Evaluation of Abstinence Education Programs Funded Under Title V, Section 510

Goals | Participating Programs | Components | Reports

In 1996, Congress authorized $50 million annually for five years in funding to states for programs that teach abstinence from sexual activity outside of marriage as the expected standard for school-age children. This funding was established through a new formula grant program created under Title V, Section 510 of the Social Security Act, authorized under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996. The funds became available to states in 1998 and are administered by the Maternal and Child Health Bureau. States must provide $3 in matching funds for every $4 in federal funds, resulting in a total of up to $87.5 million available annually for these state programs. Abstinence education programs funded through this grant program teach an unambiguous abstinence message to youth. Programs receiving these funds may not endorse or promote contraceptive use. 

Since the passage of PRWORA, the percentage of teens reporting that they have had sex has decreased, continuing a decline that started in 1991. At this time, however, no definitive research has linked the abstinence education legislation with these downward trends. Most people acknowledge that “abstinence works.” It is certain to prevent unwanted pregnancy, sexually transmitted diseases (STDs), abortions, and out-of-wedlock childbearing. However, an important question remains: To what extent are abstinence education programs effective in persuading youth to be sexually abstinent and in changing teen sexual behavior? 

To address this question, Congress authorized a federally funded, independent evaluation of Section 510 abstinence education programs in the Balanced Budget Act of 1997 (Public Law 105-33). In fall 1998, the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, awarded a competitive contract to Mathematica Policy Research to conduct an independent evaluation of Section 510 abstinence education programs.

What is the Title V, Section 510 abstinence education program? The Section 510 abstinence education funding (Title V, Section 510 (b)(2)(A-H) of the Social Security Act) specifies that a program must:

The Maternal and Child Health Bureau guidelines offer the following interpretation of the A-H definition. “It is not necessary to place equal emphasis on each element of the definition. However, a project may not be inconsistent with any aspect of the abstinence education definition” (U.S. Department of Health and Human Services 1997). The guidelines also stipulate that abstinence education grant funds cannot be used to provide instruction in the use of birth control or to promote the use of such methods.

Goals of the Study

The evaluation addresses three important questions:

• What are the nature and underlying theories of the abstinence education programs supported with Section 510 funding?
• What are the implementation and operational experiences of local communities and schools that have received abstinence education funding?
• What are the impacts of abstinence education programs?
  - How successful are they in changing the knowledge, attitudes, and intentions of youth?
  - How successful are they in reducing teen sexual activity among youth?
  - How do they change the risk of pregnancy and STDs?

Participating Section 510 Abstinence Education Programs

Within and across states, there is great diversity in how Section 510 abstinence education funds are distributed, the nature of the programs supported, and the youth most aggressively targeted. Funded abstinence initiatives range from brief, curriculum-based classroom programs to more intensive ones with many complementary services or “boosters” to reinforce the abstinence messages and to provide youth with alternatives to high-risk behaviors. Examples of the types of complementary services offered are after-school care, tutoring and other forms of academic support, peer or adult mentors, motivational assemblies, cultural events, and parent and family support and education programs. Many states have encouraged and supported community-wide abstinence initiatives, which attempt to alter behaviors through a combination of targeted services to youth and efforts to create systemic changes in community norms, messages, and support.

Eleven programs, representing a range of program models and serving different target populations, have been selected for in-depth study (see Table). Five of the 11 are referred to as “targeted” programs: they target services to specific, identifiable groups of youth. These programs range from curriculum-based programs operating in school settings to multiyear, multipronged efforts that extend beyond the school to the home and community. Some use nationally disseminated abstinence education curricula, while others have developed their own curriculum materials in house.

The remaining six programs are community-wide, systemic-change initiatives that use the abstinence education funding to increase public awareness of the problems of teen sexual activity, to change community norms and attitudes, to engage parents and encourage stronger parent-child communications, and to engage youth in abstinence education and support services. Four of the programs are operated by community-based organizations, two of which were set up specifically to operate the Title V abstinence education grant. The other two community-wide programs are run by county health departments. Each project includes an abstinence education curriculum delivered through local schools as well as a variety of efforts aimed at changing community norms and behaviors. Some projects are student-focused, with less outreach to parents and other community members. Others have concentrated on engaging parents and community leaders early on. One project has an especially heavy emphasis on media efforts.

While the abstinence education programs selected are considered interesting and well-implemented programs, they are not necessarily better than or representative of the more than 700 abstinence education programs funded under Section 510 and operating nationwide. Many of the other Section 510 abstinence education programs are being examined in evaluations that states and localities have funded themselves, and these other studies will provide rich and important detail on the range of abstinence strategies and their effects.

Study Components

The federally funded evaluation includes an extensive implementation and process analysis, focused on the 11 Section 510-funded abstinence education programs, as well as rigorously designed impact studies of the 5 targeted programs. The analysis documents the experience of organizations and communities applying for and receiving abstinence education funding in both the targeted and community-wide program sites. It describes the abstinence interventions implemented—the program goals, the underlying theoretical framework, and the specific curriculum elements covered by the program. It examines the target population and community context, and reports participants’ experiences with the program. It also details the organizational structure of the abstinence education program models, identifying those models that have been used and the factors associated with successful implementation. The implementation and process analysis uses three primary data sources: (1) review of program documents and records; (2) interviews and focus groups with program staff, school staff, community leaders, parents, and program participants; and (3) on-site program observations.

The impact studies of the five targeted programs use longitudinal survey data for groups of youth randomly assigned to the Section 510 abstinence program in each site or to a control group. Critical features of the impact analysis study design are:

• The impact study uses experimental designs in all sites. In each site, program effectiveness is measured by comparing outcomes of eligible youth who were randomly assigned to the program or to a control group.
• Sample sizes are between 400 and 700 youth per site. Large sample sizes protect against the possibility of failing to detect true program impacts simply because the study lacks statistical power. To achieve adequate sample sizes, youth were enrolled in the study from fall 1999 through fall 2001.
• Followup of the sample continued for up to five years after study enrollment. The first wave of data collection occurred at “baseline” as participants were first enrolled in the program or the control group (fall 1999 through fall 2001), a second wave occurred 6 to 12 months later (fall 2000 through spring 2002), a third wave occurred 18 to 36 months after initial sample enrollment (spring 2002 through fall 2003), and a fourth wave was administered to the full sample in spring 2005, between three and five years after youth enrolled in the program group or the control group.
• Data collection procedures respect the rights of students and parents and protect the privacy of respondents. The evaluation uses an active parental consent process, whereby the parent or guardian must provide written consent before a student is eligible to participate. The evaluation also uses confidentiality protections designed to ensure that no one from local schools—including teachers, administrators, and program staff—has access to the student surveys.
• Student surveys and data collection procedures are designed to maximize the accuracy and reliability of student responses. Research indicates that youth may underreport socially undesirable behaviors, such as sexual activity and other risk-taking activity. Furthermore, abstinence means different things to different people. The surveys for the study measure specific, clearly defined behaviors. Students provide their answers on self-administered forms under the supervision of trained, independent interviewers.

Reports

"Impacts of Four Title V, Section 510 Abstinence Education Programs," April 2007
"First-Year Impacts of the Heritage Keepers^® Life Skills Education Component," August 2006
"First-Year Impacts of Four Title V, Section 510 Abstinence Education Programs," June 2005
“The Evaluation of Abstinence Education Programs Funded Under Title V Section 510: Interim Report,” April 2002

Table: Title V Abstinence Education Programs
Participating in the Federally Funded Evaluation

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