Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001–2013

Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African–American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.     

Violent Behaviors in Early Adolescent Minority Youth: Results from a “Middle School Youth Risk Behavior Survey”

Objectives: To describe the prevalence and characteristics of violence and violence-related behaviors among six populations of U.S. minority adolescents in grades 6–8. Methods: Six thousand four hundred non-White adolescents were recruited from six sites that were part of a collaborative project. Surveys were administered either during the school day or at community facilities. All students at each site were asked 10 questions about recent violence-related behaviors (including use of threats, fighting, weapon carrying, and weapon use). Prevalence of each violence-related behavior was reported within and across sites, and stratified by race/ethnicity, gender, age, and other characteristics expected to influence the behaviors. Results: Sixty-six percent (66%) of the middle school students sampled reported being involved in some type of recent fighting and/or weapon-related behaviors. Sixty-one percent (61%) indicated some form of fighting behavior in the past 3 months (threatening to beat someone up, physical fighting, and/or being hurt in a fight). Thirty percent (30%) of participating youth reported one or more weapon-related behaviors (threatening to use a weapon, carrying a weapon, using a weapon, and/or being cut, stabbed or shot at). Reported gun carrying among males varied depending upon site, but was as high as 20%. Grade in school was positively associated with reported violent behaviors. Adolescents who reported living full-time with a parent or parent figure, and those who reported religious observance or beliefs, were less likely to report violence involvement. All violence-related behaviors were more common among male than female adolescents. Conclusions: Violence prevention efforts should begin in elementary school and continue throughout adolescence. Programs should be prepared to provide services or referrals to victims of violence, implement programs tailored toward females as well as males, and build partnerships with churches and other community organizations in which youth are involved.     

Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997–2003

Objective To examine the prevalence of health risk-behaviors among American Indian/Alaska Native (AI/AN) youth in urban areas. Methods Data from the national Youth Risk Behavior Survey (YRBS) for the years 1997–2003 were used for the analyses (Urban sample = 52,364). The YRBS is a self-report questionnaire administered to a sample of 9th–12th grade students intended to monitor health risk-behaviors. “Urban” is defined as areas within a Metropolitan Statistical Area. Whites are used as the comparison group for the examination of AI/AN estimates. Results Urban AI/AN youth represented 1% of the urban sample (N = 513). The presence of a number of risk-behaviors were at least threefold higher in AI/AN compared to white youth in urban areas, including suicidal behaviors, feeling unsafe at school and needing medical treatment from a fight. Other factors were over twofold higher among AI/AN, including sexual behaviors, illegal drug use, violence at school, and experiences of rape, assault and pregnancy. Conclusions The higher prevalence of health risk-behaviors in urban AI/AN compared to white youth reflects a need for interventions focused on urban AI/AN youth.     

Prescription Opioid Misuse and Suicidal Behaviors Among US Veterans: A Cross-Sectional Study from the 2015–2019 National Survey on Drug Use and Health

The Journal of Behavioral Health Services & Research - Suicide continues to be a serious public health issue for the US veteran population as its prevalence has skyrocketed over the last...     

Stability and Change of Adolescents’ Aggressive Behavior in Residential Youth Care

Background

Aggression in residential youth care institutions is a frequent problem.

Objective

The present short-term longitudinal study examined individual and institutional predictors of aggression in a group of 198 adolescents placed in open, semi-secure and secure residential institutions from the perspective of the importation and deprivation model.

Methods

A total of 198 adolescents in residential youth care filled in questionnaires regarding group climate and aggression with a 3 month interval. Hierarchical multiple regression analyses were performed to test the degree to which individual and contextual factors predict aggression.

Results

Very limited support was found for the effect of contextual factors; only repression showed a trend, predicting direct aggression, while gender composition of the living groups yielded a small effect. Girls placed in same-gender groups showed lower levels of indirect (relational) aggression compared to adolescents placed in mixed-gender or boys-only groups, even when controlled for gender and initial levels of aggression. Type of institution (i.e., level of security) did not predict differences in aggression. In particular individual characteristics of the adolescents were associated with later aggression, including initial levels of aggression, showing substantial 3 months stability, age and gender of the adolescents.

