The United States continues to have among the highest teen pregnancy rates of the modern nations (Hamilton et al, 2009). Certain sexual risk-taking behaviours increase an adolescent’s chances of becoming pregnant or contracting a sexually transmitted infection. Although efforts have been made to avoid teenage sexual risk-taking through sex education, this continues to baffle researchers, healthcare providers, teachers and parents. The understanding of these behaviours can improve education and help produce and implement better prevention programmes.
Tammy King Jones (20I0) conducted interviews of 15 pregnant teenagers and wrote the article “It drives us to do it” based on these teenagers interviews. The purpose of the study was to explore and give a say to pregnant teenagers’ experiences, the realities related to school-based sex education and their understanding of its effectiveness.
This essay is a critique of Jones (2010) research study on the sexual risk-taking behaviours of American teenagers and the effects on their health and future, using a qualitative approach.
Ryan et al (2007) states that critiquing is a methodical approach to evaluating the strong points and limitations of a research report so as to know its validity while also determining if it would be able to be put into practice. According to Polit et al. (2006) critiquing a research report allows feedback for improvement as well as contributes to knowledge of nursing. Ryan et al (2007) reports that a qualitative research critique focuses on believing the study and the issues influencing the strength of the study. This critique would thus attempt to do this by using a feministic qualitative design method.
The title of the paper is concise, yet capture the essence of the paper, thus easily providing readers with an idea of what the paper is about which goes in hand with Dawson (2002) who suggests that one of the keys of a well written paper is a title that somehow captures the essence of the write up without being overly lengthy.
The abstract is well structured, easily read, not too long yet explanatory. It provides a to the point impression of the write-up from its aims to its conclusion without going beyond the recommended 250 words (Holloway & wheeler 2010; LoBiondo-Wood & Haber 2006). The statement of interest is also clearly stated within its background adhering to the standard of quality suggested by LoBiondo-Wood & Haber (2006).
Though Tammy king Jones (2010) holds several qualifications such as, RNC-OB, PhD all in the medical/ academic field and this helps give some credibility to this paper as suggested by Playe (2000) that hints of the quality of a paper can be gotten from the professional background of the writer(s), yet the fact that this paper was a seemingly a solo effort by her can put doubt over how in-depth it may be, as argued by Polit et al. (2003) who suggest that the experience , associations to the subject among by the write can help either establish or diminish the credibility of a research paper.
Qualitative research seeks to understand other people’s views and motivations (Meadows 2006). It seeks to investigate the dilemma in question by concentrating on the persons who were affected, (Vishnevsky et al. 2004). Qualitative methods are concerned with experiences, feelings and attitude (Ryan et al. 2007) and it also tries to help us get an understanding of social phenomena as the happen in their natural setting i.e. not a controlled setting like a laboratory, while taking into consideration the views, experiences and meanings of the participants (Lee 2006; Merrem 2009).
This makes the qualitative approach taken by Tammy King Jones (20I0) correct for the study, as the intended aims of the research is based on gaining insight on a social issue with emphasis being based on the meanings, experiences and views of the participants. And also, the question the research seeks to address is clearly identified.
Additionally the author used questionnaires designed specifically for this purpose alongside, in-depth interviews with different pregnant teenagers, where among other things details about why they got pregnant were discussed. The research design was addressed appropriately to the aims of the research. It tells the reader how the research actually implemented the research approach i.e. via questionnaires and interviews. Meadows (2006) states that there is no concrete way for researchers to get a true picture of the important issues affecting their participant as seen by them (the participants) regarding a certain issue except via discussion with them. Implying that topic guides need to be used by the qualitative researchers, which in turn helps lists the issues that need to be discussed, allowing much needed freedom in such scenarios than the strict questionnaire would all. While also allowing the researcher to build appropriate bond with the participants which in turn produces richer data. So, designing a scenario specific questionnaire and combining that with detailed interviews gives the research validity of a qualitative research as the right methods of gaining data was used.
According to Patton (2002) qualitative research has the strengths of allowing human insights and experiences to be used in developing new understanding of the world but it also has the weakness of it being largely dependent on the skills, creativity, intellect and training of the researcher involved, thus meaning that for the same reason (the method used to get data) the research is open to errors, hence making its reliability dependent on the knowhow of the researcher.
The main argument of this study has to do with the sexual risk-taking behaviours that have negative effects on the health and the future of American teenagers. It focuses on gaining insight into different sexual risk-taking behaviours and efforts for prevention by performing a study that explores the views and experiences of 15 pregnant teenagers aged between 15 to19 years old through extensive interviews. Narrative information was analysed using content analysis and constant comparison. This study was very important to the topic of sex education being taught in schools because the participants of the study discussed how sex education had influences on their sexual decision making this approach target the main aims of the research, while also meeting the requirements of a qualitative based research to garner more understanding based on an uncontrolled environment but based on the experience of its participants (Lee 2006; Merrem 2009).
