Parent Power: What Parents Need to Know and Do to Help Prevent Teen Pregnancy

Insights from research

While parents clearly cannot determine their children's decisions about sex, the quality of their relationships with their children can make a real difference.4 More than two decades of robust research - supplemented by common sense, recent public opinion polls and the voices of teens themselves - provides parents with some guiding themes:

Relationships matter. Overall closeness between parents and their children, shared activities, parental presence in the home, and parental caring and concern are all associated with a reduced risk of early sex and teen pregnancy.5 Teens who are close to their parents and feel supported by them are more likely to abstain from sex, wait until they are older to begin having sex, have fewer sexual partners, and use contraception more consistently.6

More than talk. It is important for parents to discuss sex, love, and relationships directly with their children. They need to be clear and candid. Parents should realize, however, that simply talking with their teens about the risks of early sex, for example, without being more deeply involved in their lives and close to them is unlikely to delay first sex, increase contraceptive use, or decrease the risk of pregnancy. The overall quality of the relationship appears to be more "protective" than specific conversations about particular sexual issues.7

Most teens (69%) agree it would be much easier for them to postpone sexual activity and avoid teen pregnancy if they were able to have more open, honest conversations about these topics with their parents. (2002 survey of young people aged 12- 19.)8

Parental reluctance is a problem. Parents and other adults often report that they are uncomfortable talking about sex and pregnancy with teens - that they shy away from taking a clear position on these issues. This may be due to queasiness about "imposing one's values on another." It may be because parents rarely had adult role models who discussed these issues when they were teens. It may also reflect a culture that has become increasingly tolerant of non-marital sex, unwed pregnancy and parenthood. Still others are unwilling to take a strong stand out of concern that they might offend those teens who are already pregnant or parenting, or might inadvertently stigmatize the children of teen mothers. Whatever the reason, if parents and other adults can't say - simply and directly - that teen pregnancy and parenthood are in no one's best interest, how can any of us be surprised at the high rates of teen pregnancy and birth in this country?

Attitudes and values matter, too. Teens whose parents are clear about the value of abstinence, and/ or about the dangers of unprotected intercourse, are more likely to delay first sex and to use contraception.10 Put another way, parents who provide clear messages about the value of delaying sex have children who are less likely to have intercourse at an early age, and those parents who discuss contraception are also more likely to have children who use contraception when they become sexually active.11

Teens offer various reasons why they don't talk with their parents about sex, including concern about their parent's reaction (83%), worry that their parents will think they are having sex (80%), embarrassment (78%), a feeling that they don't know how to bring the subject up (77%), and the belief that parents won't understand (64%). (2002 survey of young people age 15-17.)

Parental supervision. Research supports what common sense suggests - supervising and monitoring teens' behavior makes a difference. Teens whose parents supervise them are more likely to be older when they first have sex, to have fewer partners, to use contraception, and to be at less risk of pregnancy. It should be noted, however, that "very strict" monitoring by parents is associated with a greater risk of teen pregnancy.12

Parents and peers. When asked who influences teens' decisions about sex the most, half of adults cited teenagers' friends as the main source. Far fewer teens agreed. Less than a third of teens (32%) said friends are most influential (2001 survey of young people aged 12-19). Parents apparently overestimate the influence of peers and underestimate their own influence.13 Teens are clear: parents matter.

"Parents are the ones we listen to the most. Even if parents don't think kids are listening, you'd be amazed at how many really are." - National Campaign Youth Leadership Team member, 16

Family structure. Family structure and where a family lives are also related to the risk of teen pregnancy. Children in single-parent families and teens with older brothers and sisters who are sexually active or have been pregnant or given birth, are more likely to begin sexual activ- ity at an early age. Young people who grow up in abusive families are more likely to be sexually active and not to use contraception consistently. And those teens living in neighborhoods beset by poverty, unemployment, and high crime rates are more likely to start having sex early, not to use contraception, and to become pregnant or cause a pregnancy (suggesting, of course, that poverty is a cause as well as a result of teen pregnancy). 18 Still, these are not the most powerful explanations for why teens initiate sex at an early age.19

More than half of teens (53%) say parents or their own morals, values, and religious beliefs influence their decisions about sex the most - far more than such other influences as friends, the media, teachers and sex educators (2002 survey of young people age 12-19.)14 Fewer than five out of ten teens recently surveyed strongly agreed that they are getting a clear message that teen pregnancy is wrong.15 (2001 survey of teens age 12-19.)

