The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Chris Bonell - One of the best experts on this subject based on the ideXlab platform.
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Can Teenage Men Be Targeted to Prevent Teenage Pregnancy? A Feasibility Cluster Randomised Controlled Intervention Trial in Schools
Prevention Science, 2018Co-Authors: Maria Lohan, Chris Bonell, Áine Aventin, Mike Clarke, Rhonda M. Curran, Clíona Mcdowell, Ashley Agus, Lisa Mcdaid, Honor YoungAbstract:The World Health Organisation advocates a direct focus on adolescent men in reducing adolescent Pregnancy; however, no trials have been conducted. This trial (ISRCTN11632300; NCT02092480) determines whether a novel Relationship and Sexuality Educational intervention, If I Were Jack , is acceptable and feasible to implement in mixed sex UK classrooms. The intervention is a teacher-delivered intervention that emphasises male alongside female responsibility in preventing unintended pregnancies and is designed to prevent unprotected sex. The trial was a parallel-group cluster randomised controlled feasibility trial with embedded process and cost evaluation in eight secondary schools (unit of randomisation) among 831 pupils (mean age 14) in Northern Ireland, alongside a qualitative evaluation of transferability in ten schools in Scotland, Wales and England. The sampling strategy was a maximum variation quota sample designed to capture a range of school management types. Four schools were randomised to each arm and the control arm continued with usual practice. Study duration was 12 months (from November 2014), with follow-up 9 months post-baseline. Results demonstrated that the intervention was acceptable to schools, pupils and teachers, and could be feasibly implemented, cost-effectively, with minor enhancements. The between-group difference in incidence of unprotected sex (primary outcome at pupil level) of 1.3% (95% CI 0.5–2.2) by 9 months demonstrated a potential effect size consistent with those reported to have had meaningful impact on Teenage Pregnancy. The study responds to global health policy for a paradigm shift towards inclusion of men in the achievement of sexual and reproductive health goals in a practical way by demonstrating that a gender-sensitive as well as a gender transformative intervention targeting males to prevent Teenage Pregnancy is acceptable to adolescent men and women and implementable in formal education structures. If I Were Jack now merits further effectiveness testing.
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improving school ethos may reduce substance misuse and Teenage Pregnancy
BMJ, 2007Co-Authors: Chris Bonell, Adam Fletcher, Jim MccambridgeAbstract:Substance misuse and Teenage Pregnancy are major public health challenges. Existing responses generally focus on individual characteristics, such as knowledge and attitudes about substances and sexual risk, rather than wider social and institutional influences, and seem to have brought about only limited benefits. We review evidence suggesting that interventions aiming to promote one such wider influence—positive school ethos—might provide an effective complement to existing interventions.
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why is Teenage Pregnancy conceptualized as a social problem a review of quantitative research from the usa and uk
Culture Health & Sexuality, 2004Co-Authors: Chris BonellAbstract:To explore why Teenage Pregnancy is regarded by researchers from the USA and UK as a major social problem, a systematic review was conducted of published research on the social influences on Teenage Pregnancy. Papers published in the USA and UK between 1981 and 2000 were examined with respect to samples, social influences and outcomes. UK studies often justified investigating Teenage Pregnancy in terms of health. Research from the USA more often viewed Teenage Pregnancy as problematic because of associated welfare expenditure. A few studies from the USA regarded Teenage parenting as mediating the intergenerational transmission of poverty. Such studies often focused on Black and minority ethnic populations. Most research considered economic and cultural influences, with a bias in research from the USA on cultural factors, and in the UK on economic factors. Overall, there were significant differences between research in the USA and UK. These may have arisen from a combination of political, religious and research design factors.
