Rural regions have among the highest teen birth rates in the nation. Even so, to date, little research has been done on adolescent pregnancy prevention programming designed to meet the needs of rural youth. To address this research gap, the Administration for Children and Families within the U.S. Department of Health and Human Services directed Mathematica Policy Research to collaborate with the Kentucky Department of Public Health to conduct a rigorous evaluation of an adapted version of Reducing the Risk in relatively low-income, mostly rural high schools. This programming was funded through the state’s Personal Responsibility Education Program grant, which it received in 2010.

For the evaluation, Mathematica partnered with two local health departments that serve a largely rural region with teen pregnancy rates substantially above the national average. Health department staff delivered the Reducing the Risk curriculum to students in area high schools as part of a required health class. Health district staff shortened the original 12-hour curriculum to 8 hours to fit within the time allotted by area schools for delivering the program. The revised curriculum the staff developed covers all the topics in the original Reducing the Risk curriculum but contains fewer role-play exercises and less repetition of material.

This report summarizes the experience that these local health departments had implementing this adapted version of Reducing the Risk during the 2013–2014 and 2014–2015 school years.