Other risky behaviors. The close parent-child relationships that help protect young people from early sex also help limit other risky behavior such as violence, substance and alcohol use, and school failure. Whether parents are concerned about drinking, drugs, violence, trouble in school, smoking, or sex (or all of the above), the best advice is the same - stay closely connected to your teenage sons and daughters.20

Parents in the dark. Many parents are not aware that their children have had sex. For example, only about a third of parents of sexually experienced 14- year-olds believe that their child has had sex.21 When sexually experienced 8th to 11th graders were surveyed, about 50% of their parents were unaware that their sons and daughters had started to have sex.22 Insights from research

Over half of young adolescents, in particular, say if they are considering having sex or if they want guidance on dealing with pressure to have sex they would first want to talk to their parents. (From a 1999 survey of young people aged 10-15.)16 Even so, close to half of all 15- to 17-year-olds surveyed (48%) - and 56% of those who have had sex - say they have never talked with their parents about how to know when you are "ready to have sex." (2002 survey of young people age 15-17.)

Dating dangers. Not surprisingly, two of the most powerful risk factors for early sex and pregnancy, are close romantic attachments and significant age differences between partners.23 Romantic relationships between young teens significantly increase the risk of too-early sex. One-on-one dating in the presence of large age differences (three years or more) is also a high-risk proposition. Consider the following information about young adolescents: 13% of same-age relationships among those aged 12-14 include sexual intercourse. If the partner is two years older, 26% of the relationships include sex. If the partner is three or more years older, 33% of the relationships include sex.24

A national consensus. Most adults share a common sense approach toward preventing early sexual activity and parenthood: School-age youth should be clearly encouraged not to have sex - both because of important consequences and because sex should be associated with meaning and serious commitment. (In fact, for most Americans, abstinence is not one of several equally attractive options for young people, it is the strongly preferred option). It is also true that even in the face of clear, direct advice to remain abstinent, some young people will not do so. Given this reality, the overwhelming majority of adults also believe that young people should be given information about the benefits and limitations of contraception and provided with appropriate health services, too.25 In short, public opinion sees a role for both abstinence and contraceptive information and services. It's not either-or, but both.

A large majority of parents (76%) and teens (64%) say they wish teens/they were getting more information about abstinence and contraception.26 (2002 survey of young people age 12-19).

Give teens credit. Discussing abstinence and contraception at the same time does not confuse teens. The overwhelming weight of scientific evidence suggests that addressing abstinence and contraception does not hasten the onset of sex, increase the frequency of sex, or increase the number of sexual partners.27 And most teens (70%) describe messages encouraging abstinence, coupled with information about contraception, as "clear and specific".28

Limits on schools. Many parents want schools to do more.29 This may be, in part, because parents are uncomfortable talking with their children; some also feel that they simply don't know enough to be fully adequate sex educators. There is good reason to turn to schools: That's where most teens are, some schools have well-trained sex education teachers, and sex-related topics can be included in broader curricula stressing health promotion. Still, expecting schools to shoulder all the responsibility in this area has a downside. No matter how good the sex education that a particular school might offer, it is unrealistic and perhaps even unwise to think that it can all be left up to schools to put the complex issues of love, sex, and relationships in the context that each family prefers. And many people feel that public schools are not the appropriate place to discuss religious teachings about these same issues, even though faith-based values often are a very important influence on the sexual decisions of teens.

In sum. Parents who (1) clearly communicate their values and expectations to their children, (2) express their concern and love for them early and often, and (3) exercise supervision - including their child's selection of friends and role models - raise children who are more likely to avoid a host of risky behaviors than parents who do not. The overall strength and closeness of parent/child relationships seems to be the best protection of all.

