Text Messaging and Teen Pregnancy Prevention: A Win-Win Intervention

Text Messaging and Teen Pregnancy Prevention: A Win-Win Intervention

By Tiffany M. Montgomery, MSN, RNC-OB, C-EFM, TeenNow California Member

Teen pregnancy is a health disparity that affects an exceptionally vulnerable population. Teen girls with ethnic minority backgrounds are doubly vulnerable. Because of their gender, age, and minority status, these teens are vulnerable on many different fronts. There have been many successful teen pregnancy prevention programs implemented and to their success, the teen pregnancy rates are continuing to decline. Still, healthcare professionals, parents, teachers, and other adults who often interact with teens have a lot of work to do in the area of teen pregnancy prevention. Although our rates of teen pregnancy are the lowest in United States history, we continue to have the second highest teen pregnancy rates in the industrialized world (Centers for Disease Control and Prevention [CDC], 2011a).

The CDC (2011b) has initiated a campaign to utilize social media as a forum for communication about teen pregnancy and increased public engagement. There are recommendations for the use of Really Simple Syndication (RSS) feeds, podcasts, online video sharing, and mobile technologies (i.e. text messaging and mobile applications [apps]) as teen pregnancy prevention interventions, in addition the use of social media websites such as Facebook and Twitter. The CDC’s support of technology in teen pregnancy prevention interventions makes complete sense once we realize just how popular technology has become among teens.

According to a 2010 report on adolescent cell phone use, 88% of teens with cell phones use their phones for text messaging (Lenhart). The rates of text messaging increase with age and are higher among teen girls than among teen boys; the mean number of text messages sent and received by teen girls is 125 texts per day while teen boys text on average 101 times daily (Lenhart, 2010). African-American teens have the highest rates of text messaging in the U.S., followed by Hispanic teens and non-Hispanic White teens (Lenhart, 2010). As it relates to teen pregnancy, Hispanic teens have the highest rates, followed by African-American teens and non-Hispanic White teens (Pazol et al., 2011). The high rates of teen pregnancy among Hispanic, African-American, and non-Hispanic White teens in conjunction with their high rates of text messaging present the perfect rationale for the use of text messaging as an intervention to decrease teen pregnancy.

In the state of North Carolina, the BrdsNBz text messaging program was established in 2009 to provide adolescents ages 14- to 19-years-old with medically sound information pertaining to their sexual health (Phillips, 2010). The aim of the program is to increase teens’ knowledge, awareness, and quality of life through the reduction of unintended pregnancies and STDs (Phillips, 2010). Teens initiate the first text message and a representative from the Adolescent Pregnancy Prevention Campaign of Northern Carolina responds within 24 hours. The program is advertised on various teen health websites and through purchased advertisements on MySpace and non-profit organizations. The program, one of the only of its kind at its inception, has received national attention from those who would like to replicate the program in their own states or regions (Phillips, 2010). Findings from formative program studies showed that teens were more likely to follow-up on information received through the BrdsNBz program than information received from school, home, or the community (Phillips, 2010).

Since the creation of the BrdsNBz text messaging program, many other text messaging programs have been implemented to combat high-risk teen sexual behaviors in general and more specifically to target teen pregnancy:

  • Alexandria Campaign on Adolescent Pregnancy—text “SEX” to 30644 to receive a response to your questions on sex, relationships, and teen pregnancy within 24 hours.
  • BrdsNBz—text a question regarding sex and relationships to 36263. Be sure to type “NC” before your question.
  • Hookup—text “HOOKUP” to 61827 to receive weekly automated text messages containing information on sex and life and to find a sexual health clinic in your zip code.
  • SexInfo—text “SEXINFO” to 36617 to receive a list of codes to text back based on the topic of concern.
  • The SexEd Loop—text “SEXEDLOOP” to 61827 to receive weekly text messages on sexual education.

