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Adolescent girls experience risks prior to pregnancy and giving birth that influence their overall health, and development, as well as community rates of infant mortality. Supporting adolescent girls through positive youth development (PYD) opportunities offers a potential long-term strategy to preventing infant mortality and improving maternal health outcomes. The current study sought to assess state-wide needs, resources and opportunities related to PYD supports for adolescent girls, especially among those most at risk for early pregnancy. A strengths, weaknesses, opportunities and threats (SWOT) analysis guided nine community forums in counties with the highest rates of infant mortality in one large Midwestern state. In total, 368 stakeholders attended the forums and provided insights related to the context of PYD for adolescent girls. Researchers also conducted three focus group with 19 parents/guardians and three focus groups with 25 adolescent girls aged 11–14 to validate the findings from the SWOT analysis. Content analysis was utilised to synthesise the qualitative results. Strengths and opportunities related to PYD for adolescent girls included access to afterschool programming and access to health and mental health services. Weaknesses brought awareness to more systemic problems as all nine counties reported a lack of communication and coordination among youth programs and a need for greater collaboration among youth agencies. Threats included challenges associated with technology and social media, unsafe neighbourhood conditions, and issues of racism, sexism, poverty and discrimination. Findings support the need for a continued focus and priority on improving access, services and supports for adolescent girls to prevent infant mortality and improve their health and well-being. Local, state and national leaders can use the results of this study to promote additional strategies for addressing infant mortality through PYD for adolescent girls.  相似文献   
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