Evaluation design principles and methodologies

¶ … teenage pregnancy has been on the decline in the U.S. generally, there is a very high rate of teenage pregnancy in some specific locations. An evaluation study of teenage pregnancy shows that the rate of teenage pregnancy is specifically high among the unmarried teens. This is however despite the fact that most of the evaluation studies in existence are however ineffective. This evaluation document presents a holistic approach to issue of tackling teenage pregnancy with a focus on the teenagers of Coconino County in the state of Arizona. The paper presents an evaluation of the program in accordance to its objectives. The degree of success of the program is evaluated with the use of the right metrics in order to capture the process as well as the outcome of the project objectives. Our focus is on the Department of Health Services which is mandated to aid in the prevention of out of wedlock teen pregnancy while encouraging adolescent abstinence by means of educational programs. This paper evaluates three major practices that are crucial to its success; youth development portion, level of family involvement as well as the cultural dimensions to the problem at hand. The implications of the program are also discussed.

Introduction

The U.S. has the highest rate of teenage pregnancy among the various industrialized nations. Arizona has continued to be among the states with the highest rates of teenage pregnancies across the nation. This is despite the fact that there has been a recorded decline in the number of teenage pregnancies since 1991. The rate has however continued to soar for teenagers who are out of wedlock. This group forms the most vulnerable members of the society to be affected by the unplanned pregnancy. A report by the Alan Guttmacher Institute (2004) ranked Arizona as the 32nd state in terms of teenage pregnancy rates. The report clearly indicated that the rate of teenage pregnancy had declined by 21.9% within a period of eight years (1998-2000).generally there has been a reduction in the number of teen pregnancies among all races (Annie E. Casey Foundation, 1998).

This paper creates a primary framework to be used in the reduction of teenage pregnancies among the youth of Coconino County in the state of Arizona. The aim is to provide certain indicators to be used in tackling the problem from a broader perspective. There are guidelines that are generated in the process. The various guidelines that are used in measuring the success of the program as well as its impact in the greater Arizonian community are also presented. This is done in order to come up with plausible and comprehensive recommendations that are geared towards achievement of practical alternatives and solutions to the teenage pregnancy in the County. Future programs can therefore rely on this framework with chances of very little amendments.

This would result in a drastic reduction in the number of teenage pregnancies in Coconino County in the state of Arizona.

The following are the six main frameworks that are to be evaluated in order to gauge the rate of success as well as the impact of the teenage pregnancy curbing initiative.

1. Monitoring of the general Performance of the Program

2. Monitoring of the program Process

3. Evaluation of the expected program Outcomes/Results

4. Evaluation of the Project Impact

5. Evaluation of Project Budget (Teen Pregnancy Prevention Budget Analysis)

6. Evaluation of the management of the project.

The evaluation process is to be carried out using a series of instruments as well as techniques in the process of collecting data. These include the following;

Data gathered from National and municipal government databases

Reports from the project

Interviews carried out at among various focus groups. The interviews are to be carried out using both structured and open-ended interviewing techniques.

Surveys carried out at the household level.

It should be noted that the data to be carried out should be separated to reflect the various cases of teen pregnancies among teenagers of different ages, roles as well as different ethnic backgrounds. This is necessary in order to bring out a comparison between the data obtained.

Literature review

There are various pieces of literature that are focused on the prevention of teen pregnancy by means of organized programs (Franklin & Corcoran, 2000; Kirby, 1997; Moore et al., 1995). A report released by The National Campaign to Prevent Teen Pregnancy indicated that theer is a major role that should be played by both parents and the families as a whole in order to reduce cases of teen pregnancy in the country (Miller, 1998).The document indicated the importance that the parental/family influence plays in the prevention of adolescent pregnancy. The document also highlights various programs that are dependent on different cultural aspect of teen pregnancy. The sensitivity of teenage pregnancy to various cultures is therefore noted in the report.

It is worthwhile to point out that the issue of adolescent pregnancy is a complex one which requires a diverse strategy in order to curtail. Therefore it is widely acknowledged that not a single approach exists that can adequately tackle the problem of teenage pregnancy. This is attributed to the fact that teenage pregnancy occurs as a result of various reasons. This therefore calls for a multi-thronged approach in terms of applicable strategies in the order to at least tackle this problem (Kirby, 1997).

The last couple of years have seen several programs that are dedicated towards the prevention of teen pregnancy. These programs have been targeted towards tackling the problem from a variety of forums. There are educational programs, contraceptive (family planning programs), youth development initiatives and school-based health care programs. Recent literature however, suggests that there are few programs that have been successful in achieving their intended objectives. This is in light of the various evaluation efforts that have been put in order to access the success rates of the programs. Some studies have however indicated that certain programs have been successful to some extent. These studies shown that there are certain sexual behavior that have been effectively been handled by the various programs. These were however in light of the various long-term effects of sexual behavior (Moore et al., 1995).