Conclusions

These findings are in line with research showing that aggression is relatively stable. Very limited support for environmental effects was found.

     

Oral Health Need and Access to Dental Services: Evidence from the National Survey of Children’s Health, 2007

This study examines associations between parents’ report of their children’s oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1–17 years, using data from the 2007 National Survey of Children’s Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.     

Patterns of Alcohol Consumption and Suicidal Behavior: Findings From the Fourth and Fifth Korea National Health and Nutritional Examination Survey (2007–2011)

Objectives:

The purpose of this study was to investigate the association between suicidal behavior and patterns of alcohol consumption in Korean adults.

Methods:

This study was based on data provided by the Korea National Health and Nutritional Examination Survey from 2007 to 2011. A total of 42 347 subjects were included in the study, of whom 19 292 were male and 23 055 were female. Logistic regression analysis was performed to assess the association between patterns of alcohol consumption and suicidal behavior.

Results:

Among the study subjects, 1426 males (11.3%) and 3599 females (21.2%) had experienced suicidal ideation, and 106 males (0.8%) and 190 females (1.1%) had attempted suicide during the previous 12 months. Alcohol Use Disorders Identification Test (AUDIT) scores were found to be associated with suicidal ideation in males and associated with both suicidal ideation and suicide attempts in females. Alcoholic blackouts were associated with suicidal ideation and suicide attempts in males, and were also associated with suicidal ideation in females.

Conclusions:

In this study, we found that certain patterns of alcohol consumption were associated with suicidal behaviors. In particular, only alcoholic blackouts and categorized AUDIT scores were found to be associated with suicidal behavior in males. We therefore suggest that further research is needed to examine this relationship prospectively and in other settings.     

Promoting Equal Developmental Opportunity and Outcomes Among America’s Children and Youth: Results from the National Promises Study

Building on a developmental framework positing five types of assets or inputs needed for children’s development, referred to as promises, we investigated the extent to which American children and youth experience the five Promises articulated by the America’s Promise Alliance. These are: (1) Caring Adults, (2) Safe Places and Constructive Use of Time, (3) A Healthy Start, (4) Effective Education, and (5) Opportunities to Make a Difference. Data came from a nationally representative poll designed to assess these five resources and involved more than 4,000 teenagers and their parents. Results showed that only a minority of young people experienced rich developmental nourishment (having 4–5 of the Promises). Males, older adolescents, adolescents of color, and adolescents from families with less education and lower parental annual incomes were significantly less likely to experience sufficient developmental opportunities and were also less likely to experience desirable developmental outcomes. However, among those young people who reported experiencing 4–5 Promises, the great majority of demographic differences in developmental outcomes were either eliminated or significantly reduced. The results suggest that increasing children’s experience of these Promises would reduce developmental inequalities among America’s young people. Editors’ Strategic Implications: Longitudinal studies with representative samples will be necessary to further validate this approach and study causal contributions of assets, but this integration of Positive Youth Development frameworks holds great promise for theory, practice, and policy.     

Adolescents’ Time During the First Year of the COVID-19 Pandemic: Evidence From the American Time Use Survey

PurposeThe aim of this study is to examine where and with whom adolescents spent time during the first months of the COVID-19 pandemic compared to 2019.MethodsTime diary data from the May 2019 to December 2020 waves of the American Time Use Survey were used to examine trends in where and with whom a sample of individuals aged 15–18 years (N = 437) spent their time.ResultsOnly 13% of adolescents spent any time at school on a given day during the pandemic (May-December 2020), compared to 36% in the same period in 2019. Average time with friends decreased by 28%. Over the 7.5-month period, this amounts to an average of 204 fewer hours/34 fewer days in school and 86 fewer hours with friends. Time spent sleeping or sleepless did not change.DiscussionTime at school and with friends decreased substantially during the first months of the pandemic.     

