title: A Socioecological Framework to Assessing Depression Among Pregnant Teens.
abstract: To examine individual, interpersonal, family, and community correlates associated with moderate-to-severe depressive symptoms among pregnant adolescents. A total of 249 primarily African American and Hispanic pregnant adolescents ages 15-18 years were recruited into either an intervention group utilizing Centering Pregnancy prenatal care and case management, or to a comparison group receiving case management only. Moderate-to-severe depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Intervention and comparison groups did not significantly differ on demographic characteristics or depression scores at baseline. A total of 115 (46.1 %) participants met criteria for moderate-to-severe depressive symptoms at entry into the program. Pregnant adolescents who were moderately-to-severely depressed were more likely to be African American, to have reported limited contact with the father of the baby, and to have experienced prior verbal, physical or sexual abuse. Depressed adolescents also experienced high levels of family criticism, low levels of general support, and exposure to community violence. A significant number of pregnant adolescents were affected by depression and other challenges that could affect their health. Comprehensive interventions addressing these challenges and incorporating partners and families are needed.
authors.affiliation: Population Program, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. rbuzi@bcm.edu.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Buzi
authors.affiliation: Population Program, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Peggy B
authors.initials: PB
authors.lastname: Smith
authors.affiliation: East Tennessee State University, Lamb Hall, Johnson City, TN, 37614, USA.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Kozinetz
authors.affiliation: Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2658, Houston, TX, 77030, USA.
authors.forename: Melissa Fleschler
authors.initials: MF
authors.lastname: Peskin
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, 6701 Fannin Street, CC1710, Houston, TX, 77030, USA.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Wiemann
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D003863:Depression / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D011203:Poverty / Q000523:psychology; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D014754:Violence / Q000523:psychology
keywords: Adolescent pregnancy; Depression; Social support