Teen Pregnancy Prevention Program Planning and Evaluation

*FOR INFORMATION ON THE NEW FEDERAL FUNDING PLEASE CLICK HERE*

Adolescent pregnancy is a complex issue that requires a community-wide solution. Anyone who influences young people—or cares about their health and futures—can play a role in preventing teen pregnancy.

The Alliance believes youth need three things to be able to prevent pregnancy: access to information, access to contraception, and hope for a bright future.

Access to information
Young people need and deserve age-appropriate, medically accurate comprehensive sexuality education from a non-judgmental perspective. Science-based programs have been proven effective at providing youth with the skills they need to reduce sexually risky behaviors. Teens need information on how to abstain from sex, as well as reasons to postpone, and they respond to honest, open conversations with parents sharing their values about sex. Young people need critical thinking skills to respond to messages about sex in the media.

Access to confidential contraceptive services for sexually active teens
Sexually active teens need confidential sexual health and contraceptive services that are youth-friendly. Services should be provided by staff trained in adolescent health, and clinics should be conveniently located, with office hours that work for teens.

Perception of opportunity and hope for a bright future
When youth are connected to schools, their parents, and other caring adults in the community; have strong aspirations for higher education and other career goals; and believe pregnancy and early parenthood would keep them from their goals, they are less likely to become pregnant. 

Is There a Teen Pregnancy Prevention Program in My Town?

The Massachusetts Department of Public Health funds teen pregnancy prevention programs in many towns across the state. These programs provide outreach education to schools, community-based organizations, and others. Please visit the DPH website for a list of sites offering teen pregnancy programs.

What Is the Picture of Teen Pregnancy in My Town?

Teen pregnancy data are difficult to obtain for Massachusetts communities, as pregnancies to teens are not reported to the state the way births are. Every 5 years the Guttmacher Institute estimates statewide teen pregnancy rates. You can find the most recent data on teen pregnancy in Massachusetts on Guttmacher's website.

Many towns and cities have Youth Risk Behavior Survey (YRBS) data on youth sexual behaviors, which is available from local education departments. If your town does not do the YRBS, you can look at Massachusetts-wide data on the Department of Elementary and Secondary Education website.

For teen birth rates, look to MassCHIP (Community Health Information Profile), a data resource provided by the Massachusetts Department of Public Health. Using MassCHIP, you can find data on teen births and STI rates by race/ethnicity, age, year, town, county, and much more.

How to Start a Teen Pregnancy Prevention Program

Want to start a program in your community? The Alliance strongly recommends you consider using a science-based program. Science-based, or evidence-based, programs have been proven effective at changing behaviors that lead to pregnancy and STIs (sexually transmitted infections) using a rigorous research design. It is important to match a potential program with your capacity to implement it, and to the characteristics of the youth you serve. If you can’t find a science-based program, the next best choice is to run a promising program. These programs either show some level of effectiveness in changing sexual behaviors, but have not yet been rigorously evaluated, or they contain the 17 characteristics of effective programs.

The Alliance has compiled a list of science-based and promising programs.

For a worksheet to help you determine what program might work for you, view our Program Selection Worksheet

For more information on science-based programs, visit these sites: 

• National Campaign to Prevent Teen Pregnancy
• Advocates for Youth
• DEBI website of effective HIV prevention programs.

If you are already running a curriculum-based program and want to know if it is promising, you can review it for the 17 characteristics of effective programs using an assessment tool developed by Healthy Teen Network called the Tool to Assess the Characteristics of Effective Sex and STD/HIV Education Programs, which is available for free download or purchase.

You can also use a BDI Logic Model to make sure your program activities line up your program goal. If you’re not familiar with BDI Logic Models, visit ETR Associates and take their free online BDI Logic Model course. Download our BDI Logic Model template to get started on developing your own.

Abstinence-Only-Until-Marriage Programs

The Alliance does not support the implementation of abstinence-only-until-marriage programs. To date, there is no evidence that abstinence-only-until-marriage programs are effective at delaying initiation of sex, increasing a return to abstinence, or reducing the number of sexual partners, and strong evidence that some abstinence-only-until-marriage programs had no impact on sexual behavior at all. There is some evidence that some abstinence-only-until-marriage programs improved participants’ intentions to abstain, but this did not translate to actual behavior change.

It is important to understand that all science-based programs and comprehensive sexuality education programs encourage abstinence, and delaying initiation of sex is an explicit goal of programs targeting youth who are not yet sexually active.

For more information on abstinence-only programs, please read Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy by Dr. Douglas Kirby, or visit the following websites.

Advocates for Youth

SIECUS (Sexuality Information and Education Council of the United States)

Guttmacher Institute  

A New, Effective Abstinence Program

One abstinence-only program for African-American urban middle schoolers has been proven effective at helping very young teens delay first intercourse for up to 2 years. This is the first time there is strong evidence of an abstinence-only program impacting sexual behavior.

This significant finding has implications for pregnancy prevention programs and sexuality education. Our take:

• It reinforces the importance of the abstinence component and message that is included in all comprehensive programs. 
• It suggests that a message encouraging youth to delay sex until a future time when they are ready - rather than until marriage - resonates better with young people. 
• Abstinence messages are most appropriate for young teens who are not yet sexually active, but since nearly all youth will be sexually active at some point in the future, it is critical that teens have information and access to condoms and contraception for when they do become sexually active.
• Studies on effective programs need to be read closely. This study's results are not generalizable beyond the population studied: African American students in grades 6 and 7 who are willing to take part in a health promotion project on weekends.
• The program did not meet the federal abstinence-only program funding "A-H" requirements and was not subject to the common concerns about those programs, which tend to moralize, discuss condoms and contraception only in terms of failure rates, give medically inaccurate information, and had the express goal of promoting abstinence until marriage. 
• It reminds us of how critical it is to match the risk and protective factors of youth to a program that will meet their needs. For example, the program did not impact condom use or number of sexual partners, two key behaviors that STI/HIV prevention programs typically affect. If you know you want to impact condom usage and/or reduce the number of young people's sexual partners, you should select a program that has been proven to change these behaviors.
• The abstinence-only program that was studied had many similarities with effective comprehensive programs: it was theory-based, designed to include HIV/STI knowledge, contained accurate information, did not portray sex in a negative light, and did not disparage condom use. 

This program is not yet available for purchase or replication.

For more information, please visit the Pediatrics article on Efficacy of a Theory-Based Abstinence-Only Intervention Over 24 Months

Program Evaluation

No matter what program you run, we strongly encourage you to evaluate your efforts. You don't have to be a professional evaluator to do evaluation! Evaluation can require just a little of your time and yield a wealth of information that can help you revise your program the next time you implement it, assess whether or not youth are learning what you want them to, and help prove the worth of your program to your funders and other stakeholders. The Free Management Library has a guide to outcomes-based evaluation for nonprofits with very limited resources.

Download evaluation planning tools and survey instruments from Healthy Teen Network or from ETR Associates.

Program Planning and Evaluation Tools for Download: