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Applying the Theory of Reasoned Action to Understanding Teen Pregnancy with American Indian Communities

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Abstract

Objectives American Indian girls have higher teen pregnancy rates than the national rate. Intervention studies that utilize the Theory of Reasoned Action have found that changing attitudes and subjective norms often leads to subsequent change in a variety of health behaviors in young adults. The current study goal is to better understand sexual decision-making among American Indian youth using the Theory of Reasoned Action model and to introduce ways to utilize attitudes and subjective norms to modify risky behaviors. Methods The project collected qualitative data at a reservation site and an urban site through 16 focus groups with American Indian young people aged 16–24. Results Attitudes towards, perceived impact of, and perception of how others felt about teen pregnancy vary between American Indian parents and non-parents. Particularly, young American Indian parents felt more negatively about teen pregnancy. Participants also perceived a larger impact on female than male teen parents. Conclusions There are differences between American Indian parents and non-parents regarding attitudes towards, the perceived impact of, and how they perceived others felt about teen pregnancy. Teen pregnancy prevention programs for American Indian youth should include youth parents in curriculum creation and curriculum that addresses normative beliefs about teen pregnancy and provides education on the ramifications of teen pregnancy to change attitudes.

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References

  • Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127(1), 142–161. doi:10.1037/0033-2909.127.1.142.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Broaddus, M. R., Schmiege, S. J., & Bryan, A. D. (2011). An expanded model of the temporal stability of condom use intentions: Gender-specific predictors among high-risk adolescents. Annals of Behavioral Medicine, 42(1), 99–110. doi:10.1007/s12160-011-9266-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carpenter, L. M. (2005). Virginity lost: An intimate portrait of first sexual experiences. New York: New York University.

    Google Scholar 

  • Chewning, B., Douglas, J., Kokotailo, P. K., LaCourt, J., Clair, D. S., & Wilson, D. (2001). Protective factors associated with American Indian adolescents’ safer sexual patterns. Maternal and Child Health Journal, 5(4), 273–280.

    Article  CAS  PubMed  Google Scholar 

  • Coley, S. L., & Aronson, R. E. (2013). Exploring birth outcome disparities and the impact of prenatal care utilization among North Carolina teen mothers. Women’s Health Issues, 23(5), e287–e294. doi:10.1016/j.whi.2013.06.004.

    Article  PubMed  Google Scholar 

  • de Ravello, L., Everett Jones, S., Tulloch, S., Taylor, M., & Doshi, S. (2014). Substance use and sexual risk behaviors among American Indian and Alaska Native high school students. Journal of School Health, 84(1), 25–32. doi:10.1111/josh.12114.

    Article  PubMed  PubMed Central  Google Scholar 

  • Diaz, C. J., & Fiel, J. E. (2016). The effect(s) of teen pregnancy: Reconciling theory, methods, and findings. Demography, 53(1), 85–116. doi:10.1007/s13524-015-0446-6.

    Article  PubMed  Google Scholar 

  • Edin, K., & Kefalas, M. (2005). Promises I can keep: Why poor women put motherhood before marriage. Berkeley, CA: University of California Press.

    Google Scholar 

  • Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior. Reading, MA: Addison-Wesley.

    Google Scholar 

  • Gavin, L., MacKay, A. P., Brown, K., Harrier, S., Ventura, S. J., Kann, L., … Ryan, G. (2009). Sexual and reproductive health of persons aged 10–24 years—United States, 2002–2007. Morbidity and Mortality Weekly Report: Surveillance Summaries, 58(6), 1–58.

    Google Scholar 

  • Gillmore, M., Archibald, M. E., Morrison, D. M., Wilsdon, A., Wells, E. A., Hoppe, M. J., … Murowchick, E. (2002). Teen sexual behavior: Applicability of the theory of reasoned action. Journal of Marriage and Family, 64(4), 885–897.

    Article  Google Scholar 

  • Greenfeld, L.A., & Smith, S. K. (1999). American Indians and crime. Retrieved from https://www.bjs.gov/content/pub/pdf/aic.pdf.

  • Griese, E. R., Kenyon, D. B., & McMahon, T. R. (2016). Identifying sexual health protective factors among Northern Plains American Indian youth: An ecological approach utilizing multiple perspectives. American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 23(4), 16–43. doi:10.5820/aian.2304.2016.16.

    Article  Google Scholar 

  • Hamilton, B. E., Hoyert, D. L., Martin, J. A., Strobino, D. M., & Guyer, B. (2013). Annual summary of vital statistics: 2010–2011. Pediatrics, 131(3), 548–558. doi:10.1542/peds.2012-3769.

    Article  PubMed  Google Scholar 

  • Hanson, J. D., McMahon, T. R., Griese, E. R., & Kenyon, D. B. (2014). Understanding gender roles in teen pregnancy prevention among American Indian youth. American Journal of Health Behavior, 38(6), 807–815. doi:10.5993/AJHB.38.6.2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harris, M. B., & Allgood, J. G. (2009). Adolescent pregnancy prevention: Choosing an effective program that fits. Children & Youth Services Review, 31(12), 1314–1320. doi:10.1016/j.childyouth.2009.06.002.

