Where Did The Boys Go? A Critique of Teen Pregnancy Prevention Approaches – Cynthia Schoettler

Introduction
Teen pregnancy has always been a looming and difficult issue for American Society. While the average teen birth rate has declined dramatically since the highs recorded in the 1980s, it has shown an increase in recent years (1). In fact, in 2006, over 400,000 babies were born to a teenage mother (2). This accounts for over 9% of all births in the US (3).

Teenage motherhood is not without risks both medically and socially. Medically, the outcomes are worse than babies born to women in their 20s (4) and added cost of supporting teenage parents to society, in dollars, is upwards of $16,000 per year, per child (5). Young mothers are also at higher risk of dropping out of high school and achieve lower educational attainment (6) thus limiting their own potential for growth. Additionally, the female children of teenage parents are at least twice as likely to become teen parents themselves (7), thus repeating the cycle of additional risks, costs and poor outcomes.

But, these statistics and the majority of academic literature available regarding teenage pregnancy are all in regards to young women. For example, a cursory search on PubMed, one of the major search engines for scientific and medical literature, for “teenage pregnancy, (female or girl)” yields roughly 2.6 times the number of results that “teenage pregnancy, (male or boy)” does (http://www.ncbi.nlm.nih.gov/pubmed). While this may be a reflection of the fact that in society, the onus of child rearing usually falls upon the woman, especially in cases unintended pregnancies, it neglects the biological fact that creating a traditional pregnancy requires two individuals; one female and one male. Consequently, when confronting the issue of teen pregnancy, it is crucial to acknowledge the role that young men play.

This is not to minimize the current efforts targeting the role that young women have and need to take charge of their own bodies, their futures and themselves. Keeping young women at the forefront of teenage sexual education and prevention of teen pregnancy should always remain a priority. Instead, I wish to argue that because teen pregnancy is the result of two players, neglecting one half is akin to dancing the tango alone – awkward and not nearly as effective as when done in tandem.

Nowhere is this lonely dance more apparent then in current, widely publicized campaigns to prevent teen pregnancy. Among the most common campaigns such as MTV’s 16 and Pregnant (http://www.mtv.com/shows/16_and_pregnant/season_2/series.jhtml) , StayTeen.org’s teen pregnancy page (12) and the Candie’s Foundation (www.candiesfoundation.org). The campaigns and messages are frequently lauded for being appealing to teens and for employing star power or drama to propel their message to a willing audience. They are also relatively even handed when it comes to giving out information regarding the options that teens have in both preventing pregnancy and what to do if a pregnancy occurs.

However, much like the empirical research regarding teen pregnancy, these prevention of teen pregnancy campaigns focus on targeting young women. This focus is especially surprising given that some of the drop in teen pregnancy rates in the early 2000s has been attributed to shifting sexual behaviors in adolescent males (8). In order to demonstrate how the paucity of campaigns targeting young men has not met its potential I will critique this approach through pointing out the three major fallacies of neglecting young men in teen pregnancy prevention campaigns, and then argue for the addition of a male centered campaign.


Critique #1 – Ignoring the Male Interest

One of the most widely talked about teen pregnancy public service announcements (PSAs) this spring has been Brisol Palin’s warning about teen pregnancy by the Candie’s Foundation. In this PSA, Bristol Palin talks directly about her experience and the consequences of her actions. At no point is the role of the father mentioned. Furthermore, most of the other PSAs or posters put out by the foundation feature mainly teen girls (9). This focus on young women is further evidenced in its media material where the colors are black and neon pink, the majority of spokespeople are women and the promotional T-shirt is displayed by and comes in only women’s sizes.

By ignoring the male interest through creating campaigns that feature female celebrities or PSAs that talk about the girl’s experience in such detail, the announcements might as well be talking about menstruation, dangly earrings or anything else that teenage boys typically find beyond their realm. Anyone who knows teens will be able to tell you that one of the fastest ways to be ignored is to be completely uninteresting to them and un-relatable (32). By focusing so heavily on the teen girl’s point of view or experience, the promoters of these campaigns are essentially doing just that.