A note about Hispanic parents. In 2001, the National Campaign - along with the Bravo Group, a leading communications firm, and PEOPLE en Espanol magazine - launched a long-term education and awareness effort to support Hispanic parents in helping their teens avoid pregnancy. This effort was undertaken, in part, because Hispanic teen pregnancy rates have not declined as steeply as have the rates of other groups. As part of this effort, focus groups were conducted with Hispanic parents.

Not surprisingly, one of the primary conclusions from this research is that Hispanic parents want what all parents want - a positive, loving relationship with their children and a successful, healthy future for them. However, the barriers they face in reaching these goals are more complex and include language and cultural differences. Parents participating in the focus groups agreed on many points:

• Communicating with children and being closely involved in their lives are essential to healthy and safe adolescent development and central to reducing teen pregnancy.

• It's often hard to have open discussions with children about sex, but parents must break the silence that often surrounds this issue.

• Parents and their children share responsibility for preventing teen pregnancy.

• Talking with kids about sex, love, and values; supervising their activities; knowing their friends; helping them define goals for the future; and providing them with direction on how to accomplish these goals are specific ways adults can help prevent teen pregnancy.

• Finally, no matter what the age of the child, a parent's job is never done.31

"We need to talk to our kids about sex because nobody talked to us." - San Antonio Father

Three out of five Hispanic girls in the U.S. become pregnant by age 20.32

"I would be extremely grateful if my parents talked to me about these issues. It shows that they care about the tough decisions that we have to make in our lives." - Lara, 15, Teen People magazine "trendspotter."

What teens want adults to know

The National Campaign has asked teens from all over the country a simple question: If you could give your parents and other important adults advice about how to help you and your friends avoid pregnancy, what would it be? The following tips represent the major themes we heard from teens.

• Show us why teen pregnancy is such a bad idea. For instance, let us hear directly from teen parents about how hard it has been for them. Hearing the real story from teen mothers and fathers can make a big difference. Help us understand why teen pregnancy can get in the way of reaching our goals.

• Show us what good, responsible relationships look like. We're as influenced by what you do as what you say.

• Talk to us honestly about love, sex, and relationships. Just because we're young doesn't mean that we can't fall in love or be interested in sex. These feelings are very real and powerful to us. Talk to us about all this (but no lectures, please). If you won't discuss these issues with us, please help us find another adult who will.

• Telling us not to have sex is not enough. Explain why you feel that way (if you do) and ask us what we think. Tell us how you felt as a teen but understand that things may be different for us. Discuss emotions, not just health and safety. Listen to us and take our opinions seriously.

• Even if we don't ask, we still have questions. How do I know when having sex is the right thing to do? Should I wait until marriage? How far is too far for me or someone my age? How do I handle pressures from my friends? Will having sex make me popular? How do I know if I'm in love? How do I say "no?" If we don't start these conversations, you should.

• Whether we're having sex or not, we need to be prepared. We need to know how to avoid pregnancy and sexually transmitted diseases. That means information about abstinence and contraception. We need honest and helpful information from the people we trust most. If we don't get information from you, we are going to get it somewhere else.

• If we ask you about sex or contraception, don't assume we are already "doing it." We may just be curious, or we may just want to talk with someone we trust. And don't think giving us information about sex and birth control will encourage us to have sex. We need to know the facts so that we can make good decisions in the future-maybe next week, month, or years from now.

• Pay attention to us before we get into trouble. Reward us for doing the right thing - even when it seems like no big deal. Don't shower us with attention only when we do something wrong. Talk with us about our friends, our school, what we're interested in and worried about - even the latest gossip. Come to our games and school things. Show us that you care what is happening in our lives.

• Don't leave us alone so much. Sometimes we have sex because there's not much else to do. If you can't be home with us after school, make sure we have something to do that we really like, where there are other kids and adults who are comfortable with us. If we're at a party, make sure there is an adult around.

• We really care what you think, even if we don't always act like it. Even though we may look all grown up, we still want your help and advice. But remember, your experiences are not the same as ours and the choices we face are often different. When we don't end up doing exactly what you tell us to, don't think that you've failed. And don't stop trying.

