One of the most fascinating long-term studies of development of positive behaviors in children is the Seattle Social Development Project (SSDP). It began in 1981 and has reevaluated its participants at age 21 years and again at age 33 yearsa pretty amazing feat in long-term research.

Begun in 1981, the study has taken several different forms, moving from one ongoing project to expand to several more. In 1985, this study examinedand continues to examinethe long-term effects of positive modeling on youth behaviors such as substance abuse, delinquency, violence, health status, andlast but not leastrisky sexual behaviors.

The study focused on fifth-grade students in public elementary schools in high-crime areas of Seattle, Washington, using a nonrandomized controlled trial with long-term follow-up. Preventive interventions included in-service teacher training, parenting classes, and social competence training for children and then assessed self-report measures of outcomes when the subjects reached 21 years of age and 33 years of age. The latest outcome measures (at age 33 years) have just been concluded at the time of this writing, but the results found when the subjects reached age 21 years are as follows:

• Full-treatment group status (when compared with the control group) has been associated with:
• o Fewer sexual partners
• o Marginally reduced risk for initiating intercourse by age 21 years
• o Significantly reduced likelihood of pregnancy
• o Significantly reduced likelihood of giving birth by age 21 years
• o Significantly increased probability of condom use among singles during last intercourse
• Significant ethnic group X intervention group interaction indicated that after controlling for socioeconomic status, single African Americans were especially responsive to the intervention in terms of this outcome.
• Significant treatment X ethnic group interaction indicated that among African Americans, being in the full-intervention group predicted a reduced probability of contracting an STI by age 21 years.

Finally, a related study by the same group examined results of longitudinal surveys of nearly 2,000 participants to find that STIs were reported at a significantly lower rate among young adults who grew up in well-managed households, who were encouraged in their school participation, and who had friends who tended to stay out of trouble.

Marina Epstein, lead author of this second study, concluded: "Kids don't engage in risky behaviors in a vacuum, there are environmental opportunities that have to be created. Pay less attention to the sex aspect of this and think of the larger context" and "Monitor your kid more generally, make sure they're engaged in school and have friends who don't get into trouble."

Sources:

Epstein M, Baiely JA, Manhart LE, et al. Understanding the link between early sexual initiation and later sexually transmitted infection: Test and replication in two longitudinal studies. Journal of Adolescent Health, 54(4), April 2014, 435-441. http://www.sciencedirect.com/science/article/pii/S1054139X13005144.

Lonczak HS, Abbott RD, Hawkins JD, Kosterman R, Catalano RF. Effects of the Seattle social development project on sexual behavior, pregnancy, birth, and sexually transmitted disease outcomes by age 21 years. Arch Pediatr Adolesc Med. 2002 May;156(5):438-447.

McElroy M. (2014). Data on today's youth reveal childhood clues for later risk of STDs. UW Today, University of Washington. http://www.washington.edu/news/2014/02/11/data-on-todays-youth-reveal-childhood-clues-for-later-risk-of-stds/.

1. The two studies in this article focus on the effects of early social prevention measures. Statistically, what was reported to be most responsible for the decrease in pregnancy among teens in the last reported decade from the Centers for Disease Control and Prevention (from 1991 to 2012)?
2. What would you say to a parent of a pregnant teen who says, "I don't get it? She could have been anything. Why would she be so willing to throw her life away like this?"
3. What kinds of factors put teens at increased risk for pregnancy and risky sexual behaviors?
4. Discuss the developmental tasks of adolescence (either Erik Erikson's Stages of Psychosocial Development or Jean Piaget's Cognitive Theory) that may need to be overcome so that a teen may become an effective parent.
5. Discuss interventions by the nurse that may enhance early identification of the pregnant teen.