National Center for Education in Maternal and Child Health
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June 7, 2002
1. Research Brief Series Looks at "What Works" in Adolescent Development
2. RAND's Promising Practices Network Highlights Effective Drug-Use-Prevention Program
3. Survey Findings Highlight Role of TV in Influencing Adolescent Sexual Decision-Making
4. Article Discusses Current Federal Sex Education Initiatives
5. Study Finds Lack of Organizational Priority Barrier to Providing STD Care in Medicaid
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1. RESEARCH BRIEF SERIES LOOKS AT "WHAT WORKS" IN ADOLESCENT DEVELOPMENT
Preventing Teenage Pregnancy, Childbearing, and Sexually Transmitted Diseases: What Research Shows is the first in the "American Teens" series of briefs based on a comprehensive review of adolescent development research by Child Trends in partnership with the John S. and James L. Knight Foundation. For this brief, Child Trends reviewed more than 150 research studies on adolescent reproductive health to identify factors that contribute to improving it. The brief defines improved adolescent reproductive health as "involving one of the following behaviors: delaying sexual initiation, reducing the frequency of sexual activity, reducing the number of sexual partners, increasing condom use and overall contraceptive use, and reducing the rate of unintended pregnancy and childbearing, as well as lowering the incidence of STDs among teenagers." The brief highlights findings from the vantage point of adolescents as individuals and within the contexts of their families, peers, partners, schools, and communities. The brief also includes a "what works" table that identifies specific programs and approaches found to have succeeded at improving reproductive health among adolescents. The brief is available at http://www.childtrends.org/PDF/K1Brief.pdf.
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2. RAND'S PROMISING PRACTICES NETWORK HIGHLIGHTS EFFECTIVE DRUG-USE-PREVENTION PROGRAM
The Preparing for the Drug Free Years Program is designed to teach parents skills that can help prevent drug and alcohol abuse in their families, and RAND's Promising Practices Network on Children, Families and Communities recently recognized it as a "proven and promising program." The original research and the program itself were funded by the National Institute of Drug Abuse, and the field testing and evaluation study were funded by the U.S. Department of Education's Drug Free Schools and Communities Program. The Promising Practices Network Web site includes a program overview as well as information on program participants, evaluation methods, key evaluation findings, those likely to implement the program, implementation details, and issues to consider. Example sites, contact information, a list of resources, and a bibliography are also available at http://www.promisingpractices.net/program.asp?programid=91.
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3. SURVEY FINDINGS HIGHLIGHT ROLE OF TV IN INFLUENCING ADOLESCENT SEXUAL DECISION-MAKING
The Teens, Sex and TV Survey Snapshot presents data on the role of television in influencing adolescents' decisions related to sexual behavior. This survey of a nationally representative sample of more than 500 adolescents ages 15 through 17 was jointly conducted by the Henry J. Kaiser Family Foundation and U.S. News and World Report. The snapshot, highlighting key findings of the survey, is available at http://www.kff.org/content/2002/3229/TeenSnapshot.pdf.
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4. ARTICLE DISCUSSES CURRENT FEDERAL SEX EDUCATION INITIATIVES
"Endorsing sex education that includes information about condoms and contraceptive use to avoid STDs and unintended pregnancy along with positive messages about the value of delaying sexual activity is . . . the position of the nation's leading medical, public health and education organizations," states the author of an article in The Guttmacher Report on Public Policy. Asserting that the exclusive promotion of abstinence is the prevailing sex education policy at the federal level, the author of this article discusses issues and implications of current federal legislative initiatives on sex education. The discussion includes information on select research findings and advocacy efforts under way to support "a more comprehensive, or abstinence-plus, approach to sex education."
Citing research conducted by the Alan Guttmacher Institute between 1998 and 2001, the author notes that adolescents in the United States have higher rates of unplanned pregnancy than those in other developed countries "because they are less likely to use any contraceptive method than young people in other developed countries and are also less likely to use methods that in actual use have the highest effectiveness rates, such as the pill." The author notes that program interventions that urge adolescents to postpone having intercourse but also discuss contraception can be effective in helping adolescents delay sexual activity and increase contraceptive use when they do become sexually active.
Continuing the discussion, the author points out that over 100 child development, education, health care, and youth-serving agencies have committed to ensuring that young Americans receive comprehensive sex education. The Family Life Education Act, legislation introduced in the House of Representatives in December 2001, presents an alternative policy proposal for these advocates to rally around. "The bill would authorize $100 million annually for five years to support state programs that operate under a nine-point definition of 'family life education programs' that stands in sharp contrast to the eight-point definition of an 'eligible abstinence education program' that now governs federal support in this area," states the author.
The author concludes that sponsors and supporters of the Family Life Education Act "hope it will help policymakers voice their opposition to the strictest form of abstinence-only education while still remaining supportive of abstinence messages."
Boonstra H. 2002. Legislators craft alternative vision of sex education to counter abstinence-only drive. The Guttmacher Report on Public Policy 5(2):1-3.
Readers: This article includes a table listing selected medical, public health, and educational organizations supporting comprehensive sexuality education. It also includes a table outlining the nine-point definition of sexuality education, as defined by the Family Life Education Act, as well as the eight-point definition of abstinence education, as defined by current federal law. A copy of the article is available as a PDF file at http://www.agi-usa.org/pubs/journals/gr050201.pdf.
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5. STUDY FINDS LACK OF ORGANIZATIONAL PRIORITY BARRIER TO PROVIDING STD CARE IN MEDICAID
"Overall, lack of organizational priority is a major barrier to providing sexually transmitted disease (STD) care to Medicaid populations," state the authors of an article published in the May/June 2002 issue of Health Affairs. The authors examined the sexually transmitted disease policies of Medicaid managed care organizations (MCOs) and their contracted medical groups (CMGs) in seven cities with a high prevalence of chlamydia, gonorrhea, and syphilis and explored whether primary care providers' (PCPs') STD practices may be influenced by the presence of STD policies in the managed care plans and medical groups.
In the absence of a single "gold standard" for evaluating STD practices, the authors developed a list of selected guidelines and practice protocols that were then reviewed by an advisory panel of STD experts. The authors chose the 21 MCOs selected to participate in the study because, of all the MCOs in that particular city, the ones chosen served the largest proportions of Medicaid beneficiaries (if more than one MCO was serving the city's Medicaid population) and because STD rates among the populations they served were high. The authors conducted telephone interviews between October 1998 and June 1999 with the medical directors of the MCOs and associated CMGs, or their designated respondents, as well as with PCPs.
The authors found that
The authors suggest that state Medicaid programs can improve STD control and management by developing and adopting explicit practice standards, providing adequate reimbursement for STD services, effectively promoting the use of recommended standards of STD care, and mandating standards of STD care in contractual agreements with Medicaid MCOs.
Pourat N, Brown ER, Razack N, et al. 2002. Medicaid managed care and STDs: Missed opportunities to control the epidemic. Health Affairs 21(3):228-239.
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MCH Alert © 2002 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by MCH Library Services at the National Center for Education in Maternal and Child Health under its cooperative agreement (U02 MC 0001-01) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.
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