• We hate "the talk" as much as you do. Please don't sit us down for a "sex talk." Instead, start talking with us about sex, love, and values when we're young, and keep the conversation going as we grow older. Making us feel comfortable and encouraging us to talk and ask questions is important too - just make sure you listen to the answers.

• For us it's about abstinence and contraception. Not either/or. We get it. We know the best way to protect ourselves is not to have sex. But we also need to know about contraception. It seems to us that adults waste an awful lot of time arguing about all this.

"The only thing my mother told me about sex is not to have it. That's not really an education. - girl, 17

"My parents haven't had the sex conversation with me yet. I think they just assume I'm not gonna get into that." - girl, 17

Tips for parents

What can parents do to help their children avoid too-early pregnancy and parenthood? Here are a few practical, research-based tips for parents. Many of these tips will seem familiar because they articulate what parents already know from experience - like the importance of maintaining strong, close relationships with their children, setting clear expectations for them, and talking with them about important matters.

• Be clear about your own sexual attitudes and values.

Communicating with your children about sex, love, and relationships is often more successful when you are certain in your own mind about these issues. To help clarify your attitudes and values, think about the following kinds of questions:

• What do you really think about school-aged teenagers being sexually active - perhaps even becoming parents?
• Who is [should be?] responsible for setting sexual limits in a relationship and how is that done, realistically?
• Were you sexually active as a teenager and how do you feel about that now?
• Were you sexually active before you were married? What do such reflections lead you to say to your own children about these issues?
• What do you think about encouraging teenagers to abstain from sex?
• What do you think about teenagers using contraception?

• Talk with your children early and often about sex, and be specific.

Initiate the conversation, and make sure that it is honest, open, and respectful. If you can't think of how to start the discussion, consider using situations shown on television or in movies as conversation starters. Tell them candidly and confidently what you think and why you take these positions. If you're not sure about some issues, tell them that, too. Be sure to have a two-way conversation, not a one-way lecture. Ask them what they think and what they know so you can correct misconceptions. Ask what, if anything, worries them.

Age-appropriate conversations about relationships and intimacy should begin early in a child's life and continue through adolescence. Resist "the talk" - make it an 18-year conversation. All kids need a lot of communication, guidance, and information about these issues, even if they sometimes don't appear to be interested in what you have to say. And if you have regular conversations, you won't worry so much about making a mistake or saying something not quite right, because you'll always be able to talk again.

Don't let your lack of technical information make you shy. Kids need as much help in understanding the context and meaning of sex as they do in understanding how all the body parts work. Discuss the differences between love and sex and remember to talk about the reasons that kids find sex interesting and enticing; discussing only dangers and diseases misses many of the issues on teenagers' minds.

• Be a parent with opinions. In addition to being an "askable parent," be a parent with a point of view. Tell your children what you think. Don't be reluctant to say such things as:
  • Because sex should be associated with commitment, I think high school-age teens are simply too young to have sex.
  • When you eventually do have sex, always use protection until you are ready to have a child.
  • Our family's values and/or religion say that sex should be an expression of love within marriage. I expect you to wait.
  • Finding yourself in a sexually charged situation is not unusual; you need to think about how you'll handle it in advance. Have a plan. Will you say "no"? Will you use contraception? How will you negotiate all this?
  • It's okay to think about sex and feel sexual desire; everybody does. But it doesn't mean you have to act on these feelings.
  • One of the many reasons I'm concerned about drinking and drug use is that they are often linked to bad decisions about sex.
  • Having a baby doesn't make you a man. Being able to wait and acting responsibly does.
  • You don't have to have sex to keep a boyfriend. If sex is the price of a close relationship, find someone else.

• Supervise and monitor your children and adolescents.

Establish rules, curfews, and standards of expected behavior, preferably through open family discussions. If your children get out of school at 3 pm and you don't get home from work until 6 pm, who is responsible for making certain that your children are not only safe during those hours, but also engaged in useful activities? Where are they when they go out with friends? Are there adults around who are in charge? Supervising and monitoring your children's whereabouts doesn't make you a nag; it makes you a parent.