Instead, the campaign needs to take a note from their own manifesto and “use celebrities that teens can relate to” (9) - male celebrities talking about the male perspective of teen pregnancy. This approach is key because despite recent movements towards gender equality, concrete gender differences regarding sexual knowledge, attitudes and behavior remain (10).

Utilizing differences to attract specific audiences is nothing new. Traditionally, marketing firms research the target audience extensively to better understand what they relate to and even more importantly, what they pay attention to. This is called “Formative Research”, and is the foundation of any successful marketing campaign (11). Yet in the teen pregnancy campaigns, this basic principal of marketing seems to be forgotten.


Critique #2 – Portrayal of the Male Role

The second area where teen pregnancy awareness and education campaigns fail is in portraying the male role. In the Candie’s Foundation campaign, the male is featured as an accessory to the crime who then disappears when the girl is handed a baby (9).

In the information regarding teen pregnancy presented by StayTeen.org, eight of the 12 facts presented focus on the consequences for teen girls. This is 75% of what was presented. For the remaining quarter, one fact talks about fathers not marrying the mother, another talks about how the male children of teen mothers are more likely to go to prison and the other two are simple statistics about teens and pregnancy in general (12). It is clear that nowhere is there any information or anecdotes about how the pregnancy was created by or affects the father of the child.

If teen pregnancy campaigns are going to engage the adolescent male through scenarios, anecdotes and information, why is there no representation of his involvement? This blatant omission of the simple biological fact that the young man was involved in creating a pregnancy is akin to pardoning him from any and all responsibility – for the act and repercussions.

The result of this omission is profound. Labeling theory tells us that creating a perception or a label of a certain demographic essentially creates a self-fulfilling prophesy – for society and especially for the labeled individual (13). Consequently, by communicating that adolescent males are exempt from responsibility for and the results of teen pregnancy, we are setting them up to believe and act so.

One very public example of this is featured in the 16 and Pregnant MTV reality show where many of the teen fathers are blatantly uninvolved (14). By placing these young men in the spotlight the show is inadvertently endorsing their behavior and furthering the reputation of teen fathers as irresponsible and irrelevant.

By widely presenting teen males as superfluous and exempt from teen pregnancy, the campaigns are essentially publicizing that the male is expected to do nothing. Because social expectations are so powerful, often acting as rules that govern the day to day functioning of society (15), these PSAs are acting to further perpetuate the exact problem they wish to solve. A result of this is that adolescent males frequently place contraceptive responsibility to females and have lower perceptions of the risk of pregnancy (16; 8).

Socially and biologically, the male exemption from teen pregnancy has many effects. Children of uninvolved adolescent fathers are more likely to drop out of school, have developmental and behavioral problems and become teen parents themselves (17). Some may argue that this may be due, in part, to the fact that teen fathers indeed are often uninvolved in the rearing and support of their children. Some statistics report that only 15% of unwed fathers provide regular support (18).

Even so, the fact of the matter is that even when disengaged, teen pregnancy does affect the father. Sullivan (19), reports that the inability to provide support in the life of their child is often viewed as a manifestation of a loss of manhood. Other studies show that teen fathers don’t necessarily view disengagement as a desirable outcome (20). Thus, in order to help stop the cycle of self-fulfilling labeling and to help better support teen fathers it is doubly important to show them exactly what their role was, how becoming a parent will affect them and how important it is for them to be involved.


Critique #3 – The Reality of Men Are From Mars

Whether it is comfortable to admit or not, there are distinct gender differences in the psychological and sexual profiles of adolescents. For example, teen boys often have less conservative attitudes about sex than teen girls (8). They also react differently to information regarding sexual health and procreation (21).

As a reflection of these differences, teen boys have been known to discontinue any use of an effective method of contraception if a current method is deemed uncomfortable (socially or physically) (22). This is worrying because some studies have shown that male methods account for half of all adolescent contraceptive use (23).

This difference likely results from the fact that adolescent males become aware of their potential to procreate at later years than adolescent females (24). This consciousness is also activated differently, through problem solving alongside the direct envisioning of of procreation (21). Adolescent females, on the other hand, become more aware of their sexuality through active experiences and often before the onset of menarche (25).