Text messaging services can be accessed anywhere at any time and they are virtually cost-free (normal text messaging rates will apply). These programs, located throughout the U.S. are available for the use of teens in any region of the country and not only those who live in the state in which the program headquarters are located. When teens feel they can’t come to the adults in their lives, we can point them in the direction of services that can help them with their questions and not simply leave them to figure everything out on their own. We can encourage teens to utilize the programs above and other reputable text messages services so that they receive accurate information on teen pregnancy and pregnancy prevention. Through the use of text messages programs that address sexual health, we can be confident that the teens in our lives are receiving the appropriate information, even when that information does not come directly from us.


Adolescent Pregnancy Prevention Campiagn on North Carolina. (2012). BrdsNBz text message warm line. Retrieved from http://appcnc.org/brdsnbz-text-message-warm-line

Alexandria Campaign on Adolescent Pregnancy. (2012). About ACAP: Text message line. Retrieved from http://keepit360.org/About/

Centers for Disease Control and Prevention. (2011a). Health disparities and inequalities report. Retrieved from http://www.cdc.gov/minorityhealth/CHDIReport.html

Centers for Disease Control and Prevention. (2011b). Teen pregnancy and socail media. Retrieved from http://www.cdc.gov/TeenPregnancy/SocialMedia/index.htm

Internet Sexuality Inormation Services. (2012). ISIS projects. Retrieved from http://www.isis-inc.org/contactus.php

Lenhart, A. (2010). Teens and cell phones. Pew Internet and American Life Project. Retrieved from http://pewinternet.org/~/media//Files/Reports/2010/PIP-Teens-and-Mobile-2010-with-topline.pdf

Pazol, K., Warner, L., Gavin, L., Callaaghan, W. M., Spitz, A. M., Anderson, . . . Kann, L. (2011). Vital signs: Teen pregnancy — United States, 1991–2009 (Vol. 60, pp. 414-420).

Phillips, K. R. (2010). BrdsNBz: a text-messaging forum for improving the sexual health of          adolescents in North Carolina. North Carolina Medical Journal, 71(4), 368-371.

The SexEd Loop. The talk: By teens, for teens. Retrieved from http://sexedloop.sexetc.org/

Drawing Attention to the Urgency of Teen Dating Violence Prevention

Drawing Attention to the Urgency of Teen Dating Violence Prevention

by Lisa Fujie Parks, California Partnership to End Domestic Violence

Five days before Cindi Santana was stabbed to death at South East High School in South Gate, California in December 2011, her ex-boyfriend, Abraham Lopez, was arrested for making a criminal threat against her. Santana’s mother notified South East High School when Lopez was released on bail, and campus security was informed of the potential threat. Yet three days later, Cindi was stabbed multiple times during lunch, allegedly by Lopez. Cindi’s death was a tragic wakeup call to all families, schools and communities in California to strengthen school and community responses to teen dating violence, also known as dating abuse.


February is Teen Dating Violence Awareness Month (TDVAPM) – a national effort to raise awareness about abuse in youth relationships and mobilize communities to support young people in having safe and healthy relationships. Sadly, just as the month began, Myrna Umanzor, 15, a teen mom from San Leandro, California was murdered, allegedly by her 19 year old boyfriend, who took his own life the next day.


We mourn the tragic loss of life in South Gate, San Leandro, and other communities throughout the country, as we join with thousands working to engage youth and reach new audiences through Proclamations, educational events, media outreach, and other efforts. Although we cannot accomplish all of our strategic goals in one short month, these focused efforts will help elevate community understanding of the issues and solutions.


What is dating abuse?

Dating abuse is the use of physical, sexual, verbal, emotional, or technological abuse by a person to harm, threaten, intimidate, or control a dating partner, regardless of whether that relationship is continuing or has concluded, or the number of interactions between the individuals involved. One in four adolescents reports verbal, emotional, physical or sexual dating violence each year. 15-40% of youth report perpetrating violence toward a dating partner. Adolescents and young adults experience the highest degree of intimate violence of any age group, and young women ages 16-24 are most likely to be victimized. Among these women, pregnant and parenting teen mothers are especially vulnerable.


