contrasted within each and among all essays,
within each gender, and among both genders. Using constant
comparative methods, the data were analyzed
using the MAX Qualitative Data Analysis©12 software. Guided
by the TASDM, data were initially color-coded to
identify major themes relevant for understanding rural teen
pregnancy and then coded line by line to identify
categories within themes.
Results
Many students were fairly specific in their initial sentences,
writing that teenage pregnancy was good or bad,
right or wrong, followed by an explanation for this stance.
Other students wrote ambivalent statements, making
contradictory remarks or stating that teen pregnancy was good
and bad. Some students said that teen
pregnancy "just happened" or it was not her/his concern. These
responses were labeled ambivalent. The

9. numbers of these responses are displayed in Table 1 .
After initial answers, most participants explained their views
about teen pregnancy. Six themes emerged:
prevalence, consequences, explanations, prevention suggestions,
positive perspectives, and sexual activity
acknowledgment. Subcategories further clarify each theme.
Prevalence
Many students (65.5%) supported their beliefs by discussing the
significant number of pregnant teens they
knew or saw in school. Females (86%) noted the prevalence of
pregnant teens more than males (37.7%). Some
participants centered their discussions about prevalence on the
difficulties pregnant teens experienced. Even
some teens who were ambivalent or supportive of teen
pregnancy noted this prevalence. The majority of
prevalence statements were impersonal, such as, "Everywhere I
look in high school, either someone is
pregnant or has had a kid." Other participants wrote about
peers, sisters, or cousins who were pregnant or
parenting, and one teen shared that she was a parent. The teen-
pregnancy prevalence was emphasized for
some by seeing infants at school, since daycare is provided as a
strategy to encourage teen parents to
complete high school.
Consequences
Many participants wrote about the consequences of teen
pregnancy. Consequences to teens were noted most
often, but effects on children, parents, and society were also
mentioned. These consequences were the primary
reasons some teens believed pregnancy was problematic.
Consequences to teens
Both females (34) and males (7) wrote that pregnancy could
"mess up" or "ruin" teens lives. Some participants
wrote about the kinds of consequences pregnant teens face. The
most important consequence noted by both
females (32) and males (12) was disruption of school. Many

10. wrote that school disruption would be a barrier to
getting a good job, making money, or being able to support a
baby. One male explained, "Usually the parents
quit school because they have to get a job to support the baby.
Then they don't graduate, so they can't get a
good job."
The second most prevalent consequence cited by females (13)
was "compromise of future success." One
female explained, "People don't realize how a baby can ruin
your plans for a future." For males, the next most
prevalent consequence was financial constraints, "so your
friends have all this money and you're broke."
Both females and males noted the likely consequence of
desertion by the infant's father. One male wrote: "The
girls are in the house all day being boring, while guys are still
having fun and doing another girl." According to
one female: "The girls that get pregnant most likely will lose
the baby's father because the male is scared or is
lazy and doesn't want to be tied down."
Consequences noted less frequently were related to other losses,
including parental rejection, social losses
(social contacts, position among peers), and rejection by peers.
Consequences to others
Consequences to infants were noted by 16 females and 14
males. "It's not fair to the child" or a similar
sentiment was expressed by many of the participants. In
addition, 8 females and 4 males noted teens' lack of
financial resources to provide for their children. One male
wrote: "It's not fair to the baby to bring it into this
world if you can't provide for it." Another participant echoed
the sentiments of many adults: "A child being raised
by another child is never a good thing."
A few teens wrote more abstractly about social consequences.

11. One female wrote that the high teen-pregnancy
rate "makes the whole town look bad." One male noted teenage
pregnancy is a "burden on the welfare system."
Explanations
Some participants offered explanations for the high rate.
According to the males, teen pregnancy occurs
because adolescents disregard the risks, are irresponsible, and
are having sex. Proportionally, females wrote
fewer comments about teen-pregnancy causes. Some cited
irresponsibility: "I find teen pregnancy to be
irresponsible, stupid, and disgusting." Both genders wrote about
living in a small town with "nothing else to do."
According to 1 female, "Some students feel sex is the only thing
to do in this small town."
Several participants were less critical, noting that sometimes
pregnancy is desired or intentional. According to 1
female, "I know some girls that want babies, just so they have
somebody to love them." One male wrote, "Kids
are doing it on purpose." Some participants cited "accidents" as
the cause, "Accidents happen, I understand
that." Other explanations included lack of parental oversight,
partner pressure, and "protection" (condom)
failure.
Prevention Suggestions
Both male and female participants wrote that pregnancy
prevention is needed, and many offered suggestions.
Some suggestions were directed toward adults, but the majority
were directed toward teens, primarily that teens
should be responsible, use contraception or "protection," focus
on school and future success, and wait to have
sex or children. One student summed up many of the prevention
comments:
Schools and other parts of the community should issue condoms
to teens from age 12. They should also have
classes about teen pregnancy to teach kids that it is not easy to

