Analyzing the contribution of community change to population health outcomes in an adolescent pregnancy prevention initiative

Abstract

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 paper 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. We 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.