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Topics In Brief

All Topics In Brief

Racial and Ethnic Disparities in Adolescent Reproductive Health

by Barbara W. Sugland


This month's edition of ReCAPP focuses on the racial and ethnic disparities in adolescent reproductive health outcomes. In addition to this Topic in Brief, new material in this edition includes: Included in this Topic in Brief are:

Introduction

Over the past 10 years, the U.S. has seen dramatic improvements in teen childbearing and teen sexual health. By now, most of us have heard the national statistics. Teen birth rates are down 26% to the lowest level ever (at 46 births per 1000 teens).1 Teen pregnancy rates are also down, some 19%, and abortion rates have dropped 32%.2 Improvements in teen fertility have occurred in every state and for all racial/ethnic subgroups.

Improvements are attributed to several factors, including more teens delaying first sex, more sexually active teens using contraception at first sex and more sexually active teens shifting to more highly reliable hormonal methods.3 These trends are indeed something to feel good about as they reflect real change in teen behavior.

In addition, research and evaluation studies have uncovered a lot of useful information about effective and promising practices, most of it made widely available to the practice community.4 Providers, more than ever before, have the potential to implement effective and promising practice and more communities are attempting to replicate several of the effective models that have been documented.

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Overview of the Issues

These improvements are very real and should be celebrated. However, it is important to recognize that the sexual health of a significant proportion of the adolescent population still remains compromised and for whom teen childbearing is still more often than not the norm. A few facts may help to redirect our attention to the needs of these teens.

  • Transition to first sex among younger teens (‹14 years of age) is on the rise. While the rate of sexual initiation among 15 to 19-year-olds is declining, rates of first sex among younger teens is actually increasing.5 Furthermore, analyses of the Youth Risk Behavior Survey (YRBS) suggest a significantly higher rate of early sex among youth of color versus white youth6 and a greater likelihood of multiple sexual partners among youth of color versus white youth.7 Trends in the sexual behavior of young men of color, in particular, warrant special and immediate attention.

  • Rates of sexually transmitted diseases have increased recently and are significantly higher among youth of color. Despite improvements in teen contraceptive use, particularly condom use, rates of sexually transmitted diseases have increased recently and are substantially higher among youth of color, particularly African-American teens. According to the Centers for Disease Control (CDC), the chlamydia rate among African-American female youth is more than six times the rate for white female youth.8

  • Substantial racial/ethnic disparities in the teen birth rate still remain. There are still substantial racial/ethnic disparities in the teen birth rate, despite recent improvements for all racial/ethnic subgroups in the past several years. The 2000 teen birth rate for Native American (68/1000), African-American (79/1000), and Hispanic youth (94/1000) is between two and close to three times higher (respectively) than the rate for white youth (33/1000).1

The growing diversity of the U.S. population has led to an increased interest in and demand for strategies effective for teen pregnancy and HIV prevention among diverse communities. While we have made important strides in identifying approaches for ethnic and linguistic minority communities, the vast majority of our interventions still lack culturally relevant and/or appropriate strategies for non-white youth.

Program staffs struggle to understand and respond to the cultural differences they encounter on a daily basis. Sponsoring agencies lack the appropriate policies and structures that facilitate implementation of culturally effective practice. As such, program staff, community residents and teens miss a critical opportunity for building partnerships important for improving teen sexual health.

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What Educators Can Do

Like any other complicated issue, there is no one easy answer for understanding or responding to disparities in teen pregnancy and HIV among teens. Experience and objective study suggest the answers may lie in the nuance of what makes us different, rather than in some large difference we perceive may distinguish one group from another. As such, effective approaches may reflect more about how we deliver our programs than what we implement.

Taking a closer look not just at the disparities among youth behavior, but also at our own behaviors as providers and provider agencies appears an important and natural first step.

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Resources for Working with African American and Latino Youth

Statistics

  • Alan Guttmacher Institute
    www.agi-usa.org
    (212) 248-1111 (New York)
    (202) 296-4012 (Washington, D.C.)
    The Alan Guttmacher Institute (AGI) is a non-profit organization focused on sexual and reproductive health research, policy analysis and public education.

