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Reducing Adolescent Pregnancy: Programs That Work

(January 1999)

Original article authored by: Douglas Kirby

An article by ETR Associates' Senior Research Scientist, Douglas Kirby, offers a promising and panoramic look at programs designed to improve outcomes for youth. The article, Reducing Adolescent Pregnancy: Programs That Work, describes the common characteristics of successful adolescent pregnancy prevention programs.

Data from 24 published studies measuring the impact of thirty-five (35) sexuality and HIV education programs were examined for their common elements and for the characteristics critical to reducing adolescent pregnancy. In addition to these 35 educational programs, six (6) effective youth development programs were also examined.

The findings indicate that sex and HIV education programs and youth development programs are both effective in reducing adolescent sexual risk-taking behavior and pregnancy. Different but complementary, sex and HIV education programs focus directly and explicitly on reducing sexual risk-taking behaviors, while youth development programs may or may not discuss sexuality. Youth development programs are thought to reduce adolescent pregnancy (or childbearing) by strengthening adolescents' belief in their future through improved job skills and enhanced self-efficacy or by helping them see other opportunities and life options beyond early childbearing.

Education Programs

Ten characteristics are common to effective sex and HIV education programs. Such programs:

  • focus on reducing one or more sexual behaviors that lead to unintended pregnancy or HIV/STD infection;
  • use theoretical approaches that have been shown to be effective in influencing other health-related risks;
  • give a clear message by continually reinforcing a definite stance on risky behaviors;
  • provide basic, accurate information about the risks of unprotected intercourse and methods of avoiding unprotected intercourse;
  • include activities that address social pressures on sexual behaviors;
  • provide modeling and practice of communication, negotiation, and refusal skills;
  • employ a variety of teaching methods designed to involve the participants and to help them personalize the information;
  • incorporate behavioral goals, teaching methods, and materials that are appropriate to the age, sexual experience, and culture of the students;
  • last long enough to complete important activities;
  • use teachers or peers who believe in the program they are implementing and provide training for them.

Particularly noteworthy is the fact that sex and HIV education programs do not increase sexual intercourse. On the contrary, effective educational programs actually reduce or delay the onset of intercourse. They also increase the use of condoms and other forms of contraception.

Youth Development Programs

This article highlights six youth development programs that were effective in reducing adolescent pregnancy.

  • The Youth Incentive Entitlement Pilot Projects guaranteed employment to high school students from low-income households, providing that they stayed in school.
  • The Seattle Social Development Project improved teaching and parenting skills so that students would be more connected to their schools and families.
  • In The Teen Outreach Program adolescents participated for approximately one hour per week in volunteer service and in a weekly discussion group facilitated by an adult, during which they talked about their volunteering experiences or discussed other life skills topics.
  • The American Youth and Conservation Corps provided education and work experience within the context of community service.
  • The Quantum Opportunities Project was a multi-year program, guiding the adolescent from ninth through twelfth grade. It included educational, service, and development activities.
  • The Children's Aid Society Program is considered one of the most comprehensive and successful youth development programs. This multi-year program addressed many aspects of adolescents' lives including: comprehensive family life and sex education; access to medical, health, and reproductive health services; help with homework and tutoring; opportunities to participate in extracurricular activities such as sports and theater productions; and guidance and care from adult facilitators.

Although the factors that mediate the success of these six very diverse youth development programs are not entirely clear, it is thought that they may have increased youth connection with adults; reduced participants' discretionary time, which in turn decreased their opportunities for having unprotected sex or for spending time with peers who are not in the program; and/or improved adolescents' beliefs and hopes for their futures.

In conclusion, the two types of programs, sex and HIV education programs and youth development programs, can be effective components in comprehensive initiatives to reduce sexual risk-taking and pregnancy.

Kirby, Douglas, PhD. Reducing Adolescent Pregnancy: Approaches that Work. Contemporary Pediatrics,1999 (January), Vol.16(1), 83-94.

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