What Works Reproductive Health Fact Sheet

Publication#2008-20 4301ConnecticutAvenue,NW,Suite350,Washington,DC20008

Phone202-572-6000 Fax202-362-8420

WHATWORKSFORADOLESCENTREPRODUCTIVEHEALTH:LessonsfromExperimentalEvaluationsofProgramsandInterventions

VictoriaBall,B.A.KristinA.Moore,Ph.D. May2008

OVERVIEW

ThereproductivehealthofAmericanadolescentshasbeen,andcontinuestobe,amatterofseriousconcern.America’steenbirthrate–alreadythehighestamongdevelopednations1,2 –isagainontherise,andratesofsexuallytransmitteddiseasesamongAmericanteensareveryhigh.3,4 Assuch,thedevelopmentandidentificationofeffectiveinterventionstohelpyouthavoidnegativereproductivehealthoutcomesisofgreatimportance.

WHATWORKS

Toidentifyprogramsthatworkandisolatethecomponentsofprogramsthatcontributetoprograms’success,wehavesynthesizedfindingsfromtheChildTrendsdatabaseofexperimentalevaluationsofsocialinterventionsforchildrenandyouth-LINKS.5 LINKScurrentlyincludesmorethan50programswhoseeffectsonreproductivehealthhavebeenexperimentallyevaluated.Ananalysisoftheseprogramsrevealedthefollowingthemes:

Manydifferent typesofprogramshavebeenshowntopositivelyaffectreproductivehealthoutcomes. Notonlyschool-andcommunity-basedsexeducationprograms,butalsoclinic-basedprograms,youthdevelopmentprograms,service-learningprograms,earlychildhoodprograms,andprogramsforyoungmothershavebeenfoundtoimprovereproductivehealthoutcomes.(Seetable.)

Comprehensivesexeducation canimproveadolescentreproductivehealth. Ofthe21comprehensivesexeducationprogramsthathavebeenexperimentallyevaluated,11hadasignificantpositiveimpactonthebehavioroftheyouthstudiedorimportantsubgroupsofthesample.6

High-quality,intensiveearlychildhoodinterventionscanpositivelyaffectreproductivehealthoutcomeslaterinlife.Thelong-termimpactsonreproductivehealthoftwoearlychildhoodprograms–theCarolinaAbecedarianProgramandtheHigh/ScopePerryPre-SchoolProgram–havebeenexperimentallyevaluated.Bothprogramshadpositiveimpactsyearsaftertheprograms

ended.AbecedarianparticipantswerefoundlesslikelytobecometeenparentsandPerryPre-Schoolparticipantshadfewernon-maritalbirths.Additionally,theNurse-FamilyPartnership–aprogramprovidingassistancetoyoungmothers–wasfoundtohavelong-termimpactsonthechildrenofmothersinvolvedintheprogram.Thesechildrenhadfewersexualpartnersoveradecadeafterserviceswereprovidedtotheirmothers.

Providing adolescentmothers withguidanceandsupportwhiletheirchildren areyoung

appearstodecreasesubsequentpregnanciesandbirths. Theimpactsonreproductivehealthoutcomesoftwoprogramsdesignedtoassistadolescentmotherswereexperimentallyevaluated.Bothprogramsledtodecreasesinrepeatpregnanciesandbirthandmoretimebetweenbirthsbythemothers.7

Programsthatincorporatecommunity servicehavebeenshowntopositivelyaffectparticipants’reproductivehealth. Theimpactsonreproductivehealthoutcomesontwoprogramsinvolvingcommunityservicewereexperimentallyevaluated.Bothprogramshadpositiveimpacts.ReachForHealthledtodelaysintheinitiationofsexualintercourse,andtheTeenOutreach

Programledtodecreasedratesofpregnancy.

At-riskyoutharereachable.Manyofthemostsuccessfulreproductivehealthinterventionsspecificallytarget minority youthfromlow-incomeareas. Successfulinterventionstargetinghigh-riskyouthincludeBecomingAResponsibleTeen,ReachForHealth,SiHLE,andtheBeProud!BeResponsible!familyofprograms.

Severalsexeducation programsinvolvingfewerthan15hoursofcontacttimehavebeenfoundtopositivelyaffectreproductivehealthoutcomes,includinginitiationofsexualintercourse,frequencyofintercourse,anduseofcondoms.ProgramsincludeBecomingAResponsibleTeen,BeProud!BeResponsible!,andMakingProudChoices.

Severalprogramsaresuccessfulforonegender,butnottheother. Twosexeducationcurricula

–DrawtheLine/RespecttheLineandTeenTalk–havebeenfoundtohavegreaterimpactsonmalesthanonfemales.Threeotherprograms–PostponingSexualInvolvement,CAS-Carrera,andYouthCorps–havebeenfoundtohavegreaterimpactsonfemalesthanonmales.

Severalprogramsaresuccessfulatonesiteorinoneevaluation, butnotinanother,indicatingthatcurriculumandprogrammingarenotthesoleelementsofasuccessfulintervention.Implementationmethods,staffing,andtailoring programstomeettheneedsofthepopulationbeingservedareallimportantconsiderations.ProgramsthathavehaddifferentialsuccessatdifferentsitesorindifferentevaluationsincludeBeProud!BeResponsible!,PostponingSexualInvolvement,WashingtonStateClientCenteredPregnancyPreventionPrograms,theTeenageParentDemonstration,andtheQuantumOpportunitiesProgram.

