Self-Efficacy of School Nurses in Providing Support for Pregnant and Parenting Teenagers
Although teenage pregnancy and birth rates have decreased during the last two decades, there are over 330,000 children born to teenage mothers every year in the United States. This is a significant public health problem, as teenage childbearing is associated with increased risk of dropping out of high school, lower lifetime earnings, and adverse health, developmental, and behavioral problems for their children. Additionally, almost 40% of teenage mothers experience a repeat pregnancy within two years of the birth of their child. Research indicates that school-based programs can be effective in reducing the dropout and subsequent pregnancy rates of teenage mothers. School nurses are in a position to provide school-based support, and are encouraged to do so by the National Association of School Nurses. The purpose of this study was to assess the current practices, self-efficacy, and perceived barriers of high school nurses in the United States in providing support to pregnant and parenting adolescent females. A survey was mailed to a national random sample of 800 high school nurses who belonged to the National Association of School Nurses. With a response rate of nearly 56%, respondents worked primarily in rural (34.1%) or suburban (41.5%) school settings. More than half of the nurses (55.2%) reported receiving education on pregnant and parenting teenagers, and almost two-thirds worked at a high school five days per week. More than half of the nurses reported assisting the majority of their pregnant and parenting students with referrals to community resources, facilitating safety accommodations, and facilitating academic collaborations, but not teaching positive parenting practices or assisting with obtaining or regularly assessing use of contraceptives. Efficacy expectations scores and outcome expectations scores were significantly higher among nurses who had received training on pregnant and parenting teenagers. Lack of time, lack of cooperation from primary care providers, lack of cooperation from students’ families, and school policy prohibiting contraception discussions were all cited as perceived barriers. Results from this study should be of benefit to school nurses, school administrators, nursing school faculty, and lastly, pregnant and parenting teenage girls. School nurses should self-evaluate their support of their pregnant and parenting students. Efforts should be made by health departments, colleges, and community organizations to educate school nurses on this topic, and school nurses should seek out this training. Additionally, school nurses and health educators should advocate for repeals of bans that prohibit the discussion of contraception in school settings.
Education, Nursing, Public Health, teenage pregnancy, adolescent childbearing, teenage mothers, adolescent mothers, school-based support
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