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Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV and Sexually Transmitted Infections
Full Study Report [pdf]
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Introduction
Until recently, teen pregnancy and birth rates had declined in the United States. Despite these declines, US teen birth and sexually transmitted infection (STI) rates remain among the highest in the industrialized world. Given the need to focus limited prevention resources on effective programs, Advocates for Youth undertook exhaustive reviews of existing research to compile a list of those programs proven effective by rigorous evaluation. Nineteen programs appeared in Science and Success when it was first published in 2003; seven additional programs are included in Science and Success, Second Edition.
Criteria for Inclusion—The programs included in this document all had evaluations that:
- Were published in peer-reviewed journals (a proxy for the quality of the evaluation design and analysis);
- Used an experimental or quasi-experimental evaluation design, with treatment and control / comparison conditions;
- Included at least 100 young people in treatment and control / comparison groups.
Further, the evaluations either:
- Continued to collect data from both groups at three months or later after intervention
And
- Demonstrated that the program led to at least two positive behavior changes among program youth, relative to controls:
- Postponement or delay of sexual initiation;
- Reduction in the frequency of sexual intercourse;
- Reduction in the number of sexual partners / increase in monogamy;
- Increase in the use, or consistency of use, of effective methods of contraception and/or condoms;
- Reduction in the incidence of unprotected sex.
Or:
- Showed effectiveness in reducing rates of pregnancy, STIs, or HIV in intervention youth, relative to controls.
Program Effects—Twenty-six programs met the criteria described above: these 26 programs were able to affect the behaviors and/or sexual health outcomes of youth exposed to the program.
Risk Avoidance Through Abstinence—Fourteen programs demonstrated a statistically significant delay in the timing of first sex among program youth, relative to comparison / control youth. One of these programs is an intervention for elementary school children and their parents. The other 13 programs target middle and high school youth and all include information about both abstinence and contraception, among other topics and/or services. (See Table A)
Risk Reduction for Sexually Active Youth—Many of the programs also demonstrated reductions in other sexual risk-taking behaviors among participants relative to comparison / control youth. (See Table A)
- 14 programs helped sexually active youth to increase their use of condoms.
- 9 programs demonstrated success at increasing use of contraception other than condoms.
- 13 programs showed reductions in the number of sex partners and/or increased monogamy among program participants.
- 7 programs assisted sexually active youth to reduce the frequency of sexual intercourse.
- 10 programs helped sexually active youth to reduce the incidence of unprotected sex.
Reduced Rates of Teenage Pregnancy or Sexually Transmitted Infections—Thirteen programs showed statistically significant declines in teen pregnancy, HIV or other STIs. Nine demonstrated a statistically significant impact on teenage pregnancy among program participants and four, a reduced trend in STIs among participants when measured against comparison / control youth. (See Table A)
Increased Receipt of Health Care or Increased Compliance with Treatment Protocols—Six programs achieved improvements in youth’s receipt of health care and//or compliance with treatment protocols, or other actions that improved their health. (See Table A)
Program Content—Of the 26 effective programs described here, 23 included information about abstinence and contraception within the context of sexual health education. Of the three that did not include sexual health education, two were early childhood interventions and one was a service-learning program.
Programs’ Setting: The programs and their evaluations are grouped in this document in three sections.
- Section I describes 11 effective programs designed for and evaluated in school settings, including some that are linked to reproductive health care.
- Section II describes 10 effective programs implemented by community agencies outside of the school or clinic environment.
- Section III describes five effective, clinic-based programs.
To view a table summarizing of programs' settings as well as the grade range, locale, and populations served by each, please see Table B. For a more detailed description of each program and its evaluation refer to the relevant sections of this document.
Within the description of each program, Advocates for Youth includes information about the program's components, the populations with whom the program is most effective, evaluation methodology, and evaluation findings. When applicable, Advocates includes this same information regarding replications. Finally, each program summary includes contact information for learning more about and/or ordering the program.
Note: A number of evaluated programs did not meet all the criteria for inclusion in this document, yet may be worth considering. Programs were not included here if the evaluation:
- Has not been published in a peer-reviewed journal;
- Found or measured only one positive behavior change;
- Did not include a comparison or control group; and/or
- Did not include at least 100 young people in participation and comparison / control groups, combined.
For information about these and other programs, please visit www.advocatesforyouth.org/programsthatwork/toc.htm.
This paper uses the researchers’ own language to identify race/ethnicity. In program summaries, the terms African American, Black, Hispanic, and Latina all may occur.
Source/Citation:
Alford S. Science and Success, Second Edition: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. Washington, DC: Advocates for Youth, 2008.
View the Publications Catalog and/or to order this publication.
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