58. Is Reproductive Health Knowledge Protective Against Adolescent Pregnancy?

Background

Though teen pregnancy rates are declining, it remains a pressing issue. Data is limited on prevention of teen pregnancy but contraception and engagement with family and community have been identified as protective. A more universal intervention may have more equitable results. This study aims to identify if knowledge of female genitourinary (GU) structures is associated with nulliparity in adolescents, assessed by identification of anatomical structures on a digital image. Nulliparous adolescents will identify more female GU structures correctly than parous adolescents.

Methods

Subjects were adolescents (12-21 years old) and patients of University of Kentucky's Adolescent Medicine Clinic (AMC) or Young Parent Program Clinic (YPP). Participant's received a $20 check through the mail after completing a survey on an iPad with questions about demographics, educational background, and identification of GU structures. The survey was offered in English and Spanish. This was a cross-sectional study with purposive sampling. Sample size was 103, 55 from the AMC and 48 from YPP. Fisher's exact, χ2, and Shapiro-Wilk normality tests were used to compare answers between the two groups. Statistical significance was set at p≤0.05, all tests were two-sided. Respective clinic attendance was the predictive variable. The primary outcome was the number and percent of GU structures identified correctly. University of Kentucky Institutional Review Board approved this study (#81195).

Results

The participants in AMC scored significantly higher than YPP participants having a higher median overall correct responses (17 vs 13). The median percent correct was 89.5% in the AMC group and 68.4% in the YPP group (Table 2). Therefore, the hypothesis was accepted as true. Grade of reproductive education differed significantly between groups. In the AMC group 41.1% reported education in grades 6-9, 39% beyond high school, and 20.5% received no education compared to 58.5%, 29% and 12% in the YPP group, respectively (Table 1).

Conclusions

These results suggest reproductive health knowledge may serve as a protective variable against teen pregnancy. Though a majority of nulliparous teens reported receiving education after high school or no education at all. Interestingly, students are taught reproductive anatomy, but these concepts are not revisited at later grade levels (10-12) when adolescents may be more likely to engage in sexual activity. Despite health education being implemented in schools, the delivery and delivery timing may be ineffective. These conclusions are limited by the cross-sectional design of the study but strengthened by a racially and ethnically diverse sample population.