- Email: [email protected]
Adolescent reproductive health
Book Reviews
275
youth and their families should be strongly stated. This book is important in its summation and unsettling in the unanswered questions it raises. Professionals involved in treating, educating, or training others to work with disturbed youth and their families should give it careful study. Andrk AZ. IVU?ZOff
REFERENCE Berman,
L. (1985).
Youth
suicide:
On
hyperbole
and
public
miseducation.
Sewslink,
fl
(4)s 3.
Adolescent Reproductive Health Edited by Peggy B. Smith and David M. Mumford New York, NY: Gardner Press, 1985; 2% pp., $28.50
(hardcover).
Adolescent Reproductive ~e~ltk is a concise and useful compilation of information which will be of interest to practitioners working with teens around the issues of sexuality and reproduction. In their preface the editors note a desire to offer readers a broad, comprehensive guide outlining the “how-to’s” of service provision focused on the reproductive health needs of adolescents. Smith & Mumford meet this challenge by organizing their book around two general types of articles. Chapters on adolescent sexual development, contraceptive methods, male reproduction, program availability, legislation, and economic issues summarize current knowledge. Various authors draw on empirical research and actual program experience to provide readers a general overview of each topic. A second approach is taken in papers which deal with contraceptive counseling, program evaluation, and advocacy. Here authors offer specific, practical guidelines for practitioners who work in programs, or plan to work in programs, serv+ng adolescents. The book’s strongest chapters are those which deal with males, counseling techniques, service availability, program evaluation. and advocacy. These are briefly reviewed here. Smith & Kolenda, in “Adolescent Male Reproduction: A Point of Focus,” discuss the complex set of social Factors which both reinforces an earlier entry of males into sexual activity and explains their concurrent lack of reproductive responsibility. The important contribution of this chapter lies in the suggestions concerning service de1iver.y to males. The authors also raise Interesting questions about the possibility of enhancing the American male’s sense of responsibility for reproductive health. Smith & Kolenda note the importance of distinguishing sexual behavior from its often nonsexual motivations. Two
Book Reviews recent investigations (Clark. Zabin & Hardy, 1984: Cohen & Rose, 1984) of the attitudes and behaviors of male teens with regard to contraception supplement Smith 8c Iiolenda’s ideas. These studies suggest that males recognize some reproductive responsibilitv but often fail to translate this Cl&k, et al. (1984) find that alknowledge into action. For example. though 9 out of 10 urban area, black males acknoivledge responsibility. half are willing to risk unprotected intercourse. Further exploration must focus on this issue to begin to unravel the interaction of. cultural. social. developmental. and psychological factors which underlie the apparent inconsistence between attitude and action. Julie Spain, in a chapter entitled “Counseling Adolescents for Conreminds us that sex education is not traceptive and Sexual Decisions,” sufficient to ensure the use of birth control by teens. She offers a threestage model to guide counselors in identifying psvchosocial barriers lvhich may interfere with effective contraception. The model is based, appropriately, on a decision-making format lvhich moves the teen through stages and finally to a specific birth of barrier identification and exploration, control decision and plan to follow through on use. The author provides case examples and discusses the specific counseling skills needed b!workers-paraphrasing, summarizing, questioning, reflecting feelings. and instructing. Although not mentioned by Spain the model can be adapted to incorporate role-plaving and other more behavior-oriented methods (see for example Schinie, 1984, pp. 45-52). Joy Dryfoos provides an excellent summar\. of the current availability and use of family planning and abortion services b\ adolescents. Se\-era1 of the statistics cited in this chapter challenge long held beliefs \t,hile raising some interesting and disturbing questions. Thus. of’ the 1.5 million teenagers lvho visited famit),,planning clinics in 1979, more than half said their parents knew of the visit. But still onlv half of the teens returned for scheduled follow-up appointments. Also of concern are the half million abortions obtained by,adolescents in 1979. These findings challenge both researchers and practitioners to critically investigate current interventions and to tackle the deeper social and &onomic contributors to teenage pregnant!