To help reduce the risks of pregnancy, sexually transmitted infections, and associated risk behaviors among teenagers, Congress authorized PREP as part of the 2010 ACA. Mathematica's evaluation is documenting how PREP-funded programs are operationalized and assessing selected programs’ effectiveness....
New Issue Brief on Delivering Adolescent Pregnancy Prevention Services to High-Risk Youth
More than half a million adolescents in the United States attend alternative schools or other specialized education programs for youth at risk of academic failure. Many of these youth have emotional or behavioral health issues and might be at high risk for teen pregnancy and sexually transmitted infections (STIs). To date, little research has been done on adolescent pregnancy prevention programming designed to meet the needs of youth in alternative school settings. An issue brief from Mathematica Policy Research summarizing lessons learned from implementing Teen Choice helps to address this research gap.
With funding from the Administration for Children & Families within the U.S. Department of Health and Human Services, Mathematica collaborated with the New York State Department of Health to rigorously evaluate the Teen Choice curriculum in alternative school settings in and around New York City. Teen Choice is funded through the Personal Responsibility Education Program (PREP), which provides federal funding to educate youth on abstinence and contraception. The issue brief is part of a multicomponent evaluation of PREP led by Mathematica for the Administration for Children & Families at the U.S. Department of Health and Human Services.
To conduct the study, Mathematica partnered with Inwood House, a nonprofit agency that developed and delivered the Teen Choice curriculum in five New York City-area schools serving high-risk youth. The curriculum—comprising 12 sessions of 45 minutes each with groups of 8 to 12 students—covers abstinence, contraception, STIs, and healthy relationships. Teen Choice relies on a mutual aid approach to instruction, which strives to create a trusting learning environment within each group that is built on constructive interactions among students and the facilitator. Structured by interactive exercises and guided discussions based on the groups’ needs, the curriculum concludes with participants creating action plans to avoid sexual risk behaviors and maintain healthy relationships.
Regarding implementation of the program, the study found the following:
- Teen Choice’s delivery and approach facilitated youth engagement and a reported increase in knowledge. Program staff reported that they liked the flexibility of the Teen Choice curriculum and its mutual aid approach, which they felt helped students develop trusting relationships with one another and identify with and retain the program’s messages. During the group sessions the evaluation team members observed, youth were generally engaged and willing to participate in group discussions. In focus groups, most participants indicated they had increased their knowledge of contraception and STIs during their time in the program.
- Maintaining regular attendance was a challenge. Inwood House worked with school administrators to identify the best strategy to implement Teen Choice given the targeted youth’s school schedules and their substantial academic and behavioral issues, including poor school attendance. A combination of reminders; modest incentives, such as providing snacks and gift cards; and scheduling class sessions in the middle of the day helped improve attendance among this hard-to-reach group. Programs planning to serve this population can build on this approach.
A full report of this implementation study is available. Mathematica conducted the research in conjunction with a rigorous impact study using a random assignment research design, in which students were assigned to receive either the Teen Choice curriculum or their regular programming. An upcoming impact report, scheduled for release this year, will examine the effects of the program on participating students’ attitudes, knowledge, and sexual activity six months after they completed the program.
Personal Responsibility Education Program (PREP)
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