Dating abuse is associated with a host of adverse outcomes, including truancy, use of alcohol and drugs, eating disorders, depression and suicide. A substantial number of incidents occur on school campuses, threatening the safety of students and staff, distracting students from learning, and compromising the school climate. Yet, the distinctive aspects of dating abuse make it one of the most overlooked forms of violence. Many young victims do not recognize warning signs and confuse controlling behaviors as a sign of care. Fear and shame discourage victims from seeking help, and when they do, adults often minimize the potential for harm, unaware of the danger of increasing frequency and severity of abuse over time, and the heightened risk for physical violence during or after a break up.


Offering age-appropriate support

Young people who are being abused or being abusive, may not identify their experience as “abuse.” Conversations can be focused on the right to have boundaries respected and to be free from control. And conversely, it’s important to model and teach how emotions and conflict can be addressed while respecting boundaries and the right to a partner’s autonomy. When speaking with teens, it’s important to assure confidentiality, be non-judgmental and empathetic, apply harm reduction principles, and have current information for referral agencies and community resources on hand. And remember, during and after a break-up is the most dangerous time when the likelihood of physical violence increases.


What you can do during TDVAPM

Please use this month as an opportunity to build your knowledge, strengthen partnerships and help draw attention to dating abuse:


  • Spread the word! Sample Facebook posts and Twitter tweets can be found at www.cpedv.org/tdvapm.
  • Build your knowledge! Online professional learning opportunities during the month of February can be found here. Additional resources can be found on the Healthy Teen Network website.
  • Link to Black History Month! African American youth are overrepresented as victims of dating abuse. Honor Black History Month and TDVAPM and support our back youth in February and beyond!
  • Educate and engage teens and parents! Useful websites with resources and curriculum can be found at www.cpedv.org/tdvapm.
  • Strengthen partnerships! Year round, we encourage teen pregnancy prevention programs to partner with local domestic violence programs and adolescent health and mental health providers, youth, parents, educators and other stakeholders.
  • Stay Connected! Sign up for the Partnership’s Prevention Digest to stay abreast of teen dating violence prevention projects, resources and opportunities in California.


The California Partnership to End Domestic Violence’s Prevention Program advances effective teen dating violence prevention policies and programs through leadership, advocacy and a statewide network of prevention advocates dedicated to promoting healthy relationships and preventing teen dating violence. For more information about the Partnership’s efforts to address dating abuse, please contact Lisa Fujie Parks at lisa@cpedv.org or 916-444-7163 x117.


Finally, if you know of a teen or parent that could benefit from speaking to a caring, well-trained peer advocate, please connect them with the National Dating Abuse Helpline, a  project of the National Domestic Violence Hotline, at 866-331-9474 (TTY: 1-866-331-8453), by texting “loveis” to 77054, or through live chat at loveisrespect.org.  

“Let’s Talk About Sex!”–Film Review

Let’s Talk About Sex

Film reviewed by Lena Schmidt

Sex is part of our culture, especially youth culture. Sexual imagery is inescapable:  billboards, magazine covers, movies, and Internet ads inundate us with it. But we’re still not supposed to talk about it. The new documentary, “Let’s Talk About Sex” by James Houston addresses this conundrum with the central question, “if sex is everywhere, but it is taboo to talk about, what effect is it having on young people?” Houston uses interesting interviews, engaging graphics, and alarming data to show that teens are paying a terrible price for this confusion, fear, and silence around sex and sexuality in US culture: increasing rates of unintended pregnancy, STDs, and HIV. And American taxpayers are paying billions of dollars to treat these preventable problems.

According to the film, 70% of Americans have had sex by the time they’re 19.  95% of Americans have sex before they’re married. The US government has spent $1.5 billion on abstinence-only education and yet the US has the highest teen birth rate in the industrialized world. 85% of parents in America want comprehensive sex education for their children; it is a small but vocal minority that is deeply opposed. Houston talks to teens, parents, teachers, doctors, faith leaders, linguists, researchers, and college students who agree that withholding information from young people does not protect them. As the film states, in the US, “teens are thought of as accidents waiting to happen—driven by raging hormones—[and] in some ways it becomes a self-fulfilling prophesy.” One concerned parent says, “We teach our kids math, reading, science, but we don’t teach them about their body and how to be responsible…sex is as much a part of life as algebra or English.” Houston advocates starting conversations to change outdated attitudes about sex.