WHATDOESN’TWORK

Threeprogramsinvolvingjobtrainingandplacementhavehadtheirimpactsonreproductive

healthoutcomesevaluated. Noneoftheseprogramshadapositiveimpactonanybehavioraloutcome.8

Noabstinence-basedinterventionshaveyetbeenshowntopositivelyaffectanybehavioraloutcomes. Sixabstinence-basedinterventionshavehadtheirimpactsonbehavioraloutcomesexperimentallyevaluated.Nonehashadanimpactoninitiationofsexualintercourse,frequencyofsexualactivity,numberofsexualpartners,useofcondoms,useofcontraceptives,pregnancies,births,orSTDcontraction.9

Noneofthesesixabstinence-basedinterventionshavebeenshowntonegativelyaffectanybehavioral outcomes,either. Inparticular,inspiteoftheirexclusivefocusonabstinence,nonehaveservedtosignificantlydecreasecondomorcontraceptiveuse.

Programsthatfailtoteachcondomuseskillsdonotappeartohaveanimpactoncondomuse.

Some31programshavehadtheirimpactoncondomuseexperimentallyevaluated.Thesevenprogramsthathavebeenfoundtopositivelyaffectthisoutcomeareallsexeducationcurriculathatspecificallyteachcondomuseskills.10

MIXEDREVIEWS

Thoughmanyprogramshavebeenshowntopositivelyaffectcondomuse,veryfew

experimentallyevaluated programshavebeenshowntohaveapositiveimpactontheacquisition ofSTDs. Tosomeextent,thisreflectsthefactthatrelativelyfewstudieshaveassessedthisoutcome.11

Programsthathaveimpactsonknowledge,beliefs,attitudes,and/or intentions donotnecessarilyhaveanimpactonbehavior. Theimpactonbothbehavioralandpsychosocialoutcomesof26programshasbeenexperimentallyevaluated.Tenofthe18programsthatpositivelyaffectedatleastonepsychosocialoutcomefailedtohaveanimpactonanybehavioraloutcomes.Mostoften,thiswastheresultofprogramsthatincreasedstudentknowledgefailingtoresultin

changesinbehavior.12

Basedonthisanalysis,itseemsthattheidealreproductivehealthprogramisonethatunderstandstherealitiesandneedsofitsparticipants. Thesuccessthatseveralprogramshavehadwithat-riskpopulationsprovidesevidencethattailoringprogramcontentforspecificcommunitiescanreaprewards.

Additionally,theidealsexeducationprogramwillteachitsparticipantsthespecificskillsandbehaviorsnecessarytoachievepositivereproductivehealthoutcomes. Thefactthatonlythoseprogramsthatteachcondomuseskillshavehadanimpactoncondomuseprovidessupportforprogramsfocusingonspecificskillsandbehaviors;andtheexistenceofsomanyprogramsthataffectparticipantknowledgeandattitudesbutnotbehaviorfurtherunderscoresthispoint. Ontheotherhand,earlychildhoodprograms’focusesonschoolsuccessandpositivedevelopmenthavealsobeenfoundtohavepositiveimpactsonreproductivehealthyearslater. Programsthatcombineyouthdevelopmentwithspecificknowledgeandskillscanalsobesuccessful.

Asyet,thereisnoone“ideal”programmodelwhenitcomestopositivelyaffectingadolescentreproductivehealth.Avarietyofprogrammodels,andinterveningatavarietyoftimesacrossthelifecourse,havebeenprovensuccessfultosomeextentforsomeoutcomesandsomepopulations.Asnoted,severaloftheseprogramsarethosethatdonotexplicitlyfocusonreproductivehealthissues,butinsteadseektoimprovedevelopmentingeneral.Thesuccessoftheseprogramssuggeststhevalueofhigh-qualityinterventionsacrossthelifecourseasameanstoimproveallyouthoutcomes,includingreproductivehealth.

NEEDEDRESEARCH

Theexistenceofprogramsthathavebeenprovensuccessfulwithonlyonegenderofparticipantindicatestheneedforfurthereffortstorenderprogramcontentrelevantandappropriateforallprogramparticipants.Futureresearchneedstoaddress:

Culturallyappropriateandmorehighlyeffectiveapproaches,

Programsthateffectivelyengagehigh-riskadolescents,and

ProgramsthatpreventbothpregnancyandSTDs.

