Scientific Evaluations of Approaches to Prevent Teen Pregnancy

^Pr^ep^ar^{ed f}^o^r^M^e^m^b^ers^an^d^Com^mⁱ^t^t^ees^of^C^ong^r^e^ss

The long-awaited experimentally designed evaluation of abstinence-only education programs,
commissioned by Congress in 1997, indicates that young persons who participated in the U.S.
Department of Health and Human Services’ Title V Abstinence Education block grant program
were no more likely than other young persons to abstain from sex. The evaluation conducted by
Mathematica Policy, Inc. found that program participants had just as many sexual partners as
nonparticipants, had sex at the same median age as nonparticipants, and were just as likely to use
contraception as nonparticipants. For many analysts and researchers, the study confirms that a
comprehensive sex education curriculum with an abstinence message and information about
contraceptives and decision-making skills is a better approach to preventing teen pregnancy.
Others maintain that the evaluation examined only four programs for elementary and middle
school students, and is thereby inconclusive. Separate experimentally designed evaluations of
comprehensive sexual education programs found that some comprehensive programs, including
contraception information, decision-making skills, and peer pressure strategies, were successful
in delaying sexual activity, improving contraceptive use, and/or preventing teen pregnancy. This
report will not be updated.

Introduc tion ..................................................................................................................................... 1
Backgr ound ..................................................................................................................................... 1
Scientific Evaluation of Teen Pregnancy Prevention Approaches...................................................2
Abstinence-Only Education......................................................................................................2
Comprehensive Sexual Education.............................................................................................4
An Abstinence-Only Intervention Versus an Abstinence Message..................................................5
Author Contact Information............................................................................................................6

For many years, there have been divergent views with regard to sex and young persons. Many
argue that sexual activity in and of itself is wrong if the persons are not married. Others agree that
it is better for teenagers to abstain from sex, but are primarily concerned about the negative
consequences of sexual activity, namely unintended pregnancy and sexually transmitted diseases
(STDs). These two viewpoints are reflected in two teen pregnancy prevention approaches. The
abstinence-only education approach centers on the abstinence-only message and exclusively
funds programs that adhere solely to bolstering that message. The Title V Abstinence Education
block grant administered by the Department of Health and Human Services (HHS) supports this
approach. The comprehensive sexual education approach provides funding (through many other
federal programs) for both prevention programs (that often include an abstinence message) and
programs that provide medical and social services to pregnant or parenting teens.

Since 1991, teen pregnancy, abortion, and birth rates have all fallen considerably. In 2002 (the
latest available data), the overall pregnancy rate for teens aged 15-19 was 75.4 per 1,000 females
aged 15-19, down 35% from the 1991 level of 115.3. The 2002 teen pregnancy rate is the lowest ¹
recorded since 1973, when this series was initiated. However, it still is higher than the teen
pregnancy rates of most industrialized nations.
After increasing sharply during the late 1980s, the teen birth rate for females aged 15-19 declined ²
every year from 1991 to 2005. The 2005 teenage birth rate of 40.4 per 1,000 women aged 15-19
is the lowest recorded birth rate for U.S. teenagers. In 2005, the number of births to teens was

421,123 (10.2% of the 4.1 million births in the U.S.), of which 6,717 births were to girls under ³

age 15. Nearly 23% of all nonmarital births were to teens in 2005. Although birth rates for U.S.
teens have dropped in recent years, they remain higher than the teenage birth rates of most
industrialized nations. According to a recent report on children and youth, in 2005, 34% of ninth
graders reported that they had experienced sexual intercourse. The corresponding statistics for ⁴
older teens were 43% for tenth graders, 51% for eleventh graders, and 63% for twelfth graders.
About 30% of female teens who have had sexual intercourse become pregnant before they reach ⁵
age 20.

