Target Populations for PREP - Minnesota

Youth of color often experience unique social, economic, and cultural barriers to preventing unintended pregnancy. Steps towards more effective pregnancy prevention for African American youth include:

• Promote reproductive justice
• Promote gender-specific interventions
• Support structural interventions
• Utilize peer influence within social networks

(Augustine, J. 2010. Youth of Color At Disproportionate Risk of Negative Sexual Health Outcomes. Advocates for Youth).

The Minnesota-based Native Teen Voices study of 148 Native male and female adolescents identified five themes for preventing teen pregnancy in Native communities. American Indian adolescents in Minnesota have the highest teen pregnancy rate compared to all other racial/ethnic groups.

• Show Native youth the reality and consequences of adolescent pregnancy
• Enhance and develop culturally relevant school- and community-based pregnancy prevention programs for Native youth through the implementation of Native-led pregnancy prevention discussions (relying on family members and elders) and culturally based activities and programs (e.g., include Native ceremonies and other cultural practices)
• Improve Native adolescents' access to contraceptives
• Discuss adolescent pregnancy with Native youth allowing them the opportunity to talk to Native peers and facilitators or other trusted adults about the issue
• Use key prevention messages and media which includes representations of AI/AN youth to reach Native youth.

(Garwick, A.W., Rhodes K.L., Peterson-Hickey M., and Hellerstedt, W.L. 2008. Native Teen Voices: Adolescent Pregnancy Prevention Recommendations. Journal of Adolescent Health. 42: 81-88).

Latino adolescents are a diverse group accounting for a spectrum of cultural traditions, countries of origin, language proficiency, educational attainment, generational status, levels of acculturation, and socioeconomic status. Pregnancy prevention programs for Latino teens should be culturally-specific and sensitive to the many differences among Latino youth populations in order to be successful. Other important factors include working with Latino families and promoting Latino cultures as a source of strength for healthy decision making. (Vexler, E.J. and Suellentrop K. 2006. Bridging Two Worlds: How Teen Pregnancy Prevention Programs Can Better Serve Latino Youth. The National Campaign to Prevent Teen Pregnancy).

Articles and Resources

• Advocates for Youth: The Sexual Health of Latina Adolescents-Focus on Assets (PDF)
• Stay Teen: Stay Joven PSA Program

Area learning centers are non-traditional educational settings tailored to students who require support and opportunities not available in conventional school environments. Youth in Minnesota area learning centers report more sexual risk behavior and have a higher rate of pregnancy than their peers in traditional high schools. (Minnesota Student Survey, 2010).

There are over 220 area learning centers and programs in Minnesota, primarily serving middle and high school students. Alternative programs may offer year-round programming, hands-on experiential approaches, resources for social emotional issues, vocational or career emphasis, independent study options for students over the age of 16 and both day or evening courses.

(Snapshots on Minnesota Youth. Vol. 3, Issue 4, Feb 2012. The Minnesota Departments of Education, Health, Human Services and Public Safety are pleased to present a series of reports focusing on issues facing Minnesota youth).

Minnesota has an estimated 11,400 children in foster care, fifty-one percent of whom are ages 13 and older. (Foster care: Temporary out-of-home care for children, Minnesota Department of Human Services.) Research has found that youth in foster care report frequent pressure to engage in sexual activity, inadequate information about pregnancy prevention and many benefits to having a child at a young age. Teens in foster care also discuss challenging or absent relationships with parents, but a desire to have strong connections and communication with adults in their life.

Primary and secondary prevention of teen pregnancy is essential to meeting the needs of this population. Strategies include ensuring proper healthcare and supporting teen parents in finishing school and becoming self-sufficient, as well as providing accurate high-quality information and education about teen pregnancy to all youth. (Love, L. T., McIntosh, J., Rosst, M. and Tertzakian, K. 2005. Fostering Hope: Preventing Teen Pregnancy Among Youth in Foster Care. National Campaign to Prevent Teen Pregnancy).

Articles and Resources

• Child Trends
  • Foster Care Data Snapshot (PDF)
  • Teen Parents in Foster Care: Risk Factors and Outcomes for Teens and Their Children (PDF)
• Guttmacher Institute: Teen Pregnancy Among Young Women In Foster Care: A Primer
• Jim Casey Youth Opportunities Initiative: Social Capital: Building Quality Networks for Young People in Foster Care (PDF)
• The National Campaign to Prevent Teen and Unplanned Pregnancy:
  • Child Welfare
  • Preventing Teen Pregnancy Through Outreach and Engagement: Tips for Working with Foster Care and Juvenile Justice.
  • Call to Action: 10 Ways to Address Teen Pregnancy Prevention Among Youth in Foster Care
  • It's Your Call: Make the Right Decision for You (PDF)
  • Our Story, Our Words: Youth Speak Out on Sex, Love, and Teen Pregnancy (PDF)
• Research and Training Center for Pathways to Positive Futures: Sexual Health Disparities Among Disenfranchised Youth. (PDF)

Adolescents involved with the juvenile justice system are often exposed to a variety of risk factors that can contribute to increased sexual risk behavior. Since detained youth report earlier sexual debut than their peers, interventions targeting this population should begin early.