  • Centers for Disease Control and Prevention
    www.cdc.gov
    (800) 311-3435
    The Centers for Disease Control and Prevention (CDC) is recognized as the lead federal agency for protecting the health and safety of people — at home and abroad, providing credible information to enhance health decisions and promoting health through strong partnerships. CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.

  • US Census Bureau Race Data
    www.census.gov/population/www/socdemo/race.html
    Provides data on race and ethnic origin.

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General Information and Programming

  • Advocates for Youth
    www.advocatesforyouth.org
    (202) 347-5700
    Advocates for Youth (AFY) develops programs for youth and advocates for policies that support youth in making informed and responsible decisions about their reproductive and sexual health. AFY provides information, training and strategic assistance to youth-serving organizations, policy makers, youth activists and the media in the United States and the developing world.

  • Congressional Black Caucus
    www.cbcfonline.org/index.html
    (202) 263-2800
    The Congressional Black Caucus Foundation, Inc. (CBCF) was established in 1976 as a non-partisan, non-profit, public policy, research and educational institute. As envisioned by its founders, the CBCF's mission is to serve as the non-partisan policy oriented catalyst that educates future leaders and promotes collaboration among legislators, business leaders, minority-focused organizational leaders, and organized labor to effect positive and sustainable change in the African American community.

  • Congressional Hispanic Caucus
    www.house.gov/reyes/CHC/
    (202) 225-2410
    "The Caucus is dedicated to voicing and advancing, through the legislative process, issues affecting Hispanic Americans in the United States and the insular areas."

  • Gente Joven
    www.gentejoven.org.mx/
    (52) 5573-7100 ext. 140 (Mexico)
    Gente Joven is a program designed to help youth obtain information and medical services that they require to prevent unwanted pregnancies, STDs, and HIV and to live their lives based on values of respect, responsibility and gender equity. Gente Joven is a program of Mexfam — the International Planned Parenthood affiliate of Mexico.

  • The Henry J. Kaiser Family Foundation
    www.kff.org/
    (650) 854-9400
    The Henry J. Kaiser Family Foundation is an independent philanthropy focusing on the major health care issues facing the nation. The foundation is an independent voice and source of facts and analysis for policymakers, the media, the health care community, and the general public.

  • The Joint Center for Political and Economic Studies
    www.jointcenter.org/
    (202) 789-3500
    The Joint Center for Political and Economic Studies is a nonpartisan, not-for-profit research organization. For 30 years, the Joint Center has been working to expand the political participation of African Americans and to improve their economic status while building bridges across racial and ethnic lines. Primary tools are research, policy analysis, and conferencing.

  • National Alliance for Hispanic Health
    www.hispanichealth.org/
    (202) 387-5000
    The National Alliance for Hispanic Health is the oldest and largest network of health and human service providers serving more than 10 million Hispanic consumers throughout the U.S. Since 1973, they have grown from a small coalition of visionary mental health providers to a large, dynamic, and strong group of organizations and individuals.

  • National Black Women's Health Project
    www.nationalblackwomenshealthproject.org/

  • The National Campaign to Prevent Teen Pregnancy
    www.teenpregnancy.org
    (202) 478-8500
    The overall goal of the National Campaign to Prevent Teen Pregnancy is to reduce the rate of teen pregnancy by one-third between 1996 and 2005. The organization offers a wealth of information, reports, research, marketing, etc.

  • The National Council of La Raza (NCLR): Institute for Hispanic Health
    www.nclr.org/policy/health.html
    (312) 269-9250
    NCLR's Institute for Hispanic Health (IHH) is dedicated to reducing the incidence, burden, and impact of health problems in Hispanics. IHH works in close partnership with NCLR affiliates, government agencies, private funders, and other Hispanic-serving organizations to deliver quality health interventions. These interventions focus on improving access to and utilization of health promotion and disease prevention programs. IHH is committed to providing technical assistance and science-based approaches that are culturally competent and linguistically appropriate.

