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I. PROGRAM RESOURCES
1. Preventing HIV/AIDS among Adolescents through Integrated Communication Programming
2. State of World Population 2003. Making One Billion Count: Investing in Adolescents' Health and Rights
3. Mini Compendium of Best Practices on Adolescent Reproductive Health
4. What Do Salvadoran Teens Think? Determining the Feasibility of Youth-friendly Pharmacies: A Focus Group Report
5. "New Generation" Models for Asia's Youth: Strengthening Networks and Building Capacity
6. Capacity Building Resources in Youth Sexual and Reproductive Health
7. Games for Adolescent Reproductive Health: An International Handbook
8. Profile of the Kenyan Youth Exchange Network
9. Adolescent and Youth Reproductive Health: Status, Issues, Policies, and Programs
10. Reproductive Health and Employment: Implications for Young People
II. RESEARCH ARTICLES
1. Abortion, contraceptive use, and adolescent pregnancy among first-year medical students at a major public university in Mexico City.
2. Adolescent health in the Caribbean: a regional portrait.
3. The effectiveness of adolescent reproductive health interventions in developing countries: a review of the evidence.
4. The influence of peer versus adult communication on AIDS-protective behaviors among Ghanaian youth.
5. Parental presence and adolescent reproductive health among the Nairobi urban poor.
6. The status of HIV/AIDS and education research among adolescents in South Africa.
7. Research summaries from developed countries: how research can help shape adolescent health policy, impact of adolescent pregnancy on postpartum contraceptive use, ethics of adolescent longitudinal research, and more.
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I. PROGRAM RESOURCES
1. Preventing HIV/AIDS among Adolescents through Integrated Communication Programming (2003)
This 113-page manual focuses on HIV prevention through integrated communication programming that blends advocacy, behaviour change communication, and education interventions with other policy and service components. It provides a series of checklists to guide the program in addressing key questions related to evidence-based communication programming for HIV prevention among adolescents.
- Organization: UNFPA
- Contact: publications@unfpa.org
2. State of World Population 2003. Making One Billion Count: Investing in Adolescents' Health and Rights (2003)
The State of World Population 2003 report examines the challenges and risks faced by the 1.2 billion adolescents that impact directly on their physical, emotional, and mental well-being. The 80-page report stresses that increasing the knowledge, opportunities, choices, and participation of young people will enable them to lead healthy and productive lives. Selected topics include gender inequality, HIV/AIDS, health behaviour, reproductive health services, examples of comprehensive programs, and giving priority to adolescents.
- Organization: UNFPA
- Languages: English, Spanish, French, Russian, Arabic
- Contact: publications@un.org
3. Mini Compendium of Best Practices on Adolescent Reproductive Health (2003)
English: http://www.advanceafrica.org/publications_and_presentations/Technical_Papers/TP_Mini-Compendium_ARH.pdf
French: http://www.advanceafrica.org/publications_and_presentations/Technical_Papers/TP_Mini-Compendium_ARH_Fr.pdf
This 90-page collection includes descriptions of promising practices that have demonstrated the successful implementation of proven, effective, evidence-based practices. As a continually updated resource, this mini-compendium attempts to include many of the best and promising practices from experiences with adolescent reproductive health programs. They encourage active submissions from all program managers, to share global and local best practices and lessons learned and building upon this as a valuable resource.
- Organization: Advance Africa
- Languages: English and French
- Contact: bestpractices@advanceafrica.org
4. What Do Salvadoran Teens Think? Determining the Feasibility of Youth-friendly Pharmacies: A Focus Group Report (2003)
A new Commercial Market Strategies study, designed to gauge the feasibility of a youth-friendly pharmacy network, summarizes the findings from 10 focus groups. This study found that Salvadoran teens want private, non-judgmental pharmacies where they can get information about responsible sexuality and, if necessary, buy contraceptives.
- Organization: Deloitte Touche Tohmatsu International, Commercial Market Strategies
- Contact: cprefontaine@cmsproject.com
5. "New Generation" Models for Asia's Youth: Strengthening Networks and Building Capacity (2003)
The case studies in this document explore "new generation" program models that seek to engage young people in programming, build the capacity of adult stakeholders to better respond to youth needs, and strengthen partnerships and networks to build a broader base of support for the implementation of youth programs.