Another realm where adolescent males differ from females is in reactance to information, instructions and especially to campaigns (32). Adolescent males consistently produce higher behavioral and verbal reactance scores than their women counterparts (26). This means teen boys react less favorably when simply instructed to do something and more favorably when presented with options – much like Hutchinson et al determined when studying male awareness of sexuality and sexual situations. By ignoring these differences between the genders, potentially effective campaigns fail to meet their potential and end up impotent.


Proposed Intervention

As stated earlier, many of the current wide-reaching initiatives are lauded for being [initially] appealing to teens as a general population, for employing star power and drama to propel their message to a willing audience. Yet, they fall short in being able to specifically target the male audience, portray adolescent males as involved in the creation of a pregnancy and the aftermath and in acknowledging the fact that adolescent males view and react to sexuality and messages different from adolescent females. Therefore, I propose to add male oriented, Public service announcements, posters and information to the present teen pregnancy prevention campaigns.

For example, piggy-backing off of the Candie’s PSA featuring a passionate scene of a teen couple in a car, instead of suddenly switching to an awkward moment with a baby, the couple would be faced with what to do because the guy just found out he has no condoms. The options would be to go ahead or be a real man and pause [the tagline of the campaign] to fix the problem. A simple change such as this would address all three of the main problems of the current campaign by a) appealing to the male interest in general and in relation to sexual health by featuring a guy the viewers can relate to, b) portraying him as a responsible partner in the act and c) acknowledging his thought patterns and reactions by placing the decision in his hands.


Defense of Intervention - Marketing Techniques

Publicity campaigns for commercial products are so successful because they are able to employ the core traits of marketing theory and framing with great skill. For example, the clothing brand Abercrombie and Fitch is able to sell rather common looking T-shirts at high prices because they appeal to teenagers’ ideals of strength and independence.

Likewise, these same tools can be re-appropriated for the prevention of teen pregnancy by incorporating them into the campaigns. It is only after being able to “get under the skin of their target audience and explore the core values” (11) that one is then able to redefine the product [teen pregnancy prevention] in a way that will be able to grab attention and make the message appealing.

One way to do this for the male addition to the teen pregnancy campaign is by changing the way the information is presented. One way is to appeal to values young men embrace – such as independence or virility. For example, instead of showing an unhappy teen father alone, contrast him to an independent and sexy teen who is not a father. A different approach would be to appeal to a teen male audience would be to portray activities, such as afterschool programs that have been proven to reduce teen pregnancy and emphasize teen success (8) in a light that also would make the participant more desirable to the opposite sex.

Another way to capture the male interest would be to present the issue as something they are affected by; to make the issue of teen pregnancy relevant to the adolescent. An effective method for this would be to feature clips of real, or admired, teenage boys talking about how preventing teen pregnancy allows them to remain independent (and still be cool). By keeping the personal stories positive the campaign would help create a positive promise for the young men that they would embrace more readily (27). Similar approaches have been used in individually focused teen prevention initiatives with great success (8), but would reach a larger target audience if part of nationwide publicity campaigns.

Furthermore, as an extension of the visual support the commercials following this formula would lend to the message, the information sections of these websites would need to also appeal to male values and interest. This would mean completely re-formatting the layout. Perhaps the websites could follow the format of Sports Illustrated, AskMen.com or GQ Magazine – any site that is specifically designed for and read by this demographic.

The information given on such informative websites would also have to focus on the ways in which a pregnancy affects the male and be nuggets of information that teen boys react to. Examples include giving statistics on how there is a threat to independence and that future achievements can be thwarted by the new responsibility and financial burden of raising a child (8). This would help fix the problem that the current sites have featuring women and the color pink (one of the colors most widely associated with women and girls) or by being gender neutral and hence less interesting to boys.


Defense of Intervention – Social Influences

Focusing on the adolescent male in broad public service campaigns is especially important because one of the remaining effects of the perception that ‘boys will be boys’ is that the sexual education of teen boys is often neglected (28) and that teen boys are essentially exempted from responsibility for creating a pregnancy (18). Thus, to counteract this attitude, the campaigns need to publicly show that teen pregnancy is indeed affects young men, and as something that they can and should control.