  • The Minority Health Network (MHNet)
    www.pitt.edu/~ejb4/min/
    The Minority Health Network (MHNet) is a world-wide web-based information source for individuals interested in the health of minority groups. "Minority" refers to all people of color and people who are underrepresented economically and socially.

  • National Latina Institute for Reproductive Health
    www.latinainstitute.org/
    (718) 229-1716
    The mission of NLIRH is to ensure the fundamental human right to reproductive health for Latinas, their families and their communities through education, advocacy and coalition building. NLIRH commenced operations as an independent organization in 1994. Its antecedent, the Latina Initiative emerged five years earlier under the auspices of Catholics for a Free Choice.

  • National Library of Medicine's MEDLINEplus African American Health Resources
    www.nlm.nih.gov/medlineplus/africanamericanhealth.html
    A list of resources on African American health.

  • National Library of Medicine's MEDLINEplus Hispanic American Health Resources
    www.nlm.nih.gov/medlineplus/hispanicamericanhealth.html
    A list of resources on Hispanic American health.

  • The National Organization of Concerned Black Men
    www.cbmnational.org/index.htm
    (888) 395-7816
    The National Organization and its chapters offer teen pregnancy and violence prevention, rites of passage, Black history spelling bee, college tours and other programs to children in schools and community centers around the country. Since the 1997, the National Organization has conducted intensive youth and family program work to develop "best practice" standards for its chapters and other community groups.

  • Office of Minority Health
    www.omhrc.gov
    (800)-444-6472
    The mission of the Office of Minority Health is to improve the health of racial and ethnic populations through the development of effective health policies and programs that help to eliminate disparities in health.

  • Planned Parenthood Federation of America
    www.plannedparenthood.org
    (212) 541-7800 (New York)
    (415) 956-8856 (San Francisco)
    Planned Parenthood is a national non-profit agency with affiliates throughout the US that offers health services, education and training, and advocacy supporting reproductive rights.


  • Sexuality Information and Education Council of the United States (SIECUS)
    www.siecus.org
    (212) 819-9770
    SIECUS develops, collects, and disseminates information, promotes comprehensive education, and advocates the right of individuals to make responsible sexual choices.

  • YouthResource
    www.youthresource.com
    YouthResource, a web site created by and for gay, lesbian, bisexual, transgender, and questioning (GLBTQ) young people 13- to 24-years-old, takes a holistic approach to sexual health by offering support, community, resources, and peer-to-peer education about issues of concern to GLBTQ young people. YouthResource has four focus areas: health, advocacy, community, and issues in our lives.

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Cultural Competence

  • Child Welfare League of America
    www.cwla.org/programs/culturalcompetence/
    (202) 638-2952
    The Division of Cultural Competence is responsible for the development and implementation of cultural competence program principles, goals, operational objectives and activities for CWLA staff and member agencies. It also conducts cultural competence assessments, develop curriculum, and provide resources and training support when necessary or when requested by CWLA staff, member agencies, and the Board of Directors.

  • Diversity Rx
    www.diversityrx.org/HTML/MODELS.htm
    Diversity Rx promotes language and cultural competence to improve the quality of health care for minority, immigrant and ethnically diverse communities.

  • The National Center for Cultural Competence
    www.georgetown.edu/research/gucdc/nccc/
    (800) 788-2066 or (202) 687-5387
    The National Center for Cultural Competence seeks to address health disparity issues through training, technical assistance and consultation, networking, linkages and information exchange and knowledge and product development and dissemination.

  • National Multicultural Institute
    www.nmci.org/
    202-483-0700
    NMCI's mission is to work with individuals, organizations, and communities in creating a society that is strengthened and empowered by its diversity. Through its initiatives, NMCI leads efforts to increase communication, understanding and respect among people of diverse backgrounds and addresses some of the important issues of multiculturalism facing our society.