    Article  Google Scholar 

  • Hellerstedt, W. L., Peterson-Hickey, M., Rhodes, K. L., & Garwick, A. (2006). Environmental, social, and personal correlates of having ever had sexual intercourse among American Indian youths. American Journal of Public Health, 96(12), 2228–2234. doi:10.2105/AJPH.2004.053454.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hsieh, H., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. doi:10.1177/1049732305276687.

    Article  PubMed  Google Scholar 

  • Johansson, T., & Hammarén, N. (2014). ‘Imagine, just 16 years old and already a dad!’ The construction of young fatherhood on the Internet. International Journal of Adolescence and Youth, 19(3), 366–381. doi:10.1080/02673843.2012.747972.

    Article  Google Scholar 

  • Kaufman, C. E., Desserich, J., Crow, C. K. B., Rock, B. H., Keane, E., & Mitchell, C. M. (2007). Culture, context, and sexual risk among Northern Plains American Indian youth. Social Science & Medicine, 64(10), 2152–2164. doi:10.1016/j.socscimed.2007.02.003.

    Article  Google Scholar 

  • Koniak-Griffin, D., Lesser, J., Uman, G., & Nyamathi, A. (2003). Teen pregnancy, motherhood, and unprotected sexual activity. Research in Nursing & Health, 26(1), 4–19. doi:10.1002/nur.10062.

    Article  Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.

    Article  CAS  PubMed  Google Scholar 

  • Lombard, M., Snyder-Duch, J., & Bracken, C. C. (2004). Practical resources for assessing and reporting intercoder reliability in content analysis research projects. Retrieved from http://matthewlombard.com/reliability/.

  • MacQueen, K. M., McLellan, E., Kay, K., & Milstein, B. (1998). Codebook development for team-based qualitative analysis. Cultural Anthropology Methods, 10(2), 31–36. Retrieved from http://rds.epi-ucsf.org/ticr/syllabus/courses/47/2013/02/13/Lecture/readings/CDC%20Guidelines%20for%20Codebooks.pdf.

  • Marsiglia, F. F., Nieri, T., & Stiffman, A. R. (2006). HIV/AIDS protective factors among urban American Indian youths. Journal of Health Care for the Poor and Underserved, 17(4), 745–758. doi:10.1353/hpu.2006.0128.

    Article  PubMed  PubMed Central  Google Scholar 

  • Martin, J. A., Hamilton, B. E., Osterman, M. J. K., Curtin, S. C., & Mathews, T. J. (2013). Births: Preliminary data for 2012. National Vital Statistics Reports, 62(3), 1–20.

    Google Scholar 

  • Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., Wilson, E. C., & Mathews, T. J. (2012). Births: Final data for 2010. National Vital Statistics Reports, 61(1), 1–71.

    Google Scholar 

  • McMahon, T. R., Hanson, J. D., Griese, E. R., & Kenyon, D. B. (2015). Teen pregnancy prevention program recommendations from urban and reservation Northern Plains American Indian community members. American Jouranl of Sexuality Education, 10(3), 218–241. doi:10.1080/15546128.2015.1049314.

    Article  Google Scholar 

  • Meade, C. S., Kershaw, T. S., & Ickovics, J. R. (2008). The intergenerational cycle of teenage motherhood: An ecological approach. Health Psychology, 27(4), 419–429. doi:10.1037/0278-6133.27.4.419.

    Article  PubMed  Google Scholar 

  • Misra, K., Matte, A., & Lewis, A. E. (2014). Understanding teen mothers: A zip code analysis. American Economist, 59(1), 52–69.

    Article  Google Scholar 

  • Mollborn, S., & Lovegrove, P. J. (2011). How teenage fathers matter for children: Evidence from the ECLS-B. Journal of Family Issues, 32(1), 3–30. doi:10.1177/0192513x10370110.

    Article  PubMed  PubMed Central  Google Scholar 

  • Montano, D. E., & Kasprzyk, D. (2008). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In K. Glanz, B. K. Reimer & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (4th edn., pp. 67–96). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Morrison, D. M., Baker, S. A., & Gillmore, M. (2000). Using the theory of reasoned action to predict condom use among high-risk heterosexual teens. In P. Norman, C. Abraham & M. Conner (Eds.), Understanding and changing health behaviour: From health beliefs to self-regulation (pp. 27–49). Amsterdam: Harwood Academic Publishers.

    Google Scholar 

  • Patton, M. Q. (2002). Two decades of developments in qualitative inquiry: A personal, experiential perspective. Qualitative Social Work, 1(3), 261–283. doi:10.1177/1473325002001003636.

    Article  Google Scholar 

  • Perper, K., Peterson, K., & Manlove, J. (2010). Diploma attainment among teen mothers. Retrieved from http://www.childtrends.org/wp-content/uploads/2010/01/child_trends-2010_01_22_FS_diplomaattainment.pdf.