¹^T^h^e^A^l^aⁿ^G^u^ttm^a^c^h^e^r^Institute^,^U^.^{S. Te}^eⁿ^age^Pr^e^g^na^nc^y^St^atis^tic^s^:^N^a^tio^na^{l a}ⁿ^d^St^ate^Tr^eⁿ^ds^a^nd^Tr^e^nds^by^R^a^c^e
^and^Et^hnic^ity^,^up^da^te^d^Se^pte^m^be^r²⁰^06,^p.^5.
²^Iⁿ¹⁹^70,^the^te^eⁿ^bir^t^{h r}^a^te^w^a^s^68.3^bir^t^hs^pe^r^1,⁰⁰^{0 w}^o^m^e^{n ag}^e^d^15-^19.^T^h^e^bir^t^h^r^a^te^dr^op^pe^{d t}^o⁵⁰^.2ⁱⁿ¹⁹⁸⁶^aⁿ^d
^ro^{se b}^{ack t}^o⁶¹^.⁸ⁱⁿ¹⁹⁹¹^.^Sⁱⁿ^{ce 19}⁹¹^,^t^h^{e t}^een^bi^rt^{h rat}^e^f^o^{r w}^o^m^eⁿ^aged¹⁵^-¹⁹^h^a^{s d}^ecreased^each^year,^d^eclⁱⁿⁱⁿ^g
^a^l^m^o^s^t^35%^durⁱⁿ^g^the^14-^y^e^a^r^perⁱ^{od f}^r^om¹⁹⁹^{1 t}^o²⁰^{05 (}^f^r^o^m^61.^{8 bir}^t^hs^pe^r^1,⁰⁰^{0 w}^o^m^e^{n a}^g^e^d¹⁵^-^{19 i}ⁿ¹⁹⁹¹^to
^40.^{4 b}ⁱ^r^t^hs^pe^r¹^,⁰^{00 w}^o^m^e^{n a}^g^e^d^15-¹⁹ⁱⁿ²⁰⁰⁵⁾^.
³^Na^tiona^{l Ce}ⁿ^t^e^r^f^o^{r He}^a^{lth Sta}^tis^tic^{s, Births:}^Pre^lim^ina^r^y^Da^ta^f^o^{r 200}^5,^by^Bra^d^y^{E. Ha}^m^{ilton, Joy}^c^e^A^.^Ma^{rtin, a}^nd
^Ste^phaⁿⁱ^e^J^.^Ve^ntu^r^a^,^Nati^on^al^Vi^tal^Stat^istic^{s Re}^ports,^Vol^.⁵⁵^{, N}^o^.¹¹^.^D^e^c^e^m^b^e^r^28,²⁰⁰⁶^.
⁴^Cen^t^{ers f}^o^{r Di}^{sease Co}ⁿ^t^ro^l^and^P^r^even^tⁱ^oⁿ^,^MMWR^{, v}^o^{l. 55}^{, n}^o^.^SS-0⁵^,^Y^o^u^t^{h R}ⁱ^s^k^Be^havⁱ^o^r^S^u^r^v^e^illanc^e^:^Uⁿⁱ^t^e^d
^State^s^{, 20}⁰⁵^{, J}^u^ne^9,²⁰⁰⁶^{, a}^v^a^ila^ble^a^t^ht^tp:/^/w^w^w^.c^dc^.g^ov^/^m^m^w^r^/^pr^e^v^iew^/^m^m^w^r^h^t^m^l/^s^s⁵⁵^05a^1.^ht^m^.
⁵^T^h^{e Nat}ⁱ^oⁿ^a^l^Cam^p^ai^gn^t^o^P^r^even^t^T^een^P^r^egn^aⁿ^c^y^,^{How is the}³⁴^%^Statistic^Calc^ul^ate^d^?^Fa^c^t^S^h^e^e^t^{. Fe}^br^ua^r^y^2004.