ENDNOTES

1 CentersforDiseaseControlandPrevention.(2007).AdolescentReproductiveHealth.DepartmentofHealthandHumanServices.Retrieved,fromtheWorldWideWeb:

2TeenBirths(2008).ChildTrends.Retrieved,fromtheWorldWideWeb:

3CentersforDiseaseControlandPrevention.(2008).NationallyRepresentativeCDCStudyFinds1in4TeenageGirlsHasaSexually

TransmittedDisease.Retrieved,fromtheWorldWideWeb:

4 CentersforDiseaseControlandPrevention.(2007).SexuallyTransmittedDiseases. DepartmentofHealthandHumanServices.Retrieved,fromtheWorldWideWeb:

5

6ThosecomprehensivesexeducationprogramsthathavebeensuccessfulincludeBecomingAResponsibleTeen,ReachForHealth,BeProud!BeResponsible!,SaferChoices,DrawtheLine/RespecttheLine,PostponingSexualInvolvement,TeenTalk,¡Cuídate!,MakingProudChoices!,FOCUS,FocusonKids,andSiHLE.[wanttosaywhatthatis?]

7 ThoseprogramsincludetheNurse-FamilyPartnershipandanuntitledhealthcareprogramforfirst-timeadolescentmothersandtheirinfants.

8Thosejobtraining/placementprogramsthathavebeenunsuccessfulincludeJobCorps,JOBSTART,andSTEP.

9 Thesixexperimentallyevaluatedabstinence-basedprogramsareMyChoice,MyFuture!,ReCapturingtheVision,TeensinControl,FamiliesUnitedtoPreventTeenPregnancy,HeritageKeepersLifeSkillsEducation,andMakingaDifference.

10 ThesevenprogramsthathavehadanimpactoncondomuseareBecomingAResponsibleTeen,BeProud!BeResponsible!,Safer

Choices,¡Cuídate!,MakingProudChoices,FocusonKids,andSiHLE.

11 SiHLEwasfoundtoincreasecondomuseandreducechlamydia;impactswerenotfoundforgonorrheaortrichomonas.

12 The10programsthatpositivelyaffectedapsychosocialoutcome,butfailedtoaffectabehavioraloutcome,areAll4You,Project

SNAPP,YAPP,ProjectCHARM,MyChoice,MyFuture!,HeritageKeepersLifeSkillsEducation,MakingaDifference,Enhanced

ManagingPressuresBeforeMarriage,ASSESS,andAIDS-PreventiveIntervention.[wanttosaywhattheacronymsstandfor?]

©2008ChildTrends.Maybereprintedwithcitation.

ThesupportoftheEdnaMcConnellClarkFoundationandTheStewartTrustisgratefullyacknowledged.Note:Asfundsbecomeavailable,ChildTrendswillbeexpandingthislineofworktoconductmeta-analyses.

ExperimentalEvaluationsofSocialProgramsthatExamined Impacts onOneorMoreReproductiveHealth

OutcomesandWhetherTheyWereFoundtoWork,NotProventoWork,orHadMixedFindings

(Source:

OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
InitiationofSexual
Intercourse / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-FamiliesUnitedtoPreventTeenPregnancy(FUPTP),anabstinence-focusedafter-schoolprogramfor8-13year-olds
-Heritage KeepersLifeSkillsEducation,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellas
service-learningactivities
-BeProud! BeResponsible!,anHIVeducationandskillstrainingprogramforAfricanAmericanadolescents
-HealthyForLifeProject (HFL),ariskybehaviorpreventionprogramformiddleschoolstudents
-McMasterTeenProgram,apregnancypreventionprogramformiddleschoolstudents
-ProjectSNAPP,anAIDSand
pregnancypreventionprogramformiddleschoolstudents
-SaferChoices,asexualityeducationprogramforhighschoolstudents
-Programsdesignedtoincreaseparent-childcommunicationaboutsex:
-EnhancedManagingPressuresBeforeMarriage,aseriesofhomework
assignmentsformiddle
schoolstudentstocompletewiththeirparents
-FactsFeelings,aseriesofsexuality-relatedvideosforadolescentstowatchwith
theirparents
-Aprogramdesignedtoreduceantisocialbehaviors:
-TheMontrealPrevention
Experiment,aninterventionforparentsandantisocialboys / -Abstinenceeducationprograms:
-MakingADifference,anabstinence-basedprogramforAfricanAmericanadolescents,delayedtheinitiationofsexualintercourseintheshort-term,butnotinthelong-term.
-Sexeducationprograms:
-DrawtheLine/Respect theLine,anSTDandpregnancypreventionprogramformiddleschoolstudents,delayedinitiationofsexualintercourseamongmales,butnotfemales.
-Postponing SexualInvolvement(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity,hashadsomesuccesswithfemales,butnotmales.
-Project TakingCharge, apregnancypreventionprogramforhigh-risk7thgraders,appearedtodelaytheinitiationofsexualintercourse,butthistrenddidnotachievesignificance.
-TeenTalk,apregnancypreventionprogramforteens,delayedinitiationofintercourseamongmales,butnotfemales.
-AdultIdentityMentoring (AIM),aprogramdesignedtohelpat-riskadolescentsarticulatefuturegoals,ledtolessfrequentincreasedratesofabstinenceintheshort-term,butnotinthelong-term.
-REALMen,aprogramdesignedtoprovidefatherswiththeskillsnecessarytocommunicatewiththeirsonsaboutHIVprevention,ledtoincreasedratesofabstinenceatthe6-monthfollow-up,butnotthe3-monthor12-monthfollow-ups. / -SexEducationPrograms:
-BecomingAResponsibleTeen(BART),anHIVeducationandskillstrainingprogramforAfricanAmericanhighschoolstudents
-Supplementingsexeducationwithcommunityservice:
-ReachForHealth,aprogramforAfricanAmericanandHispanicmiddleschoolstudents
Frequency ofSexual
Activity / -Abstinenceeducationprograms:
-MakingaDifference,anabstinence-basedprogramforAfricanAmericanadolescents
-Sexeducationprograms:
-ARREST,aprogramforinner-city,minorityadolescents
-Postponing SexualInvolvement / -Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellasservice-learningactivities,ledto
initialdecreasesinfrequencyofsexualactivitythatwerenolongersignificant
atthe12-monthor18-monthfollow-up
points. / -Sexeducationprograms:
-BecomingAResponsibleTeen(BART),anHIVeducationandskillstrainingprogramforAfricanAmericanhighschoolstudents
-¡Cuídate!, anHIVrisk-reductioncurriculumforLatinoadolescents
OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity
-ProjectSNAPP,anAIDSandpregnancypreventionprogramfor
middleschoolstudents
-SaferChoices,asexualityeducationprogramforhighschoolstudents
-Clinic-basedprograms:
-ASSESS,asafe-sexeducationprogramforyoungteens
-Reproductivehealthcounselingforyoungmen
-AdolescentswhoparticipatedinextendedHIVcounselinghadsexno
lessfrequentlythanadolescentswhoparticipatedinstandardcounseling
(AIDSEducationandCounseling
inanOfficeSetting). / -BeProud! BeResponsible!,anHIVeducationandskillstrainingprogramforAfricanAmericanadolescents,
significantlydecreasedfrequencyof
sexualactivityatoneprojectsite,butnotanother.
-DrawtheLine/Respect theLine,an
STDandpregnancypreventionprogramformiddleschoolstudents,significantlydecreasedfrequencyofsexualintercourseamongmales,butnotfemales.
-MakingProud Choices,asafe-sexprogramforAfricanAmericanadolescents,significantlydecreasedfrequencyofsexualactivityamongstudentswhoweresexuallyexperiencedbeforeenteringtheprogram.
-AdultIdentityMentoring (AIM),aprogramdesignedtohelpat-riskadolescentsarticulatefuturegoals,ledtolessfrequentintercourseamongmales,butnotamongfemales.
Number ofSexual
Partners / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-FamiliesUnitedtoPrevent
TeenPregnancy(FUPTP),anabstinence-focusedafter-schoolprogramfor8-to13-year-olds
-Heritage KeepersLifeSkills
Education,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludes
classroomcurriculumaswellas
service-learningactivities
-ARREST,aprogramforinner-city,minorityadolescents
