"Hey, Mom. It's time to do my sex ed homework. Have you got a minute?"
Homework. Sexuality education. And Mom (or Dad). It's an unlikely combination, to say the least. But in this issue of Family Planning Perspectives, Susan Blake and her coauthors report on an evaluation of the effects of asking students to complete homework assignments with their parents as part of their sexuality education class. The evaluation was conducted in middle schools teaching the curriculum Managing the Pressures Before Marriage (an abstinence-only version of Postponing Sexual Involvement).
The five homework assignments were designed to aid parents in understanding the pressures that their children face, communicating with them about sex and sexuality, helping them combat peer pressure and, ultimately, reducing their likelihood of engaging in risky sexual behavior. Students who completed any of the homework assignments communicated more often with their parents about sexual issues, expressed stronger beliefs about the importance of remaining abstinent and were more confident about their ability to abstain from intercourse than were those who received the same curriculum but had no homework assignments. While the evaluation can shed no light on the long-term impact on the youths' sexual behavior, it suggests that getting parents and their children to talk about sexual behavior in a structured way can be a very positive step.
Elsewhere in this issue, two articles examine the interplay of teenage childbearing and poverty. Douglas Kirby, Karin Coyle and Jeffrey Gould take a community-oriented approach to identifying factors that contribute to adolescent fertility. Their analysis focuses on zip code areas in California during the early and middle 1990s with a certain minimum number of adolescent women aged 15-17. In those areas, the proportion of families living below the poverty level was far and away the strongest influence on the birthrate among 15-17-year-olds, followed by the proportion of adults aged 25 or older with a college degree. In contrast, race and ethnicity were by themselves only weakly associated with adolescent births. The findings clearly point to poverty and low levels of education and employment as important contributing factors to births among young teenagers.
Taking a societal perspective on the effects of teenage childbearing, Petra Otterblad Olausson and a group of Swedish colleagues report on findings from a national record-linkage study of nearly 900,000 women born between 1941 and 1970 who gave birth before age 30. Swedish women who had been teenage mothers were less educated and had had more births than were women who first gave birth at ages 20-24. Moreover, the early mothers were more likely to be living without a partner, to be collecting a disability pension and to be relying on welfare. These findings held after the researchers adjusted for the effects of the women's family socioeconomic background when they were teenagers.
Past research has shown that teenagers with siblings who gave birth during adolescence are at heightened risk of doing the same. In this issue, Patricia East and Elizabeth Kiernan offer evidence (taken from a study of 1,500 California youths) that young women who have two or more sisters who had teenage births are at especially elevated risk of initiating sexual intercourse and of experiencing problems in school, using drugs or alcohol, and engaging in delinquent behavior. Young men with more than one parenting sister also are more likely to be sexually experienced. The authors suggest that professionals serving at-risk youths consider screening clients for their number of parenting sisters and for those sisters' age at first birth, as a potentially useful way of identifying youths who are at high risk of an early pregnancy.
In 1997, the federal government established the State Children's Health Insurance Program (CHIP) as a means to ensure that uninsured, low-income children have health insurance coverage up to age 19. States' flexibility in what services are covered might limit adolescents' access to reproductive health services, though. Rachel Gold and Adam Sonfield report here that CHIP administrators say their states allow relatively comprehensive coverage of such services, especially routine gynecologic care, screening for sexually transmitted diseases and pregnancy testing. CHIP programs appear to be inconsistent, however, in guaranteeing that teenagers will have the flexibility in choosing providers, the information and the confidentiality that they need.
Finally, in this issue, we welcome the members of our newly revamped Editorial Advisory Committee. We look forward to working with them to refine and improve Family Planning Perspectives over the next several years. We also express our deep thanks to the departing members of the committee, who advised and assisted us over the course of many years.