- Organization: NGO Networks for Health Project/PATH
- Contact: publications@path.org
6. Capacity Building Resources in Youth Sexual and Reproductive Health (2003)
Downloadable in six (6) PDF files:
This comprehensive training package with a focus on Southeast Asia is designed to help organizations integrate youth sexual and reproductive health into on-going programs or to introduce it as a new area. This manual evolved from a series of workshops in Bangkok, Thailand and is divided into four areas: program design, strategic planning and networking; programming for behavior change and development; youth-friendly health services; and monitoring and evaluation.
- Organization: NGO Networks for Health Project/PATH
- Contact: publications@path.org
7. Games for Adolescent Reproductive Health: An International Handbook (2002)
This international manual teaches how to use games to teach youth about reproductive health and sexuality. Included are theory, tips, instructions for 45 games, guidance on creating and modifying the games, and ready-to-use card sets.
- Organization: PATH
- Contact: publications@path.org
8. Profile of the Kenyan Youth Exchange Network (2003)
This 30-page report profiles the Kenyan Youth Exchange Network (YEN), a group of eight organizations working in the slums of Nairobi in adolescent sexual and reproductive health. This report describes the YEN (purpose, structure, funding, membership, etc) as well as its activities, achievements, challenges and lessons learned.
- Organization: NGO Networks for Health Project/PATH
- Contact: publications@path.org
9. Adolescent and Youth Reproductive Health: Status, Issues, Policies, and Programs (2003)
These papers on adolescent reproductive health (ARH) status are part of a series of assessments in 13 countries in Asia and Near East. The purpose of the assessment is to highlight the reproductive health status in each country, within the context of the lives of adolescent boys and girls. The paper begins with social issues that need to be addressed to meet the reproductive health needs of adolescents. It also discusses ARH issues, legal and policy issues related to ARH, current in-country programs on ARH, and operational barriers, before concludings with recommendations for improvements.
10. Reproductive Health and Employment: Implications for Young People (2002)
This publication provides a very brief overview of how youth unemployment, especially among girls, is linked to problems of poverty, ill health, and illiteracy.
- Organization: UNFPA
- Contact: publications@unfpa.org
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II. RESEARCH ARTICLES
Most of these articles are not available on-line without a subscription to the journal. To obtain the full article, you will need to contact the journal directly or through your organization's library.
1. Abortion, contraceptive use, and adolescent pregnancy among first-year medical students at a major public university in Mexico City. Ortiz-Ortega A, De La Torre GG, Galvan F, Cravioto P, Paz F, Diaz-Olavarrieta C et al. Pan American J Public Health 2003;14(2):125-30.
This study analyzed the frequency of unwanted pregnancies and induced abortions among first-year female medical students in Mexico City compared to the general population of Mexican females aged 15 to 24. A 1998 cross-sectional survey among all first-year medical students at the National Autonomous University of Mexico, the largest university in Latin America, resulted in 549 completed surveys. Of these women, 120 had been sexually active at some point, 100 had used a contraceptive method at some time, and 19 had been pregnant. Of those 19 women, 10 had had an illegal induced abortion (illegal in Mexico except under certain extenuating circumstances). The 2% reported abortion rate among the female medical students was very low compared to the 11% rate for women of similar ages in the Mexican general population. The researchers concluded that when young Mexican women have access to medical information and are highly motivated to avoid unintended pregnancy and abortion, they can do so.
2. Adolescent health in the Caribbean: a regional portrait. Halcon L, Blum RW, Beuhring T, Pate E, Campbell-Forrester S, Venema A. Am J Public Health 2003;93(11):1851-7. This study assessed youth health in the Caribbean Community and Common Market countries through a self-administered classroom questionnaire. While most youths reported good health, 1 in 10 reported a limiting disability or significant health problem, and violence was a pervasive concern. Of those who reported history of sexual intercourse, many reported that their first intercourse was forced, and nearly half reported that they were aged 10 years or younger when they first had intercourse. Such problems indicate the importance of monitoring trends and designing effective youth health programs.