Mental Health Literacy: A Conceptual Framework for Future Inquiry into Child and Youth Care Professionals’ Practice with Suicidal Adolescents

Knowledge and beliefs about mental disorders; attitudes that promote help-seeking; knowledge of risk factors and causes, treatments and self-help, and professional help available are all elements of mental health literacy. The complexities of practice with suicidal adolescents and young people suffering from mental health concerns require conceptual frameworks, such as mental health literacy, that can adequately identify professionals’ strengths and educational needs. In light of current research, this paper identifies Child and Youth Care (CYC) professionals as optimally situated to prevent adolescent suicide, examines adolescent help-seeking as an element of mental health literacy central to CYC practice, explores additional elements of mental health literacy relevant to CYC practice, and offers suggestions for future inquiry into CYC professionals’ mental health literacy in practice with suicidal adolescents.     

Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth

This study examines the alternative implications of the measurements of unintended pregnancy during contraceptive failure in the US. The data from the 1995 National Survey of Family Growth (NSFG) were used to compare levels of unintended pregnancy among contraceptive users based on two definitions: the standard definition based on women's report of contraceptive failure; and the NSFG definition based on pregnancy timing. An attitudinal scale was used to examine women's feeling about their unintended pregnancy. The results of the analysis revealed 68% were unintended pregnancies under the classification of standard definition, while 59% of women with contraceptive failure classified under NSFG definition and reported feeling unhappy or very unhappy about their pregnancy. About 90% of those with contraceptive failure classified as an intended pregnancy reported feeling happy or very happy. Although these results were consistent with one another, it is still unclear why these women feeling happy about their unintended pregnancy are practicing contraception.     

Prevalence and Associated Factors of Tinnitus: Data From the Korean National Health and Nutrition Examination Survey 2009–2011

Background

Tinnitus is a common condition and frequently can be annoying to affected individuals. We investigated the prevalence and associated factors for tinnitus in South Korea using the data from the Korea National Health and Nutrition Examination Surveys (KNHANES) during 2009–2011.

Methods

KNHANES is a cross-sectional survey of the civilian, non-institutionalized population of South Korea (n = 21 893). A field survey team that included an otolaryngologist moved with a mobile examination unit and performed interviews and physical examinations.

Results

Among the population over 12 years of age, the prevalence of any tinnitus was 19.7% (95% CI 18.8%–20.6%). Tinnitus was more prevalent in women, and the prevalence rate increased with age (P < 0.001). Among those with any tinnitus, 29.3% (95% CI 27.3%–31.3%) experienced annoying tinnitus that affected daily life. Annoying tinnitus also increased with age (P < 0.001), but no sex difference was demonstrated (P = 0.25). In participants aged 40 years or older, age, quality of life, depressive mood, hearing loss, feeling of dizziness, and rhinitis were associated with any tinnitus (P < 0.05). Age, hearing loss, history of cardiovascular disease, and stress were associated with annoying tinnitus (P < 0.05).

Conclusions

Tinnitus is a common condition, and a large population suffers from annoying tinnitus in South Korea. Public understanding of associated factors might contribute to better management of tinnitus.Key words: tinnitus, epidemiology, associated factor, South Korea     

How do economic downturns affect the mental health of children? Evidence from the National Health Interview Survey

Research linking economic conditions and health often does not consider children's mental health problems, which are the most common and consequential health issues for children and adolescents. We examine the effects of unemployment rates and housing prices on well‐validated child and adolescent mental health outcomes and use of special education services for emotional problems in the 2001–2013 National Health Interview Survey. We find that the effects of economic conditions on children's mental health are clinically and economically meaningful; children's mental health outcomes worsen as the economy weakens. The effects of economic conditions on child and adolescent mental health are pervasive, found in almost every subgroup that we examine. The use of special education services for emotional problems also rises when economic conditions worsen. Our analyses of possible mechanisms that link economic conditions to child mental health suggest that parental unemployment cannot fully explain the relationship between economic conditions and child mental health.     

