Although rural counties have the highest teen birth rates in the United States, teen pregnancy prevention practitioners and researchers have developed and tested relatively few programs for youth in rural areas. To help identify effective pregnancy prevention approaches for these young people, Mathematica, in collaboration with the Kentucky Department of Public Health, conducted a rigorous evaluation of an adapted eight-hour version of Reducing the Risk, a teen pregnancy prevention curriculum. A final report presents two-year impacts of the adapted curriculum, details program costs, and documents the study methods. The research is part of a multicomponent evaluation of the Personal Responsibility Education Program (PREP) led by Mathematica Policy Research for the Administration for Children & Families at the U.S. Department of Health and Human Services. PREP provides federal funding to educate youth on abstinence and contraception.
An earlier impact report presented evidence on the program’s effects after one year. That earlier report showed that students in the Reducing the Risk schools had better knowledge of contraception and sexually transmitted infections and expressed greater support when asked about the importance of condom use among sexually active youth. Relative to the standard school curriculum, Reducing the Risk did not change students’ sexual risk behaviors, intentions to have sex, attitudes toward abstinence, or perceived ability to avoid sexual risk behaviors after one year. Another earlier report and accompanying issue brief showed that the program was implemented as intended by trained facilitators from two local health departments.
The new two-year impact report adds a number of key findings:
- The adapted version of Reducing the Risk led to a sustained increase in students’ knowledge of contraception and sexually transmitted infections after two years, and a longer-term impact on sexual risk behavior had emerged for one subgroup of students.
- Relative to the standard school curriculum, the adapted version of Reducing the Risk did not change the likelihood of students’ having sex or having sex without a condom in the three months before the two-year follow-up survey for the overall sample.
- The program did, however, reduce the likelihood of having sex without a condom in the three months before the two-year follow-up survey for the smaller sample of students who were already sexually active before study enrollment.
- For the overall sample, the program increased students’ knowledge of contraception and sexually transmitted infections relative to the standard school curriculum.
- After two years, the program did not change students’ attitudes, refusal skills, communication with parents, or intentions regarding sex.
- The program’s impacts are commensurate with the dosage of programming offered (eight hours) and a modest operational cost of $113 per student.