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effect of social exclusion on the risk of Teenage Pregnancy development of hypotheses using baseline data from a randomised trial of sex education
Journal of Epidemiology and Community Health, 2003Co-Authors: Chris Bonell, Ann Oakley, Vicki Strange, Judith Stephenson, Andrew Copas, Simon Forrest, Anne M Johnson, S BlackAbstract:Study objective: The UK government argues that “social exclusion” increases risk of Teenage Pregnancy and that educational factors may be dimensions of such exclusion. The evidence cited by the government is limited to reporting that socioeconomic disadvantage and educational attainment influence risk. Evidence regarding young people's attitude to school is not cited, and there is a lack of research concerning the UK. This paper develops hypotheses on the relation between socioeconomic and educational dimensions of social exclusion, and risk of Teenage Pregnancy, by examining whether dislike of school and socioeconomic disadvantage are associated with cognitive/behavioural risk measures among 13/14 year olds in English schools. Design: Analysis of data from the baseline survey of a study of sex education. Setting and participants: 13/14 year old school students from south east England. Main results: The results indicate that socioeconomic disadvantage and dislike of school are associated with various risk factors, each with a different pattern. Those disliking school, despite having comparable knowledge to those liking school, were more likely to have sexual intercourse, expect sexual intercourse by age 16, and expect to be parents by the age of 20. For most associations, the crude odds ratios (ORs) and the ORs adjusted for the other exposure were similar, suggesting that inter-confounding between exposures was limited. Conclusions: It is hypothesised that in determining risk of Teenage Pregnancy, the two exposures are independent. Those disliking school might be at greater risk of Teenage Pregnancy because they are more likely to see Teenage Pregnancy as inevitable or positive.
Mark Walker - One of the best experts on this subject based on the ideXlab platform.
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Increased risks of neonatal and postneonatal mortality associated with Teenage Pregnancy had different explanations.
Journal of clinical epidemiology, 2008Co-Authors: Xi-kuan Chen, Shi Wu Wen, Nathalie Fleming, Qiuying Yang, Mark WalkerAbstract:Abstract Objective To determine the potential pathway of the association between Teenage Pregnancy and neonatal and postneonatal mortality. Study Design and setting We carried out a retrospective cohort study of 4,037,009 nulliparous pregnant women under 25 years old who had a live singleton birth during 1995 to 2000, based on linked birth and infant death data set of the United States. Results Teenage Pregnancy (10–19 years old) was associated with increased neonatal mortality (odds ratio [OR]: 1.20, 95% confidence interval [CI] = 1.16–1.24) and postneonatal mortality (OR: 1.47, 95% CI = 1.41–1.54) after adjustment for potential confounders. With further adjustment for weight gain during Pregnancy, Teenage Pregnancy was still associated with increased risk of neonatal (OR: 1.23, 95% CI = 1.19–1.28) and postneonatal mortality (OR: 1.48, 95% CI = 1.42–1.55). When adjustment was made for gestational age at birth, there was no association of Teenage Pregnancy with neonatal mortality (OR: 0.98, 95% CI = 0.95–1.02), whereas there was significant association with postneonatal mortality (OR: 1.40, 95% CI = 1.34–1.46). Conclusion The increased risk of neonatal death associated with Teenage Pregnancy is largely attributable to higher risk of preterm births, whereas increased postneonatal mortality is independent of the known confounders and gestational age at birth.
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Teenage Pregnancy and congenital anomalies which system is vulnerable
Human Reproduction, 2007Co-Authors: Xi-kuan Chen, Shi Wu Wen, Nathalie Fleming, Qiuying Yang, Mark WalkerAbstract:BACKGROUND: Teenage Pregnancy may be associated with some forms of congenital anomalies. The objective of this study was to identify the types of congenital anomalies associated with Teenage Pregnancy. METHODS: We carried out a retrospective cohort study of 5 542 861 nulliparous pregnant women younger than 35 years of age with a live singleton birth between 1995 and 2000 in the USA. RESULTS: Compared with adult Pregnancy (20–34 years old), and after adjustment for confounding variables, Teenage Pregnancy (13–19 years old) was associated with increased risk of central nervous system anomalies [odds ratio (OR) 1.08; 95% confidence interval (CI): 1.01, 1.16], gastrointestinal anomalies (OR: 1.39; 95% CI: 1.31, 1.49) and musculoskeletal/integumental anomalies (OR: 1.06; 95% CI: 1.03, 1.10). The Teenage Pregnancy associated increase in risk for central nervous system anomalies was mainly attributable to anomalies other than anencephalus, spina bifida/meningocele and hydrocephalus and microcephalus; for gastrointestinal anomalies the risk was mainly attributable to omphalocele/gastroschisis; and for musculoskeletal/integumental anomalies the risk was mainly attributable to cleft lip/palate and polydactyly/syndactyly/adactyly. No increased risk was found for circulatory/respiratory anomalies, urogenital anomalies, or Down’s syndrome. CONCLUSIONS: Teenage Pregnancy increases the risks of congenital anomalies in central nervous, gastrointestinal and musculoskeletal/integumental systems.