These conversations may need to take place in surprising venues. African-American contributors in the documentary explain that in the same way that the church was involved with abolishing slavery, the end of segregation, and the civil rights movement, it needs to continue to address the needs of the time, which means talking about sex in church. African-American communities often demonstrate high rates of teen pregnancy, and although African Americans make up only 15% of the US, they make up 50% of all new HIV infections. The film makes it difficult to argue with the fact that talking about sex will save lives.

The film brilliantly compares European and American attitudes about sexuality and sex education. In Holland/the Netherlands sex is discussed as a natural part of a relationship and as a way to express love. One mom in Holland says, “Kids have sex. If they don’t have sex in the bedroom they’ll probably have sex in the street or in the park.” This mom even offers her own condoms to her son to use. This and other examples (and the statistics presented about teen pregnancy rates) demonstrate that abstinence-only education is insufficient in protecting our teens. Some highlights of the film include: a classroom of expectant teens being taught abstinence-only education despite the clear evidence that it wasn’t relevant to their lives, a teacher putting a condom over her hand all the way to her elbow to rebut the myth that size matters, and the disparate attitudes teens have in the US and the Netherlands about young women and men who carry condoms in their wallets.

This film is recommended and appropriate for parents, teens, and educators. It is a great conversation starter—watch it today and start talking. Let’s talk about sex! To learn more about the film and resources, check out the film’s website: http://www.letstalkaboutsexthefilm.com/ The film was made in collaboration with http://www.advocatesforyouth.org/  To talk about sex and sex education in California, become a member of TeenNow California: http://teennowcalifornia.org/Join.php

New Report Shows that Juvenile Incarceration is Ineffective

A new report from the Annie E. Casey Foundation confirms what we in the adolescent health field already know: Locking kids up does more harm than good. According to the report, not only does juvenile incarceration not stem crime, it also puts many youth in dangerous situations where they can be abused by staff and other youth, and live in fear of physical assault.

States spend an average of $88,000 a year for EACH YOUTH who is incarcerated, yet 75% of youth who leave juvenile detention are re-arrested within three years. The report also found that states with lower levels of juvenile confinement from 1997 to 2007 saw a greater decline in juvenile arrests for violent crime than states with higher incarceration rates—showing that perhaps incarcerating youths is training them to be more criminal. In addition, incarceration exposes youth to further violence and abuse. According to reports released in 2010, one in eight confined youth have reported being sexually abused by staff or other youth, while 42 percent have feared physical attack.

The report contains several recommendations to juvenile justice officials, including policies that lock up only the most dangerous youth while finding non-residential solutions for most teen offenders, and adopting best practices for work with juveniles.

Most Americans Support No-Cost Birth Control, Poll Says

A new poll by the Kaiser Family Foundation shows, among other things, that 66% of Americans support the Department of Health and Human Services’ decision to require health insurers to cover the full cost of birth control. Only 24% disapprove of the law. This shows once again that most Americans take a very rational approach to reproductive health issues. As we saw in past polls, most parents want their children to receive comprehensive sex education in the schools, despite vehement opposition by a very vocal minority. (http://www.alternet.org/sex/101535/new_poll%3A_parents_overwhelmingly_support_age-appropriate_sex_ed/, http://www.npr.org/programs/morning/features/2004/jan/kaiserpoll/publicfinal.pdf ) It seems now that the same is true for supporting access to contraceptives—most Americans understand that preventing unintended pregnancies and improving women’s health is critical to strengthening families and communities. This poll should be an important factor in the ongoing debate about health care reform and the budget, as the House has tried repeatedly to eliminate funding for family planning and sex education. The real question is, will it make a difference? Do politicians really care about what their constituents think, or do they simply push their own agenda? Tell us what you think!