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Reproductive Health Programs that have been Implemented with Hispanic Communities

  • Asistencia Para Latinos
    www.siecus.org/pubs/biblio/bibs0003.html
    HIV Prevention for Latinos: Interactive Bilingual HIV Education for English as a Second Language Programs. This curriculum is designed to teach Latinos factual and culturally competent HIV/AIDS information. Lesson plans are in English and Spanish. Topics include "HIV 101 for ESL Classrooms," "Understanding HIV and the Body," "Sexual Relationships," "Needle Sharing," and "Reproduction and Prenatal Care."

  • Charlas Entre Nosotros (CEN)
    National Council of La Raza: Institute for Hispanic Health

    www.nclr.org/policy/health.html
    Charlas Entre Nosotros (CEN) is a Latino Youth Peer-to-Peer HIV/STD Prevention Program that involves charter schools and CBOs in developing and providing a peer-to-peer HIV/STD prevention program for Latino youth 13-19 years of age. The goal of the CEN program is to reduce the incidence of HIV/STDs among Latino youth through education, the promotion of effective and culturally appropriate prevention strategies, and reinforcement of positive sexual behavior. The program seeks to provide youth with the tools necessary to develop and recognize strategies that are effective in their networks to resist peer/societal pressures, and strengthen their self-concept, cultural values, and
    beliefs.

  • Draw the Line, Respect the Line
    ETR Associates
    www.etr.org/pub/
    Draw the Line, Respect the Line features English/Spanish worksheets and a Latino-sensitive approach, stresses that postponing sexual activity is the best plan, and covers setting limits to prevent HIV, STD and pregnancy, discusses social pressures, challenges to personal limits, and communication and refusal skills.

  • El Joven Noble
    Jerry Tello, National Latino Fatherhood Family Institute
    www.nlffi.org/docs/eljovenoble.htm
    El Joven Noble is a 20-week Rites of Passage program that provides additional cultural teachings to the young men, which connects them to their families and their communities. These young men are developing leadership skills and applying them into their lives and the community.

  • It's Up to Us: An AIDS Education Curriculum for ESL Students
    Hostos Community College Department of English, City University of New York
    Henry Lesnick
    www.hostos.cuny.edu/homepages/lesnick/
    This curriculum provides five hours of HIV/AIDS instruction for high school and young adult students who speak English as a second language (ESL). Using exercises which require students to use listening, reading, writing, speaking, and critical thinking skills, this curriculum helps them develop English language skills while learning how HIV is transmitted and prevented. Background materials, exercises, and activities come with each lesson. The curriculum also includes a list of international HIV/AIDS education and support service providers.

  • Jovenes Sabios (Wise Guys)
    Family Life Council of Greater Greensboro, NC
    www.wiseguysnc.org/
    Jovenes Sabios or Wise Guys is an 8-12 week male responsibility program which provides education and activities in Spanish designed to prevent adolescent pregnancy among high risk 10-14 year old males.

  • Nosotras Viviremos
    The National Coalition of Advocates for Students
    www.ncasboston.org/
    Updated in 1996 by the National Coalition of Advocates for Students, this curriculum consists of two parallel training manuals: one addressing the issues and concerns of farm-working mothers/mentors and the other addressing the issues of pre-adolescent and adolescent farm-working girls. Each consists of six units, including basic HIV/AIDS/STD information, exercises, stories, and handouts. The manuals are designed to help participants explore self-identity and to use self-reflection to address the reality of sexuality, HIV, and STDs in their lives. The intervention is designed for implementation in four sessions, with each session lasting between two and three hours. The curriculum is also available in Spanish.

  • Plain Talk (Hablando Claro)
    Annie E. Casey Foundation
    www.aecf.org/publications/plaintalk/whatis.htm
    Plain Talk is a neighborhood-based initiative aimed at helping adults, parents and community leaders develop the skills and tools they need to communicate effectively with young people about reducing adolescent sexual risk-taking. San Diego implementation (Hablando Claro) provides an example of implementation of the program in a Mexican American Community.