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Teenage Pregnancy and adverse birth outcomes a large population based retrospective cohort study
International Journal of Epidemiology, 2007Co-Authors: Xi-kuan Chen, Nathalie Fleming, Kitaw Demissie, George G Rhoads, Mark WalkerAbstract:Results All Teenage groups were associated with increased risks for pre-term delivery, low birth weight and neonatal mortality. Infants born to Teenage mothers aged 17 or younger had a higher risk for low Apgar score at 5min. Further adjustment for weight gain during Pregnancy did not change the observed association. Restricting the analysis to white married mothers with ageappropriate education level, adequate prenatal care, without smoking and alcohol use during Pregnancy yielded similar results. Conclusions Teenage Pregnancy increases the risk of adverse birth outcomes that is independent of important known confounders. This finding challenges the accepted opinion that adverse birth outcome associated with Teenage Pregnancy is attributable to low socioeconomic status, inadequate prenatal care and inadequate weight gain during Pregnancy.
Elizabeth H Bradley - One of the best experts on this subject based on the ideXlab platform.
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economic evaluation of a comprehensive Teenage Pregnancy prevention program pilot program
American Journal of Preventive Medicine, 2009Co-Authors: Marjorie S Rosenthal, Joseph S Ross, Roseanne Bilodeau, Rosemary S Richter, Jane Palley, Elizabeth H BradleyAbstract:Background Previous research has suggested that comprehensive Teenage Pregnancy prevention programs that address sexual education and life skills development and provide academic support are effective in reducing births among enrolled Teenagers. However, there have been limited data on the costs and cost effectiveness of such programs. Purpose The study used a community-based participatory research approach to develop estimates of the cost–benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents. Methods Using data from 1997–2003, an in-time intervention analysis was conducted to determine program cost–benefit while Teenagers were enrolled; an extrapolation analysis was then used to estimate accrued economic benefits and cost–benefit up to age 30 years. Results The program operating costs totaled $3,228,152.59 and reduced the Teenage childbearing rate from 94.10 to 40.00 per 1000 Teenage girls, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 years on average, with social benefits outweighing total social costs by age 20.1 years. Conclusions This comprehensive Teenage Pregnancy prevention program is estimated to provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost effectiveness of similarly comprehensive programs when they are implemented more widely in high-risk neighborhoods.
Xi-kuan Chen - One of the best experts on this subject based on the ideXlab platform.
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M: Teenage Pregnancy and congenital anomalies: which system is vulnerable
2016Co-Authors: Xi-kuan Chen, Shi Wu Wen, Nathalie Fleming, Qiuying Yang, Mark C. WalkerAbstract:BACKGROUND: Teenage Pregnancy may be associated with some forms of congenital anomalies. The objective of this study was to identify the types of congenital anomalies associated with Teenage Pregnancy. METHODS: We carried out a retrospective cohort study of 5 542 861 nulliparous pregnant women younger than 35 years of age with a live singleton birth between 1995 and 2000 in the USA. RESULTS: Compared with adult Pregnancy (20–34 years old), and after adjustment for confounding variables, Teenage Pregnancy (13–19 years old) was associated with increased risk of central nervous system anomalies [odds ratio (OR) 1.08; 95 % confidence interval (CI): 1.01, 1.16], gastrointestinal anomalies (OR: 1.39; 95 % CI: 1.31, 1.49) and musculoskeletal/integumental anomalies (OR: 1.06; 95 % CI: 1.03, 1.10). The Teenage Pregnancy associated increase in risk for central nervous system anomalies was mainly attributable to anomalies other than anencephalus, spina bifida/meningocele and hydrocephalus and microcephalus; for gastrointestinal anomalies the risk was mainly attributable to omphalocele/gastroschisis; and for musculoskeletal/integumental anomalies the risk was mainly attributable to cleft lip/palate and polydactyly/syn-dactyly/adactyly. No increased risk was found for circulatory/respiratory anomalies, urogenital anomalies, or Down’s syndrome. CONCLUSIONS: Teenage Pregnancy increases the risks of congenital anomalies in centra
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Increased risks of neonatal and postneonatal mortality associated with Teenage Pregnancy had different explanations.