3. The effectiveness of adolescent reproductive health interventions in developing countries: a review of the evidence. Speizer IS, Magnani RJ, Colvin CE. J Adolesc Health 2003;33(5):324-48. This review identified 41 evaluation studies in which there was a sufficient scientific basis for making inferences concerning causality (experimental or quasi-experimental design, called "Level 1" studies) and other studies ("Level 2") that reported statistical associations and changes in reproductive health outcomes after interventions. The analysis divides the studies into school-based, mass media, community, workplace, and health facility, including tables summarizing the findings from each of the 41 studies. The available evidence paints a mixed picture, with positive impact on knowledge and attitudes, but less impact on behaviors. While interventions did not lead to increased sexual risk-taking, studies did not find evidence that promoting youth friendly services or youth centers had significant impact. The review cited the need to know more about the relative merits of alternative intervention approaches, impact of large-scale programs, long-term behavioral impact, and cost. Earlier versions of this paper have appeared in the FOCUS on Young Adults end of program report (2001), summarized in a YouthNet Youth Issues Paper (2002), both available at: http://www.fhi.org/en/Youth/YouthNet/Publications/index.htm.
4. The influence of peer versus adult communication on AIDS-protective behaviors among Ghanaian youth. Wolf RC, Pulerwitz J. J Health Commun 2003;8(5):463-74.
This paper explores who most influences AIDS-protective behaviors among Ghanaian youth: peers, adults, or a combination of both. Contacts of peer educators in Ghana were surveyed at three sites during April 1998, with 490 respondents age 11 to 26 years included in the study. Youth who talked with both peers and adults (n=90) were 2.08 times more likely to report having done anything to protect themselves from AIDS than those who talked to no one (n=202), while those who talked with peers only (n=150) were 1.71 times more likely to have done something to protect themselves from AIDS. Youth who talked with adults only were not significantly more likely to protect themselves from AIDS than those who spoke with no one (n=42). Sexually active youth were more than twice as likely to talk to peers as adults. Specific AIDS-protective behaviors reported by youth differed substantially depending on whether their contact source was peers or adults. Understanding the relationships between peer and adult influence allows program managers to design increasingly effective programs.
5. Parental presence and adolescent reproductive health among the Nairobi urban poor. Ngom P, Magadi MA, Owuor T. J Adolesc Health 2003;33(5):369-77.
To investigate whether the presence of parents constitute a protective factor against adverse reproductive health outcomes for adolescents living in slums of Nairobi, Kenya, a cross-sectional survey canvassed a random sample of 4,564 households representative of Nairobi slums in February-June 2000. An analysis of a sub-sample of 788 never-married girls aged 12-19 years compared reproductive health outcomes of those living with neither parent, father only, mother only, and both parents. The study found that the father's presence, unlike that of the mother, is associated with stronger resilience among adolescents in this population. When the father is present in the household, adolescent girls are 42% less likely to have ever had sex, 45% less likely to have been sexually active in the most recent 4-week period, and 59% less likely to have ever experienced an unwanted pregnancy than when neither parent, or only the mother, is present in the household.. When programming for adolescents in these resource-constrained settings, it is important, therefore, to involve parents, especially the father.
6. The status of HIV/AIDS and education research among adolescents in South Africa. Hartell CG. Int J Adolesc Youth 2003;11(2):113-33.
South Africa has the fastest growing HIV/AIDS epidemic in the world, with prevalence rates highest among young people ages 15 to 24, especially adolescent girls. Information on existing research on HIV/AIDS and education among adolescents can provide an important base for educational interventions aimed at reducing further transmission. This paper provides a comprehensive and critical synthesis of the research literature in South Africa, highlighting major strengths and shortcomings.
7. Research summaries from developed countries:
- Adolescent women underestimate their susceptibility to sexually transmitted infections. Ethier KA, Kershaw T, Niccolai L, Lewis JB, Ickovics JR. Sex Transm Infect 2003;79(5):408-11.
