PROGRAMS AND SERVICES TO PREVENT PREGNANCY, CHILDBEARING, AND POOR BIRTH OUTCOMES AMONG ADOLESCENTS IN RURAL-AREAS OF THE SOUTHEASTERN UNITED-STATES

Purpose: To illustrate how rural adolescents' needs for pregnancy prev ention and improved birth outcomes are currently being addressed, and to suggest strategies for future programs. Methods: Local and state-le vel informants knowledgeable about services to adolescents in the Sout heastern United States were identified. Semistructured interviews were used to determine the program start date and time frame, funding sour ces, target population, participating counties, implementing agency or organization, specific program services, and status of program activi ties. These programs were categorized by the type of services offered and the population targeted. Results: The most common adolescent servi ces in the rural Southeast attempt either to improve life options of y outh, reduce sexual activity, or provide prenatal and postnatal care. Unlike urban areas where there are a variety of family planning provid ers, in the rural Southeast, health departments are the primary source of family planning for adolescents. There are no abortion providers i n most rural areas of the Southeast. The majority of rural programs th at include adolescents among the population served are developed for a ll women rather than specifically for adolescents. Programs specific t o rural adolescents are described. Conclusions: The majority of progra ms in the rural Southeast address only selected adolescent health issu es. Successful interventions require locally supported, multipronged, intensive approaches with consistent messages targeted to high-risk po pulations. Evaluation tools are needed to determine the effectiveness of each component of prevention programs. (C) Society for Adolescent M edicine, 1997.