Interventions addressing the social determinants of teenage pregnancy

Purpose - The limited evidence of effectiveness of existing teenage pregnancy strategies which focus on sex education, together with growing evidence that factors such as poor school ethos, disaffection, truancy, poor employment prospects and low expectations are associated with teenage pregnancy, has increased interest in interventions which target these " wider" social determinants. This paper aims to identify promising interventions and priorities for future research and to make recommendations for policy and practice in the UK. Design/methodology/approach - This paper discusses the evidence regarding the potential of interventions which target determinants of teenage pregnancy relating to school disaffection and low expectations, drawing on recent systematic reviews and trials to consider future directions for research, policy and practice. Findings -High-quality research evidence illustrates the potential of two approaches to address determinants of teenage pregnancy relating to disaffection and low expectations. These are school-ethos interventions, which aim to facilitate a positive and inclusive school-ethos, strengthen school relationships and reduce disaffection; and targeted, intensive youth work interventions, which aim to promote positive expectations, vocational readiness and self-esteem through vocational and life-skills education, volunteering and work experience. Practical implications - Two forms of intervention which address key social determinants of teenage pregnancy-school-ethos interventions and targeted youth work interventions-require more attention from researchers and policy-makers. Originality/value - This paper calls for a shift in the research and policy agenda. In addition to interventions that aim to address proximal, individual factors, such as sexual health-related knowledge, there should be a more complementary focus on socio-environmental as well as targeted individual-focused interventions aiming to address the wider social determinants of teenage pregnancy.