12. be a young parent, not having a job, not able to
go to school, or not even enjoying life like you would.
The suggestions directed toward adults include increased
parental influence, education, and communication
about sexual issues, and greater accessibility of protection
(condoms, contraceptives). Some participants
thought more activities in their small town would help prevent
teen pregnancy.
A few students provided insight into why teens do not use
protection. One female wrote, "I think girls are scared
to ask for birth control." According to 1 male, "Almost every
student I know is sexually active, and half the time
they don't use protection because you're not going to stop the
intimacy for something and totally blow it off."
Another male wrote, "Teens don't really care or like to use
protection."
Positive Pregnancy Reflections
Some teens provided more positive reflections about teen
pregnancy. One female wrote, "I know I'm not ready
for kids right now, but if it were to happen I wouldn't be
completely upset...I don't frown upon teenage mothers. I
actually kind of envy them." Several wrote that teen pregnancy
might be good because it could teach teens to
be more responsible. Others wrote that teen pregnancy was not a
problem and gave both positive and negative
reasons. Several males and females wrote that they either had
no opinion or teen pregnancy was not their
concern. Some females noted that pregnant or parenting teens
need help, not criticism. Others noted that
pregnancy itself is good, but becoming pregnant as a teen is
not--timing, not the pregnancy, is problematic.
Sexual Activity Acknowledged
Even though not requested, some participants acknowledged

13. adolescent sexual activity. Both females and
males wrote that teens are having sex, some with multiple
partners. One female wrote, "Boys and girls are
going to have sex regardless of the consequences." Another
wrote, "I'm not a virgin myself." A male stated,
"You can't stop kids from having sex. I mean that's what they
think about 90% of the time." Many of these
participants recommended using "protection." Explanations for
adolescent sexual activity include peer or partner
pressure, fear of partner loss if refused, and sex is expected in
"long-term" relationships: "After a lengthy period
of time, that's what you're supposed to do."
Some participants disagreed with adolescent sexual activity.
Ten females and one male wrote that teens should
wait until they are older to have sex. One male wrote, "It's
really not that hard to be celibate. I'm 16 and still a
virgin. I've had plenty of chances but still resisted." Three
females and 2 males wrote that sex before marriage is
wrong.
Discussion
As indicated by these participants, and in current literature,
there are many reasons for the higher teen-
pregnancy rates in rural communities, some socioeconomically
based. Rural adolescents are more likely to
have younger, less educated parents and less likely to have
health insurance. They are more likely to live in
mother-only families and in poverty, especially in the rural
South. 13,14 As suggested by some participants and
other researchers, limited activities and decreased parental
monitoring may contribute to increased risky
behaviors.15
In rural communities or "small towns with nothing to do,"
where everyone "knows each other," some parents
may feel a false sense of security and less need to monitor their
children. Even if rural teens believe that
becoming pregnant is wrong or has negative consequences,

14. without education about pregnancy prevention or
financial support to become involved in afterschool activities,
or health insurance to obtain birth control,
pregnancy may be more likely. NPs, especially those who work
in these environments, must be creative in
helping teens and parents overcome these barriers.
While 68% of the participants believed teen pregnancy is bad or
wrong, more than 32% believed teen
pregnancy is good or OK or were ambivalent. As indicated in
the TASDM and identified by other researchers,
positive or ambivalent teen pregnancy attitudes promote risk
taking. 16,17 This ambivalence was not explained
but could be related to living in environments where many
adults were teen parents and did not complete high
school or education beyond high school. The most important
consequence noted by these participants was the
disruption of school but without parental examples of
educational success, pregnancy might seem equally
desirable. As health promotion experts, nurse practitioners
(NPs) could enquire about future plans and promote
success in the context of their usual teen-pregnancy prevention
strategies.
Nearly 66% of participants commented about the prevalence of
pregnancy among their peers. Without being
asked, many also noted that teens are sexually active. This, too,
could contribute to high teen-pregnancy rates
since sexually active adolescents influence non-sexually active
peers to engage in risky behaviors. 18
Recognizing the prevalence of teen pregnancy and sexual
activity could lead some teens to view pregnancy as
normal or even desirable.10 Limited activities and resources in
rural communities, the high prevalence, and the