Many of these youth report depressive symptoms, drug use, gang involvement, exposure to community violence, and sexual abuse. Important topics to include in programming for youth in juvenile justice are intimacy, communication, assertiveness, gender role expectations, and problem solving, in addition to the reproductive basics of anatomy, physiology, and contraception.

(Gowen, L. K., & Aue, N., Eds., 2011. Sexual Health Disparities Among Disenfranchised Youth. Portland, OR: Public Health Division, Oregon Health Authority and Research and Training Center for Pathways to Positive Futures, Portland State University).

Articles and Resources

• Child Welfare League of America: Profiles of Girls Entering the Juvenile Justice System
• Research and Training Center for Pathways to Positive Futures: Sexual Health Disparities Among Disenfranchised Youth (PDF)
• The National Campaign to Prevent Teen and Unplanned Pregnancy: "When You Decide..." A Judge's Guide to Pregnancy Prevention Among Foster Youth With Bench Tools and Scripts (PDF)

Lesbian, Gay, Bisexual and Transgender (GLBT) adolescents experience a variety of challenges to protecting against pregnancy including increased risk, strained family communication and lack of access to inclusive, medically-accurate information and appropriate health care services. (Healthy Teen Network. Fast Facts: The Unique Sexual and Reproductive Health Needs of Gay, Lesbian, Bisexual, Transgender, and Questioning Youth).

Recommendations for improving sexual health outcomes for LGBT youth include:

• Increase and support Gay-Straight Alliances and support groups in schools
• Work with parents of LGBT adolescents to help increase understanding and acceptance of their child's gender and/or sexual identity
• Provide LGBTQ-sensitive sexuality education

(Gowen, L. K., & Aue, N., Eds., 2011. Sexual Health Disparities Among Disenfranchised Youth. Portland, OR: Public Health Division, Oregon Health Authority and Research and Training Center for Pathways to Positive Futures, Portland State University).

Data and Fact Sheets

• Centers for Disease Control and Prevention: Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12 - Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009 (PDF)

Articles and Resources

• American Psychological Association: Healthy Lesbian, Gay, and Bisexual Students Project.
• Research and Training Center for Pathways to Positive Futures: Sexual Health Disparities Among Disenfranchised Youth (PDF)
• Resource Center for Adolescent Pregnancy Prevention. Topics in Brief: Gay, Lesbian, Bisexual, Transgender and Questioning Youth
• Canadian Journal of Human Sexuality: Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia. (PDF)
• Centers for Disease Control and Prevention: Lesbian, Gay, Bisexual and Transgender Health
• American Academy of Pediatrics: Gay, Lesbian, and Bisexual Teens: Facts for Teens and Their Parents

Reaching homeless and runaway teens can be challenging, although research has shown that the internet and social media may be a promising way to engage these youth and help increase positive sexual health outcomes. Programs targeting homeless youth should be tailored to duration of homelessness, gender, and sexual orientation. (Gowen, L. K., & Aue, N., Eds., 2011. Sexual Health Disparities among Disenfranchised Youth. Portland, OR: Public Health Division, Oregon Health Authority and Research and Training Center for Pathways to Positive Futures, Portland State University).

A 2015 single night count of homeless individuals in Minnesota found 1,463 unaccompanied youth and 3,296 youth under 17 accompanied by parents who were homeless. (Wilder Research. 2016. Homelessness in Minnesota: Key findings: 2015 Minnesota Homeless Study.) These youth have unique experiences and require programming that is specific to their needs.

Articles and Resources

• Runaway and Pregnant: Risk Factors Associated with Pregnancy in a National Sample of Runaway/Homeless Female Adolescents
• National Recommended Best Practices for Serving LGBT Homeless Youth
• Youth Services Network: Runaway Youth/Homelessness/Youth Crisis Hotline Links
• National Gay and Lesbian Task Force
• Sexual Health Disparities Among Disenfranchised Youth (PDF)

Teen mothers face a unique set of social and economic challenges that impact their ability to prevent additional pregnancies. In addition to their own health outcomes, teen mothers must also tend to the health needs of their child. Effective ways to prevent subsequent births among teen mothers include:

• social support programs
• mentoring
• nurse home visitation
• school-based model

Lewis, C. M., Faulkner, M., Scarborough, M., & Berkeley, B. (2012). Preventing subsequent births for low-income adolescent mothers: an exploratory investigation of mediating factors in intensive case management. American journal of public health, 102 (10), 1862-1865.

Articles and Resources

• Advocates for Youth: Science and Success: Programs that Work to Prevent Subsequent Pregnancy Among Adolescent Mothers (PDF)
• Federal Youth Services Bureau: Reaching Out to Young Mothers to Delay Subsequent Pregnancies