-Postponing SexualInvolvement
(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity
-ProjectSNAPP,anAIDSandpregnancypreventionprogramfor
middleschoolstudents
-SaferChoices,asexualityeducationprogramforhighschoolstudents
-TheYouthAIDSPrevention
Project (YAPP),apreventionprogramforAfricanAmericanmiddleschoolstudents
-Clinic-basedprograms:
-ASSESS,asafe-sexeducation
Programforyoungteens
-AdolescentswhoparticipatedinextendedHIVcounselinghadnofewerpartnersthanadolescentswho
participatedinstandardcounseling
(AIDSEducationandCounselinginanOfficeSetting). / -Sexeducationprograms:
-BeProud! BeResponsible!,anHIVeducationandskillstrainingprogramforAfricanAmericanadolescents,
significantlydecreasednumberof
sexualpartnersatoneprojectsite,butnotanother.
-DrawtheLine/Respect theLine,an
STDandpregnancypreventionprogramformiddleschoolstudents,significantlydecreasednumberofsexualpartnersamongmales,butnotfemales.
-FOCUS,acurriculumforfemaleyouth,ledtolowernumbersofsexualpartnersfor subjectswhoweresexuallyinexperiencedatbaseline,butnotforsubjectswhoweresexuallyexperiencedatbaseline.
-Project CHARM,anHIVrisk-reductionprogramforpregnantadolescents,significantlydecreasednumberofsexualpartnersintheshort-term,butnotinthelong-term / -Sexeducationprograms:
-¡Cuídate!, anHIVrisk-reductioncurriculumforLatinoadolescents
-AstudyonVaryingtheTimingofanHIV-PreventionIntervention
foundthatdeliveringinterventioncontentduringseven1.5hour
sessionsworkedbetterthandeliver-ingitduringthree3.5-hoursessions.
-Grouptherapyforrecentlydivorcedmothersandtheirchildren:
-NewBeginnings
-Childrenofpoor,unmarriedwomenwhoparticipatedintheNurse-FamilyPartnership(NFP)(ahome-visitingprogramforlow-incomefirst-timemothers)hadsignificantlyfewersexualpartnersthanchildrenofpoor,unmarriedcontrolgroupwomen.
OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
UseofCondomsforSTDand/orPregnancy
Prevention / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-FamiliesUnitedtoPrevent
TeenPregnancy(FUPTP),anabstinence-focusedafter-schoolprogramfor8-13year-olds
-MakingADifference,an
abstinence-basedprogramforAfrican
Americanadolescents
-Heritage KeepersLifeSkillsEducation,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-ARREST,aprogramforinner-city,minorityadolescents
-DrawtheLine/Respect theLine,an
STDandpregnancypreventionprogramformiddleschoolstudents
-FOCUS,acurriculumforfemaleyouth
-HealthyForLifeProject (HFL),a
programtopreventriskybehaviorformiddleschoolstudents
-Postponing SexualInvolvement
(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity
-Project CHARM,anHIVrisk-reductionprogramforpregnant
adolescents
-ProjectSNAPP,anAIDSandpregnancypreventionprogramformiddleschoolstudents
-Neitheradidacticnoradiscussion-basedAIDSpreventionprogramworkedtoincreasecondomuseamongdelinquentandabusedadolescents(AIDS-PreventiveIntervention).
-Anintensiveafter-schoolyouthdevelopmentprogramwithsexeducationcomponent:
-CAS-Carrera
-Clinic-basedprograms:
-PARTNERSProject, apreventionprogramdesignedforsexuallyactiveHispanicwomenandtheirpartners
-Adolescentsthatparticipatedin
extendedHIVcounselingwerenomorelikelytousecondomsthanadolescentsthatparticipatedinstandardcounseling(AIDSEducationandCounselinginanOfficeSetting). / -Clinic-basedprograms:
-ASSESS,asafe-sexeducationprogramforyoungteens,hadanearlyimpactoncondom
use,butnolong-termimpact.
-Ahealthbeliefmodelinterventionforhigh-risk
adolescentfemalesincreased
condomuse,butclientsremainedinconsistentusers.
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellasservice-learningactivities,ledtoinitialincreasesincondomusethatwerenolongersignificantatthe12-monthor18-monthfollow-uppoints.
-YouthAIDSPreventionProject
(YAPP),apreventionprogramforAfricanAmericanmiddleschoolstudents,didnotincreasetheuseofcondomsamongstudents,butdidincreasetheuseofcondomsincon-junctionwithcontraceptivefoam.
-CondomPromotion VideosforCollegeStudents hadmixedsuccesspromotingcondomuse.
-REALMen,aprogramdesignedtoprovidefatherswiththeskillsnecessarytocommunicatewiththeirsonsaboutHIVprevention,ledtoincreasedcondomuseatthe12-monthfollow-up,butnotthe3-monthor6-monthfollow-ups. / -Sexeducationprograms:
-BecomingAResponsibleTeen(BART),anHIVeducationandskillstrainingprogramforAfricanAmericanhighschoolstudents
-BeProud! BeResponsible!,an
HIVeducationandskillstrainingprogramforAfricanAmericanadolescents
-¡Cuídate!, anHIVrisk-reductioncurriculumforLatinoadolescents
-FocusonKids,anAIDS-preventionprogramfromlow-
incomeAfricanAmericanchildren
-MakingProud Choices,asafe-sexprogramforAfricanAmericanadolescents
-SaferChoices,asexualityeducationprogramforhighschoolstudents
-SiHLE,anHIV-preventioninter-ventionforAfricanAmericanfemaleadolescents
