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Health Education & Behavior
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Analyzing the Contribution of Community Change to Population Health Outcomes in an Adolescent Pregnancy Prevention Initiative

Adrienne Paine-Andrews, PhD

University of Kansas, Lawrenceapa{at}ku.edu

Jacqueline L. Fisher, MPH, CHES

Jannette Berkely Patton, MA

Stephen B. Fawcett, PhD

University of Kansas, Lawrence

Ella L. Williams, MEd

City Vision Ministries, Kansas City, Kansas

Rhonda K. Lewis, PhD, MPH

Department of Psychology at Wichita State University, Wichita, Kansas

Kari Jo Harris, PhD, MPH

Department of Preventive Medicine in the School of Medicine at the University of Kansas, Kansas City, Kansas

Few evaluations of community initiatives have established a link between intermediate outcomes, such as community or systems change, and more distant population-level health outcomes (e.g., estimated rates of employment or adolescent pregnancy). This article describes an analysis of the contribution of community changes facilitated by a community health initiative to prevent adolescent pregnancy to the population-level outcome of birth rates for teens. The authors examine a hypothesis that this link might be expected when community changes are of greater amount, intensity, duration, and exposure. The results showed reductions in birth rates in Target Area A, where there was a greater concentration of community changes and a slight increase where there were far fewer changes. This report provides a method for describing empirically the contribution of environmental change to more distant population-level outcomes.

Health Education & Behavior, Vol. 29, No. 2, 183-193 (2002)
DOI: 10.1177/109019810202900204
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