• Know your children's friends and their families.

Clearly, friends have a strong influence on each other. Meet with the parents of your children's friends so that you can get to know them and establish common rules and expectations. It is easier to enforce a curfew that all your child's friends share rather than one that makes him or her different - but even if your views don't match those of other parents, hold fast to your convictions. Welcome your children's friends into your home and get to know them.

• Discourage early, frequent, and steady dating.

Allowing teens to begin steady, one-on-one dating much before age 16 can lead to trouble. Instead, support group activities. Make your strong feelings about this known early on - don't wait until your young teen proposes a plan that differs from your preferences in this area. Otherwise, he or she will think you just don't like the particular person or invitation.

• Take a strong stand against your child dating someone older.

Try setting a limit of no more than a two- (or at most three-) year age difference. While older guys can seem glamorous to a young girl, the power differences between younger girls and older boys or men can lead girls into risky situations, including unwanted sex and sex with no protection. Young boys with older girls brings similar risks.

• Help your teen-agers to have options for the future that are more attractive than early pregnancy and parenthood.

The chances that your children will delay sex, pregnancy, and parenthood are significantly increased if their future appears bright. This means helping them set meaningful goals for the future, talking to them about what it takes to make future plans come true, and helping them reach their goals. Explain how becoming pregnant - or causing pregnancy - can derail the best of plans.

• Let your children know that you value education highly.

Encourage your child to take school seriously and set high expectations about school performance. School failure is often the first sign of trouble that can end in teenage parenthood. Monitor your children's grades and discuss them together. Meet with teachers and principals, guidance counselors, and coaches. Limit the number of hours your teenager gives to part-time jobs (20 hours per week should be the maximum) so that there is enough time and energy left to focus on school. Know about homework assignments and support your child in getting them done. Volunteer at the school, if possible.

• Talk to sons as well as daughters.

The nearly 900,000 teen girls who get pregnant each year don't do it alone. Boys need to know that teen pregnancy has serious con- Tips for parents sequences for them, too. Talk with boys - not just girls - about consequences, responsibility, sex, love, and values.

• Know what your kids are watching, reading, and listening to.

Television, radio, movies, music videos, magazines, and the Internet send many messages about sex: Sex often has no meaning, unplanned pregnancy seldom happens, and few people in the media having sex ever seem to be married or even especially committed to each other. Is this consistent with your expectations and values? If not, it is important to talk with your children about what the media portray, what you think about it, and what your children think about it. If certain programs or movies offend you, say so, and explain why. Encourage your kids to think critically: ask them what they think about the programs they watch and the music they listen to. Watch their favorite shows with them and ask whether the scenarios on TV relate to anything in their lives or their friend's lives. While you cannot fully control what your children see and hear, you can certainly make your views known and control your own home environment by turning off the TV, canceling subscriptions, and placing certain movies off limits.

Habits of the heart

These tips for helping your children avoid teen pregnancy work best when they occur as part of strong close relationships with your children that are built from an early age. Strive for relationships that are warm in tone, firm in discipline, and rich in communication, and that emphasizes mutual trust and respect. There is no single way to create such relationships, but the following habits of the heart can help:

• Express love and affection clearly and often. Hug your children, and tell them how much they mean to you. Praise specific accomplishments, but remember that expressions of affection should be offered freely, not just for a particular achievement.

• Listen carefully to what your children say and pay thoughtful attention to what they do.

• Spend time with your children engaged in activities that suit their ages and interests, not just yours. Shared experiences build a "bank account" of affection and trust that forms the basis for future communication with them about many topics, including sexual behavior.

• Be supportive and be interested in what interests them. Attend their sports events; learn about their hobbies; be enthusiastic about their achievements, even the little ones; ask them questions that show you care and want to know what is going on in their lives.

• Be courteous and respectful to your children and their friends. Avoid hurtful teasing or ridicule. Don't compare your teenager with other family members (i.e., why can't you be like your older sister?). Show that you expect courtesy and respect from them in return.