‘. Dryfoos recommends expanding sex education and farnil! planning clinic programs, including contraceptive counseling in abortion clinics, continuing technological research in the area of’ birth control methods, and, maybe most important, incl-easing the options available to adolescents. That is, teens must ha\,e reason IO \.ie\\adolescent p-egnanc\ as a realistic threat to their future social, educational. aiid economic POten&l. In a more recent article (1984). Drvfoos elaborates on the recommendations provided in this chapter. ~I~uw other chapters ~varrant mention here. one on program evaluation and the other dealing \vith ad\wx\ In “E:\Auatiyg Reproductive Health Programs” Lorraine Klerman, \\.ell kno\vIl for her evaluations of programs for pregnant and parent teellagel-s, presents a succinct directorv of’ strategies to evaluate familv planning programs. Klerman disc&ses measures and research designs that most facilities can adopt to
Book Reviews
277
evaluate programs attempting to provide services for contraception, sexually transmitted diseases, pregnancy, and birth. This chapter should assist administrators to meet the every day challenges of program evaluation. Lastly, Sharon Alexander, the Sex Education Project Director for the National Association of State Boards of Education, contributes an article on advocacy. In a step-by-step manner, Alexander outlines essential techniques for practitioners wishing to effectively defend and advance services for adolescents. In general, Adolescent Reproductive Health is a valuable presentation correlates, and interventions of current knowledge on the incidence, associated with adolescent family planning services and issues. There are, however, three areas where the book proves weak. First, there is minimal discussion of clinic and provider characteristics as well as peer influences on teen contraceptive use. Research with practical implications has been conducted on these crucial issues (See, for example, Einhorn, Sear, Perez & Cabrera, 19’77; Jorgensen, King, & Torrev, 1980; Litt SC Cuskey, 1984). Second, the role of sexually transmitted disease in reproductive health is not given sufficient consideration. The impact of these diseases on service provision, as well as on individual sexuality and longterm health, merits attention in any book attempting to explore the full range of issues related to adolescent reproductive health. Last, although still in an early stage, the role of schools in teenage health care deserves notice. Undoubtedly, over the next few years, school-based interventions will dominate attempts to meet the reproductive health care needs of adolescents. Despite these limitations, Smith & hlumford’s book is recommended to readers interested in both teenagers and reproductive health.
References Clark. S. D., Zabin, L. S., 8r Hardy, J. B. (1984). Sex, contraception, and parenthood: Experience and attitudes among urban, black young men. Fnalr/] I”ln?lnlng I~r~-.rprcrr:~s, 16. 77-82. Cohen. D. D., & Rose, R. D. (1984). Male adolescent birth control beha\,ior-: I-he importance of developmental factors and sex differences.Jourwzl of l’orcth awl .Uo/ocr~r[.\, 13. 239-32. Dryfoos. J. (1984). A new strategy for preventing unintended teenage childbearing. Fnmil~ Pla?ln??lg PPqxclrues. 16, 193-93. Einhorn. R.F.. Sear, A. M.. Perez, E., & Cabrera, E. (1975). (:ontraceptive method rontinuation according to type of provider. Ameman Journal of Puhlrr Hmlth. hi. 1 1.?i-53. Jorgensen, S. R., King, S.L.. & Torrey, B.A. (1980). Dyadlr & social netwvrh influences on adolescent exposure to pregnancy risk. Journnl of .\Jnmn,q, nrd r/w I;nvd\. 42. 143-5.5. Litt. 1. F., & Cuskey. \V. R. (1984). Satisfaction with health care: A predictox- of adolescents’ appointment keeping. Journd ofAdolt~cm~ Htahh Caw, 5. l W-200. Schinke. S. P. (1984). Preventing teenage pregnanq. f’)ugrc.\\ 1~ Hrhrrrwr ,\Jod$cclrwn, 16. 31-64.