15. pregnancy ambivalence of some teens are identified problems
that NPs may recognize and could address with
teens.
Many participants noted the importance of using "protection" if
engaging in sexual activity. Some desired more
information about sexual matters, and researchers have shown
that providing information in schools about
sexually transmitted infections and pregnancy risks can
decrease risky behaviors. 19 However, many rural
community leaders and educators prefer abstinence-only
education, which restricts this desired instruction.
Abstinence is an essential component of sexuality education as
postponement of sexual debut is clearly
associated with decreased risky behaviors. 20 However,
abstinence-only education is often ineffective in
preventing teen pregnancy21 because it often results in minimal
or no sexuality education. NPs, unlike other
educators, have opportunities for open conversations about
sexual issues and must use these opportunities as
much as possible.
This research indicates that many rural adolescents are very
aware of teen pregnancy, understand the causes,
consequences, and means of prevention, which correlates with
evidence-based recommendations. However,
limited activities and resources of many rural teens, combined
with high teen-pregnancy prevalence (suggesting
normalcy) and the ambivalence of some, may be overriding
forces. These findings, which are helpful in
understanding high teen pregnancy rates, resonate with many
NPs and provide guidance for care strategies.
Limitations
These data were obtained from a timed writing exercise to help
students prepare for state testing. Since this
was an in-class assignment, students did not have the
opportunity to opt out of the exercise. The pressure of a
writing assignment to prepare for state testing and being asked

16. to write about a "problem" could have biased
the participants to write negatively about teen pregnancy.
However, because the essays were written
anonymously, students might have shared their feelings more
candidly. While the essays provide a snapshot of
insight from rural high school students, individual interviews or
focus groups using probing questions could have
generated more comprehensive qualitative information. While
data were collected in a nontraditional manner,
insightful information resulted that would have been difficult to
obtain any other way in this population.
While difficult to ensure in qualitative research, several
measures were used to determine the validity and
significance of this project. The data were analyzed separately
and jointly and relevant themes identified with a
research assistant. The findings were shared and clarified with
other adolescents, educators, and researchers
during and after data analysis to ensure significance.
Conclusions
These results indicate that teens have significant insight about
teen pregnancy, including explanations,
consequences, and prevention suggestions. The recognized
prevalence of pregnant or parenting teens and
ambivalence of some suggests that teen pregnancy could be seen
as a rural norm. Based on the insight and
recommendations of these teens, NPs could be bolder in
initiating conversations about the consequences of
pregnancy and need for safe sexual practices. Hearing this "cry"
from the teens themselves could be
persuasive to community and school leaders who prefer
abstinence-only education.
These findings could improve efforts to decrease rural teen
pregnancy. The greatest need cited by these
participants is for more sexual information, while the greatest
teen-pregnancy consequence they noted is school
disruption and decreased future success. NPs are on the front

17. line in their efforts to promote safe sexual
practices while parents and educators focus on school success.
It's time to join forces in these efforts!
Boys (n) Boys % Girls (n) Girls % Total (N) Total %
Bad, wrong, stupid 39 73.58% 46 63.89% 85 68%
Ambivalent 13 24.52% 23 31.94% 36 28.8%
References
1 SD Hoffman, By the numbers: The public costs of teen
childbearing, 2006, The National Campaign to Prevent
Teen Pregnancy, Washington, DC
2 K Kost, S Henshaw, L Carlin, U.S. teenage pregnancies, births
and abortions: national and state trends and
trends by race and ethnicity, Accessed September 10, 2012.
3 E Terry-Humen, J Manlove, KA Moore, Playing catch-up:
how children born to teen mothers fare, Accessed
September 10, 2012.
4 VJ Hotz, SW McElroy, SG Sanders, Consequences of teen
childbearing for mothers, SD Hoffman, RA
Maynard, Kids Having Kids: Economic Costs and Social
Consequences of Teen Pregnancy, 2008, Urban
Institute Press, Washington, DC, 51-118
5 B Wolfe, EM Rivers, Children's health and healthcare, SD
Hoffman, RA Maynard, Kids Having Kids:
Economic Costs and Social Consequences of Teen Pregnancy,
2008, Urban Institute Press, Washington, DC,
221-247
6 MJ Brien, RJ Willis, Costs and consequences for the fathers,
SD Hoffman, RA Maynard, Kids Having Kids:
Economic Costs and Social Consequences of Teen Pregnancy y,
2008, Urban Institute Press, Washington, DC,