• Help them to build self-esteem by mastering skills; selfesteem is earned, not given, and one of the best ways to earn it is by doing something well.

• Try to have meals together as a family as often as possible, and use the time for conversation, not confrontation. Tips for parents

One final thought

Parenting is one of life's most rewarding and challenging responsibilities. Helping young people navigate the passage to adulthood, in general, and avoid such problems as pregnancy, violence, drugs, alcohol, smoking, and school failure, in particular, can be daunting. Research makes clear - and teens themselves underscore - that parents can do much to help. Parents should not be afraid to be more parental. They must not avoid the job that parents have always had - to teach their children about life's choices and the consequences of those choices. It's their time-tested role and responsibility.

In particular, parents should recognize that a close loving, relationship with their children can be the best protection of all. It's never too early to start or never too late to improve a relationship with a child or teenager. Don't underestimate the great need that children of all ages feel for their parents' guidance, approval, and support.

"Children have to know that there is someone out there for them always." - Miami father

Need more?

The National Campaign to Prevent Teen Pregnancy offers many additional resources concerning parents and teen pregnancy prevention, all of them low-cost and many of them available free of charge on the Campaign's website www.teenpregnancy.org. Visit the parent section of the Campaign's website for a host of materials for parents, including an online quiz, and for a selected list of other organizations' resources for parents.

Publications

• Ten Tips for Parents to Help Their Children Avoid Teen Pregnancy

• Consejos a los padres para prevenir el embarazo en la adolescencia (Tips developed by and for Hispanic parents to help their children avoid teen pregnancy)

• It All Starts At Home: Hispanic Parents Speak Out on Preventing Teen Pregnancy

• Talking Back: Ten Things Teens Want Parents to Know About Teen Pregnancy (also available in Spanish)

• Families Matter: A Research Synthesis of Family Influences on Adolescent Pregnancy

• Parents Matter: Tips for Raising Teenagers

• Thinking About the Right Now: What Teens Want Other Teens to Know About Preventing Pregnancy (also available in Spanish)

• Where Are the Adults? The Attitudes of Parents, Teachers, Clergy, Coaches, and Youth Workers on Teen Pregnancy: A Focus Group Report

• What About the Teens? Research on What Teens Say About Teen Pregnancy: A Focus Group Report

Videos

• A Walk in Your Shoes: Originally aired on The N, the Noggin network's nighttime network for teens, this special episode of the network's hit series, A Walk In Your Shoes, details a teen couple who "switches lives" with another couple who are teenage parents. Includes a study guide.

• Mothers Too Soon and Fathers Too Soon: Based on a television series originally aired on Channel One, these videos provide a first-hand look at how teen pregnancy affects the lives of teens, their children, and families. Includes a study guide.

• Jessica's Story: Based on the characters and story line from ABC's One Life to Live, this video examines the consequences of 18-year-old Jessica Buchanan's pregnancy. Includes a study guide.

