Primary Sources: Preventing Teen Pregnancy

Photograph of a teen couple.

Though national teen pregnancy and birth rates have fallen over the last 20 years, the United States still has some of the highest rates among industrialized nations. Appropriately, recent research has focused on replicating effective programs, and the federal government has made evidence-based teen pregnancy prevention a priority in new grant programs from the Office of Adolescent Health and the Family and Youth Services Bureau. 

In this installment of Primary Sources, we take a look at four recent reviews of the literature on teen pregnancy prevention. By weighing the findings and rigor of evaluations of specific curricula or youth development programs, each research team has produced a list of programs that have successfully deterred young people from having risky sex, misusing contraceptives, becoming pregnant or getting STDs. 

Each of the reviews relies on different definitions of “effective,” but the authors describe several things that successful programs have in common. First, trained leaders of effective programs believe in the program. Second, they provide a clear message to young people that consistently and carefully using contraception or abstaining from sex altogether is the right thing to do. Third, they engage participants in activities that address peer pressure and teach communication skills. And finally, effective programs need to run an ample amount of time for messages to sink in—at least three months according to some reviewers—and are tailored to the age, sexual experience and culture of participants.

(Publications discussed here do not necessarily reflect the views of NCFY, FYSB or the Administration for Children and Families.)

  • OAH and Mathematica Policy Research have created an extensive list of effective programs eligible to be replicated for OAH funding. A total of 28 out of 429 programs reviewed met criteria regarding the age of participants, the year the study was conducted or published, and whether researchers found a positive change in at least one measure, such as risky sexual behaviors, pregnancy, STDs, and other outcomes or consequences of risky sex. Overviews of the 28 effective programs are included on the OAH website.
  • What Works 2010: Curriculum-Based Programs That Help Prevent Teen Pregnancy” (PDF, 440 KB) is the National Campaign to Prevent Teen and Unplanned Pregnancy’s annual list of programs that help delay sex, improve contraceptive use or prevent teen pregnancy.
  • The CDC’s Replicating Effective Programs Plus, or REP Plus, initiative lists “tested, science-based behavioral interventions with demonstrated evidence of effectiveness in reducing risky behaviors, such as unprotected sex, or in encouraging safer ones, such as using condoms and other methods of practicing safer sex.” Its review, concluded in 2008, focuses primarily on HIV prevention.
  • In the second edition of its Science and Success series, released in 2008, reproductive health nonprofit Advocates for Youth provides a list of effective programs for preventing teen pregnancy and HIV and other sexually transmitted infections.

For a comparison of the criteria used by the reviews, see below. Go to the NCFY literature database for abstracts of these and other publications.

OAH: Studies conducted or published since 1989; United States only; participants at start of program are age 19 or older; impact measured is at least one measure of sexual risk behavior or its health consequences; uses quantitative data, statistical analysis and hypothesis testing.

What Works 2010: Studies conducted or published since 1980; United States or Canada; participants are ages 12-18; measures impact of sexual risk behavior; uses sound statistical analysis; baseline and follow-up data for at least three months; at least 75 people in treatment and control or comparison groups; study design is experimental or quasi-experimental.

REP Plus: Reported since 1988 (published or unpublished); conducted in the United States; age range not stated; HIV prevention focus, also sex- and drug-related behaviors and health outcomes; statistically significant intervention measures or relative outcomes; includes post-intervention data; study design is experimental or quasi-experimental.

Science and Success II: No publication year cut-off, but must be published in peer reviewed journal; geographical location not stated; age range not stated; must impact at least two measures of positive behavior changes, or show evidence of effectiveness; no statistical analysis; baseline and follow-up data for at least three months, unless two positive behavior changes were shown; at least 100 people in treatment and control or comparison groups; study design is experimental or quasi-experimental.

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