-AstudyonVaryingtheTimingofanHIV-PreventionInterventionfoundthatdeliveringinterventioncontentduringseven1.5hoursessionsworkedbetterthandeliver-ingitduringthree3.5-hoursessions.
Useof
Contraception / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders / -Sexeducationprograms:
-Postponing SexualInvolvement(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity,significantlyincreaseduseofcontraceptionamongfemalesinonestudy.
-TeenTalk,apregnancyprevention / -Sexeducationprograms:
-SaferChoices,asexualityeducationprogramforhighschoolstudents
-Clinic-basedprograms:
-ReproductiveHealthCounselingforYoungMen
OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
-FamiliesUnitedtoPreventTeenPregnancy(FUPTP),anabstinence-focusedafter-school
programfor8-13year-olds
-Heritage KeepersLifeSkillsEducation,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellasservice-learningactivities
-McMasterTeenProgram,apregnancypreventionprogramformiddleschoolstudents
-ProjectSNAPP,anAIDSandpregnancypreventionprogramformiddleschoolstudents
-Clinic-basedprograms:
-PARTNERSProject, apreventionprogramdesignedforsexuallyactiveHispanicwomenandtheirpartners
-Familyplanning clinicsupport services / programfor teens,significantlyincreaseduseofcontraceptionamongmales,butnotfemales.
-Youthdevelopmentprogramswithsexeducationcomponent:
-CAS-Carerrasignificantlyincreaseduseofcontraceptionamongfemales,
butnotmales.
-TheWashingtonStateClient-CenteredPregnancyPreventionProgramsignificantlyincreaseduseofcontraceptionamongteenagersatone
ofthreesites.
Pregnancies and
Births / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-FamiliesUnitedtoPrevent
TeenPregnancy(FUPTP),anabstinence-focusedafter-schoolprogramfor8-13year-olds
-Heritage KeepersLifeSkillsEducation,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellasservice-learningactivities
-McMasterTeenProgram,apregnancypreventionprogramformiddleschoolstudents
-Postponing SexualInvolvement
(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity
-ProjectSNAPP,anAIDSandpregnancypreventionprogramfor
middleschoolstudents
-Clinic-basedprograms:
-Familyplanning clinicsupportservices
-Programscombiningjobplacementwitheducationandsupportservices:
-JobCorps,aprogramfordisadvantagedyouthandyoungadults
-JOBSTART, aprogramforhighschooldropouts
-STEP,asummerprogramforlow-achievingadolescents. / -Sexeducationprograms:
-SiHLE,anHIV-preventioninter-ventionforAfricanAmerican
femaleadolescents,ledtomarginallysignificantdecreasesinpregnancies.
-Youthdevelopmentprograms:
-CAS-Carerrasignificantlydecreasedpregnanciesandbirthsamongfemales,butnotmales.
-QuantumOpportunitiesProgram,
anintensive,multi-componentinterventionfordisadvantagedhighschoolstudents,significantlydecreasedchildbearingatoneoffivesites.
-Programscombiningjobplacementwitheducationandsupportservices:
-TheTeenageParentDemonstration(TPD)significantlydecreasedpregnanciesandbirthsatoneofthree
sites.
-YouthCorps,aprogramforyoungadultsoutofschool,significantlydecreasedpregnanciesamongAfricanAmericanfemales,butnotamongwhiteorHispanicfemales. / -Sexeducationprograms:
-FOCUS,acurriculumforfemaleyouth
-Youthdevelopmentprograms:
-TeenOutreachProgram
-Earlychildhoodprograms:
-CarolinaAbecedarianProgram,achild-careandpre-schoolprogramforhigh-riskchildren
-High/ScopePerry Pre-SchoolProgramforpoverty-strickenAfricanAmericanchildren
-Programsforyoungmothers:
-Low-incomefirst-timemothersassignedtotheNurse-FamilyPartnership(NFP)home-visiting
programsignificantlydecreased
subsequentpregnanciesandbirthsrelativetomothersinacontrolgroup.
-Adolescentmothersassignedtoreceivespecialhealthcareweresignificantlylesslikelytohaveanotherchildthanweremothersinacontrolgroup(UntitledHealth
CareProgramforFirst-TimeAdolescentMothersandtheirInfants).
OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
ContractingSTDs / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-FamiliesUnitedtoPrevent
TeenPregnancy(FUPTP),anabstinence-focusedafter-schoolprogramfor8-13year-olds
-Heritage KeepersLifeSkillsEducation,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-Postponing SexualInvolvement(PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity
-ProjectSNAPP,anAIDSandpregnancypreventionprogramformiddleschoolstudents
-Clinic-basedprograms:
-Ahealthbeliefmodelinterventionforhigh-risk adolescentfemales / -Sexeducationprograms:
-SiHLE,anHIV-preventioninter-ventionforAfricanAmerican
femaleadolescents,ledtodecreasesintheacquisitionofchlamydia,butnot
trichomonasorgonorrhea.
-Clinic-basedprograms:
-ASSESS,asafe-sexeducation
programforyoungteens,showedsomeevidenceofreducingSTD
contraction. / -Sexeducationprograms:
-FOCUS,acurriculumforfemaleyouth

