OBJECTIVE: To explore the beliefs, attitudes, and needs young men have regarding their role as a father. DESIGN AND SAMPLE: Exploratory, descriptive, qualitative design. Young fathers/young expectant fathers were recruited from service sites within a city in Massachusetts. Men were considered young fathers/young expectant fathers if they were or would be <20 years old at the birth of a first child or the mother of their baby was or would be><20 years old at the>baby's birth and the young man was <25 years old. MEASURES: Participants were interviewed utilizing open-ended>questions, which included the following: the characteristics of good fathers, goals/needs for self and child, and whether or not they planned to raise the child as their father raised them and why. RESULTS: Responses regarding fathering clustered into the following themes: being available; providing support; and self-improvement, including completing education and becoming a positive role model. Forty-seven percent believed that being employed or finishing school would help them be better fathers; 77% reported they would not raise their child as their own father had raised them, citing physical and/or emotional abuse/abandonment. CONCLUSIONS: Young men in this study identified several challenges to being "good" fathers. These included lack of employment, education, and positive role models.

The obesity rates of Job Corps students, a predominantly ethnic minority and low income group of youth, are unknown. The purpose of this project was to examine obesity rates among these youth as well as their weight-related perceptions and behavior. First, medical charts (N=641) of all Job Corps students (ages 16-25) who were enrolled in the program in the past year were examined for height and weight. In the second phase of the study, 344 Job Corp students were recruited and information on weight perceptions, knowledge of obesity consequences, and weight loss behavior were examined. Almost half of the participants were overweight or obese. Overweight males were less likely to perceive themselves as being overweight than females. The majority of participants were aware of obesity-related health consequences but of those with past weight loss attempts, only 13% reported using both exercise and diet. High levels of overweight and obesity among Job Corps students are likely to impact employment and career goals. Evidence-based obesity interventions for Job Corps students are needed.

Summary: Overview of teenage pregnancy in the U.S., including characteristics of teen parents, clinical evaluation, patient management, pregnancy outcomes, and prevention.

OBJECTIVES: To evaluate: change in Body Mass Index (BMI) of adolescent mothers (14-19 years of age) from pre-pregnancy to 36 months postpartum; BMI of their children age 2 or older; relationship between maternal BMI and children's BMI. METHODS: Retrospective medical record abstraction of adolescent mothers attending a medical program in Massachusetts between 2001 and 2005 who had self-reported pre-pregnancy BMI data at first prenatal visit, at least one BMI measure 12 or more months postpartum, and who did not experience a repeat pregnancy (n = 52). Children of adolescent mothers were included if they had received their 2 (n = 41) and/or 3 (n = 28) year physical. RESULTS: Adolescent mothers: overweight increased from 25% pre-pregnancy to 33% at 24-36 months postpartum; obesity more than doubled in the same time period, from 15% to 36%. Those with BMI data available pre-pregnancy and postpartum had an increase in mean BMI from 25 pre-pregnancy to 29 at 24-36 months postpartum (P < 0.001). Two-year-old children: About 5% were at risk for overweight and 12% were overweight. Three-year-old children: About 18% were at risk for overweight and 18% were overweight. When BMI categories of children were compared to BMI categories of their mothers, there was a trend for adolescent mothers with overweight/obesity at 24-36 months postpartum to have 3-year-old children at risk for overweight or overweight (P = 0.092). CONCLUSIONS: There was a significant increase in overweight/obesity in this cohort of adolescent mothers and their children followed 36 months postpartum. The long-term sequelae of overweight/obesity indicates a need for effective interventions.

STUDY OBJECTIVE: To understand attitudes and beliefs influencing use and nonuse of contraceptive methods pre- and postpartum among a group of adolescent mothers. DESIGN AND SETTING: Qualitative descriptive study utilizing focus groups conducted between May, 2005 and January, 2006 in Central Massachusetts. PARTICIPANTS: Adolescent mothers attending a federally funded multi-professional medical program. Inclusion criteria included being at least one year postpartum. Forty-six mothers were eligible; 34 were successfully contacted via telephone. Twenty-two agreed to attend; 15 adolescent mothers attended one of four groups. MAIN OUTCOME MEASURE: Emergent themes were identified concerning adolescent mothers' attitudes and beliefs regarding contraception pre and postpartum. RESULTS: Themes pertaining to nonuse of contraception prior to first pregnancy were: denial, not planning to have sex, not considering the consequences of unprotected sex, and wanting to become pregnant. Participants identified barriers to obtaining and utilizing contraception, including embarrassment discussing the topic, confidentiality, inability to obtain contraception without parental knowledge, and lack of knowledge regarding methods. Participants reported that convenience, perceived effectiveness, familiarity, and side effects were the primary reasons for selecting or changing a method of contraception postpartum and recommended several methods of promoting contraceptive use among adolescents. These included persuading health care providers to discuss the issue routinely with every adolescent patient, parental involvement, outreach by young mothers to at-risk teens, and media campaigns. CONCLUSIONS: Given the adverse consequences of adolescent pregnancy, understanding the attitudes and beliefs of postpartum adolescents regarding contraceptives is important for developing effective interventions. Focus groups conducted with adolescent mothers, a difficult population to engage, provide a venue for exploring this complex issue.

Teen birth rates have decreased steadily over the past decade, but the United States still has the highest birth rates among all developed countries. Young women who give birth as adolescents are likely to have poor school performance, and come from families with low socioeconomic status, a history of teen pregnancies, and low maternal education. The fathers of babies who are born to teen mothers are likely to be unsuccessful in school, have limited earnings, have high rates of substance use, and have trouble with the law. Infants who are born to teen mothers are at risk for low birth weight and physical neglect and abuse; at school age, these children are more likely than children born to adult women to have trouble with school achievement, and they are at risk for becoming teen mothers or fathers themselves. Programs that are successful in reducing teen birthrates are usually multifactorial and combine comprehensive sexuality education with youth development activities; reduction in repeat pregnancies is associated with home visits by nurses combined with long-acting contraceptive use.

Many adolescents with cancer are denied the benefits of protocol inclusion and optimal supportive care. More than 70% of older adolescent patients are not treated at institutions representing pediatric cooperative groups and are not enrolled in clinical trials, despite a demonstrated survival advantage for patients registered in protocols. Failure to refer adolescent cancer patients to specialized pediatric oncology treatment centers also has an impact on their quality of care. The challenge before both the medical and pediatric health care communities is to assure adolescent patients the benefits of inclusion in clinical trials and treatment in age-appropriate settings.