Our evaluation program is based on the various recommendations that were formulated by the National Campaign to Prevent Teen Pregnancy (Kirby, 1997) which made an analysis of the various research papers that covered over seventy five programs. Their recommendations made note of various key components that were missing and were necessary to be integrated into various teenage pregnancy prevention programs.

Just before we proceed with our assessment, it is important to remember the following facts that lead to the development of the Teenage Pregnancy Prevention Program (TAPP).

An average of 39 girls become pregnant in Arizona every day

Arizona has the fifth highest rate of adolescent baths in the U.S.

About 95% of all teenage pregnancies are never planned

An average of 45% of all students in high school have had sex at one time

About 25% of all sexually active students have been users of alcohol or other forms of drugs in their last period of having sex

80% of all teens reported feeling some form of pressure to be engaged in sex

10% of all female students in high school were forced into having sex at a time when they did not want it

42% of all sexually active students never used a condom when they last engaged in sex

The data above has been sourced from Coalition on Adolescent Pregnancy and Parenting (ACAPP).

ACAPP (2006) came up with a report to indicate the cost of teenage pregnancy on the general public. Their report indicated that the rate of childbearing among the teens (of 15-19 years) from an analysis carried out by the National Campaign to Prevent Teen Pregnancy cost the taxpayers about $268 million in the year 2004.That is to mean that it cost an average of $3,822 for every teenage birth. Their report also indicated that of all the teenage pregnancies in the state of Arizona, about 51% were attributed to federal costs while 49% were both state and local costs. The report also indicated that most of the expenditure associated with teen child bearing is as a result of negative consequences that are associated with teenage child mothers. The Arizonian situation costs an average of $48 million in terms of public health care (Includes both Medicaid and SCHIP).Child welfare costs $32,incarceration costs $43 and lost tax revenue is about $88.The report also indicated that the rate of teen births in Arizona had a 23% decline in the period of 1991 and 2003. This led to a general saving in terms of taxpayer's money of about $76 million (2004).

Current Practice's Assessment

In order to come up with the best recommendations, it is important to conduct a thorough assessment of all the teen pregnancy prevention programs in Coconino County, Arizona. This was conducted via surveys, interviews as well as visits to various sites.

Twenty surveys were deployed to various schools and agencies that are actively involved in programs that are geared towards the prevention of teen pregnancy. We made every possible attempt to contact as many programs as possible. This was mainly through contacting various advisors, coalitions, staff, networks and directories. There were also several telephone calls as well as reminders (in the form of both mail, and fax) to the various programs. This was however done to the ones that never returned their surveys. After initiating second mailing attempts as well as phone calls and faxes, an average of 12 completed surveys was received representing a 60% rate of response. A total of 13 programs were visited .There was interviewing of the staff members during the various site visits. The intention was to obtain as much information as possible from their programs as well as to come up with fully completed surveys.

The move aided us to find out that there were various prevention efforts that were instituted in various clinics, community agencies as well as in various schools. All the agencies as well as participating schools had the privilege of being supported with grants from the Arizona Department of Health Services. The grants were aimed at the primary prevention of teenage pregnancies in the county. The programs were targeted towards the prevention of tee pregnancies among the high risk female teens. There were also some programs that targeted the male teens. Currently, there are several school-based health clinics that are geared towards the prevention of teen pregnancies. It is however good to note that the primary prevention programs that are in existence are a good representative of the wide list of services that have been instituted in order to reduce teen pregnancy among the specific target population at the Coconino County.

There are also secondary prevention programs that are running in the county. These secondary prevention programs are aimed to provide services as well as care to both pregnant as well parenting teens. This category was also visited and surveyed .This category comprises of various county health services programs (public health services); In order tpo cme up with the best methods of prevention, it was necessary to include our knowledge from the varois extant literature on the best techniques of preventing teen pregnancy.

We therefore had to consider the following questions;

Are the existing teen prevention programs based on research findings?

Is there feasible impact of the evaluation process?

Does the recommended prevention program serve to meet the need and demand of the multi-ethnic adolescent target group?

Do the recommended prevention program details fit seamlessly into the existing socio-economic adolescent base?

Do the recommended teen prevention techniques apply in various settings

Are the recommended solutions feasible?

Are the recommended solutions applicable in both the present and future circumstances?

By means of the program information obtained as well as reviews obtained from extant literature (Hutchins, 1999), the following key points were derived to be used by various practitioners in the teen pregnancy prevention programs (Gong, et al., 1999):

Emphasis on the development of youth

Utmost involvement of various family members as well as other adults

Involvement of the male gender in the issue.