275
youth and their families should be strongly stated. This book is important in its summation and unsettling in the unanswered questions it raises. Professionals involved in treating, educating, or training others to work with disturbed youth and their families should give it careful study. Andrk AZ. IVU?ZOff
REFERENCE Berman,
L. (1985).
Youth
suicide:
On
hyperbole
and
public
miseducation.
Sewslink,
fl
(4)s 3.
Adolescent Reproductive Health Edited by Peggy B. Smith and David M. Mumford New York, NY: Gardner Press, 1985; 2% pp., $28.50
(hardcover).
Adolescent Reproductive ~e~ltk is a concise and useful compilation of information which will be of interest to practitioners working with teens around the issues of sexuality and reproduction. In their preface the editors note a desire to offer readers a broad, comprehensive guide outlining the “how-to’s” of service provision focused on the reproductive health needs of adolescents. Smith & Mumford meet this challenge by organizing their book around two general types of articles. Chapters on adolescent sexual development, contraceptive methods, male reproduction, program availability, legislation, and economic issues summarize current knowledge. Various authors draw on empirical research and actual program experience to provide readers a general overview of each topic. A second approach is taken in papers which deal with contraceptive counseling, program evaluation, and advocacy. Here authors offer specific, practical guidelines for practitioners who work in programs, or plan to work in programs, serv+ng adolescents. The book’s strongest chapters are those which deal with males, counseling techniques, service availability, program evaluation. and advocacy. These are briefly reviewed here. Smith & Kolenda, in “Adolescent Male Reproduction: A Point of Focus,” discuss the complex set of social Factors which both reinforces an earlier entry of males into sexual activity and explains their concurrent lack of reproductive responsibility. The important contribution of this chapter lies in the suggestions concerning service de1iver.y to males. The authors also raise Interesting questions about the possibility of enhancing the American male’s sense of responsibility for reproductive health. Smith & Kolenda note the importance of distinguishing sexual behavior from its often nonsexual motivations. Two
Book Reviews recent investigations (Clark. Zabin & Hardy, 1984: Cohen & Rose, 1984) of the attitudes and behaviors of male teens with regard to contraception supplement Smith 8c Iiolenda’s ideas. These studies suggest that males recognize some reproductive responsibilitv but often fail to translate this Cl&k, et al. (1984) find that alknowledge into action. For example. though 9 out of 10 urban area, black males acknoivledge responsibility. half are willing to risk unprotected intercourse. Further exploration must focus on this issue to begin to unravel the interaction of. cultural. social. developmental. and psychological factors which underlie the apparent inconsistence between attitude and action. Julie Spain, in a chapter entitled “Counseling Adolescents for Conreminds us that sex education is not traceptive and Sexual Decisions,” sufficient to ensure the use of birth control by teens. She offers a threestage model to guide counselors in identifying psvchosocial barriers lvhich may interfere with effective contraception. The model is based, appropriately, on a decision-making format lvhich moves the teen through stages and finally to a specific birth of barrier identification and exploration, control decision and plan to follow through on use. The author provides case examples and discusses the specific counseling skills needed b!workers-paraphrasing, summarizing, questioning, reflecting feelings. and instructing. Although not mentioned by Spain the model can be adapted to incorporate role-plaving and other more behavior-oriented methods (see for example Schinie, 1984, pp. 45-52). Joy Dryfoos provides an excellent summar\. of the current availability and use of family planning and abortion services b\ adolescents. Se\-era1 of the statistics cited in this chapter challenge long held beliefs \t,hile raising some interesting and disturbing questions. Thus. of’ the 1.5 million teenagers lvho visited famit),,planning clinics in 1979, more than half said their parents knew of the visit. But still onlv half of the teens returned for scheduled follow-up appointments. Also of concern are the half million abortions obtained by,adolescents in 1979. These findings challenge both researchers and practitioners to critically investigate current interventions and to tackle the deeper social and &onomic contributors to teenage pregnant!