In an ideal world, teenagers would not engage in sex. They would not get pregnant, would not have babies and then live a step behind their peers for the rest of their lives.
So says Spokane County health educator Elaine Blair.
The girls and young women of the Round Table — Candace, Holly, Becky, April, Patty and Jessica — represent the real world. They meet weekly around a table to talk sex and motherhood.
The youngest is 15; the oldest, 19. Each has had multiple sex partners. Among them they have had three pregnancies, two births, one abortion and a lot of hardship.
They are part of an experimental program that essentially pays them not to get pregnant. Last year it was $1 a day. If they got pregnant, they were out. Recently it has been changed to $100 a year. The strategy boils down to the same thing: financial incentive.
“Public health deals with the real world,” Blair says.
“With real-world problems, sometimes you have to try the untried, the creative.”
The girls, considered the most at-risk for pregnancy, have been referred by counselors or social-service agencies or by other girls who have gone through the program.
The original group last year started with 28 girls and ended with 24. Of the 28 who began the Your Choice, Not Chance program, only one got pregnant. Many of the graduates will be mentors to the new group.
The financial incentive is only one part of the program. More important components include the weekly discussions, one-on-one counseling, free family-planning services and educational presentations such as slide shows and lectures.
Evaluators are assessing last year’s program to determine what role the financial incentive played in the program’s apparent success and whether such incentives should be used elsewhere.
“Yeah, we got paid, but that’s not what kept me going,” says Candace, 15. “I kept going because I got good advice and I could say anything that was on my mind. I didn’t have anybody else to talk to. You can’t trust just anybody.”
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