  • Richards, J., & Mousseau, A. (2012). Community-based participatory research to improve preconception health among northern plains American Indian adolescent women. American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 19(1), 154–185. doi:10.5820/aian.1901.2012.158.

    Article  Google Scholar 

  • Rink, E., FourStar, K., Medicine Elk, J., Dick, R., Jewett, L., & Gesink, D. (2012). Pregnancy prevention among American Indian men ages 18 to 24: The role of mental health and intention to use birth control. American Indian and Alaska Native Mental Health Research: The Journal of the National Center, 19(1), 57–75. doi:10.5820/aian.1901.2012.57.

    Article  Google Scholar 

  • Rushing, S. C., & Stephens, D. (2012). Tribal recommendations for designing culturally appropriate technology-based sexual health interventions targeting Native youth in the Pacific Northwest. American Indian and Alaska Native Mental Health Research: The Journal of the National Center, 19(1), 76–101. doi:10.5820/aian.1901.2012.76.

    Article  Google Scholar 

  • Rutman, S., Taualii, M., Ned, D., & Tetrick, C. (2012). Reproductive health and sexual violence among urban American Indian and Alaska Native young women: Select findings from the National Survey of Family Growth (2002). Maternal and Child Health Journal, 16(Suppl 2), 347–352. doi:10.1007/s10995-012-1100-1.

    Article  PubMed  Google Scholar 

  • Seamark, C. J., & Lings, P. (2004). Positive experiences of teenage motherhood: A qualitative study. British Journal of General Practice, 54(508), 813–818.

    PubMed  PubMed Central  Google Scholar 

  • Sipsma, H. L., Ickovics, J. R., Lewis, J. B., Ethier, K. A., & Kershaw, T. S. (2011). Adolescent pregnancy desire and pregnancy incidence. Women’s Health Issues, 21(2), 110–116. doi:10.1016/j.whi.2010.09.004.

    Article  PubMed  Google Scholar 

  • SmithBattle, L. I. (2013). Reducing the stigmatization of teen mothers. MCN: The American Jouranl of Maternal/Child Nursing, 38(4), 235–241. doi:10.1097/NMC.0b013e3182836bd4.

    Google Scholar 

  • Somerville, L. H. (2013). Special issue on the teenage brain: Sensitivity to social evaluation. Current Directions in Psychological Science, 22(2), 121–127. doi:10.1177/0963721413476512.

    Article  PubMed  PubMed Central  Google Scholar 

  • The National Campaign to Prevent Teen Pregnancy. (2009). American Indian/Alaska Native youth and teen pregnancy prevention. Retrieved from http://www.thenationalcampaign.org/resources/pdf/SS/SS39_NativeAmericans.pdf.

  • Tremblay, L., & Frigon, J.-Y. (2004). Biobehavioural and cognitive determinants of adolescent girls’ involvement in sexual risk behaviours: A test of three theoretical models. Canadian Journal of Human Sexuality, 13(1), 29–44.

    Google Scholar 

  • Trivedi, D., Brooks, F., Bunn, F., & Graham, M. (2009). Early fatherhood: A mapping of the evidence base relating to pregnancy prevention and parenting support. Health Education Research, 24(6), 999–1028. doi:10.1093/her/cyp025.

    Article  CAS  PubMed  Google Scholar 

  • Weed, K., & Nicholson, J. S. (2015). Differential social evaluation of pregnant teens, teen mothers and teen fathers by university students. International Journal of Adolescence and Youth, 20(1), 1–16. doi:10.1080/02673843.2014.963630.

    Article  PubMed  Google Scholar 

  • White House, Executive Office of the President. (2014). 2014 Native youth report. Retrieved from https://www.whitehouse.gov/sites/default/files/docs/20141129nativeyouthreport_ final.pdf.

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Acknowledgements

This research was supported by Award Number P20MD001631-06 from the National Center on Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health and Health Disparities or the National Institutes of Health (NIH). Special thanks to Dr. Renee Seiving, Melissa Huff, Char Green, Jen Prasek, Dr. Paul Thompson, Noelani Villa, Donna Keeler, Reggan LaBore, Kathy White, Cassandra Crazy Thunder, and Tonya Belile for their contributions to this project.

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  1. Center for Health Outcomes and Population Research, Sanford Research, 2301 E. 60th St North, Sioux Falls, SD, 57104, USA

    Elizabeth A. Dippel, Jessica D. Hanson, Tracey R. McMahon, Emily R. Griese & DenYelle B. Kenyon

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  1. Elizabeth A. Dippel
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  2. Jessica D. Hanson
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  3. Tracey R. McMahon
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Correspondence to Jessica D. Hanson.

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Dippel, E.A., Hanson, J.D., McMahon, T.R. et al. Applying the Theory of Reasoned Action to Understanding Teen Pregnancy with American Indian Communities. Matern Child Health J 21, 1449–1456 (2017). https://doi.org/10.1007/s10995-017-2262-7

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