Teenage pregnancies: how one east London project is involving teenagers in child care to discourage pregnancies

A project aiming to cut teenage pregnancy rates by involving young people in the care of children will this year spread beyond London. Gill Mein and Andrew McDowell here describe what Teens and Toddlers has achieved so far

The UK has the highest rate of teenage pregnancy in western Europe, but an evaluation of a programme originating in the US in the 1970s is showing signs of working over here.1,2 The Teens and Toddlers programme started in England in 2001 – as a project run by the UK charity Children Our Ultimate Investment – in the London Borough of Greenwich and has now spread to six London boroughs, and will be starting up outside London in 2007.

The Teens and Toddlers scheme targets teenagers from deprived areas who have problems in the education system. Teenagers deemed to be most at risk of becoming pregnant are selected by their schools and recommended to the programme.

The risk factors include poverty, experience of being in care, own mother being a teenage mother, educational and behavioural problems, experience of sexual abuse, mental health problems or experience of crime.

The programme focuses on three areas:

● Preventing pregnancy by helping the teenagers become aware of the hard work, expense and responsibility of having a child, especially when the parent is unsupported. The curriculum includes material and discussion about the realities of having sexual relationships, risks of sexually transmitted infections and contraception, as well as the affects of drugs, alcohol, and violence on unborn and newborn babies.

● The programme involves regular, directly supervised contact with toddlers in a nursery setting during 20 afternoons over 10 or 20 weeks. Each afternoon combines nursery time with classroom time where theoretical learning is combined with experience.

The scheme helps the young people to understand the behaviour and needs of young children. It encourages them to appreciate that children need a secure, safe and caring environment. The curriculum covers the physical and psychological development of children and the difficulties parents encounter when bringing up children.

● The programme focuses on strengthening the emotional literacy of the teenagers by encour aging and developing skills in self-reflection, empathy, and communication. It also encourages them to realise they have a choice in life, can set goals for themselves, have an enjoyable and satisfying job, and that parenthood might be better delayed until they are older.

It is common for the teenagers who attend the course to have very low self-esteem. They can be seen by outsiders as troublemakers and frequently they do not feel wanted or a part of their (often dysfunctional) family.

A recent evaluation of Teens and Toddlers approached 256 teenagers who had undertaken the programme between 2001 and 2005, to assess pregnancy rates in those under 18. In addition to seeking information about the pregnancy status of participants, part of the evaluation asked teenagers to make open-ended responses about the programme (see Teenage Relections).

Currently Teens and Toddlers uses facilitators from the central London office. A counsellor who specialises in working with  young people is also involved. However, to encourage long-term sustainability, facilitators from the local community are being trained. There is also close monitoring of standards through quality assurance and supervision visits from the main office.

Successful completion of the programme now gives teenagers a national award in interpersonal skills (level one) and this has made the course extremely popular with teenagers and schools. There have been important benefits for teenagers on the programme. These include:

● A lower teenage pregnancy rate, resulting in significantly reduced financial burden on social services, benefits, NHS and housing costs.
● Teenagers stay in the education system longer.
● Increased emotional literacy has benefited mental health. The skills of self-reflection, selfmanagement, relationship to others and relationship to society have been nurtured.
● Development of future parenting skills, breaking generational patterns of disadvantage.
● Crime prevention development work through anger management: work with self-valuing and self-assertion, awareness of choice, personal responsibility and future life goals.
● Citizenship skills through multicultural participation and the scheme’s promotion of an appreciation of difference and improved social behaviour.

Teens and Toddlers programmes are showing excellent success rates. Government departments have recommended more widespread uptake of the programmes.(3),(4) Teenagers certainly leave the programme feeling valued and cared for – something parents and schools often fail to achieve in underprivileged and under-resourced areas.

TEENAGE REFLECTIONS

As part of the evaluation one question asked, “What was the most important thing you learned from Teens and Toddlers?”

“I learned that children are precious. But the most important thing I learned is that it is not easy having children; you have to focus 100 per cent on them and you have to be strong, confident and have courage in yourself. T&T taught me a lot.”
Female, 17 years

“The learning about sexually transmitted diseases and how to be safe from them and pregnancy by using protection. It made me think about what I want in life.”
Male, 16 years

“It shows you to be sensible in life and respect yourself. I would love to do this programme again because T&T has shown me I want to work with children but not have them.”
Female, 17 years

“Care of children takes a lot and how important it is to do it properly. Responsibility to become a parent is big and I don’t want it yet.”
Female, 19 years

The results showed that Teens and Toddlers had positively influenced practice of safe sex for more than 75 per cent of respondents. Eighty-five per cent reported it had influenced them to increase the age at which they would have children, and more than 73 per cent reported they considered the ideal age to become a parent was over 22 years.

GILL MEIN is a senior research fellow in the Faculty of Health and Social Care Sciences. She specialises in qualitative research. She is a facilitator with Teens and Toddlers and has a background in health visiting and community work and previously worked overseas in emergency and development programmes.

ANDREW McDOWELL is director of social  research at The Dream Mill Research and Consultancy.

TRAINING AND LEARNING
The author has provided questions about this article to guide discussion in teams. These can be viewed at
www.communitycare.co.uk/prtl and individuals’ learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

ABSTRACT
Teens and Toddlers programmes target teenagers from underprivileged areas who have problems in the educational system. Evaluation shows the approach is highly cost effective in reducing teenage pregnancy and that 97.5 per cent of teenagers who have “graduated” from the programme were found not to be pregnant under the age of 18 years.

REFERENCES
(1) www.teensandtoddlers.org
(2) A J McDowell, Pregnancy Rates, Attitudes and Behaviour Changes among Graduates of Teens and Toddlers Programmes, The Dream Mill, 2006
(3) Cabinet Office, Reaching Out: an Action Plan on Social Exclusion, 2006
(4) DfES, Teenage Pregnancy: Accelerating the Strategy to 2010, HMSO, 2006

FURTHER INFORMATION
The evaluation approached 256 teenagers who had undertaken the scheme between 2001-5. A good response rate of 71 per cent was achieved. The age range was 13.3 to 16.5 years when undertaking the project.

This article appeared in the 4 January issue of the magazine under the headline “Parent prevention”