Teen births: Solutions embrace cultural nuances

Multi-million dollar initiatives to help at-risk and parenting teens across Connecticut call for "evidence-based" and "culturally appropriate" approaches – the mantra of experts assisting Hispanic youth, who have the highest number of teen births in the state.   

"There’s been a shift in federal funding toward using culturally tailored programs that have been scientifically tested to be effective in changing behaviors," explained Carol Stone, Ph.D., an epidemiologist with the Family Health Section of the state Department of Public Health.

People unfamiliar with the Hispanic culture can at times misinterpret strong family ties with promoting teenage pregnancy, experts said. "They see families having baby showers and celebrations. But it’s really about supporting the teen mom and the baby because that’s what families do," said Grace Damio, director of Research and Service Initiatives at the Hispanic Health Council, which provides cross-culture training to workers across the state.

Even Hispanics from different Spanish-speaking countries can benefit from cross-cultural training, said Regina Roundtree, executive director of Hartford Action Plan. "Just because someone is considered Hispanic or Latino doesn’t mean they approach things the same way," she said. "It’s important that we understand, not judge, cultural differences."

Family Bonds Bring Challenges

RoseAnne Bilodeau, executive director of Pathways/Senderos Center in New Britain, gets a flurry of kisses from students as they arrive at the after-school program. The greetings are simple, yet subtle gestures, of the cultural nuances that set Hispanic youth apart.

"Latinos have a great love for family and children," said Bilodeau. "There is a great deal of concern about keeping the family together." Modeled after the Carrera Academy in Harlem, Pathways serves as a "parallel family" for 60 at-risk youth grades five to high school. "Most of our kids come from families started by teen parents. We help these parents raise their children."

The interdependent nature of Hispanic families can pose challenges, especially if parents didn’t finish school or expect their children to help support the family. "Some view college as a threat that will take their children away," said Bilodeau. "We try to explain that education is not going to destroy the love and commitment that Latino parents and their children have together. The whole family benefits when a child finishes high school and goes on to college or other training."

Talking About Taboo Subjects

Language, culture and religious barriers can arise when Spanish-dominant parents try to communicate with English-dominant children. "It’s difficult to have conversations with conservative parents without it becoming a moral issue when it’s really about education and information," said Roundtree.

Matthew Gross, director of the Teen Outreach Program with the Coordinating Council for Children in Crisis in New Haven, works with eighth-graders at the Barnard Environmental Studies School in New Haven, Harry M. Bailey Middle School in West Haven and Park City Magnet School in Bridgeport. "There’s lots of focus on education and awareness so students are fully aware of the facts and the myths about how to prevent pregnancy," he said. "We have very up front conversations that are not taking place in homes, schools and in the community because these are considered taboo subjects or people don’t know how to talk about it."

Debunking Myths About Child Care

"Debunking the myths around child care has been a major focus of the Support Pregnant and Parenting Teens Program," said Shelby Pons, program manager for the state Department of Education. "Some cultures believe only family should take care of the baby. They see child care as giving someone else the responsibility of raising their baby. We focus on educating young moms about the value of childcare centers that provide a positive environment geared to growing their babies’ brain. That’s a powerful message for young moms to hear."

The $1.9 million federal initiative targets the five Connecticut cities with the highest teen pregnancy and high school drop out rates – Bridgeport, Hartford, New Britain, New Haven and Waterbury. The program aims to help teens stay in school, avoid a second pregnancy, and increase access to healthcare, childcare and social services. The school-based model includes a social worker, nurse and home visitation caseworker to assist 250 girls and 160 boys each year.

"It’s a dream team," said Pons, referring to the network of experts who collaborate to provide comprehensive services. "It’s a strength-based, cost-effective approach that gives teen parents a little support now so they can be self-sufficient for the rest of their lives."

As part of the grant, the Hispanic Health Council will provide cross-cultural training to staff working with Hispanic teens. "Teens face a lot of discrimination when they become pregnant," said Pons. "There isn’t a natural advocate in the high school environment."

Straight Talk to Navigate Gender Roles

"Breaking the Cycle" – a $4.5 million federally funded effort targeting Hispanic and African American teens in Hartford – calls for cross-cultural training and curriculum-based programs that address sensitive issues such as gender roles and contraception. The program will serve 3,200 youth ages 13 through 19 at schools, community-based agencies and other venues with the goal of reducing Hartford’s teen pregnancy rate by 10 percent in five years.

"This is a community effort that goes beyond providing direct services to teens," said Roundtree of the Hartford Action Plan, which is working with educators, healthcare providers, religious leaders, community-based agencies and residents to develop teen pregnancy prevention strategies. A community open forum is scheduled for Feb. 15 at Trinity College followed by town meetings in the Barry Square, Frog Hollow and Northeast neighborhoods in the spring.

The grant will help schools and community agencies to implement evidence-based, culturally appropriate programs. Among those under consideration is !Cuídate! – Spanish for "take care of yourself." This program reframes aspects of Hispanic culture – such as gender-role expectations, including machismo – to show abstinence and condom use as culturally acceptable.

Dr. Raul Pino, acting director of the Hartford Department of Health and Human Services, hopes these approaches will help youth to better navigate relationships. "Teen pregnancy is complicated because it takes two to tango," he said. "The ability of females to negotiate protection is a huge impediment. We need to empower women to recognize that they have a right to protect their body without being afraid of offending men when they ask them to abstain or wear a condom."

Helping Young Fathers Parent

Reaching young fathers can be difficult, especially when many Hispanics have seen their grandmothers, mothers, sisters, aunts and girlfriends raise families on their own, said Maria Damiani, director of Maternal Child and Family Health and Wellness for New Haven. "Many young fathers who have personal experience with such a strong matriarchy feel they are indispensible," she said. "It’s easier to walk away from your girlfriend and baby when you feel you aren’t important."

Despite the difficult task ahead, Pamela Giannini, director of the Bureau of Aging, Community and Social Work Services for the state Department of Social Services, remains optimistic.

"As the Latino community becomes the nation’s majority," she said, "we’ll see more and more successful Latinos who will be able to serve as models for teens and support young people who want to break out of traditional roles."