Evaluation of Adolescent Pregnancy Prevention Approaches

Prepared for
U.S. Department of Health and Human Services, Office of Adolescent Health

The Evaluation of Adolescent Pregnancy Prevention Approaches (PPA) was a major federal effort to expand available evidence on effective ways to prevent and reduce pregnancy and related sexual risk behaviors among teens in the United States. The eight-year (2008-2016) evaluation documented and tested promising pregnancy prevention approaches in seven sites across the United States, each of which implemented a different program.

The program models selected for evaluation included:

  • Chicago HealthTeacher, a general health education curriculum with a comprehensive sex education component, carried out in Chicago Public Schools.
  • Gender Matters, a week-long intensive curriculum that focuses on gender roles, being implemented with youth involved in summer employment programs in Texas.
  • An adapted version of WAIT Training, an abstinence-until-marriage curriculum developed by the Center for Relationship Education, carried out in middle schools in Florida through 16 class sessions across two years
  • Teen PEP, peer-led comprehensive sex education workshops implemented in New Jersey and North Carolina high schools
  • AIM for 4 Teen Moms, an adapted version of Project AIM (Adult Identity Mentoring), that provides home-based educational sessions and group support for pregnant and parenting teens in Los Angeles, California
  • T.O.P.P., an 18-month intervention that provides telephone-based care coordination, motivational interviewing, and access to family-planning services for pregnant and parenting teens in Columbus, Ohio
  • Power Through Choices, a group-based sex education program targeting high-risk youth in residential group homes in three states (California, Maryland, and Oklahoma)

The PPA evaluation had two components. For all seven sites, the study team conducted an in-depth process study to document how the programs were designed and implemented. For six of the seven sites, the study team conducted a rigorous random assignment impact study to measure the effectiveness of the programs in changing youth outcomes. The impact studies used experimental designs and longitudinal survey data to assess the effectiveness of each selected program on its own, compared to a control group in the same site.

The evaluation was related to federal efforts focused on preventing risky sexual behavior and pregnancy among adolescents, including the Teen Pregnancy Prevention (TPP) Initiative and the Personal Responsibility Education Innovative Strategies (PREIS) programs. Six of the seven programs in the PPA evaluation were implemented by local organizations with TPP or PREIS grant funding. In these six sites, the PPA evaluation team collaborated with the independent local evaluators, funded as part of each TPP or PREIS grant, on the design and implementation of the PPA impact and implementation studies.

The study team reported the evaluation findings in a series of site-specific implementation reports, impact reports, and peer-reviewed journal articles. Findings included the following: 

  • All six impact study sites had favorable impacts on at least one of their targeted outcomes.
  • Three of the six impact study sites met the U.S. Department of Health and Human Services standards for evidence-based teen pregnancy prevention programs.
  • Two of the six impact study sites led to measurable declines in the ultimate outcome of teen pregnancy.