18. 119-160
7 Florida Charts, Florida Department of Health Office of Health
Statistics &Assessment. 2011. Florida Birth
Query System, Accessed September 10, 2012.
8 US Census Bureau, State &County QuickFacts, Accessed
October 27, 2010.
9 Weiss JA. Decreasing teen pregnancy in vulnerable
adolescents. Poster presentation, National Academies of
Practice Forum 2011, Washington, DC, March 2011.
10 JA Weiss, ML Jampol, JA Lievano, SM Smith, JL Wurster,
Normalizing risky sexual behaviors: a grounded
theory study, Pediatr Nurs, Vol. 34, 2008, 163-169
11 JA Weiss, Preventing teen pregnancy by avoiding risk
exposure, American J Health Studies, Vol. 25, 2010,
202-210
12 MAXQDA, VERBI Software. Consult. Sozialforschung,
2007, GmbH, Marburg Germany
13 US Department Health &Human Services, Health Resources
&Services Administration, Maternal &Child
Health Bureau. 2011, The Health and Well-Being of Children in
Rural Areas: A Portrait of the Nation 2007,
2007, The Department, Rockville, MD
14 C Rogers, Rural children at a glance, Accessed September
10, 2012.
15 BE Molnar, AL Roberts, A Browne, H Gardener, SL Buka,
What girls need: recommendations for preventing
violence among urban girls in the US, Soc Sci Med, Vol. 60,
2005, 2191-2204
16 JC Abma, GM Martinez, CE Copen, Teenagers in the United
States: Sexual activity, contraceptive use, and
childbearing, National Survey of Family Growth 2006-2008.
National Center for Health Statistics, Vital Health
Stats, Vol. 23, Iss. 30, 2010
17 C Stevens-Simon, J Sheeder, S Harter, Teen contraceptive
decisions: childbearing intentions are the tip of
the iceberg, Women Health, Vol. 42, 2005, 55-73

19. 18 R Sieving, ME Eisenberg, S Pettingell, C Skay, Friends'
influence on adolescents' first sexual intercourse,
Perspect Sex Reproduct Health, Vol. 38, 2006, 13-19
19 D Kirby, BA Laris, L Rolleri, Sex and HIV education
programs for youth: their impact and important
characteristics, Accessed February 16, 2008.
20 TG Sandfort, M Orr, JS Hirsch, J Santelli, Long-term health
correlates of timing of sexual debut: results from
a national US study, Am J Public Health, Vol. 98, Iss. 1, 2008,
155-161
Good, right, OK 1 1.89% 3 4.16% 4 3.2%
Total 53 100% 72 100% 125 100%
21 KF Stanger-Hall, DW Hall, Abstinence-only education and
teen pregnancy rates: why we need
comprehensive sex education in the U.S., PLoS ONE, Vol. 6,
Iss. 10, 2011, e24658
Subject: Teenage pregnancy; Teenagers; Writing; Pregnancy;
Teachers; Qualitative research; Secondary
schools; Secondary school students; Decision making; Mothers;
Data analysis; Teenage parents; Community;
Rural areas;
Publication title: The Journal for Nurse Practitioners
Volume: 8
Issue: 10
Pages: 804-809
Publication year: 2012
Publication date: Nov 2012
Year: 2012
Publisher: Elsevier Limited
Place of publication: Philadelphia
Country of publication: United States

20. Publication subject: Medical Sciences--Nurses And Nursing
ISSN: 15554155
Source type: Scholarly Journals
Language of publication: English
Document type: Journal Article
DOI: http://dx.doi.org/10.1016/j.nurpra.2012.02.028
ProQuest document ID: 1507211795
Document URL:
http://search.proquest.com/docview/1507211795?accountid=458
Copyright: Copyright Elsevier Limited Nov 2012
Last updated: 2014-03-21
Database: ProQuest Central
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Listen? Rural Teen Pregnancy Reflections