Adolescent females are at significant risk for sexually transmitted infections (STI) and may not accurately incorporate indicators of risk into their perceptions of susceptibility. This analyses examined the relation between perceived susceptibility, indicators of risk, and actual STI diagnosis among 209 sexually active adolescent females. Indicators of STI risk included STI history, recent symptoms, and sexual risk behaviour (that is, recent unprotected sex and numbers of sexual partners). Chlamydia and gonorrhoea infection were assessed at baseline, 6, and 12 months post-baseline using urine based ligase chain reaction testing. Most participants perceived little or no chance that they would be diagnosed with an STI in the following year. There was no relation between almost all STI indicators and perceptions of susceptibility. Among those receiving a positive chlamydia or gonorrhoea test (n=49) at baseline or in the year following, about four of five (81%) had perceived themselves to be at little or no risk. Adolescent females in this sample did not accurately perceive their susceptibility to STI and need to be enabled to more effectively assess and modify their risk.
- Health and behavior risks of adolescents with mixed-race identity. Udry JR, Li RM, Hendrickson-Smith J. Am J Public Health 2003;93(11):1865-70.
This study compared the health and risk status of adolescents who identify with one race with those identifying with more than one race. Data were from self-reports of race, using the National Longitudinal Study of Adolescent Health (Add Health), which provides a large representative national sample of adolescents in grades 7 through 12; respondents could report more than one race. Mixed-race adolescents showed higher risk when compared with single-race adolescents on general health questions, school experience, smoking and drinking, and other risk variables. The findings are compatible with interpreting the elevated risk of mixed race as associated with stress.
- A role for public health research in shaping adolescent health policy. Bleakley A, Ellis JA. Am J Public Health 2003;93(11):1801-2.
This editorial in the major U.S. public health journal calls for a greater role for public health research in shaping adolescent health policy, saying that a "trickle down theory" of influence from the evidence of public health research into policy is problematic. The authors recommend three steps to remedy this: to include policy questions in research activities so as to directly assess the impact of policy decisions; to work with communities to promote evidence-based policy and advocacy efforts; and to build relationships directly with policymakers.
- Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy. Kershaw TS, Niccolai LM, Ickovics JR, Lewis JB, Meade CS, Ethier KA. J Adolesc Health 2003;33(5):359-68.
To examine patterns and changes in contraceptive use among pregnant adolescents in early and later postpartum compared with nonpregnant adolescents, the study interviewed 176 pregnant and 187 nonpregnant adolescents, recruited through community clinics, three times (baseline, 6 months, 12 months) about their condom and hormonal contraceptive practices. Changes in contraception use and patterns of consistent hormonal and/or condom use were examined. Pregnant adolescents increased hormonal contraceptive use from baseline to early postpartum, but decreased use from early postpartum to late postpartum. Nonpregnant adolescents did not change their hormonal contraceptive use over time. Neither group changed condom use over time. Pregnant adolescents were more likely to be consistent dual users and hormonal-only users during the 6-month follow-up compared with nonpregnant adolescents. These findings persisted at the 12-month follow-up, although there was a decline in hormonal contraception use. Adolescents change their contraceptive use during the postpartum period. Given the slight decline in contraceptive use in late postpartum in this sample, more work is necessary to maintain motivation to continue these positive postpartum trends.
- Truth and consequences: ethics, confidentiality, and disclosure in adolescent longitudinal prevention research. Lothen-Kline C, Howard DE, Hamburger EK, Worrell KD, Boekeloo BO. J Adolesc Health 2003;33(5):385-94.
This study examined data from a natural experiment resulting from a change made in the confidentiality agreement midway through a randomized, longitudinal, controlled trial to prevent or delay adolescent alcohol use. The investigators explored the impact of the change on adolescents' rates of participation and affirmative responses to a question on suicidal thoughts. Adolescents 12-17 years old were administered a question on suicidal thoughts as part of a confidential exit interview after a general health examination with their primary care provider. After administration to 263 adolescents, the exit interview was made conditionally confidential with the remaining 181 adolescents. The revised consent form and protocol stipulated that researchers would reveal to appropriate professionals and parents any adolescent indicating suicidal thoughts. Prevalence estimates for the suicidal thoughts question and study participation rates were computed for conditions both before and after the change. Fewer adolescents responded affirmatively to the suicidal thoughts question when they were recruited using the revised (1%) than the original (8%) consent form and protocol. The revised confidentiality agreement did not affect participation rates. Adolescents who assent to participate in research studies may be less likely to disclose personal information regarding suicidal thoughts if they know that their disclosure may result in a break in confidentiality. Specific guidelines are needed for conditional and unconditional confidentiality agreements to study mental health in adolescent longitudinal prevention research.