Relevance of culture in the program

Campaigns targeting the entire community

Programs aimed at educating the youth on teen pregnancy

Programs to improve the level of employment among the youth

Provision of sex education among the youth

Inclusion of Outreach services in the Teen Pregnancy Prevention Programs

Offering of to Reproductive Health Services to the youth.

The success of the program is pegged on its ability to full address the issue of teen pregnancy with specific objective of ensuring that everybody is involved in the process. The following are the key features of the teen pregnancy programs.

Development of the youth

The teen pregnancy program must have a youth development subset among its ranks. This programs is intended at providing both support and encouragement to the youth in order for them to be fully equipped with the knowledge for them to be able to grow up to be responsible adults. This is through shaping and aiding them to be involved in relationships that are both meaningful and mature. It is important to note that young adults are in need of structures that a re necessary to enable them to have both the skills and the connections that are import for them to peacefully coexist with other members of the community. These should be formulated into programs that entail both educational and career opportunities that are aimed at providing protection to them against issues such as drugs and teen pregnancy. There is in fact a proven correlation that exists between education and pregnancy. Improved education of the girl child results in reduced rates of pregnancies as well as rates of birth (Kirby, D., 1997).

There has been a lot of interest in the level of youth development as well as the level of teen pregnancy and its related prevention efforts. Several national organizations as well as federal and local ones have been actively involved in the process of reducing the level of teenage pregnancy in the nation (National Campaign to Prevent Teen Pregnancy, 1998). The various federal organizations that are aiding in the reduction and prevention of teenage pregnancy include the following

Family and Youth Services Bureau-this is an organization which works under the umbrella of the U.S. Department of health and Human Services.

Community Coalition Partnership which is a Centers for Disease Control and Prevention program

The Arizona the Departments of Education and Health Services is also involved in various initiatives that are aimed at developing and implementing various youth development programs aimed at reducing the level of teen pregnancy in the state.

There are various critical components that are integral to the achievement of perfect youth development programs. These components bear the following characteristics.

They should be able to have various workers who are equipped with the prerequisite knowledge necessary to work with various youths

The programs must be able to acknowledge the fact that there are various resources necessary to be used in the process of planning and developing programs for the youth. The youth must therefore be part of the persons involved in the development of the components since the programs are directed towards them therefore it is them who know the exact components that are required.

The programs must be able to seamlessly integrate and collaborate with various community organizations as well as other government agencies, families and schools (Carnegie, 1996).

It is worth noting that one of the most effective methods of reducing teen pregnancy is the provision of service learning. This is achieved when community service is combined with both experiential learning processes as well as disciplined reflection. An evaluation of the service learning initiatives from the numerous amount of data collected nationwide provides some of the most compelling and consistent evidence of the fact that the inclusion of the youth development programs is an effective method of reducing teen pregnancy ( Philliber and Allen, 1992).

The service learning programs have an added advantage of reducing other problems in the youth such as school suspension, immorality and drug abuse among others.

Involvement of the family as well as other adults

It is important to note that while some of the programs surveyed involved the aspects of family and caring adult's involvement in the issue of teenage pregnancy, a good number did not have this aspect. The need for these programs to have a broader perspective makes it necessary to ensure that there is a dimension of both family and adult involvement. This is because strengthened family bonds as well as enhanced parenting styles are important in the provision of both contraceptive and reproductive services to the teenagers (Moore et al., 1995).

The integral role of the family is necessary in the provision of guidance to adolescent pregnancy. The recommended strategies of reducing teenage pregnancy can be complemented by means of family involvement (Moore et al., 1995).below is a series of factors that are meant to help in reducing the risk of adolescent pregnancy.

Having parent who have a high level of education and income

Having parents who have a strong opinion regarding the need of abstinence and peotected sex

Teenagers who are involved in family relationships which are supportive (Miller, 1998).

Teenagers who are involved in various activities involving their parents' participation

It is also important to take note of the following factors that can lead to an increased level of risk of adolescent pregnancy.

Strict parent who are overcontrolling

Low socio-economic status

Single parenthood

Sexually active siblings

A lack of religious affiliation as pointed out by Kirby (1997).

Earlier exposure to violence or some forms of abuse.

It is therefore importance to include both parents and the entire family in the various teenage prevention programs. This is important in ensuring that the life opportunities of the pregnant and parenting teenagers are enhanced as well as those of the infants born by the teenagers (Hanson, 1992).

On the issue of family involvement and teenage pregnancy, it is worthwhile to note that the existence of multigenerational families be put into consideration (Chase-Lansdale et al., 1992). The best technique is to incorporate labor-intensive and very involving family ties in the programs so as to ensure that efforts of teen pregnancy prevention bear fruit.