The first step would be to reduce the optimistic bias experienced by adolescent males (8, 34) and most individuals who engage in common high-risk behaviors (29). To do this, the new male focused campaign could continue with its format of featuring relatable teens, but also feature young men who became teen fathers and the way their new responsibility has affected their lives. By engaging the audience with a compelling personal story, the consequences become less abstract and more real. As a result, teen boys would be less apt to believe that a pregnancy won’t happen to them, and will be more willing to pursue options for its prevention.

A second component to changing opinions regarding the male role in teen pregnancy would be to model safe sex or abstinence behaviors in a way that preserves the ideal of manhood. This would also remove the perception that engaging in safe sex behaviors or refusing intercourse is damaging to one’s self-image or loosing the respect of one’s peers (30). Instead, it would add the perception that [the male] taking responsibility is expected and desirable. An example of this could be a commercial asking the question “What is a real test of strength, 100 pushups in a minute or saying no to sex without condoms?” The end result of a sustained and successfully executed campaign with these components would be an eventual shift in society’s perceptions and expectations [of the guy’s responsibility] and young men would follow suit (15).

While this approach may seem far sighted and impossible in some areas given the pervasive culture of machismo in nearly every social group of teen boys, current programs already promoting this approach, such as the Young Men’s Clinic in New York City (8) have proven to be very successful. They are successful because they consistently present young men with positive role models who achieve many of the same goals as the adolescents aspire to. While not as interactive as an group specific outreach program, a national information and media campaign with the same message would begin the process of normalizing the responsible adolescent male.


Defense of Intervention – Irrational Decision Making

The current campaigns fail to address the reality of the way individuals, especially adolescent males, make decisions. For example, in the Candies campaign, one PSA beings well with a very passionate scene of a teen couple (9). While this opening is an excellent use of context by creating a hot state for the viewer, it falls short in the delivery of the message. This is because after creating the hot state, the scene suddenly changes to a cold one by cautiously presenting the guy with a baby in a pram and no information about how to prevent this reversal of situation. Based on our knowledge of how adolescent males think about procreation, the PSA would be much more effective if it continued to give its information in the hot state and presented the male viewer with a quick dilemma and subsequent solutions (21).

Tailoring the message to the way adolescent males made decisions is crucial because especially in middle adolescence, teen boys do not respond well to scare tactics and instead are pushed to take the exact risks they have been warned about (8). Therefore, by engaging the teen in problem solving and by framing the options as a choice, the campaign takes advantage of the teens’ need to make their own choices and exercise their growing ability to reason (31).

As a result of such an approach, the teens would begin to feel more involved in their own actions and in the protection of themselves and their livelihood. This is especially important because when individuals feel ownership over themselves, an object or even something as abstract as a brand, they are more willing to go to great lengths to maintain the situation (33). By creating an adolescent ownership of responsible sexuality or abstinence through the media campaign, through showing believable threats to their situation and through enabling teens to feel ownership through decision making, they will naturally be more apt to maintain what they have and stay pregnancy free.

Lastly all individuals, but especially adolescents, respond with less negative reactance and stronger agreement when the communicator is viewed as more similar to the target audience (32). So, by continuing to present popular yet relatable young men who act responsibly when it comes to sex the new campaign would garner greater credibility and allow adolescent males to take ownership over their actions because they would view their options as both desirable and reachable (33).

Conclusion

The end result of all these elements playing a role in the addition of a male oriented branch to current teen pregnancy prevention efforts would be to essentially create a sought after brand that is the responsible and involved teen male – who just happens to engage in safe sex practices or abstinence. The campaign would shift the current paradigm away from ignoring the male interest, promoting the lack of male responsibility for the creation of a pregnancy and the sequelae, and blatant lack of recognition of the male psyche. Instead, it would create an awareness of the benefits of avoiding teen pregnancy through effective marketing strategies, create favorable associations between the teen and the outcome through facilitating realistic decision making for the teen male and last but not least create loyalty to the prevention of teen pregnancy through promoting social expectations of responsibility.

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