摘要：Latina adolescent parents are at increased risk for rapid repeat births (second birth ≤ 24 months after the first), sexually transmitted infections, and negative educational and social outcomes. Although several effective parent-based interventions have been developed to prevent Latino youths’ sexual risk taking, little research has explored the development of interventions to prevent repeat births that involve the parents of these adolescents. Existing preventative interventions involving parents suffer from important methodological limitations. Additional research is needed to advance theories of behavior, identify the causal pathways of parental influence, and specify appropriate behavioral targets. Future parent-based interventions to prevent repeat births should target pregnancy intentions, age of partners, contraceptive use, integrated prevention of pregnancies and sexually transmitted infections, educational attainment, and future orientations. The development of programs and policies to address adolescent pregnancy among Latina youths in the United States has focused increasingly on the importance of Latino parents. Organizations such as the National Campaign to Prevent Teen and Unplanned Pregnancy and the National Council of La Raza 1,2 have developed initiatives specifically for Latino families and have widely disseminated materials to support Latino parents’ efforts to prevent unplanned pregnancies, sexually transmitted infections (STIs), and HIV among their adolescent children. 3,4 In part, these efforts reflect a growing recognition that Latino parents play an important role in the lives of young people and that pregnancy prevention initiatives may benefit from capitalizing on their influence. 5 For example, findings from a nationally representative, random-digit-dial telephone survey of 1008 American adolescents aged 12 to 19 years found that the majority of Latino youths (55%) identified their parents as the greatest influence on their sexual decision-making, a proportion significantly greater than reported by their White (42%) and African American (50%) peers. 6 Several efficacious parent-based interventions have been developed to prevent and reduce sexual risk behavior among Latino youths, including Families Talking Together 7,8 and Familias Unidas (United Families). 9,10 Cuidalos (Take Care of Them), a computer-based parent intervention to improve Latino parent–adolescent communication about sexual intercourse, and Rompe el Silencio (Break the Silence), a mother–daughter intervention targeting maternal communication about sexual intercourse and HIV/AIDS, are also promising. 11,12 Although differing in scope and intensity, these interventions seek to teach parents how to communicate effectively with their children and how to implement parenting strategies that reduce sexual risk taking, enhance child development, and promote Latino adolescents’ ability to assume healthy and productive lives. As the Latino population in the United States continues to grow, the demand for science-driven, Latino parent-based interventions that can be used in conjunction with school, community, and larger policy efforts is likely to increase. One promising yet underexplored focus for the development of parent-based interventions is prevention of rapid repeat births among Latina adolescents. Nationwide, an estimated 20% of adolescent mothers experience a rapid repeat birth, which is defined as a subsequent birth occurring within 24 months of a previous birth. 13,14 Latina adolescents bear the highest burden of first and secondary adolescent births in the United States. 15 From 1991 to 2006, the proportion of secondary and higher-order births among adolescents aged 15 to 19 years declined among all racial and ethnic groups except Latinas, whose repeat birth rate increased from 19% to 35%. 16 Although a few scholars have suggested that not all adolescent births are harmful, 17,18 most research suggests that secondary and higher-order births in general, and rapid repeat births in particular, are a serious public health concern. Among Latina adolescent parents, secondary and higher-order births have been associated with reduced educational attainment and decreased financial independence. 13,19 In addition, research suggests that the presence of a pregnant or parenting adolescent in Latino families can increase the likelihood that younger siblings will become pregnant during adolescence, 20–22 possibly because of changes in the nature and quality of parenting that occur in the aftermath of an adolescent birth. 21 Adolescent childbearing can also negatively affect future generations. Children born to adolescent mothers have lower levels of cognitive development in childhood, 23 experience less academic achievement in adolescence, 23 and have a greater risk of becoming adolescent parents themselves than do children born to older parents. 24,25 The consequences of adolescent childbearing and rapid repeat births among Latina adolescents are serious and warrant considerable research and intervention efforts. In 2010, the National Campaign to Prevent Teen and Unplanned Pregnancy, the National Council of La Raza, and other Latino organizations issued a National Consensus Statement on how to address adolescent pregnancy among Latino youths. 2 The statement positioned poverty, access to health care, and education as key contextual factors that shape pregnancy, STI, and HIV risk among Latino adolescents in the United States. In addition, it emphasized the important role of Latino families and called for additional programs to facilitate and support parent–adolescent communication about adolescent sexual behavior, pregnancy, and sexual and reproductive health. Parent-based interventions are urgently needed to prevent rapid repeat births among Latina adolescents. It is likely that many of the issues pertaining to developing such interventions are also relevant for researchers interested in developing them for other ethnic and racial groups.