European Sex Attitudes Versus American Sex Attitudes

We all know European countries have a different take on sex education, and that many European countries also have some of the lowest teen pregnancy rates. The US, on the other hand, has the highest teen pregnancy rate in the industrialized world. According to the California Department of Heath, the California teen birth rate in 2008 was 35.2 for every 1,000 females; for Hispanic teens it was 56.9; and for African American teens it was 39.9. Although the teen birth rate in California has been declining, compare with 37.1 per 1,000 females in 2007, teen pregnancy still remains a public health challenge, especially for teens from ethnic minority groups who still have extremely high teen birth rates. The amount of sexually transmitted infections among American teens is also phenomenal, with nine million new cases of STIs among 15 to 24-year-old youth and more than five thousand new HIV infections among 13-to 24-year-old youth.

Contrast these high rates of teen pregnancy and sexually transmitted infections with that of Germany, France, and the Netherlands. The United States’ teen pregnancy rate is over eight times that of the Netherlands, over four times that of Germany, and over three and a half times that of France. The percentage of the United States’ adolescent and adult population that has been diagnosed with HIV or AIDS is six times greater than in Germany, three times greater than in the Netherlands, and one and a half times greater than in France. Meanwhile, young people in the United States are significantly less likely to use contraception than youth in these European nations.

Why do some European countries have such a lower teen pregnancy rate than the United States? Well, of course this isn’t an easy answer, but the 3Rs program by Advocates for Youth is an intelligent look at the differences between our sex education and sexuality practices, and that of other European countries, and also offers solutions on how American sex education could become more like the European model. To get an understanding though of how differently our two cultures treat sexuality, especially among teens, all one needs to do is take a look at our different advertisements for condoms.

For My Health German AdMen In Fire US Ad

The first ad is a German ad which says “For My Health,” the second, a US advertisement for condoms with a wrapper that states “Don’t be Stupid.” These advertisements show a clear juxtaposition between Germany’s stance towards condom use, that it’s healthy and comparable to eating an apple a day, and the US’s, which uses fear tactics to reach US teens.

Don't Get Screwed American AdGift of Love Ad



Here is another German ad which states, “Give the gift of love,” contrasted with a US ad which says, “If you’re going to have sex, don’t get screwed.” The US ad does not say anything about love, respect, or pleasure; instead, it again relies on fear to get its message across.

Trojan Ad

Not all US ads take such a fear-based stance, here is a Trojan ad where all the men without condoms are portrayed as pigs, and the one man with the condom “evolves” into a hunk of a man who gets the girl. Originally though, this ad, in commercial form, was banned from some television channel.

The differences between Europeans’ attitudes towards sex and Americans can be clearly seen in these advertisements. But the hard part is, how do we instill a more progressive view of sex and sexuality into American youth, when we have a history of consistently negative views toward sex and fear-based approaches towards contraceptive use?

Pictures provided from: http://www.slate.com/id/2272631/


Parent-Child Communication

A new study put out by North Carolina State University shows that most parents don’t think their teens are having sex–although they think that their kids’ friends are. The study, conducted by researcher Sinikka Elliott, an assistant professor of sociology at North Carolina State University, found that most parents interviewed say their children as immature or naive. The parents felt that if their children did engage in sex, it would be because someone had taken advantage of them or pressured them into it.

While I’m sure that all parents can identify with the urge to close their eyes and pretend their children aren’t growing up, this particular fantasy has devastating side effects. Parent who can’t come to terms with the fact that their adolescent children are most likely thinking about sex, talking about sex and possibly engaging in sex tend to neglect the responsibility to talk to their kids about the consequences of sex, and how to protect themselves from unintended pregnancy and sexually transmitted infection. Parents should—and can—be an integral part of their children’s sex education, by being open to questions, bringing up issues related to sex and relationships, and even taking on the job of teaching their kids about reproduction, abstinence and contraception.

There are a lot of great resources for parents who want to learn how to talk to their children about sex. The National Campaign to Prevent Teen and Unintended Pregnancy offers many booklets, as does Advocates for Youth. We recommend that parents check out these resources, or that professionals who work with teens and parents look at ways to foster the involvement of parents in the sex education of their children. The link below is a good starting point.