Exploring the Venue’s Role in Risky Sexual Behavior Among Gay and Bisexual Men: An Event-Level Analysis from a National Online Survey in the U.S.

Venue-based characteristics (e.g., alcohol in bars, anonymous chat online, dark/quiet spaces in bathhouses) can impact how men who have sex with men (MSM) negotiate sex and HIV-associated risk behavior. We sought to determine the association between HIV-associated risk factors and the venues where MSM met their most recent new (first-time) male sex partner, using data from a 2004 to 2005 national online anonymous survey of MSM in the U.S. (n = 2,865). Most men (62%) met their partner through the Internet. Among those reporting anal sex during their last encounter (n = 1,550), half had not used a condom. In multivariate modeling, and among men reporting anal sex during their last encounter, venue where partner was met was not significantly associated with unprotected anal intercourse (UAI). Nevertheless, venue was related to other factors that contextualized men’s sexual encounters. For example, HIV status disclosure was lowest among men who met their most recent partner in a park, outdoors, or other public place and highest among men who met their most recent partner online. Alcohol use prior to/during the last sexual encounter was highest among men who met their most recent partner in a bathhouse or a bar/club/party/event. These data suggest it is possible to reach men online who seek sex in many different venues, thus potentially broadening the impact of prevention messages delivered in virtual environments. Although not associated with UAI, venues are connected to social-behavioral facets of corresponding sexual encounters, and may be important arenas for differential HIV and STI education, treatment, and prevention.     

Allostatic Load in Foreign-Born and US-Born Blacks: Evidence From the 2001–2010 National Health and Nutrition Examination Survey

