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Abstract

Teen birth rates and teen pregnancy prevention strategies vary widely across individual states in the US, which has the highest overall teen birth rate among developed nations. California and Texas, the two most populous states currently accounting for a quarter of all teen births, have taken very different approaches to addressing adolescent reproductive health. This case study examines the racial/ethnic composition and socioeconomic factors of these two states from 1981 to 2008. State programs and policies implemented between 1991 and 2008 as well as changes in access to contraception and public–private partnerships are discussed. Based on the lessons learned from California, a similar multifaceted campaign in Texas may be effective in reducing teen births.

Key Take Away Points

  • State policies can facilitate teen pregnancy prevention efforts that are effective in reducing teen birth rates.
  • A coordinated approach to teen pregnancy prevention, which includes mandating evidence-based sex education programs, improving access to contraceptive services, reframing the issue in the public sphere, and partnering with the community may help Texas realize greater successes in preventing teen births.

Author Biography

Susan Tortolero, PhD, Associate Professor of Health Promotion and Behavioral Sciences, and Epidemiology at the University of Texas School of Public Health, and Director of the Center for Health Promotion and Prevention Research and the University of Texas Prevention Research Center, has over 20 years’ experience researching risk and protective factors for adolescent physical and mental health. She is Vice Chair for the Texas Campaign to Prevent Teen Pregnancy.

Paula Cuccaro, PhD, Associate Director of Research for the University of Texas Prevention Research Center, is Project Director for Healthy Passages, a longitudinal adolescent health study following a group of youth over a 10-year period. She is an expert in adolescent protective and risk factors, mental health, the needs of foster care youth, and the human-animal bond.

Nancy Wood, MS, PhD candidate in Health Economics at the University of Texas School of Public Health, has expertise in biomedical informatics, geographic information systems, and cost-effectiveness analysis.

I. Sonali Weerasinge, MPH, CHES, a research assistant at the University of Texas Prevention Research Center, has research experience in chronic disease management, adolescent sexual health education, intervention development, and program dissemination.

Dennis Li, MPH candidate in Health Promotion and Behavioral Science at the University of Texas School of Public Health, has research experience in adolescent sexual health, program evaluation, and intervention development.

Melissa Peskin, PhD, Assistant Professor of Health Promotion and Behavioral Sciences at the University of Texas School of Public Health and Associate Director of Dissemination at the University of Texas Prevention Research Center, is an expert in the development, implementation, evaluation, and dissemination of adolescent sexual health programs.

Ross Shegog, PhD, Assistant Professor of Behavioral Science at the University of Texas School of Public Health and Associate Director of Communication at the University of Texas Prevention Research Center, is an expert in the application of instructional technology in health promotion and disease prevention to optimally impact adolescent health behavior.

Christine Markham, PhD, Assistant Professor of Health Promotion and Behavioral Sciences at the University of Texas School of Public Health and Deputy Director at the University of Texas Prevention Research Center, has over 20 years’ experience in child and adolescent sexual health research including family- and school-based programs.

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Responses to this Article:

Ronna Popkin, John Santelli, and Douglas Kirby, Commentary on "A Tale of Two States" (October 2011)