The nitty-gritty

1. National Campaign to Prevent Teen Pregnancy analysis of Henshaw, S.K. (2003). U.S. teenage pregnancy statistics with comparative statistics for women aged 20-24. [Online]. Available: www.guttmacher.org/pubs/ teen_stats.pdf. New York: The Alan Guttmacher Institute. Ventura, S.J., Martin, J.A., Curtin, S.C., Menacker, F., & Hamilton, B.E. (2001). Births: Final data for 1999. National Vital Statistics Reports, 49(1).
2. The National Campaign to Prevent Teen Pregnancy. (2001). Halfway there: A prescription for continued progress in preventing teen pregnancy. Washington, DC: Author.
3. Albert, B., Brown, S., & Flanigan, C. (eds.) (2003). 14 and Younger: The Sexual Behavior of Young Adolescents. Washington, DC: National Campaign to Prevent Teen Pregnancy.
4. Miller, B. (1998). Families matter: A research synthesis of family influences on adolescent pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
5. Blum, R.W., & Rinehart, P.M. (1998). Reducing the risk: Connections that make a difference in the lives of youth. Center for Adolescent Health and Development, University of Minnesota. Minneapolis, MN.
6. Miller, B. (1998). Families matter:A research synthesis of family influences on adolescent pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
7. Blum, R.W., & Rinehart, P.M. (2002). Mothers' influence on teen sex: Connections that promote postponing sexual intercourse. Center for Adolescent Health and Development, University of Minnesota. Minneapolis, MN.
8. The National Campaign to Prevent Teen Pregnancy. (2002) With one voice 2002: America's adults and teens sound off about teen pregnancy. Washington, DC: Author.
9. The Kaiser Family Foundation. (2002). Sex smart. Communication: A series of National surveys of teens about sex. Menlo Park, CA: Author.
10. Blum, R.W., McNeely, C.A., Rinehard, P.M. (2002). Improving the odds: The untapped power of schools to improve the health of teens. Center for Adolescent Health and Development, University of Minnesota. Minneapolis, MN.
11. Blum, R.W., & Rinehart, P.M. (1998). Reducing the risk: Connections that make a difference in the lives of youth. Center for Adolescent Health and Development, University of Minnesota. Minneapolis, MN
12. Miller, B. (1998). Families matter:A research synthesis of family influences on adolescent pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
13. The National Campaign to Prevent Teen Pregnancy. (2001). With one voice: America's adults and teens sound off about teen pregnancy. Washington, DC: Author.
14. The National Campaign to Prevent Teen Pregnancy. (2002) With one voice 2002: America's adults and teens sound off about teen pregnancy. Washington, DC: Author.
15. The National Campaign to Prevent Teen Pregnancy. (2001). With one voice: America's adults and teens sound off about teen pregnancy. Washington, DC: Author.
16. The Kaiser Family Foundation/Children Now. (1999). Talking with kids about tough issues. A national survey of parents and kids. Menlo Park, CA: Author.
17. The Kaiser Family Foundation (2002). Sex Smart. Communication: A series of national surveys of teens about sex. Menlo Park, CA: Author.
18. Miller, B. (1998). Families matter: A research synthesis of family influences on adolescent pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
19. Blum, R.W., & Rinehart, P.M. (1998). Reducing the risk: Connections that make a difference in the lives of youth. Center for Adolescent Health and Development, University of Minnesota. Minneapolis, MN.
20. Resnick, M.D., Bearman, P.S., Blum, R.W., Bauman, K.E., Harris, K.M., Jones, J., Tabor, J., Beuhring, T., Sieving, R.E., Shew, M., Ireland, M., Bearinger, L.H., & Udry, J.R. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278(10), 823-832.
21. Bruckner, H., & Bearman, P. (2003). Dating behavior and sexual activity of young adolescents: Analyses of the National Longitudinal Study of Adolescent Health. In Albert, B., Brown, S., & Flanigan, C (Eds.), 14 and younger: the sexual behavior of young adolescents (pp. 31-56). Washington, DC: National Campaign to Prevent Teen Pregnancy.
22. Blum, R.W. (2002). Mothers' influence on teen sex: Connections that promote postponing sexual intercourse. Center for Adolescent Health and Development, University of Minnesota. Minneapolis, MN.
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24. Albert, B., Brown, S., & Flanigan, C. (eds.) (2003). 14 and Younger: The Sexual Behavior of Young Adolescents. Washington, DC: National Campaign to Prevent Teen Pregnancy.
25. The National Campaign to Prevent Teen Pregnancy. (2002) With one voice 2002: America's adults and teens sound off about teen pregnancy. Washington, DC: Author.
26. The National Campaign to Prevent Teen Pregnancy. (2002) With one voice 2002: America's adults and teens sound off about teen pregnancy. Washington, DC: Author.
27. Kirby, D. (2001). Emerging answers: research findings on programs to reduce teen pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
28. National Campaign to Prevent Teen Pregnancy. (2002). With one voice 2002: America's adults and teens sound off about teen pregnancy. Washignton, DC: Author.
29. The Kaiser Family foundation. (2000). Sex education in America: A view from inside the nation's classrooms. A series of national surveys of students, parents, teachers and principals. Menlo Park, CA: Author.
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