Engaging Males to Prevent Unplanned Pregnancies in Virginia
By Deborah Harris, MPH, RD, CDE
Women’s Health Coordinator, Virginia Department of Health
The Partners in Prevention Program (PIP) was established to encourage and support community-directed strategies to reduce and prevent the incidence of non-marital births in Virginia. The majority (62.7%) of non-marital births occur in those aged 20-29. This percentage has increased approximately 15% since 1998. Because program funds are limited, PIP targets single women and men in their 20s who reside in high-risk communities as an efficient means of reducing the overall non-martial birth rate in Virginia. Through the implementation of innovative interventions, locally funded PIP sites focus on an array of topics that include healthy relationships, family planning, healthy attitudes and behavioral intentions regarding marriage, career and family, and discouraging high risk sexual behavior. In addition, local programs work diligently to produce value added outcomes such as GED attainment, job placement, career and goal setting, financial literacy, college enrollment, access to medical and mental health services, and domestic violence prevention.
In recent years, the program has deployed two key strategies to address the non-marital birth rate. First, because men play a key role in pregnancy prevention, PIP targets intervention efforts in venues in which men typically engage, such as sports leagues. Most notable are the interventions in Fredericksburg and Galax, Virginia. These sites sponsor basketball games as incentives to motivate men to participate in PIP. Once the men are engaged, the PIP intervention is delivered in an open, facilitated forum that generates dialog regarding male responsibility and their roles in healthy relationships, family planning, fatherhood, etc. As a result, men not only participated in the program, but were also successful recruiters for PIP. These men are sponsored to participate in a basketball tournament, “Male Responsibility: Take it to the Court.” Other interventions that motivate men to participate in PIP are those that offer tangible benefits, such as computer training, prisoner reentry services and job seeking assistance. The graduation certificate from the Heart to Heart Life Skills Program (part of the Norfolk, VA PIP site), which involves computer training, resume building and the components of PIP, is highly regarded by employers in that area.
Second, to address the reported stigma and barriers associated with marketing a program related to non-marital birth reduction to stakeholders and participants, the PIP message and marketing was changed to focus on the goal of preventing unplanned pregnancies (as opposed to non-marital births). Research conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy showed that most of the general public found this to be an acceptable goal. A newly developed PIP campaign (“Have a Plan") which specifically targets men was launched in 2007. With regards to unplanned pregnancy prevention, all male and female participants are assessed for access to and desire for family planning services and receive detailed information on the “Plan First” program, which is the Virginia Medicaid family planning waiver. Those desiring services are then assisted with procurement either through the Medicaid application process or the local Title X family planning clinic. For many men served by PIP, this is the first and perhaps the only opportunity to learn about the importance of male reproductive health as well as their overall health. Another benefit of the PIP program is that it allows men to talk to their peers about the issue of male responsibility as it relates to fatherhood and contraception within their community. This is a significant benefit, as it can lead to a change in social norms among this group.
As a result of efforts to increase male participation, men now comprise 51 percent of the population served by PIP, which is a substantial improvement from less than 15% four years ago. Furthermore, the retention rate of males in this program has increased, and the number of men recruiting for the program continues to grow. The PIP program has been recognized by the National Campaign to Prevent Teen and Unplanned Pregnancy as a model program for targeting men and addressing the issue of male responsibility. Recent evaluations conducted by Virginia Commonwealth University show statistically significant improvements from baseline to post intervention in the number of men reporting condom use and appropriate responses regarding birth control responsibility, decreasing high-risk sexual behavior, and the role of fathers in the lives of children. As mentioned above regarding valued added outcomes, a substantial number of male participants are now gainfully employed, enrolled in college, or working towards GED attainment. Most notable are the anecdotal reports from local PIP coordinators regarding the number of single men reporting increased involvement with their children.