Reducing adolescent pregnancy through a school- and community-based intervention: Denmark, South Carolina, revisited. TT -

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A 1987 article by Vincent, Clearie, and Schluchter in the Journal of the American Medical Association documented declines in estimated pregnancy rates among adolescents in Denmark, South Carolina, site of a pregnancy prevention program. The School/Community Program for Sexual Risk Reduction Among Teens was launched in the early 1980s as an intensive school- and community-based intervention which included graduate-level sexuality education courses for school teachers; workshops for parents, clergy, and community leaders; programs which trained students to serve as peer counselors; and media campaigns. During the same period, adolescent pregnancy rates increased in three comparison counties which did not receive program services. This reported success naturally drew widespread interest from other communities looking to accomplish the same goal. The intense interest from outside of Denmark prompted the authors to reexamine the decline in pregnancy rates in the area and investigate all plausible alternative explanations for the decrease. They found that concurrently with the operation of the Denmark program, a school nurse counseled male and female students likely to initiate sexual intercourse to avoid doing so and provided students who were already sexually active with contraceptive counseling, services, and supplies. Activities of the nurse are therefore considered components of the overall prevention intervention in Denmark. Comparison areas were better matched and the time period covered extended to confirm that the adolescent pregnancy rate in the intervention area significantly decreased from an annual average of 77 pregnancies per 1000 women aged 14-17 during the preprogram period of 1981-82 to 37/1000 after the intervention in 1984-86. The reanalysis also, however, indicates that the pregnancy rate returned to 66/1000 in 1987-88 after the discontinuation of important program components and related nonprogram services. In particular, adolescents younger than 16 years old required parental approval to receive contraceptive services from August 1985. Moreover, a state legislator banned the provision of contraceptive services and condoms to youths at the Teen Life Center adjacent to the high school in April 1987. From then through 1988, the county health department clinic nine miles away and inaccessible by public transportation was the only family planning clinic. The school nurse resigned November 1988, while the program overall lost momentum.

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  • Evaluation Report; Adolescent Pregnancy; Adolescen

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  • Koo HP; Dunteman GH; George C; Green Y; Vincent M

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