ExperimentalEvaluationsofSocialProgramsthatExamined Impacts onOneorMoreReproductiveHealth

OutcomesandWhetherTheyWereFoundtoWork,NotProventoWork,orHadMixedFindings

(Source:

OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
Psychosocial
Variables
Communication / -Sexeducationprograms:
-Postponing SexualInvolvement(PSI), amiddleschoolprogramthatfocusesondelayingsexualactivity,didnotincreaselikelihoodof
parent-teencommunicationaboutsex.
-Project TakingCharge, apregnancypreventionprogramforhigh-risk7thgraders,didnotincreasethelikelihoodofparent-teencommunicationaboutsex,norteens’comfortlevelwithsuchcommunication.
-Clinic-basedprograms:
-ASSESS,asafe-sexeducationprogramforyoungteens,didnotincreasethelikelihoodofparent-teencommunicationaboutsex.
-Familyplanning clinicsupportservicesdidnotincreaseteens’comfortlevelwithparent-teencommunicationaboutsex.
-Ayouthdevelopmentprogramwithsexeducationcomponent:
-TheWashington StateClient-CenteredPregnancy Prevention
Programsdidnotincreasethe
likelihoodofparent-teencommunicationaboutsex. / -Programsspecificallydesignedtoincreaseparent-childcommunicationaboutsex:
-EnhancedManagingPressuresBeforeMarriage,aseriesofhomeworkassignmentsformiddle
schoolstudentstocompletewiththeir
parents,increasedthelikelihoodofparent-teencommunicationaboutsex,butdidnotincreaseteens’comfortlevelwithsuchcommunication.
-FactsFeelings,aseriesofsexuality-relatedvideosforadolescentstowatchwiththeir
parents,initiallyincreasedthe
likelihoodofparent-teencommunicationaboutsex,butthisincreasedidnotpersistovertime.
-Sexeducationprograms:
-SaferChoicesinitiallyincreasedthelikelihoodofparent-teencommunicationaboutsex,butthis
increasedidnotpersistovertime. / -Programsspecificallydesignedtoincreaseparent-childcommunicationaboutsex:
-TheFamily/Media ApproachtoHIVPreventionincreasedteens’sexualcommunicationskills.
-REALMen,aprogramdesignedto
providefatherswiththeskillsnecessarytocommunicatewith
theirsonsaboutHIVprevention,ledtoincreaseddiscussionofsex-
relatedtopics.
-SavingSexForLater increasedparent-childcommunicationaboutriskybehaviors.
-Sexeducationprograms:
-BecomingAResponsibleTeen(BART),anHIVeducationandskillstrainingprogramforAfrican
Americanhighschoolstudents,
increasedteens’sexualcommunicationskills.
-YouthAIDSPreventionProject
(YAPP),apreventionprogramforAfricanAmericanmiddleschoolstudents,madestudentsmorecom-fortabletalkingtotheirparentsaboutsexandrelatedissues.
KnowledgeBeliefs / -Abstinenceeducationprograms:
-ReCapturingtheVision,aone-yearprogramfor8th-gradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-FamiliesUnitedtoPrevent
TeenPregnancy(FUPTP),anabstinence-focusedafter-schoolprogramfor8-to13-year-olds
-Heritage KeepersLifeSkills
Education,acharacter-based
programfor6th-to12th-gradestudents
-Sexeducationprograms:
-FocusonKids,anAIDS-preventionprogramfromlow-incomeAfricanAmericanchildren
-Clinic-basedprograms:
-Ahealthbeliefmodelinterventionforhigh-risk adolescentfemales
-Programsdesignedtoincreaseparent-childcommunicationaboutsex:
-EnhancedManagingPressuresBeforeMarriage,aseriesofhomeworkassignmentsformiddleschoolstudentstocompletewiththeirparents / -Abstinenceeducationprograms:
-MakingADifference!,an
abstinence-basedprogramforAfricanAmericanadolescents,increasedstudents’knowledgeaboutHIV,but
notaboutcondoms.
-Sexeducationprograms:
-Insomestudies,Postponing Sexual
Involvement (PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity,increasedstudents’knowledgeintheshortterm,but,innostudiesdiditincreasestudents’knowledgeinthelongterm.
-Project TakingCharge, apregnancypreventionprogramforhigh-risk7thgraders,increasedstudents’knowledgeaboutanatomyandSTDs,butnotaboutcomplicationscausedbyadolescentpregnancy. / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellasservice-learningactivities
-BecomingAResponsibleTeen(BART),anHIVeducationandskillstrainingprogramforAfricanAmericanhighschoolstudents
-BeProud! BeResponsible!,anHIVeducationandskillstrainingprogramforAfricanAmericanadolescents
-DrawtheLine,RespecttheLine,anSTDandpregnancypreventionprogramformiddleschoolstudents
-MakingProud Choices!,asafesexprogramforAfricanAmericanadolescents
-Project CHARM,anHIVrisk-reductioncurriculumforpregnantadolescents
-ProjectSNAPP,anAIDSandpregnancypreventionprogramformiddleschoolstudents
-SaferChoices,asexuality
OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
educationprogramforhighschoolstudents
-TeenTalk,apregnancypreventionprogramforteens
-YouthAIDSPreventionProject
(YAPP),apreventionprogramforAfricanAmericanmiddleschoolstudents
-Adiscussion-basedAIDSpreventionprogramfordelinquentandabusedyouth(AIDS-
Preventive Intervention)
-Anintensiveout-of-schooltimeyouthdevelopmentprogramswithsexeducationcomponent:
-CAS-Carrera
-Summer TrainingandEducationProgram(STEP),asummerprogramforlow-achieving
adolescents
-Clinic-basedprograms:
-ASSESS,aclinic-basedsafe-sexeducationprogramforyoungteens
-Clinic-BasedAIDSEducation
ProgramsforAdolescentFemales
-ReproductiveHealthCounselingforYoungMen
-Programsdesignedtoincreaseparent-childcommunicationaboutsex:
-Family/Media ApproachtoHIVPrevention