An October 2006 study by the National Campaign to Prevent Teen Pregnancy estimated that, in
2004, adolescent childbearing cost U.S. taxpayers about $9 billion per year. Research indicates
that teens who give birth are less likely to complete high school and go on to college, thereby
reducing their potential for economic self-sufficiency. The research also indicates that the
children of teens are more likely than children of older parents to experience problems in school
and drop out of high school, and as adults are more likely to repeat the cycle of teenage
pregnancy and poverty. The 2006 report contends that if the teen birth rate had not declined
between 1991 and 2004, the annual costs associated with teen childbearing would have been ⁶
almost $16 billion (instead of $9 billion). In recognition of the negative, long-term consequences
associated with teenage pregnancy and births, the prevention of teen pregnancy is a major
national goal.

Although a number of different techniques are available to evaluate the impact of policy changes,
there is widespread consensus that well-designed and well-implemented studies that require
random assignment to experimental and control groups provide more reliable, valid, and objective
information than other types of approaches. Random assignment experimental studies generally
assign potential participants to two groups. Individuals assigned to a control group are subject to
current policies or practices (no policy change); individuals assigned to the experimental or
treatment group are subject to a different policy initiative (i.e., intervention), such as abstinence-
only education. Individuals are randomly assigned to these two groups, and any differences
between the experimental and control group are attributed to the policy initiative being examined.
The random assignment experimental approach attempts to estimate a program’s impact on an
outcome of interest. It measures the average difference between the experimental group and the
control group. For a policy to have an impact, it must be determined that the impact did not just
occur by chance. In other words, the difference must be determined to be “statistically
significant.” Differences between experimental and control groups that pass statistical ⁷
significance tests are reported as policy impacts. The random assignment experimental approach
generally is considered to provide the most valid estimate of an intervention’s impact, and thereby
provides useful information on whether, and the extent to which, on average, an intervention
causes favorable impacts for a large group of subjects. (For information about some of the
problems with the experimental approach, see CRS Report RL33301, Congress and Program
Evaluation: An Overview of Randomized Controlled Trials (RCTs) and Related Issues.)
P.L. 105-33, the Balanced Budget Act of 1997, included funding for a scientific evaluation of the
Title V Abstinence-Only Education block grant program (Title 510 of the Social Security Act),

⁶^T^h^{e Nat}ⁱ^oⁿ^a^l^Cam^p^ai^gn^t^o^P^r^even^t^T^een^P^r^egn^aⁿ^c^y^,^B^y^t^h^{e Nu}^mb^{ers: T}^h^{e P}^u^b^lⁱ^c^C^o^s^t^of^Te^eⁿ^C^h^ild^be^arⁱⁿ^g^{, by}^Sa^ul
^D.^Ho^f^f^man^.^Octo^b^e^{r 20}⁰⁶^.
⁷^U.^S^.^Hou^s^{e o}^f^Rep^r^esen^t^a^tⁱ^v^es.^Co^mmⁱ^t^t^{ee o}ⁿ^W^a^{ys an}^d^M^ean^s.²⁰⁰^{4 G}^r^e^eⁿ^B^ook^:^B^a^c^k^g^r^o^un^{d M}^a^te^rⁱ^al^an^{d D}^a^t^a
^{on t}^h^e^Pro^g^{rams W}^ith^{in t}^h^e^J^u^ris^d^ic^tio^{n o}^f^the^C^o^mmitte^e^oⁿ^W^a^y^s^an^{d M}^e^ans^.^W^M^C^P^:¹^08-^{6. O}ⁿ^p^.^A^ppe^ndix^L^-^31.
^Ma^r^c^{h 20}⁰⁴^.