Journal of clinical epidemiology, 2008Co-Authors: Xi-kuan Chen, Shi Wu Wen, Nathalie Fleming, Qiuying Yang, Mark WalkerAbstract:Abstract Objective To determine the potential pathway of the association between Teenage Pregnancy and neonatal and postneonatal mortality. Study Design and setting We carried out a retrospective cohort study of 4,037,009 nulliparous pregnant women under 25 years old who had a live singleton birth during 1995 to 2000, based on linked birth and infant death data set of the United States. Results Teenage Pregnancy (10–19 years old) was associated with increased neonatal mortality (odds ratio [OR]: 1.20, 95% confidence interval [CI] = 1.16–1.24) and postneonatal mortality (OR: 1.47, 95% CI = 1.41–1.54) after adjustment for potential confounders. With further adjustment for weight gain during Pregnancy, Teenage Pregnancy was still associated with increased risk of neonatal (OR: 1.23, 95% CI = 1.19–1.28) and postneonatal mortality (OR: 1.48, 95% CI = 1.42–1.55). When adjustment was made for gestational age at birth, there was no association of Teenage Pregnancy with neonatal mortality (OR: 0.98, 95% CI = 0.95–1.02), whereas there was significant association with postneonatal mortality (OR: 1.40, 95% CI = 1.34–1.46). Conclusion The increased risk of neonatal death associated with Teenage Pregnancy is largely attributable to higher risk of preterm births, whereas increased postneonatal mortality is independent of the known confounders and gestational age at birth.
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Teenage Pregnancy and congenital anomalies which system is vulnerable
Human Reproduction, 2007Co-Authors: Xi-kuan Chen, Shi Wu Wen, Nathalie Fleming, Qiuying Yang, Mark WalkerAbstract:BACKGROUND: Teenage Pregnancy may be associated with some forms of congenital anomalies. The objective of this study was to identify the types of congenital anomalies associated with Teenage Pregnancy. METHODS: We carried out a retrospective cohort study of 5 542 861 nulliparous pregnant women younger than 35 years of age with a live singleton birth between 1995 and 2000 in the USA. RESULTS: Compared with adult Pregnancy (20–34 years old), and after adjustment for confounding variables, Teenage Pregnancy (13–19 years old) was associated with increased risk of central nervous system anomalies [odds ratio (OR) 1.08; 95% confidence interval (CI): 1.01, 1.16], gastrointestinal anomalies (OR: 1.39; 95% CI: 1.31, 1.49) and musculoskeletal/integumental anomalies (OR: 1.06; 95% CI: 1.03, 1.10). The Teenage Pregnancy associated increase in risk for central nervous system anomalies was mainly attributable to anomalies other than anencephalus, spina bifida/meningocele and hydrocephalus and microcephalus; for gastrointestinal anomalies the risk was mainly attributable to omphalocele/gastroschisis; and for musculoskeletal/integumental anomalies the risk was mainly attributable to cleft lip/palate and polydactyly/syndactyly/adactyly. No increased risk was found for circulatory/respiratory anomalies, urogenital anomalies, or Down’s syndrome. CONCLUSIONS: Teenage Pregnancy increases the risks of congenital anomalies in central nervous, gastrointestinal and musculoskeletal/integumental systems.
