A critique of community-based primary prevention of adolescent pregnancy

In summary, adolescent pregnancy is a major public health problem. Although the magnitude of mortality is low, the magnitude of morbidity is enormous. Even though adolescent pregnancy rates have not increased in recent years, these rates remain high. The economic and psychosocial costs of adolescent pregnancy are staggering. Admittedly, adolescent pregnancy does not fit a conventional infectious disease model of an easily transmitted disease with a high potential for rapid spread. However, it is possible that role identification and behavior modeling could influence the occurrence of adolescent pregnancy in susceptible adolescents. Moreover, for many years public health authorities have acknowledged the critical significance of noninfectious causes of unnecessary mortality and morbidity. Very importantly, adolescent pregnancy is preventable. I agree strongly with Dr. Norr that the nursing profession is ideally suited to take a leadership role in community-based adolescent pregnancy prevention. Dr. Norr has stressed the important role of nurses in family planning clinics, school health, and nursing education. I would like to stress the important role of nurses in two additional specialty settings. First, I believe nurse researchers can make tremendous contributions to better characterize the distribution, determinants, and effective prevention of adolescent pregnancy. Second, because of their appreciation of community needs and their knowledge of community resources, I believe nurses in public health departments may be in the very best position to take a leadership role in community-based prevention of pregnancy among adolescents. In closing, I commend Dr. Norr on her thoughtful review. The need to initiate and augment community action to prevent adolescent pregnancy is compelling.