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About one-third of teen girls become pregnant at least once by age 20 and fully half of all pregnancies in the United States are unplanned.  Not too good

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Recently in Federal Funding Category

May 01 2012

starsSurvey Says: With One Voice 2012

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Geek confession time: Besides taking in a Nationals game, enjoying Woodford Reserve, hanging out at Jake's Boiler Room, or spending time with my perfect son Harrison, one of my favorite activities every year is pouring over pages and pages and pages of public opinion survey data and trying to make sense of it. How do teen guys age 15-19 from families with limited means living in southwestern states feel about the first time they had sex anyway? I gots to know, right?

Having now spent some quality time with the results of The National Campaign's latest survey of teens and adults I have come to the simple conclusion that making sense of it all is actually, well, simple. It's really not complicated at all. A moment to explain...

Apr 24 2012

starsThe Best Lobbyists

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I think there are many misconceptions out there about lobbyists. We're all having steak at The Palm, right? We push and cajole and buy our way to a vote we want. We're straight out of casting for the movie Thank You For Smoking, a comedy I highly recommend by the way, despite not being anything like the so-called M. O.D. (Merchants of Death) lobbyists portrayed in the film.

Last week, with the help of many colleagues, I trained 15 teenagers from all across the country on how to be lobbyists--specifically how to advocate for evidence-based teen pregnancy prevention programs--then sent them off to Capitol Hill to meet with members of Congress and their staff and, well, lobby. As members of The National Campaign's Youth Leadership Team (YLT), I expected this group of youth leaders to be impressive, but I was blown away. These are some of the most thoughtful, smart, eloquent, and--yes--fun, kids I've ever met. So what could I possibly teach them? Well, I told them what to expect, such as hallway meetings and remembering to turn off your cell phone ringer, and to remember to make "the ask" (in this case, to protect funding for evidence-based teen pregnancy prevention programs). I reminded them that every lobbyist has tough meetings and not to be discouraged. But most importantly I told them to share their stories. Why does this issue matter to them? Why is this so important for all American teenagers?

And now I get to the "wow" factor. These teens blew me away with how they told some of the most heart-wrenching stories and deftly wove those into a narrative about the need to prevent teen pregnancy--and to do so using programs that are proven to work. Here were a group of young adults who spoke of being the child, sibling, or friend of a teen parent. Here were teens who had seen up close what happens when one of their peers gets pregnant. This is what we call grassroots lobbying at its best. Members of Congress need to hear these stories, happening in their own states and districts, and they need to hear it from those impacted right now.

As one Hill staffer wrote to me immediately after a meeting with a YLT member, "impressive constituent." All I would add is to make that plural. Impressive indeed.

Mar 23 2012

starsLanguage Matters, Values Matter More

I've been fortunate enough to spend some time recently with federal grantees and other leaders working to address teen pregnancy all over the country. Even though my colleagues and I are often invited to national meetings and gatherings to provide information and advice to these state and local experts, I always walk away feeling like I have gained more wisdom from them than I could possibly teach in our short time together.

Last week's workshops focused on communication--specifically, how we can talk about what we do in a way that resonates with the communities we're trying to reach and, well...doesn't tick anybody off. After hours of training and exercises and simulating interviews and chart paper, a really smart colleague raised this point:

The language we have at our disposal stinks.

It's true. We work in a field where we say stuff like:

  • Evidence-based teenage pregnancy prevention programs (I fell asleep typing that)
  • Adolescent sexual and reproductive health services (umm...what?) sometimes shortened to the hip and cool 'ASRH'
  • Opportunity costs/deficits/insert noun that implies a connection to financial ledgers here

And the list goes on.

Nothing is wrong with using these phrases. In fact, if you work in this field, using this jargon is second nature. Not to mention, really smart people researched for years to develop the important concepts behind these terms. The problem is that they don't do a good enough job of capturing our values--put another way, you can't tell why we do what we do if you listen to the way we speak.

Let's pick on the Campaign for a moment and our decision to frame much of what we advocate for as "pregnancy prevention." Sounds kind of medical, kind of blah. Some would even argue that it implies an inappropriate singular focus on a particular reproductive health outcome (add the phrase "reproductive health outcome" to the list above) rather than giving weight to the full range of issues and circumstances that youth are facing when they make decisions about sex, relationships, and contraception.

But here's what we believe:

  • Addressing high rates of teen pregnancy is an important issue to work on, including in communities where stark disparities exist for racial/ethnic groups, and even considering that in some situations the issue is complicated by poverty, a lack opportunity and resources for young people, and spotty access to information and services.
  • We approach our work in communities with great consideration of these circumstances (also known as social determinants of health...LIST ALERT), and do our best to address all barriers that inhibit progress on this health issue and others.
  • Our messages and actions about prevention should never, EVER alienate or stigmatize teen parents. They also must acknowledge that every single teen who becomes pregnant ALWAYS has a right to choose to parent, and that in a small number of cases, teens become pregnant intentionally.