Objectives. We tested whether the immigrant health advantage applies to non-Hispanic Black immigrants and examined whether nativity-based differences in allostatic load exist among non-Hispanic Blacks.Methods. We used pooled data from the 2001–2010 National Health and Nutrition Examination Survey to compare allostatic load scores for US-born (n = 2745) and foreign-born (n = 152) Black adults. We used multivariate logistic regression techniques to assess the association between nativity and high allostatic load scores, controlling for gender, age, health behaviors, and socioeconomic status.Results. For foreign-born Blacks, length of stay and age were powerful predictors of allostatic load scores. For older US-born Blacks and those who were widowed, divorced, or separated, the risk of high allostatic load was greater.Conclusions. Foreign-born Blacks have a health advantage in allostatic load. Further research is needed that underscores a deeper understanding of the mechanisms driving this health differential to create programs that target these populations differently.There is growing interest in improving population health because Healthy People 2020 and the Patient Protection and Affordable Care Act include important provisions to reduce health disparities.1,2 Recent research suggests that certain racial/ethnic groups in the United States, particularly non-Hispanic Blacks, have higher rates of morbidity and all-cause mortality than do Whites. However, non-Hispanic Blacks are a heterogeneous group that includes a growing population of immigrants from a variety of countries and cultural backgrounds. Recent estimates suggest the foreign-born segment of the Black population has almost tripled over the past 3 decades—with the majority migrating from the Caribbean and Africa—and represents roughly 8% of the Black population.3,4 Despite this marked increase, little is known about the health of foreign-born Blacks.Previous research suggests that Caribbean and African immigrants differ from their US-born counterparts in various physical5–8 and mental health indicators.9 Some research suggests that foreign-born Blacks have better health outcomes than do US-born Blacks because of the healthy immigrant effect.10,11 The healthy immigrant effect posits that immigrants have healthier lifestyles in their home countries, are among the healthiest from their home country, and are the group most willing and able to endure the stressors associated with immigration, therefore placing them at a health advantage. However, the health advantage declines with increased time spent in the United States, as immigrants adapt to the US sociocultural environment.10 Research suggests Caribbean and African immigrants have worse health over time because they have higher levels of psychological stress related to immigration and adjusting to new sociocultural environments.9 Additionally, the impact of exposure to racism in the United States may be particularly stressful for immigrants from regions of the world where they were a demographic majority.8,9To measure the deleterious effects of stress on the body, the concept of allostatic load has been introduced as a unique approach to understanding the underlying biological processes that might explain health vulnerability. Allostatic load accounts for the cumulative impact of physiological responses to acute, chronic, or long-term psychosocial stressors generated by social conditions that continuously activate hormonal responses to stressful conditions. Prolonged activation of these physiological systems is thought to place persons at risk for the development for both physical and mental disorders.12,13 The literature on allostatic load suggests that overexposure to adverse conditions while adapting to US culture can create a buildup of stressors endemic to the immigrant experience, particularly for immigrants of color.Some studies document the deleterious effects for foreign-born populations of psychosocial stress on the body and dysregulation of physiological systems known to protect the individual from disease.14 Much of this research has focused on Hispanics, partly because they are one of the largest immigrant ethnic groups, there is available survey data, and there is scientific interest in the Hispanic health paradox.15,16 This paradox—that Hispanics exhibit better health outcomes than do non-Hispanic Whites despite their lower than expected socioeconomic status—has been challenged in various studies in which time in the United States has been shown to be the predictor that is most associated with health declines.17 Kaestner et al.18 found that with increased time in the United States, the probability of having a high allostatic load score increased for foreign-born Mexicans. Peek et al.19 reported that among foreign-born Mexicans, those who had lived in the United States for more than 10 years were more likely to have high allostatic load scores. In this way, allostatic load offers a viable reason for the health decline among immigrants but has not been extensively studied in foreign-born Black populations.The only study to investigate the association between allostatic load and chronic health conditions for a population of Latinos that can identify themselves as Black or of African descent20 found that increasing allostatic load scores were significantly associated with abdominal obesity, hypertension, diabetes, self-reported cardiovascular disease, and arthritis for Puerto Ricans.21 However, to our knowledge, no study has examined the relationship between nativity and allostatic load among US- and foreign-born Blacks. Testing this hypothesis will provide knowledge about whether allostatic load operates in a similar way for this understudied population as evidenced in the Latino immigrant literature. We used the 2001–2010 National Health and Nutrition Examination Survey (NHANES)—one of the largest surveys designed to assess the health and nutritional status of adults residing in the United States—to examine nativity-based differentials in allostatic load. On the basis of previous research on immigrant health, we expected to observe a health advantage in allostatic load for foreign-born over US-born Blacks similar to what has been documented in studies focused on Mexican-born individuals.     

Interpersonal Risk Factors,Sexual and Gender Minority Status,and Suicidal Ideation: Is BDSM Disclosure Protective?

Suicidal ideation is elevated among individuals who engage in BDSM practices and those with sexual and gender minority (SGM) identities. There is limited research on the intersectionality of these identities and how they relate to suicidal ideation, especially within a theoretical framework of suicide risk, such as the interpersonal theory of suicide. Thus, we tested the indirect relation between BDSM disclosure and suicidal ideation through thwarted belongingness and perceived burdensomeness, as well as the moderating role of SGM identity on these indirect associations. Participants were 125 (M_age?=?28.27 years; 64% cisgender men) individuals recruited via online BDSM-related forums who endorsed BDSM involvement and recent suicidal ideation. Results indicated significant moderated mediation, such that BDSM disclosure was indirectly negatively related to suicidal ideation through lower thwarted belongingness, but not perceived burdensomeness, among SGM individuals. This was due to the significant relation between BDSM disclosure and thwarted belongingness. There were no significant moderated mediation or indirect effects related to perceived burdensomeness. We also provide supplemental analyses with positive ideation (i.e., positive thoughts toward life) as the criterion variable. In conclusion, BDSM disclosure appears to be protective against suicidal ideation through thwarted belongingness but only for SGM individuals. This work furthers our understanding of the impact of intersecting marginalized identities on suicide risk and resilience. Implications, limitations, and future directions are further discussed.