originally authorized by P.L. 104-193, the 1996 welfare reform law. Mathematica Policy ⁸
Research, Inc. won the contract for the evaluation.
Two other programs—the Community-^A^{Title V Abstinence Education p}^rog^ram⁽¹⁾^{has, as its}
Based Abstinence Education (CBAE) ^{exclusive p}^u^r^{pose, teaching t}^{he s}^ocial^{, psychological, and health}
program funded via HHS appropriations ^{gains of abstaining}^{from sex}^{ual ac}^{tivity; (2) teaching abstine}^nce^{from sex}^{ual activity outside of marriage as the e}^x^p^ected
and the “prevention” component of the ^{standard for all school-age children; (3) teachi}^{ng that}
Adolescent Family Life (AFL) ^abstinence^{is the only ce}^{rtain wa}^{y to avoid out-of-wed}^lock
program—include the eight statutory ^pregna^{ncy, STDs, and associated health p}^{roblems; (4) teac}^hing
elements of the Title V Abstinence-Only ^{that a m}^{utually faithf}^{ul monogamous relationship within}^{marriage is the e}^xpect^{ed standar}^{d of huma}^{n sex}^{ual activity; (5)}
Education block grant program (see Text ^{teaching that}^sex^{ual activity outside of marriage is likely to have}
Box at right). For FY2007, total ^harmf^{ul psyc}^{hological and physical effects; (6) teac}^{hing that}
abstinence-only education funding ^{bearing c}^{hildren out-of-wedlock i}^s^{likely to have harmf}^ul
amounted to $177 million: $50 million ^consequ^ences^{for the}^{child, the c}^{hild’s parents, and society; (7)}
for the Title V abstinence program; $13 ^{teaching you}^{ng peo}^{ple how to reject sex}^{ual advances a}^{nd how}^{alcohol and drug use inc}^{reases v}^u^{lnerability to sexual advances;}
million for the AFL abstinence education ^{and (8) teaching}^{the importa}^nce^{of attaining self-sufficiency}
projects; $109 million for the CBAE ^{before e}^{ngaging in se}^x.
program (up to $10 million of which may ^Source:^{Section 51}^{0 of t}^{he Social Security Act. [Title 42 U.S.}
be used for a national abstinence ^{C. Section 710]}

education campaign); and $4.5 million
for an evaluation of the CBAE program.
Mathematica’s April 2007 report presents the final results from a multi-year, experimentally
based impact study on several abstinence-only block grant programs. The report focuses on four
selected Title V abstinence education programs for elementary and middle school students: (1)
My Choice, My Future!, in Powhatan, VA; (2) ReCapturing the Vision, in Miami, FL; (3)
Families United to Prevent Teen Pregnancy (FUPTP), in Milwaukee, WI; and (4) Teens in
Control, in Clarksdale, MS. Based on follow-up data collected from youth (aged 10 to 14) four to
six years after study enrollment, the report, among other things, presents the estimated program
impacts on sexual abstinence and risks of pregnancy and STDs.
According to the report:
^Fin^dⁱⁿ^gsⁱⁿ^{dicate t}^h^at^y^o^u^t^hⁱⁿ^th^{e prog}^ra^m^g^r^o^u^p^w^e^reⁿ^o^m^o^{re lik}^el^y^t^h^an^coⁿ^t^{rol g}^r^ou^p
^y^o^ut^{h t}^o^ha^ve^a^b^st^aⁱ^ne^d^fr^o^m^s^e^{x a}ⁿ^d^,^a^m^oⁿ^{g t}^h^o^s^e^w^h^o^r^e^p^o^r^t^e^d^ha^vⁱⁿ^g^ha^d^se^x,^t^h^e^y^ha^d
^si^m^{ilar num}^{bers o}^f^se^x^u^a^{l part}ⁿ^e^{rs an}^d^h^a^{d in}^itia^{ted sex}^{at t}^h^{e sa}^m^e^m^ean^a^g^{e.... P}^r^og^ram
^an^{d con}^t^rol^g^r^ou^p^y^out^h^di^{d n}^o^t^di^ff^{er i}ⁿ^t^h^ei^{r rat}^e^s^of^u^nprot^ect^{ed s}^e^x^,^ei^t^h^{er at}^fⁱ^rst
ⁱⁿ^tercou^rs^{e or ov}^{er th}^{e la}^s^t^{12 m}^oⁿ^t^h^s^{.... Ov}^eral^{l, th}^{e prog}^ram^sⁱ^m^prov^{ed iden}^ti^fⁱ^catioⁿ^of
^S^T^D^s^b^u^t^ha^d^no^o^v^e^r^a^l^lⁱ^m^p^a^c^t^oⁿ^kno^wl^e^d^ge^o^f^unp^r^o^tected^s^e^x^ris^k^s^an^d^t^h^e^con^s^equ^eⁿ^ces
^of^S^T^D^s^{. Bot}^h^pr^og^ra^m^an^{d con}^t^rol^g^r^ou^p^y^o^u^t^h^h^a^{d a g}^{ood u}ⁿ^d^ers^t^aⁿ^di^ng^of^t^h^{e ri}^s^k^s^of⁹
^pregⁿ^aⁿ^c^y^bu^{t a le}^s^s^{clear un}^d^e^rs^tan^d^ing^of^ST^Ds^an^{d th}^eir^h^ealt^h^con^s^eq^u^eⁿ^c^e^s^.