An appropriate sample group was used bases on the reason(s) for the research. Jones (2010) obtained the thoughts and opinions of the teenagers who have experienced the required phenomenon i.e. pregnancy. This was important, as they were more able to answer the questions properly. Though the sample size fits the general trend of picking pre-meditated participant and does have some reliability to it as it the age range and gender of the sample is clearly given. Its size seems lacking as it is lower than the mean sample size as suggested by Mark (2010) whose research of over 500 qualitative studies showed an average sample size of 31 participants. This may also pose a generalisation problem as the size coupled with the fact that this research was carried out on a set of girls in only one school in one country (the USA). It thus makes it hard to say that the finding is generally correct for most people in that age group.
Ethical issues were taken into consideration as the participants were a vulnerable group. Approval was obtained from the Institutional Review Board to go ahead with the study. Nurses assisted the researcher to recruit the right participants for this study after careful assessment. Consent was obtained from the participants. This was not just about obtaining ethical approval for a study but also ensuring that the rights of the participants are not violated. When reporting qualitative research, participants anonymity and confidentiality must not be breached (The Central Office for Research Ethics Committee 2006), and this was attended to by obtaining documented approval from the institutional Review Board and the participating girls.
The article focused on external and internal drivers. The author identified six key “drivers” which were grouped as internal or external. The drivers are pushes that teenagers feel when they are growing up that make them feel they have to do something or another (Jones 20l0). The research discovered that most teens felt that the “drivers” have more to do with making a decision about sex than school based sex education. Internal drivers were described as ‘fitting in’, ‘curiosity’ and ‘forbidden fruit’. While the external drivers were ‘partners’ pressure’, ‘peer pressure’ and the ‘media’. The participants each identified these drivers as powerful influences on sexual decision making, when discussing their experience with sex education (Jones 20I0). The participants also discussed how these influences “overpowered” the knowledge they gained on sex education. The author in this article concluded by saying that if people keep addressing “sexual content as off limits for adolescents” then it is going to drive them to take more sexual risks.
The researcher when discussing about the six key drivers, includes the teenage girls own words and quotes them exactly as said to prove that she identified the “drivers” based on the teenagers’ interviews. By interviewing these teenagers, the author is able to know what affected their decisions and also able to know if school based sexual education played a role.
It is important to understand that there are many variables when it comes to sexual activity by teenagers and by trying to frighten teenagers away from it can sometimes draw them to it and by miss informing them or omitting information they can be put at more risk of harm.
Teen pregnancy is a complicated and contentious social subject in the USA (Domenico et al. 2007). According to the Kaiser Family Foundation (2013), the USA is listed as number one on the list of countries with high teen pregnancy in the world, with its effect cutting across the individuals, their family and the society at large. The question now becomes given the abundance of birth control methods and sex education in schools why is teenage pregnancy still so rampant? Why is it still so widespread in this day and age? How can the society prevent or reduce the causes of teenage pregnancy?
To be able to address this complex problem researchers claim the four major causes of teen pregnancy have to be known. Based on researchers, the four main grounds for teenage pregnancy are ‘peer pressure and low self-esteem’, ‘lack of parental guidance’, ‘unprotected sex’ and ‘media influence’ (Brendgen et al. 2007).
Teenagers are aware of the risks of their behaviours but these risks are not out weighted by the internal and external pressures they are faced with. Therefore, when using sexual education as a deterrent several methods of sex education need to be used for it to be successful.
In this research study, most of the teenage girls agreed that when someone tells them not to do it or asked them to abstain from sex, it would make them want to do it even more. Therefore, from this behaviour we can learn that ‘abstinence only education’ needs to be changed. This can help show educators that, abstinence only education is not working effectively because it gives an impression that sex is a “forbidden fruit”, which only raises teenagers curiosity to know why it is forbidden, so they engage in this activity anyway.
A significant number of teenagers seem to indulge in sexual relationships so as to fit in with what seems to be accepted behaviour. Research from The Kaiser Family Foundation (2013) show that more than 25% of teenagers who are pregnant believe they were not ready to have sex but went ahead because they wanted to fit in. It is also generally agreed that during the teenage years teens usually try extremely hard to fit in with their peers and would indulge in certain activities including sex to achieve this. In other words they want to be ‘cool’.
It is clear from this research study that peer pressure has its impact on teenagers choice to have sec or not too. These teenagers were affected by peer pressure because they wanted to get recognition and acceptance from their companions.
Teenage pregnancy in the media influences young teenage girls by showing that it is okay to have children at a young age. The media glamorises teenage pregnancy and makes ordinary pregnant girls famous for the problem they have created (Lewis, 2013). Television programmes like “16 and pregnant” shows how the teenagers deals with the ‘problem’ and still go on with their lives. Exposure to sexual contents via written and digital media may surge teen pregnancy by promoting a kind of relaxed attitudes towards abstinence and the use of various prevention methods e.g. contraceptives. In other words creating the perception that there is little risk to sex (Brown et al. 2008). In this day and age, we have to consider that every event or situation is a potential learning experience. Every program that is viewed on television and every magazine that is read sends a message to the audience. The scary part is that teenagers do not think that they are influenced by the media (Werner-Wilson et al. 2004).
