Programs and services to prevent pregnancy, childbearing, and poor birth outcomes among adolescents in rural areas of the southeastern United States.
OBJECTIVE
To illustrate how rural adolescents' needs for pregnancy prevention and improved birth outcomes are currently being addressed, and to suggest strategies for future programs.


METHODS
Local and state-level informants knowledgeable about services to adolescents in the Southeastern United States were identified. Semistructured interviews were used to determine the program start date and time frame, funding sources, target population, participating counties, implementing agency or organization, specific program services, and status of program activities. These programs were categorized by the type of services offered and the population targeted.


RESULTS
The most common adolescent services in the rural Southeast attempt either to improve life options of youth, reduce sexual activity, or provide prenatal and postnatal care. Unlike urban areas where there are a variety of family planning providers, in the rural Southeast, health departments are the primary source of family planning for adolescents. There are no abortion providers in most rural areas of the Southeast. The majority of rural programs that include adolescents among the population served are developed for all women rather than specifically for adolescents. Programs specific to rural adolescents are described.


CONCLUSIONS
The majority of programs in the rural Southeast address only selected adolescent health issues. Successful interventions require locally supported, multipronged, intensive approaches with consistent messages targeted to high-risk populations. Evaluation tools are needed to determine the effectiveness of each component of prevention programs.
Loda
F A
FA
Department of Community Pediatrics, School of Medicine, University of North Carolina at Chapel Hill 27599-7590, USA.
Speizer
I S
IS
Martin
K L
KL
Skatrud
J D
JD
Bennett
T A
TA
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D003153:Community Health Services; D005193:Family Planning Services; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D019035:Rural Health Services / Q000706:statistics & numerical data; D015144:Southeastern United States