⁸^T^h^e^T^itle^V^A^b^s^tineⁿ^c^e^Ed^uc^a^tio^{n bl}^oc^k^g^r^aⁿ^{t pr}^og^ram^{to s}^t^a^t^e^s^w^a^s^orig^ina^lly^prov^ide^d^$25^{0 m}^illi^{on i}ⁿ^f^e^de^ra^{l f}^unds
^($5⁰^m^illion^pe^{r y}^e^a^r^f^o^{r f}ⁱ^v^e^y^ears^,^f^r^om^FY^{1998 t}^o^FY²⁰^02).^Fuⁿ^d^s^m^u^s^t^be^re^que^s^t^e^d^by^s^t^a^t^e^s^w^h^eⁿ^the^y^s^o^lic^it
^T^itle^V^Ma^te^rna^l^aⁿ^{d C}^h^ild^H^e^a^{lth (MCH}⁾^bloc^k^g^r^aⁿ^{t f}^unds^,^aⁿ^d^m^u^s^t^be^us^e^d^e^x^c^l^us^iv^e^l^y^f^o^{r te}^a^c^hing^a^b^s^tⁱⁿ^eⁿ^c^e^.^T^o
^recei^{ve fed}^e^ral^f^unds^{, a}^s^t^a^t^e^m^u^s^t^m^a^t^c^{h e}^v^e^r^y^{$4 in f}^e^de^r^a^{l f}^unds^w^{ith $3 i}ⁿ^s^t^a^t^e^f^unds^.^T^h^is^m^e^aⁿ^s^tha^t^f^u^{ll f}^und^ing
^f^o^{r a}^b^s^tineⁿ^c^e^e^duc^a^tio^{n m}^u^s^t^tot^a^{l a}^t^le^a^s^{t $8}^7.5^m^{illion a}ⁿ^nua^lly^{. A}^lthoug^{h t}^h^e^T^itle^V^a^b^s^t^ineⁿ^c^e^-^only^e^duc^a^tion
^bloc^k^g^r^aⁿ^{t ha}^s^{not y}^e^{t be}^eⁿ^r^e^a^u^t^hor^iz^e^d^,^the^la^te^s^t^e^x^te^ns^io^{n, c}^o^nt^aⁱ^ne^{d in}^P^.^L^.¹^10-⁴⁸⁽^S^.¹⁷⁰¹⁾^,^c^o^ntin^ue^s^f^undi^ng
^f^o^{r the}^bl^oc^k^g^r^aⁿ^{t thro}^ug^{h Se}^pte^m^be^{r 30, 2}⁰⁰⁷^{. A}^c^c^o^rding^to^Ma^t^h^e^m^a^tic^a^,^m^o^re^thaⁿ⁷⁰^{0 T}^itle^V^a^b^stineⁿ^c^e
^pr^og^r^a^m^s^ha^ve^be^eⁿ^f^unde^d.
⁹^M^a^t^h^em^atⁱ^{ca P}^o^lⁱ^c^y^Rese^arch^,^Inc.^,^Impac^ts^{of F}^our^Title^V^,^Se^c^tⁱ^o^{n 5}¹⁰^Abstiⁿ^eⁿ^c^e^Ed^uc^ati^oⁿ^Pro^g^r^ams^{, by}
⁽^c^onti^nue^d.^..)

