A review of five rigorously evaluated adolescent pregnancy prevention programs shows that all five incorporate an emphasis on abstinence or delay of sexual initiation, training in decision-making and negotiation skills, and education on sexuality and contraception. Four of the five directly or indirectly provide access to contraceptive services. Comparisons between treatment and control groups show that all four programs that measured changes in rates of sexual initiation among adolescents had a significant effect on that outcome, reducing the proportion of adolescents who initiated sexual activity by as much as 15 percentage points; the programs were most successful when they targeted younger adolescents. Three of these four programs also significantly increased rates of contraceptive use among participants relative to controls; the most successful programs, which increased contraceptive use by as much as 22 percentage points, provided access to contraceptive services and targeted adolescents who were younger and those who were not yet sexually experienced. Two programs significantly decreased the proportion of adolescents who became pregnant; these programs were the two that were most active in providing access to contraceptive services.
PIP: A review of 5 rigorously evaluated adolescent pregnancy prevention programs, mostly implemented in low-income areas, showed that all 5 incorporate an emphasis on abstinence or delay of sexual initiation, training in decision-making and negotiation skills, and education on sexuality and contraception. The 5 programs were: Postponing Sexual Involvement, initially implemented in Atlanta, Georgia, among 8th graders; Reducing the Risk, initially implemented in several schools in California; School/Community Program, used in a rural community in South Carolina; Self Center, implemented in high schools located in Baltimore, Maryland; and Teen Talk, designed for use in both educational and community-based settings in Texas and California. Four of the 5 directly or indirectly provide access to contraceptive services. Comparisons between treatment and control groups showed that the 4 programs that measured changes in rates of sexual initiation among adolescents had a significant effect on that outcome, reducing the proportion of adolescents who initiated sexual activity by as much as 15%; the programs were most successful when they targeted younger adolescents. Three of these 4 programs also significantly increased rates of contraceptive use among participants relative to controls; the most successful programs increased contraceptive use (the Self Center program by as much as 22% for girls and 7% for boys), provided access to contraceptive services, and targeted adolescents who were younger and those who were not yet sexually experienced. Two programs significantly decreased the proportion of adolescents who became pregnant; these programs were the 2 that were most active in providing access to contraceptive services. In the Baltimore treatment schools, the pregnancy rate of 23% of sexually active teenagers declined to 17% during the 20 months preceding the follow-up survey. In South Carolina 7.7% of girls ages 14-17 had become pregnant during 1981-82, which rate dropped to 3.7% after the program's implementation (1984-86).