  • Poder Latino
    New England Research Institutes and Hispanic Office of Planning & Evaluation www.socio.com/srch/summary/pasha/full/passt11.htm
    This multifaceted community-based intervention targets Latino youth, ages 14 to 20, at elevated risk for HIV/AIDS. One goal of the program is to increase awareness of the disease by saturating target neighborhoods with public service announcements broadcasting risk reduction messages. In addition, the program aims to reduce infection by encouraging sexually active teens to use condoms. Project messages are reinforced through ongoing activities conducted by specially trained peer leaders, including workshops in schools, community organizations, and health centers, group discussions in teens' homes, presentations at large community centers, and door-to-door canvassing.

  • Reducing the Risk: Building Skills to Prevent Pregnancy, HIV and STD (RTR)
    ETR Associates
    Reducing the Risk
    RTR includes 16 well-defined lessons for 9th and 10th graders which clearly emphasize teaching refusal statements, delay statements and alternative actions students can use to abstain or protect. The student workbook is available in Spanish.

  • Safer Choices
    ETR Associates
    Safer Choices
    The Safer Choices intervention consists of five primary components: 1) School Organization, featuring a School Health Promotion Council involving teachers, students, parents, administrators, and community representatives; 2) Curriculum and Staff Development, which includes a sequential 20-session classroom curriculum with 10 lessons for ninth-grade students and 10 lessons for tenth-grade students as well as staff awareness and training events; 3) Peer Resources and School Environment, 4) Parent Education; and 5) School/Community Linkages.

  • SALSA! (STDs, Adolescents and Latinos: Sexual Health Awareness)
    American Social Health Association
    www.ashastd.org/programs/kbr.html
    With funding from the Kate B. Reynolds Charitable Trust, this project aims to increase the availability of bilingual, culturally appropriate STD prevention and education resources for Latino teens in North Carolina, particularly in rural counties.

  • Teach Outreach Program (TOP)
    CornerStone Consulting
    www.cornerstone.to/top/top.html
    Teen Outreach is a program based on the principles of positive youth development that is designed to meet the needs of adolescents during the transitional period in which they are growing into adulthood. TOP combines curriculum-guided classroom discussion and community service work in a program that supports positive youth development and prevents negative youth behaviors, such as early pregnancy and school failure. TOP is available in Spanish.

  • Will Power/Won't Power: A Sexuality Education Program for Girls Ages 12-14
    Girls Inc.
    www.girlsinc.org
    This updated curriculum is a component of Girls Inc.'s Preventing Adolescent Pregnancy program. It consists of 10 90-minute sessions for girls 12 to 14 years of age on reproductive health, assertiveness, sexual pressures, values, abstinence, and decision making. Originally designed to help girls who were likely to be facing decisions about sexual intercourse but who had not yet become sexually active, it has been revised to address sexual decision making for girls who are sexually experienced. A Spanish version, Querer/Poder Decir "No," is also available.

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Additional Resources

  • Ain't No Shame Ladies Do Yo Thang: Just Make Sure You Safe In The Game. (2003). Common Ground, USA. www.jimmiehatz.com

  • Aguirre-Molina, M., C. W. Molina, et al. (2001). Health Issues in the Latino Community. San Francisco, CA, Jossey-Bass, Inc. www.josseybass.com/WileyCDA/WileyTitle/productCd-0787960276.html

  • Betancourt, J. R., A. R. Green, et al. (2003). Public Health Reports. Racial/Ethnic Desparities: Contemporary Issues and Approaches. Boston, MA, Oxford University Press. phr.oupjournals.org/cgi/reprint/118/4/293

  • Braithwaite, R. L. and S. E. Taylor (2001). Health Issues in the Black Community. San Francisco, CA, Jossey-Bass, Inc. www.josseybass.com/WileyCDA/WileyTitle/productCd-0787952362.html

  • Brindis, C. D., A. K. Driscoll, et al. (2002). Fact Sheet on Latino Youth: Immigrant Generation. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.imm.pdf

  • Brindis, C. D. A., M.A. Biggs, et al. (2002). Fact Sheet on Latino Youth: Health Care Access. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.hca.pdf