In response to the report, HHS has stated Experimentally Designed Studies of Effective
that the Mathematica study showcased Comprehensive Sexual Education Pregnancy
programs that were among the first Prevention Programs
funded by the 1996 welfare reform law. It ^{(1) Aban Aya}^{Youth Project—Ch}^{icago, Il}^linois^{: The study found}
stated that its recent directives to states ^{that 7}^{8% of}^{boys in th}^{e p}^{rogram/interve}^{ntion group}^used
have encouraged states to focus ^{condoms compared to 6}^{5% of}^{boys in the}^{control group.}
abstinence-only education programs on ^{There were}^{no significant findings}^{for the girls.}
youth most likely to bear children outside ^{(2) Children’s Aid Society (CA}^S)^{Carrera Program—}^{NY, MD,}
of marriage, i.e., high school students, ^{FL, TX, OR, and WA:}^{The study}^{found that t}^{he girls in t}^he
rather than elementary or middle-school ^{program grou}^{p we}^{re 1}^{8% less likely to have had se}^{x tha}^{n girls}
students. It also mentioned that programs ^{in the cont}^{rol group; were}⁵⁵^{% less likely to become preg}^nant;^{and were}^80%^{more likely to use}^{dual methods of}
need to extend the peer support for ^{contraception at last se}^{xual e}^{ncounter. The}^{re were}^no
abstinence from the pre-teen years ¹⁰^{significant findings for t}^{he boys.}
through the high school years. ^{(3) Draw the Lin}^{e/Respect t}^{he Li}^ne—North^{ern California: At}
^{the th}^{ree-year follow-up, 19}^{% of}^{the boys in}^the^program
^group^{had engaged in se}^{xual activ}^{ity compared to 27}^{% of boys}^{in the cont}^{rol group. There we}^re^{no significant findings for}^the
^girls.
^{(4) Postponing Sexual I}^{nvolvement, Huma}^{n Sex}^{uality, and}
Advocates of a more comprehensive ^{Health Screening}^Cur^riculum—^{Washington, DC: Several}
approach to sex education argue that ^{months afte}^{r the}^interve^{ntion, girls in the p}^{rogram were}^twice^{as likely as girls in the control gr}^{oup to delay sex; and girls in}
today’s youth need information and ^{the p}^{rogram grou}^{p were}^three^t^o^{seven times more likely than}
decision-making skills to make realistic, ^{girls in the control group}^{to have}^{used contra}^{ception at last}
practical choices about whether to ^{sexual en}^counte^{r. There we}^{re no}^{significant findings for t}^he
engage in sexual activities. They contend ^boys.
that such an approach allows young ^{(5) Safer Choices—Texas a}^{nd California: At the 31-month}
people to make informed decisions ^follow^{-up, sexually active p}^rogra^{m participant}^{s (boys a}^{nd girls)}
regarding abstinence, gives them the ^{were 1.5 times}^{more likely than c}^{ontrol group pa}^{rticipants to}^{use a condom; and}^program^parti^{cipants wer}^{e 1.5 times}^more
information they need to resist peer ^{likely than the cont}^{rol group to u}^{se a second met}^{hod of birth}
pressure and to set relationship limits, ^control.
and also provides them with information ^Source:^The^{National Campaign}^{to Prevent Teen P}^regna^ncy.
on prevention of STDs and the use of ¹¹^{Putting What Works To}^{Work: Curr}^{iculum-Based Programs That}
contraceptives. ^{Prevent Teen Pregnancy}^{. P. 4.}

