a dollar a day keeps the babies away preventing secondary pregnancy in north carolina n.
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A dollar a day keeps the babies away ? Preventing Secondary Pregnancy in North Carolina. Presented By: AJ Bickford. PADM 5111. Make Good Decisions. Libertarian paternalism at work Drawing from social science research, individuals can and often do make PRETTY BAD decisions.

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a dollar a day keeps the babies away preventing secondary pregnancy in north carolina

A dollar a day keeps the babies away? Preventing Secondary Pregnancy in North Carolina

Presented By: AJ Bickford

PADM 5111

make good decisions
Make Good Decisions
  • Libertarian paternalism at work
  • Drawing from social science research, individuals can and often do make PRETTY BAD decisions.
  • These decisions could be avoided if people had complete information, unlimited cognitive abilities and complete self-control
  • http://www.youtube.com/watch?v=lI-8Ifi2PVI
so what s the problem
So What’s the Problem?
  • The Unites States has the highest adolescent pregnancy rate in the industrialized world.
  • In 2006, the number of births for girls aged 15 to 17 was about 139,000, or 22 for every 1,000 girls.
  • 1/3 of girls in the United States got pregnant before age 20, and more than 435,000 babies were born to teens between 15 and 19 years in 2006.
  • Of the teens who do get pregnant almost 17% become pregnant again within a year.
  • Estimated 60% of those who become pregnant before age 15 will have three children by age 19
social and economic costs
Social and Economic Costs
  • Direct and indirect costs of adolescent pregnancy in the United States now surpass $34 billion annually.
  • Adolescent mothers have more children overall, children closer together, and report more of their births as unwanted than do other mothers.
  • Repeated pregnancy in adolescence is associated with failure to complete high school and reduced economic sufficiency
  • Delaying a second pregnancy offers adolescents better chances to mature physically and psychologically, to finish high school, plan for the future, and develop vocational skills. 
a dollar a day
A Dollar-A-Day
  • During the first five years, 65 adolescent mothers participated in the Dollar-A-Day program.
  • Members ranged from 13 to 16 years of age on admission.
  • Primarily from the lower socioeconomic group.
a dollar a day cont
A Dollar-A-Day (cont)
  • The group meet every Monday for an hour.
  • First part of the program consisted of personal goal setting and reporting.
  • Each adolescent set a goal to achieve during the following week, and those goals and accomplishments were recorded.
  • Social exchange theory was used to help assist mothers in defining their values and setting short and long term goals
  • At the end of each session, each participant present receives 7 $1 bills, one for each day of the week.
results and significance
Results and Significance
  • After five years of operation, only 15% of the 65 girls who had been enrolled in the program experienced subsequent pregnancies.
  • Following their first birth, 85% of the Dollar-A-Day group remained non-pregnant, as compared with a 50–70% repeat pregnancy rate reported from other studies.
  • A 50% decrease in subsequent pregnancy rates would decrease the national cost of adolescent births by approximately $17 billion.
pregnancy a nudgeable choice
Thaler and Sunstein give criteria characterizing choices that are amenable to nudges:

Benefits now – Costs later: benefits of sex now, costs of a child 9 months later;

Self-control: hard to control ourselves when aroused;

Frequency: becoming pregnant and raising a child is not something easily practised;

Feedback: clear and immediate feedback is not available (the child might be cute and affordable a couple of years in, but that may not continue).

Pregnancy: A Nudgeable Choice
the dollar a day nudge
The Dollar-a-Day Nudge
  • At first glance, $1 a day is a simple monetary incentive that both Econs and Humans would respond to.
  • But according to T+S, it is a nudge, so Econs would not respond to it.
  • Makes sense: the $1 a day is negligible compared to the cost of raising a child, so it should not affect an Econ’s decision.
the dollar a day nudge cont
The Dollar-a-Day Nudge (cont.)
  • Reasons why the $1 a day nudged Humans:
    • Salience: $1 a day is very noticeable, while the opportunity cost of not going to school or work while caring for the child is easier to neglect (in T+S).
    • Cash immediately available: little effort required to receive it.
    • Made use of Humans’ asymmetric value function: the $1 gains were segregated.
other nudges at play
Other Nudges at Play
  • Nudges that exploit human desire to conform:
    • Priming:
      • Voicing goals and intentions among others makes them more likely to be achieved.
    • Social norms are both constructive and destructive:
      • “My name is ____, and today I am not pregnant”: being not pregnant is the norm, and most conformed to it.
      • However, another norm was that each participant already had a child, which prompted one girl to become pregnant again.
    • Peer Pressure: norms and priming were more effective because the girls became attached to each other and to the leaders.
other nudges at play cont
Other Nudges at Play (cont.)
  • Feedback/Education
    • Education about sexuality, contraception and parenting was occasionally provided, as were referrals to child care, health and finances organizations.
    • Every week saying that they were not pregnant and receiving $7 served as positive feedback (and also as a reminder) for not getting pregnant.
  • Mapping from choice to welfare
    • Mapping the choice to have sex to all the financial, emotional and professional consequences of having a child is difficult.
conclusion
Conclusion
  • Unclear which nudges in the Dollar-a-Day program most influenced the teens’ decisions to not get pregnant.
  • But it is clear that these small changes in choice architecture, the meetings, feedback and small allowance, improved the lives of the program participants.
  • Where else could a similar Dollar-a-Day program work?