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Teenage Pregnancy and adverse birth outcomes a large population based retrospective cohort study
International Journal of Epidemiology, 2007Co-Authors: Xi-kuan Chen, Nathalie Fleming, Kitaw Demissie, George G Rhoads, Mark WalkerAbstract:Results All Teenage groups were associated with increased risks for pre-term delivery, low birth weight and neonatal mortality. Infants born to Teenage mothers aged 17 or younger had a higher risk for low Apgar score at 5min. Further adjustment for weight gain during Pregnancy did not change the observed association. Restricting the analysis to white married mothers with ageappropriate education level, adequate prenatal care, without smoking and alcohol use during Pregnancy yielded similar results. Conclusions Teenage Pregnancy increases the risk of adverse birth outcomes that is independent of important known confounders. This finding challenges the accepted opinion that adverse birth outcome associated with Teenage Pregnancy is attributable to low socioeconomic status, inadequate prenatal care and inadequate weight gain during Pregnancy.
Roger Ingham - One of the best experts on this subject based on the ideXlab platform.
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implementing the united kingdom s ten year Teenage Pregnancy strategy for england 1999 2010 how was this done and what did it achieve
Reproductive Health, 2016Co-Authors: Alison Hadley, Roger Ingham, Venkatraman ChandramouliAbstract:In 1999, the UK Labour Government launched a 10-year Teenage Pregnancy Strategy for England to address the country’s historically high rates and reduce social exclusion. The goal was to halve the under-18 conception rate. This study explores how the strategy was designed and implemented, and the features that contributed to its success. This study was informed by examination of the detailed documentation of the strategy, published throughout its 10-year implementation. The strategy involved a comprehensive programme of action across four themes: joined up action at national and local level; better prevention through improved sex and relationships education and access to effective contraception; a communications campaign to reach young people and parents; and coordinated support for young parents (The support programme for young parents was an important contribution to the strategy. In the short term by helping young parents prevent further unplanned pregnancies and, in the long term, by breaking intergenerational cycles of disadvantage and lowering the risk of Teenage Pregnancy.). It was implemented through national, regional and local structures with dedicated funding for the 10-year duration. The under-18 conception rate reduced steadily over the strategy’s lifespan. The 2014 under-18 conception rate was 51% lower than the 1998 baseline and there have been significant reductions in areas of high deprivation. One leading social commentator described the strategy as ‘The success story of our time’ (Toynbee, The drop in Teenage pregnancies is the success story of our time, 2013). As rates of Teenage Pregnancy are influenced by a web of inter-connected factors, the strategy was necessarily multi-faceted in its approach. As such, it is not possible to identify causative pathways or estimate the relative contributions of each constituent part. However, we conclude that six key features contributed to the success: creating an opportunity for action; developing an evidence based strategy; effective implementation; regularly reviewing progress; embedding the strategy in wider government programmes; and providing leadership throughout the programme. The learning remains relevant for the UK as England’s Teenage birth rate remains higher than in other Western European countries. It also provides important lessons for governments and policy makers in other countries seeking to reduce Teenage Pregnancy rates.
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implementing the united kingdom government s 10 year Teenage Pregnancy strategy for england 1999 2010 applicable lessons for other countries
Journal of Adolescent Health, 2016Co-Authors: Alison Hadley, Venkatraman Chandramouli, Roger InghamAbstract:Abstract Purpose Teenage Pregnancy is an issue of inequality affecting the health, well-being, and life chances of young women, young men, and their children. Consequently, high levels of Teenage Pregnancy are of concern to an increasing number of developing and developed countries. The UK Labour Government's Teenage Pregnancy Strategy for England was one of the very few examples of a nationally led, locally implemented evidence-based strategy, resourced over a long duration, with an associated reduction of 51% in the under-18 conception rate. This article seeks to identify the lessons applicable to other countries. Methods The article focuses on the prevention program. Drawing on the detailed documentation of the 10-year strategy, it analyzes the factors that helped and hindered implementation against the World Health Organization (WHO) ExpandNet Framework. The Framework strives to improve the planning and management of the process of scaling-up of successful pilot programs with a focus on sexual and reproductive health, making it particularly suited for an analysis of England's Teenage Pregnancy strategy. Results The development and implementation of the strategy matches the Framework's key attributes for successful planning and scaling up of sexual and reproductive health programs. It also matched the attributes identified by the Centre for Global Development for scaled up approaches to complex public health issues. Conclusions Although the strategy was implemented in a high-income country, analysis against the WHO-ExpandNet Framework identifies many lessons which are transferable to low- and medium-income countries seeking to address high Teenage Pregnancy rates.
