Adolescent pregnancy prevention strategies used by school nurses
Kobokovich, L.J.; Bonovich, L.K.
Journal of School Health 62(1): 11-14
1992
ISSN/ISBN: 0022-4391 PMID: 1548856 DOI: 10.1111/j.1746-1561.1992.tb01210.xDocument Number: 424335
Public school nurses were surveyed in May, 1989 in a Mid Atlantic state to ascertain the nature of school nurse activities in adolescent pregnancy prevention. The sample consisted of 246 returned questionnaires out of 446 verified as having received it from a mailing to 600. The instrument consisted of a questionnaire developed by White to identify clusters of school activities which was expanded to include the following pregnancy prevention strategies: a facilitation cluster such as referral for pregnancy testing or contraception, or counseling for sex related problems; an instruction cluster such as directing assertiveness training, or teaching a family life/human sexuality education course; and an administration cluster such as coordinating activities for sexuality education, or participating in media campaigns for teen pregnancy prevention. Activities were rated on how frequently these activities were performed. The nurse respondent profile was one of primarily female, middle aged married mothers. 77.1% served elementary schools (K-5th) and 44% in middle schools (6-8th). 35% had a high school population (9-12th). Nurses worked in multiple settings and 55% served 500-5000 students/nurse, and another 32.1% served 499 students/nurse. The results indicated that only 1 strategy, "communicating with teachers regarding a student's performance", was used frequently (weekly to 1-2 times as month), but nurses felt well prepared in handling this facilitative function. 25-45% reported using 7 other pregnancy prevention strategies weekly to monthly. These activities were referring for pregnancy counseling, referring for pregnancy testing, counseling students individually for sex related problems, communicating with teachers regarding a student's performance, referring for contraception, counseling for suspected pregnancy and referring students with behavior problems to community resources. Nurses felt moderately to extremely well prepared to handle these functions. 20% of respondents felt that 5 of the activities should be handled by someone else. The 14 remaining activities were rarely or never performed by nurses, and 20-35% felt these activities should be performed by someone else. In the separate analysis of nurses serving 6-12th grades, the same 7 prevention strategies were the most frequently performed. Nurses perceived all activities to be appropriate functions. School board policies or influence limited functions; time was another factor. The implications are that nurses may need to increase their use of primary prevention activities in 6-12th, and nurses in K-5th need to understand the importance of instruction in human sexuality and human relations for younger students. Nurses are not being used to their full capabilities, but political and economic issues also need resolution. Nurses must assume a more activist role.