  • Brindis, C. D. A., M.A. Biggs, et al. (2002). Fact Sheet on Latino Youth: Families. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.fam.pdf

  • Brindis, C. D. A., M.A. Biggs ,et al. (2002). Fact Sheet on Latino Youth: STIs and HIV/AIDS. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.sti.pdf

  • Brindis, C. D. A., M.A. Biggs, et al. (2002). Fact Sheet on Latino Youth: Sexual Behavior. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.sex.pdf

  • Brindis, C. D. A., M.A. Biggs, et al. (2002). Fact Sheet on Latino Youth: Population. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.pop.pdf

  • Brindis, C. D. A., M.A. Biggs, et al.(2002). Fact Sheet on Latino Youth: Education. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.edu.pdf

  • Brindis, C. D. A., M.A. Biggs, et al. (2002). Fact Sheet on Latino Youth: Income and Poverty. San Francisco, CA, University of California, San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Health Sciences and the Institute for Health Policy Studies. reprohealth.ucsf.edu/articles/Latino.pov.pdf

  • Campanelli, R. M. (2003). Addressing Racial and Ethnic Health Disparities. American Journal of Public Health, 93(10): 1624-1625.

  • Chen, J. T., P. D. Waterman, et al. (2003). Race/Ethnicity, Gender, and Monitoring Socioeconomic Gradients in Health: A Comparison of Are-Based Socioeconomic Measures-The Public Health Disparities Geocoding Project. American Journal of Public Health, 93(10): 1655-1671.

  • Don't Get Caught Slippin' Yo Pimpin' When It Comes to HIV: Reduce Yo Risk. (2003). Common Ground, USA. www.jimmiehatz.com

  • HIV/AIDS Policy Fact Sheet: African Americans and HIV / AIDS. (2003). San Francisco, CA, The Henry J. Kaiser Family Foundation. www.kff.org/content/2003/6089/6089rev.pdf

  • Ibrahim, S. A., S. B. Thomas, et al. (2003). Achieving Health Equity: An Incremental Journey. American Journal of Public Health, 93(10): 1619-1621.

  • Issue Brief On Latino Youth: Reproductive Health. (2002). San Francisco, Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Sciences and the Institute for Health Policy Studies, UC San Francisco. reprohealth.ucsf.edu/articles/Latino.IB.pdf

  • LaVeist, T. A. (2002). A Public Health Reader: Race, Ethnicity, and Health. San Francisco, CA, Jossey-Bass. www.josseybass.com/WileyCDA/WileyTitle/productCd-0787964514.html

  • Leigh, W. A. and J. L. Andrews (2002). Fact Sheets On The Reproductive Health Of African American Adolescents: Contraceptive Use. The Reproductive Health of African American Adolescents: What We Know and What We Don't Know. Washington, DC, Joint Center for Political and Economic Studies. jointcenter.org/whatsnew/a_report/contraceptive.pdf

  • Leigh, W. A. and J. L. Andrews (2002). Fact Sheets On The Reproductive Health of African American Adolescents: Reproductive Health Knowledge, Attitudes, Expectations, and Intentions. The Reproductive Health of African American Adolescents: What We Know and What We Don't Know. Washington, DC, Joint Center for Political and Economic Studies. www.jointcenter.org/whatsnew/a_report/knowledge.pdf

  • Leigh, W. A. and J. L. Andrews (2002). Fact Sheets On The Reproductive Health of African American Adolescents: Sexually Related Diseases. The Reproductive Health of African American Adolescents: What We Know and What We Don't Know. Washington, D.C, Joint Center for Political and Economic Studies. jointcenter.org/whatsnew/a_report/sexually.pdf

  • Leigh, W. A. and J. L. Andrews (2002). Family Infulence on Sexual Behavior: What We Know About African American Teens. The Reproductive Health of African American Adolescents: What We Know and What We Don't Know. Washington, DC, Joint Center for Political and Economic Studies. www.jointcenter.org/publications/details/health/n-family.html

  • Leigh, W. A. and J. L. Andrews (2002). Peer Influence on Sexual Behavior: What We Know About African American Teens. The Reproductive Health of African American Adolescents: What We Know and What We Don't Know. Washington, DC, Joint Center for Political and Economic Studies. www.jointcenter.org/publications/details/health/n-peer.html

  • Let Me Holla At Cha About STDs. (2003). Common Ground, USA.
    www.jimmiehatz.com

  • Positive: That's How I'm Livin'. (2003). Common Ground, USA. www.jimmiehatz.com

  • Ruiz, S., J. Kates, et al. (2003). African Americans and HIV/AIDS, Henry J. Kaiser Family Foundation.