The extent to which the media can influence a teenager depends on their mentality. If they go out to any situation well prepared mentally, then they will perceive things with a broader and developed thinking. Teenagers who are easily influenced in general are the ones who are more likely to watch a program and internalise bad values and aspirations (Jones, 20IO). Learning about sex via several media sources is educational but the messages given can be potentially harmful to teenagers as a young mind is vulnerable.
There are often cultural barriers that can have a huge impact on teenagers and the way in which they perceive teenage parenting and protection from sexual activity. Allen (2007) states that culture suggests that teenagers must be protected from sexual activity as there are many dangers and negative consequences related with it. Therefore, instead of informing the teenagers on how to protect themselves, those who believe in this feel that it is their duty to protect the adolescents. According to Allen (2007) theses ideologies are similar to those of abstinence-only ideas which states that sexual activity should be postponed as long as possible with some focusing on advising teenagers that they must protect themselves if they do chose to become sexually active. However, they have to recognise that there are outside “drivers” that may influence their decisions and provide no means of protection or outreach advice to teenagers to protect themselves when these “drivers” have a greater influence on their decision (Allen, 2007).
The aim of educating yongsters in school i.e. early sex education is said to be to get them adequately informed about sex, pregnancy prevention methods and pregnancy itself so that they are equipped to make informed decisions about sex (Surmann, 2005). Sex education can help reduce the high rates of teenage pregnancies in USA. Reducing unintended pregnancy is a national public health goal because of the risks and costs of unintended pregnancies (Guttmacher Institution 2012). The goal of having sex education in schools would be to give students knowledge about how pregnancy happens, contraception and sexually transmitted diseases (Guttmacher Institution, 2012).
Teaching teenagers about who they are and understanding what they think about themselves, will enable educators to help teenagers understand what they think about themselves by soul searching (Advocates for Youth 2008). With teenagers having a positive attitude towards teen parenting, it makes it a lot more difficult for educators to address the issues in order to promote behaviour change (Garwick et al 2008). Therefore, educators should address this issue in a different way, that is their background should be considered, including how they can learn, what barriers they may face and instilling hope and providing enrichment to their lives (Garwick et al, 2008). While the main goal of comprehensive sex education is to delay the onset of sexual activity, the main purpose is to educate all teenagers in case they decide to become sexual active. Advocates for Youth (2008) states that the five components of the Sexual Education Standards are sensuality, intimacy via sex, sexual identity, reproduction and sexual health which are all important as they touch on several aspects of the teenagers lives, including their emotional, physical and mental state and well-being. And addressing these areas can promote real behavioural change.
The critique paper contains a clear account of finding with the collected data haven being thoroughly analysed, and clearly displayed. The research used quotes from each “driver” given. The research was valuable as it has contributed to the development of nursing knowledge.
In whole this papers findings appear to be reliable. The issues of reliability are conformability, credibility, transferability and dependability. Conformability covers how well supported a research is by the data collected (Lincoln and Guba, 1985). Credibility is the assessment of how well what the research deduced is true based on the data originally gotten from the participants (Lincoln and Guba 1985). In this study credibility was maintained by members. From my assessment, the study can contribute meaningful evidence that can be useful to the nursing discipline. Lincoln and Guba (1985) mentions that transferability is the extent to which finds can be transferred between projects i.e. what was gained from one project could be applied to another project. Dependability deals with the quality of the incorporated processes of data gathering, data examination and theory generation (Lincoln and Guba, 1985).
The study concluded that programs and initiatives need to move beyond addressing a focus on knowledge acquisition and move towards addressing certain influential factors that are not typically included in sex education programmes (Jones, 2010). Hence, the study suggested that more time should be spent on certain areas of sex education than others. All the sources in this research study are reliable sources because it is peer review. It also had all its information citied with facts. I believe that it is a reliable study with some very good information. Therefore, when developing preventative efforts for teenage sexual risk-taking, the drivers identified by the pregnant teenagers should be considered. The researcher realised that her research needed to be expanded by getting teenagers from different socio-economic backgrounds and the interviews raised more questions. Even though it could have been more diverse, it still provides very good insight information.
This qualitative study provides practitioners with a clearer understanding of how teenagers view or understand being pregnant. Thus, providing a means by which individual practitioners can improve their service provision while also contributing to evidence base practice. Initiative programmes should also address influential factors that are not normally included in school based sex education curricula. It is now considered the responsibilities of the family, schools and the society to aid in educating teenagers. If the goal as educators is to ensure the best interest of our teenagers and provide them with the best opportunities in life, then their health must be at the forefront of our attention, concerns and efforts. After all, a healthy teenager is a happy teenager.