Attitudes / -Sexeducationprograms:
-ProjectSNAPP,anAIDSandpregnancypreventionprogramformiddleschoolstudents
-Project TakingCharge, apregnancypreventionprogramforhigh-risk7thgraders
-TeenTalk,apregnancypreventionprogramforteens
-Clinic-basedprograms:
-Clinic-BasedAIDSEducation
ProgramsforAdolescentFemales
-Ahealthbeliefmodelinterventionforhigh-risk adolescentfemales
-Programsdesignedtoincreaseparent-childcommunicationaboutsex:
-EnhancedManaging Pressures
BeforeMarriage,aseriesofhomeworkassignmentsformiddleschoolstudentstocompletewiththeirparents / -Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellasservice-learningactivities,hadmixedsuccessimpactingattitudes.
-Insomestudies,Postponing SexualInvolvement (PSI),amiddleschoolprogramthatfocusesondelaying
sexualactivity,improvedstudents’
attitudesintheshortterm,but,innostudiesdiditimprovestudents’attitudesinthelongterm.
-SaferChoices,asexualityeducationprogramforhighschoolstudents,didnothaveapositive impactonstudents’attitudestowardsex,butitdidhaveapositiveimpactontheirattitudestowardcondomuse.
-Bothadidacticandadiscussion-basedAIDSpreventionprogramworkedtoimproveattitudesamongdelinquentandabusedyouthintheshortterm,butneitherhadalastingimpact(AIDS-PreventiveIntervention).
-Clinic-basedprograms:
-ASSESS,asafe-sexeducationprogramforyoungteens,didnothaveapositiveimpactonstudents’
attitudestowardabstinence,butitdid
haveapositiveimpactontheirattitudestowardcondomuse. / -Abstinenceeducationprograms:
-MakingADifference!,anabstinence-basedprogramforAfricanAmericanadolescents
-Heritage KeepersLifeSkillsEducation,acharacter-basedprogramfor6th-12thgradestudents
-Sexeducationprograms:
-BeProud! BeResponsible!,an
HIVeducationandskillstrainingprogramforAfricanAmericanadolescents
-Clinic-basedprograms:
-ReproductiveHealthCounselingforYoungMen
OUTCOME AREA / NOTPROVENTOWORK / MIXEDFINDINGS / FOUNDTOWORK
Intentions / -Abstinenceeducationprograms:
-MyChoice,MyFuture!,athree-yearprogramfor8th,9th,and10thgraders
-ReCapturingtheVision,aone-yearprogramfor8thgradegirls
-TeensinControl, atwo-yearprogramfor5thand6thgraders
-Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellas
service-learningactivities
-MakingProud Choices,asafesexprogramforAfricanAmericanadolescents
-Project TakingCharge, apregnancypreventionprogramforhigh-risk7thgraders
-Clinic-basedprograms:
-ASSESS,aclinic-basedsafe-sexeducationprogramforyoungteens
-Programsdesignedtoincreaseparent-childcommunicationaboutsex:
-FactsFeelings,aseriesofsexuality-relatedvideosforadolescentstowatchwiththeir
parents / -Abstinenceeducationprograms:
-FamiliesUnitedtoPreventTeenPregnancy (FUPTP),anabstinence-focusedafter-schoolprogramfor8-13year-olds,had
mixedimpactsonstudents’intentionstoremainabstinent.
-Heritage KeepersLifeSkills
Education,acharacter-basedprogramfor6th-12thgradestudents,hadmixedimpactsonstudents’intentionstoremainabstinent.
-Sexeducationprograms:
-Insomestudies,Postponing SexualInvolvement (PSI),amiddleschoolprogramthatfocusesondelayingsexualactivity,hadashort-termpositiveimpactonstudents’intentions,but,innostudiesdidithavealong-termpositiveimpact.
-YouthAIDSPreventionProject(YAPP),apreventionprogramforAfricanAmericanmiddleschool
students,didnothaveapositive
impactonstudentsintentionstohavesexortousecondoms,butitdidhaveapositiveimpactontheirintentionstousecondomsinconjunctionwithcontraceptivefoam.
-Youthdevelopmentprogramswithasexeducationcomponent:
-StudentsinAdultIdentity
Mentoring(AIM),aprogramdesignedtohelpat-riskadolescentsarticulatefuturegoals,weremorelikelytoreportanintentiontoabstainfromintercourseatashort-term
follow-up,butnotalong-termfollow-up.
-TheWashington StateClient-CenteredPregnancy PreventionProgramhadapositiveimpacton
students’intentionsatoneofthree
teenagesites. / -Abstinenceeducationprograms:
-MakingADifference!,anabstinence-basedprogramforAfricanAmericanadolescents
-Sexeducationprograms:
-AllStars,ariskreductionprogramformiddleschoolstudents
-BeProud! BeResponsible!,an
HIVeducationandskillstrainingprogramforAfricanAmericanadolescents
-Project CHARM,anHIVrisk-reductioncurriculumforpregnantadolescents
-Adiscussion-basedAIDSpreventionprogramfordelinquentandabusedyouth(AIDS-Preventive Intervention)
-Programsdesignedtoincreaseparent-childcommunicationaboutsex:
-EnhancedManaging Pressures
BeforeMarriage,aseriesofhomeworkassignmentsformiddleschoolstudentstocompletewiththeirparents
-CondomPromotion Videosfor
CollegeStudents
Self-Efficacy / -Sexeducationprograms:
-ProjectSNAPP,anAIDSandpregnancypreventionprogramformiddleschoolstudents / -Sexeducationprograms:
-All4You,aprogramforstudentsinalternativehighschoolsthatincludesclassroomcurriculumaswellas
service-learningactivities,hadmixed
successimpactingself-efficacy.
-SaferChoices,asexualityeducationprogramforhighschoolstudents,didnothaveapositiveimpactonstudents’self-efficacyinrefusingsex,butitdidhaveapositiveimpactonstudents’self-efficacyforcondomuse. / -EnhancedManaging PressuresBeforeMarriage,aseriesofhomeworkassignmentsformiddleschoolstudents
tocompletewiththeirparents
-CondomPromotion Videosfor
CollegeStudents