  • Saha, S. A., J.J. and L. A. Cooper (2003). Patient-Physican Realtionships and Racial Disparities in the Quality of Health Care. American Journal of Public Health, 93(10): 1713-1719.

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References

1Papillo, A., Franzatta, K., Manlove, J., Moore, K., Terry-Human, E. and Ryan, S. (2002). Facts-At-A-Glance. Washington, D.C. Child Trends. Ventura, S. J., Matthews, T. J., and Hamilton, B.E. (2001). Births to Teenagers in the United States: 1940-2000. National Vital Statistics Reports. Vol. 49 (10). Hyattsville, MD. National Center for Health Statistics.

2Ventura, S. J., Mosher, W.D., Curtin, S.C., Abma, J.C., and Henshaw, S. (2001). Trends in Pregnancy Rates for the United States, 1976-97: An Update. National Vital Statistics Reports. Vol. 49 (4). Hyattsville, MD. National Center for Health Statistics.

3Abma, J. and Sonenstein, F. (2001). Sexuality Activity and Contraceptive Practices among Teenagers in the United States, 1988 and 1995. Vital Health Statistics. 23(21). Hyattsville, MD. National Center for Health Statistics. Centers for Disease Control. (2002). Youth Risk Behavior Survey, Online Fact Sheet. 1991 – 2001.

4Kirby, D. (2001). Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, D.C. The National Campaign to Prevent Teen Pregnancy.

5Terry, E. and Manlove, J. (2000). Trends in Sexual Activity and Contraceptive Use Among Teens. Washington, D.C. National Campaign to Prevent Teen Pregnancy.

6Sugland, B.W. (2003). Racial/Ethnic Disparities and Cultural Competency in Teen Pregnancy and HIV Prevention. Presentation for ETR Associates and NOAPPP — Bridging Science to Practice: Capacity Building Institute. Charleston, SC. Baltimore, MD. CARTA, Inc.

7Kann, L., Kinchen, S.A., Williams, B.I, etal (2000). Youth Risk Behavior Surveillance — United States, 1999. In: CDC Surveillance Summaries, June 9, 2000. MMWR. 49(No. SS-5). Pg. 19-20.
Terry, E., & Manlove, J. (2000). Trends in Sexual Activity and Contraceptive Use Among Teens. Washington, DC: National Campaign to Prevent Teen Pregnancy.

8Centers for Disease Control. (2001). STD Surveillance 2001. Table 12b. Chlamydia — Reported Rates per 100,000 population by age, sex, and race/ethnicity: United States, 1997-2001. pg. 95.

Barbara W. Sugland, MPH, ScD, Executive Director
Center for Applied Research and Technical Assistance (CARTA):
Baltimore, MD

Dr. Sugland is recognized nationally for her work in the fields of adolescent reproductive health and transition to adulthood with particular emphasis on youth of color. She is particularly well-known for her ability to bridge the gap between research and community-based practice by making scientific information relevant and accessible for providers working with diverse communities.

Dr. Sugland has conducted numerous workshops on cultural competence and has worked directly with providers helping them to understand the significance of culture and implications for their work. She is currently involved in work that explores the cultural significance of parent and family influences on adolescent sexuality for African-American and Latino youth. This work will result in a tool for providers that can be used to develop programs and practices for culturally diverse populations. Prior to founding CARTA, Dr. Sugland was the Area Director for Adolescent Childbearing Research at Child Trends, Inc. For more information about CARTA, visit www.cartainc.org/