We act on these values by supporting community-based organizations that provide services and programs to youth while addressing barriers to access within those communities, constantly asking teens what they want for themselves and how we can best support them, and by exploring data and important research questions about the circumstances in which teen and unplanned pregnancy occur, which provides important context about young people's lives for the work we do. But saying all of that takes too long. The language we have is imperfect, but it's what we have.

Here is what I propose. If we can acknowledge that our terminology leaves something to be desired, then you can assume when we say we work on "teen pregnancy prevention" that it entails much more than just going into communities and blindly telling teens not to get pregnant.

Language matters, but not as much as our values do.

Mar 08 2012

starsOpposition to Contraception is a Losing Position

In American politics there are many guiding principles that, while you won't find them taught in school, are true nonetheless. These include truisms like you can't be against Ethanol and win in Iowa, or, the only thing that can sink a really successful campaign is for the politician to be found in bed with a dead girl or a live boy. (Ugh, right? Credit for that has been attributed to many different politicians over the years, but a Google search reveals many seem to think it originated with former Louisiana Governor Edwin Edwards.)

Then again, there are some things that are just common sense. When there is overwhelming support for something, being against that something, whatever it is, is not good for your political health. So, I feel somewhat bad for politicians of late who have come out against the contraceptive coverage provision requiring employers to provide coverage of contraception in their insurance plans without co-pays or deductibles. To be clear, churches and houses of worship are exempt from this requirement, and for religiously-affiliated institutions, the insurance company would be required to offer that coverage directly to the woman.

The media has characterized polling on this issue as mixed, but as a recent blog post by Margie Omero shows, the opinions haven't been mixed so much as the wording of the questions has been. As Omero illustrates, support for contraceptive coverage is extremely high. This is not a shocker to anyone who knows that 99 percent of American women who have ever had sex have used contraception. Americans, it turns out, possess common sense. We understand that contraception is something we all use or benefit from (for example in the case of "penis-ed Americans," as Jon Stewart characterized them the other night). We get that if contraception is accessible and affordable, more people will be able to use it, we will have fewer unplanned pregnancies, and fewer abortions will result from those unplanned pregnancies.

So, back to why I feel pity for many politicians who have opposed contraceptive coverage in recent weeks? Well, while this might help them appeal to a select group of voters in the short term, it is not where the nation is. Perhaps in this election we'll learn a new principle to add to those above--being against contraception is a losing position.

Mar 07 2012

starsBoys, Men, and Birth Control

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Photo of 2011 Youth Leadership Team members by Stephen Jeter.

I read Laura Sessions Stepps' March 6th CNN article with interest. Laura poses the question "Why don't we hear more from ordinary men" regarding the recent contraception controversy. She suggests--and I agree--that many men from the baby boom generation were not part of the contraceptive decision-making process in their personal relationships. Those very same men are the policy decision-makers of today, though that lack of involvement doesn't seem to have prevented them from having some strong opinions (Hence, an all-male Congressional panel debating the whether insurance companies should be required to cover contraception under health reform.)

Laura continues the article with the hope that the succeeding generation will be different. Her research indicates that 20-something men are more involved in contraceptive decision-making. My own observation of teenage boys is that this trend of increased involvement will become the new norm.

With teenage girls in the house, and therefore teenage boys hanging around, I have developed a new respect for the interest and--yes--responsibility, that teenage boys are taking regarding birth control. I unfortunately cannot credit the local school system for this interest. (Not so funny story: in my daughter's high school freshman physical education class, approximately three days were devoted to the complexities of sexual health, sexual relationships, and protection from pregnancy and sexually transmitted infections. And the best advice given by the teacher if the young people were to experience sexual urges was to "bake cookies." Honestly.)

I also cannot credit as many parents as I would like. Some parents I know talk often to their boys about healthy sexuality, responsibility, and birth control. But many do not. One mom told me recently, "I depend on the moms of daughters to talk to their girls, because, you know, I have a boy and there is really nothing I can say to him."

Frankly, I credit the media--both social and otherwise--and the teenage boys themselves for the new level of interest in birth control. The boys don't want "anything bad to happen" and they clearly think that untimely pregnancy is bad. Television programs like 16 & Pregnant paint an often painful future for teen fathers, one that my daughters' friends do not want. They know that they will be responsible for paying for the babies. They know that a teen pregnancy can spell the end to fun, partying, and just "hanging out" (hanging out being high on any teen's priority list).  And the internet, while no doubt providing more than its fair share of misinformation, certainly has a wealth of easy-to-find sites for teens that provide dating and relationship advice, contraceptive information,* and and facts about sexually transmitted infections.

While they may not always be keen to use condoms, teenage boys will ask outright what birth control a girl is using. I admit that it appears that these teen boys I am praising believe that birth control is primarily the girl's responsibility. But I am talking about 17-year-old boys, not known for overt responsibility-taking in any case. Simply being aware and asking about contraceptive use is the first step, and I, for one, am delighted that these boys are taking it. It bodes well for the future of contraceptive use as well as public policy.

*Bedsider is targeted to 18-29-year-old women and, while we think it can be a great resource for guys, it may not be appropriate for teens under 18.

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