     

Occurrence and Risk Factors of Unintentional Injuries among 12- to 18-Year-Old Finns – A Survey of 8219 Adolescents

The aim of this study was to evaluate the incidence, nature, and risk factors of unintentional injuries among 12-, 14-, 16- and 18-year-old Finnish adolescents. Of the 8219 respondents (response rate 75%) 5.5% reported an injury that had required medical attention during the past month. The total number of injuries was 506 and the incidence of injuries 62 per 1000 person-months. Boys had a slightly higher injury occurrence rate than girls (OR: 1.33; 95% CI: 1.13-1.59). The most common injuries were sprains (27%), fractures (26%) and wounds (16%) of the upper and lower limbs. In multivariate logistic regression analysis the strongest risk factors of injury were: having experienced violence during past month (OR: 3.6; 95% CI: 2.8-4.6), daily leisure time exercise in sports club (OR: 3.3; 95% CI: 2.3-4.6), having several somatic health complaints weekly (OR: 2.2; 95% CI: 1.7-2.9) and having chronic disease (OR: 2.0; 95% CI: 1.5-2.6). In conclusion, injuries were an important cause of morbidity among our 12-18-year-old adolescents. Adolescents' school success and their parents' education, occupation and employment status were not associated with injuries. The finding that several health and health behaviour variables are important risk factors for injuries challenges the researchers and the society to identify and treat the risk factors that can be modified to reduce the number of adolescent injuries.     

The Association Between Men’s Concern About Demonstrating Masculine Characteristics and Their Sexual Risk Behaviors: Findings from the Dominican Republic

Quantitative analyses exploring the relationship between masculinities and men’s sexual risk behaviors have most commonly used one dimension of masculinities: men’s gender ideology. Examining other dimensions may enhance our understanding of and ability to intervene upon this relationship. In this article, we examined the association between gender role conflict/stress (GRC/S)—men’s concern about demonstrating masculine characteristics—and three different sexual risk behaviors (having two or more sex partners in the last 30 days; never/inconsistent condom use with non-steady partners; and drinking alcohol at last sex) among a sample of heterosexual men in the Dominican Republic who were participating in an HIV prevention intervention (n = 293). The GRC/S Scale we used was adapted for this specific cultural context and has 17 items (α = 0.75). We used logistic regression to assess the relationship between GRC/S and each sexual behavior, controlling for sociodemographic characteristics. In adjusted models, a higher GRC/S score was significantly associated with increased odds of having two or more sex partners in the past 30 days (AOR 1.33, 95 % CI 1.01–1.74), never/inconsistent condom use with non-steady partners (AOR 1.45, 95 % CI 1.04–2.01), and drinking alcohol at last sex (AOR 1.56, 95 % CI 1.13–2.17). These results highlight the importance of expanding beyond gender ideology to understanding the influence of GRC/S on men’s sexual risk behaviors. Interventions should address men’s concern about demonstrating masculine characteristics to reduce the social and internalized pressure men feel to engage in sexual risk behaviors.     

Pregnancy Rate and Risk Behaviors Among Female Adolescents in Vitória, Brazil

BACKGROUND: Adolescents are vulnerable to unplanned pregnancy. Prevention measures and assistance are of significant public health importance in this population. OBJECTIVES: To identify demographic, behavioral, and clinical factors and to determine the prevalence for unplanned pregnancy among female adolescents in Vitória, Brazil. METHODS: A cross-sectional study was performed among female adolescents (15-19 years) assisted by the Family Health Program. Participants completed in person interviews. Demographics, pregnancy rate, and knowledge and behavior were evaluated. RESULTS: The sample consisted of 464 young women, 320 of whom reported sexual activity. The prevalence of pregnancy was 31.6% (95% CI 26.5-36.7%). Not living with parents, not having access to health service, having first sexual intercourse younger than 15 years of age and having less than 9 years of schooling were identified as being independently associated with pregnancy in the final model. CONCLUSION: A high prevalence of pregnancy was found in this population, and behavioral risk was high, despite readily available prevention information. These results demonstrate the need for ongoing pregnancy prevention activities among adolescents.