According to a recent report by the
National Campaign to Prevent Teen Pregnancy, five random assignment experimentally designed
studies (published since 2000) of teen pregnancy prevention programs have been proven to be
effective in delaying sexual activity, improving contraceptive use among sexually active

^(...c^on^tin^ue^d)
^Ch^ri^st^op^h^e^{r T}^r^en^ho^l^m^,^Barb^{ara Devan}^e^y^,^Ken^F^o^rt^soⁿ^,^Lⁱ^{sa Qu}^a^y^,^Ju^stⁱⁿ^W^h^eel^er,^an^{d M}^e^lⁱ^{ssa Cl}^ark.^Fⁱⁿ^a^l^Repo^rt^.
^A^p^{ril 200}^{7. C}^oⁿ^t^ra^c^t^{No.: HHS}¹^00-^98-⁰⁰^10.^htt^p^://a^spe^.^hhs.g^ov^/^h^sp/a^bstineⁿ^c^e^07/.
¹⁰^U^.^{S. D}^e^pa^r^t^m^e^{nt of}^H^e^a^{lth a}^nd^H^u^m^a^{n Se}^r^v^ic^es⁽^H^H^S⁾^,^Re^por^{t R}^e^le^as^e^d^on^Fo^ur^Tit^l^e^{V A}^b^s^tineⁿ^c^e^Educ^a^tioⁿ
^Pr^ogr^am^s^{. HHS}^P^r^e^{ss Off}ⁱ^c^e^.^A^p^{ril 1}³^,²⁰⁰⁷^htt^p^://a^sp^e^.^hhs.g^ov^/^h^sp/^a^bstineⁿ^c^e^07/^f^a^c^t^she^e^t^.sht^m^l^.
¹¹^A^lthoug^{h m}^o^r^e^thaⁿ³⁰^f^e^de^r^a^{l pr}^og^r^a^m^s^ha^v^e^a^u^thor^ity^{to pr}^ovⁱ^d^e^f^unding^f^o^r^pr^e^g^na^nc^y^pr^e^v^eⁿ^tio^{n s}^e^r^v^ic^e^s^{, the}
^am^ount^of^f^e^de^r^a^l^f^unding^a^c^t^ua^ll^y^s^p^eⁿ^{t on c}^o^m^p^r^e^he^ns^iv^e^s^e^x^u^a^l^e^duc^a^tion^pr^og^r^a^m^s^or^s^e^r^v^ic^e^s^f^o^r^te^eⁿ^a^g^e^r^s^c^a^nnot
^be^isola^t^e^d^.^Se^e^a^G^e^ne^ra^l^A^c^c^ounting^Of^fⁱ^c^e^(now^G^ove^rnm^e^{nt Ac}^c^ounta^bⁱ^lity^Offⁱ^c^e⁾^re^{port, GAO/HEHS-99-}^4,^T^een
^P^r^egⁿ^aⁿ^{cy: S}^t^a^t^{e an}^d^F^e^d^e^ra^l^E^f^f^o^rt^{s t}^o^Im^p^l^emen^t^P^r^even^tⁱ^oⁿ^P^r^og^ra^{ms an}^d^Mea^s^u^r^e^T^h^ei^{r E}^f^f^ectⁱ^ven^ess^{, N}^o^v^e^m^b^e^r
¹⁹⁹^8.

teenagers, or preventing teen pregnancy¹² (see the Text Box above). Many analysts and
researchers agree that effective pregnancy prevention programs have many of the following
characteristics:
• Convince teens that not having sex or that using contraception consistently and
carefully is the right thing to do.
• Last a sufficient length of time.
• Are operated by leaders who believe in their programs and who are adequately
trained.
• Actively engage participants and personalize the program information.
• address peer pressure.
• Teach communication skills.
• Reflect the age, sexual experience, and culture of young persons in the programs.
Although there have been numerous evaluations of teen pregnancy prevention programs, there are
many reasons why programs are not considered successful. In some cases the evaluation studies
are limited by methodological problems or constraints because the approach taken is so
multilayered that researchers have had difficulty disentangling the effects of multiple components
of a program. In other cases, the approach may have worked for boys but not for girls, or vice
versa. In some cases, the programs are very small, and thereby it is harder to obtain significant
results. In other cases, different personnel may affect the outcomes of similar programs.

