Sarah Perez McAdoo, MD, MPH


Population Health Capstone Director, University of Massachusetts Medical School-Baystate, Springfield, MA; Chair, Board of Health, East Longmeadow, MA

Dr. McAdoo’s interests focus on adolescent reproductive health disparities. Her most recent research looked at the leadership capacity at the state and local level addressing teen pregnancy in Massachusetts. She is particularly interested in becoming an advocate for the health of Latinas. Currently Dr. McAdoo has developed a network of community leaders to address the high teen birth rates in Hampden County, MA. The network will develop a comprehensive, proactive approach to teen pregnancy prevention by tracking local needs and by advocating for effective legislation. During her tenure as clinical associate at Tufts University School of Medicine, Dr. McAdoo developed a sex education/family life program for pregnant and parenting teens at Putnam Vocational Technical High School. Dr. McAdoo received the Residents Recognized for Excellence in Teaching Award by the third-year clerkship students.

Dr. McAdoo received her medical degree from the Albert Einstein College of Medicine in 2001, and completed her residency training in Obstetrics and Gynecology at Baystate Medical Center in Springfield, MA in 2005. She received an M.P.H. from the Harvard School of Public Health as a CFHU Fellow in 2006.

Assessment of the Leadership Capacity Addressing Latina Teen Pregnancy in Massachusetts


The Massachusetts teen birth rate is at the lowest level in the history of the state with teen birth rates 46% below the national average.   Although Massachusetts has been successful in reducing the teen birth rates, the disparity in the teen birth rate across racial and ethnic groups remains high. Latinas continue to have the highest teen birth rate in the state with birth rates almost 6 times greater than for non-Hispanic whites.  The communities that have been disproportionately affected by persistently high teen birth rate continue to be communities of color.  The most recent statistics published by the Massachusetts Department of Public Health show communities with teen birth rates greater than 200% above the state average.  With the increasing Latino population and the high teen birth rate, this is a pressing problem in many communities in Massachusetts.


The purpose of this project is to help the Massachusetts Alliance on Teen Pregnancy begin to focus on some of the barriers to decreasing Latina teen pregnancy in Massachusetts. The Massachusetts Alliance seeks to develop insight into the leadership capacity addressing Latina teen pregnancy at the state and local levels. This information is important in order to gain a better understanding of how to engage leaders on the issue of teen pregnancy among Latino youth.  The primary objective is to understand the leadership capacity of agencies at the local level that are concentrating on teen pregnancy in communities with high Latina birth rates in Hampden County, Massachusetts.  The secondary objective is to identify statewide Latino-based organizations that may have the ability to address Latina teen pregnancy and collaborate with the Massachusetts Alliance.


Agencies in Hampden County Massachusetts working on teen pregnancy were identified through the Massachusetts Alliance membership registry.  Forty one agencies were identified in Springfield and Holyoke.  Twenty five were recruited for in-depth interviews and 11 agencies granted interviews during the recruitment period. Statewide agencies focusing on Latino issues were identified through the Massachusetts Alliance on Teen Pregnancy, an Internet search of Latino- based organizations in Massachusetts and referrals from other existing organizations.  Seven organizations were recruited but only one interview was granted during the recruitment period.  A series of in-depth interviews and questionnaires were conducted with local and statewide agencies.    The interviews focused on perceptions of Latina teen pregnancy, level of involvement in addressing Latina teen pregnancy and the leadership capacity at the state and local levels.


Perceptions of local agencies addressing teen pregnancy in communities with the highest teen birth rates in Hampden County

Most respondents believed that teen pregnancy and teen births among Latinas is a problem but they did not believe that the Latino community they served viewed Latina teen pregnancy being as much of a problem as the general community. The majority of respondents believed that the issue is not being addressed at the state and community levels.  They expressed concern that if Latina teen pregnancy became a primary focus, targeting one ethnic group may have a negative impact.

Leadership capacity of local agencies in Hampden County

The majority of the agencies were established at lease 20 years ago.  They vary in size ranging from less than 10 employees to greater than 100 employees.  Although most of the respondents provided health services or were community centers, there was significant variation in the types of agencies interviewed.  Although most of the agencies stated that they collaborated with Latino-based organizations at the state level, none of the respondents were aware of any statewide organization focusing on Latina teen pregnancy.  At the community level, community centers were often identified as leaders in addressing Latina teen pregnancy because they were established organizations that are trusted within the community.  Within these agencies, executive directors or program directors were identified as leaders because they were able to set the agenda for their agencies.

Leadership capacity of Latino-based organizations

Five statewide and three local organizations were identified that focused on issues affecting the Latino population of Massachusetts.  From a total of seven agencies identified, only one interview was obtained.  The study identified several barriers to engaging Latino-based organizations in addressing teen pregnancy:  No coordinated resource to easily identify the existing Latino based- organizations at the state or local level; limited availability of their staff; lack of knowledge on the issue and organizational perception that since Latina teen pregnancy was not a primary focus of the agency, they could not contribute to addressing the issue.


Role of the Massachusetts Alliance on Teen Pregnancy

At the state level

  •     Act as facilitator to begin focusing on Latina teen pregnancy in Massachusetts.
  •     Connect with The National Campaign on Teen Pregnancy Prevention for information on initiatives of similar states focusing on the Latino community.
  •     Gather research on Latina teen pregnancy from national and state resources and disseminate the information to communities with high Latina birth rates.
  •     Tackle the barriers to engaging Latino based organization at the state and local levels.
  •     Convene a statewide task force of various stakeholders to discuss and create a strategic plan to address the disparity in teen birth rate.
  •     Continue to advocate for increased funding and engaging policy makers on the issue.
  •     Re-framing the issue of Latina teen pregnancy so that it does not negatively impact the Latino community.

 At the community level

  •     Survey the Latino community regarding their views on teen pregnancy.
  •     Assist communities with high Latina birth rates in training local leadership to address Latina teen pregnancy

Faculty Preceptor:

Joanne E. Cox MD, Associate Chief General Pediatrics Primary Care, Children’s Hospital Boston

Agency  Preceptor:

Patricia Quinn, Director of Public Policy

Sponsoring Agency:

The Massachusetts Alliance on Teen Pregnancy