‘. Dryfoos recommends expanding sex education and farnil! planning clinic programs, including contraceptive counseling in abortion clinics, continuing technological research in the area of’ birth control methods, and, maybe most important, incl-easing the options available to adolescents. That is, teens must ha\,e reason IO \.ie\\adolescent p-egnanc\ as a realistic threat to their future social, educational. aiid economic POten&l. In a more recent article (1984). Drvfoos elaborates on the recommendations provided in this chapter. ~I~uw other chapters ~varrant mention here. one on program evaluation and the other dealing \vith ad\wx\ In “E:\Auatiyg Reproductive Health Programs” Lorraine Klerman, \\.ell kno\vIl for her evaluations of programs for pregnant and parent teellagel-s, presents a succinct directorv of’ strategies to evaluate familv planning programs. Klerman disc&ses measures and research designs that most facilities can adopt to
Book Reviews
277
evaluate programs attempting to provide services for contraception, sexually transmitted diseases, pregnancy, and birth. This chapter should assist administrators to meet the every day challenges of program evaluation. Lastly, Sharon Alexander, the Sex Education Project Director for the National Association of State Boards of Education, contributes an article on advocacy. In a step-by-step manner, Alexander outlines essential techniques for practitioners wishing to effectively defend and advance services for adolescents. In general, Adolescent Reproductive Health is a valuable presentation correlates, and interventions of current knowledge on the incidence, associated with adolescent family planning services and issues. There are, however, three areas where the book proves weak. First, there is minimal discussion of clinic and provider characteristics as well as peer influences on teen contraceptive use. Research with practical implications has been conducted on these crucial issues (See, for example, Einhorn, Sear, Perez & Cabrera, 19’77; Jorgensen, King, & Torrev, 1980; Litt SC Cuskey, 1984). Second, the role of sexually transmitted disease in reproductive health is not given sufficient consideration. The impact of these diseases on service provision, as well as on individual sexuality and longterm health, merits attention in any book attempting to explore the full range of issues related to adolescent reproductive health. Last, although still in an early stage, the role of schools in teenage health care deserves notice. Undoubtedly, over the next few years, school-based interventions will dominate attempts to meet the reproductive health care needs of adolescents. Despite these limitations, Smith & hlumford’s book is recommended to readers interested in both teenagers and reproductive health.
References Clark. S. D., Zabin, L. S., 8r Hardy, J. B. (1984). Sex, contraception, and parenthood: Experience and attitudes among urban, black young men. Fnalr/] I”ln?lnlng I~r~-.rprcrr:~s, 16. 77-82. Cohen. D. D., & Rose, R. D. (1984). Male adolescent birth control beha\,ior-: I-he importance of developmental factors and sex differences.Jourwzl of l’orcth awl .Uo/ocr~r[.\, 13. 239-32. Dryfoos. J. (1984). A new strategy for preventing unintended teenage childbearing. Fnmil~ Pla?ln??lg PPqxclrues. 16, 193-93. Einhorn. R.F.. Sear, A. M.. Perez, E., & Cabrera, E. (1975). (:ontraceptive method rontinuation according to type of provider. Ameman Journal of Puhlrr Hmlth. hi. 1 1.?i-53. Jorgensen, S. R., King, S.L.. & Torrey, B.A. (1980). Dyadlr & social netwvrh influences on adolescent exposure to pregnancy risk. Journnl of .\Jnmn,q, nrd r/w I;nvd\. 42. 143-5.5. Litt. 1. F., & Cuskey. \V. R. (1984). Satisfaction with health care: A predictox- of adolescents’ appointment keeping. Journd ofAdolt~cm~ Htahh Caw, 5. l W-200. Schinke. S. P. (1984). Preventing teenage pregnanq. f’)ugrc.\\ 1~ Hrhrrrwr ,\Jod$cclrwn, 16. 31-64.