There is a significant difference between abstinence as a message and abstinence-only
interventions. While the Bush Administration continues to support an abstinence-only program
intervention (with some modifications), others argue that an abstinence message integrated into a
comprehensive sex education program that includes information on the use of contraceptives and
that enhances decision-making skills is a more effective method to prevent teen pregnancy. A
recent nationally representative survey found that 90% of adults and teens agree that young
people should get a strong message that they should not have sex until they are at least out of high
school, and that a majority of adults (73%) and teens (56%) want teens to get more information ¹³
about both abstinence and contraception. The American public—both adults and teens—
supports encouraging teens to delay sexual activity and providing young people with information
about contraception. (For additional information on teen pregnancy prevention, see CRS Report
RS20301, Teenage Pregnancy Prevention: Statistics and Programs, and CRS Report RS20873,

¹²^T^h^{e Nat}ⁱ^oⁿ^a^l^Cam^p^ai^gn^t^o^P^r^even^t^T^een^P^r^egn^aⁿ^c^y^,^Putting^W^hat^W^o^rk^{s To W}^o^rk^{: Curric}^u^l^u^m-Bas^e^{d Progr}^ams
^T^h^a^t^P^r^even^t^T^een^P^r^egn^aⁿ^c^y^{. 2}⁰^{07. N}^o^te^{: T}^h^e^r^e^por^{t lis}^ts^{23 e}^f^f^e^ctiv^e^pr^og^r^a^m^s^tha^t^us^e^d^eⁱ^t^h^e^r^aⁿ^e^x^pe^rⁱ^m^e^nta^l^or
^qua^sⁱ^-^e^x^p^e^r^im^eⁿ^ta^{l de}^sⁱ^gⁿ^{. T}^h^e^ea^r^lie^s^t^pr^og^r^a^m^lis^te^{d w}^a^s^ba^s^e^{d on a}¹⁹⁹⁰^e^v^a^l^ua^tio^{n. Se}^e^t^h^e^Te^x^t^B^o^x^a^b^o^v^{e f}^o^{r a}
^lis^{t of}^fⁱ^v^e^pr^og^r^a^m^s^w^{ith a}ⁿ^e^x^pe^rⁱ^m^e^nta^l^de^sⁱ^gⁿ^tha^t^w^e^r^e^ev^a^l^ua^t^e^{d in}²⁰⁰⁰^or^la^te^r^.
¹³^T^h^{e Nat}ⁱ^oⁿ^a^l^Cam^p^ai^gn^t^o^P^r^even^t^T^een^P^r^egn^aⁿ^c^y^,^W^{ith O}ⁿ^e^Voi^c^e²⁰⁰^7—Am^e^r^ic^a’^s^A^dults^an^d^T^e^eⁿ^s^Sou^nd^O^ff
^A^b^ou^t^T^{een P}^r^eg^naⁿ^c^y^,^by^{Bill Albe}^{rt. Fe}^brua^ry²⁰⁰^7,^p.^2.^h^ttp:^/^/^www^.te^e^npre^g^na^nc^y^.^org^/^re^sourc^e^s^/da^t^a^/^pdf^/
^W^O^V²⁰⁰^7_f^ullte^x^t^.p^df^.

Reducing Teen Pregnancy: Adolescent Family Life and Abstinence Education Programs, both by
Carmen Solomon-Fears.)
^Car^m^eⁿ^So^lo^m^o^n-^Fear^s
^Specialis^{t i}ⁿ^{Social P}^o^lic^y
^cs^ol^o^m^onf^ears@^crs^.^l^o^c.g^o^v^,⁷^-⁷³⁰⁶