Combining Quantitative and Qualitative Techniques in Planning and Evaluating a Community-Wide Project to Prevent Adolescent Pregnancy Michelle C. Kegler, Dr.P.H. ; Sharon Rodine, M.Ed. ; Kenneth McLeroy, 1 2 Ph.D. ; Roy Oman, Ph.D. 1 1 Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences 1 Center Oklahoma Institute for Child Advocacy 2 Corresponding Author: Michelle Kegler, Dr.P.H.; Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, P.O. Box 26901, Oklahoma City, OK 73190; 405.271.2017 (phone), 405.271.2099 (fax); e-mail: MICHELLE.KEGLER@CCLINK.NET.UOKHSC.EDU; Abstract Adolescent pregnancy is a significant public health problem. The adolescent pregnancy rate in the United States is higher than in many other industrialized nations. Reviews of programs designed to prevent teen pregnancy conclude that few effective interventions exist. This article describes a promising approach to teen pregnancy prevention currently underway in diverse neighborhoods in Oklahoma City. The project—Healthy, Empowered and Responsible Teens of Oklahoma City-- is asset-based and focuses on positive youth development. The needs and assets assessment and the evaluation methodologies are described in detail. The methods are both qualitative and quantitative and include key informant interviews, focus groups, data mapping, observation, collection and content analysis of documents, case studies, a neighborhood youth and resident survey, community leader survey, and organizational network survey. Concepts measured in the evaluation include neighborhood mobilization and planning, implementation, institutionalization, sustainability, assets at multiple levels, risk behaviors associated with adolescent pregnancy, and teen birth rates. Introduction Over one million girls become pregnant in the United States each year. The rates of teen pregnancy and 1-3 births in the United States continue to remain far above those of other industrialized nations. Compared to females who wait until age 20 to give birth, teenage childbearing results in poorer health outcomes, lower levels of school completion, an increased chance of welfare dependency, larger families and a greater likelihood of being a single parent. 3-5 During the preceding decades program providers and researchers have explored several different strategies to prevent adolescent pregnancy, from school-based programs serving pregnant and parenting students to sexuality education to programs that link with job training. Unfortunately, recent comprehensive reviews of adolescent pregnancy prevention programs and evaluations draw similar conclusions: after several decades of discussion, strategy development, and pilot programs, there exist few programs that have been well- evaluated and successful in reducing teen pregnancy. 6-8 One of the most thorough reviews of teen pregnancy program interventions and their evaluations identified four broad factors that consistently predict early parenthood: poverty, early school failure, early behavioral problems, and family problems and dysfunction. Moore 6 and colleagues note that only a small number of 6 interventions address the four factors identified as predictors of early parenthood. Instead, they observe that interventions focus narrowly on one aspect of prevention, tend to be brief and superficial and happen too late to have any impact on high-risk populations. Moore and colleagues also describe several points that need to be 9 considered in designing effective adolescent pregnancy prevention programs, including the importance of working with families and communities to create successful programs and avoid destructive controversy, the need to recognize cultural diversity and that varied groups need varied degrees of intervention. They also encourage adolescent pregnancy prevention projects to recognize that sexual risk-taking is one of several forms of risk-taking, that non-voluntary sex plays a role in initiation of sexual activity and pregnancy, and that males partners of adolescent women may not be teenagers. In another review of the literature, Philliber & Namerow comment that given the complexity of issues 8 surrounding adolescent pregnancy, the program responses have been “too simple, too weak, too short, and overall, not up to the task of dealing with these complex behaviors and the societal trends surrounding them”(p. 3). They note several factors that only recently have started receiving attention, including the role of adult men, the link with other risk behaviors such as alcohol and drug use, the direct relationship with sexual abuse, and the greater number of teens growing up in poverty. Recent reviews of evaluated programs suggest there may be general strategies that are more likely to be effective in addressing adolescent pregnancy and its antecedents. These include paying attention to cognitive skills and educational achievement, job preparation and