For the first time since the early 1990s, the overall rates of pregnancy and birth among teenagers and young women increased from 2005 to 2006 and continued to increase in 2007 (the most recent year with final data).1,2 The rates of STIs also continued to rise among teens ages 15–19, during this same time period.3 More than 60% of teen mothers live in poverty at the time of their child's birth, and children of teen mothers are more likely to exhibit lower cognitive achievement, exhibit behavior problems, and drop out of high school or give birth as a teenager themselves.4,5 It is for these reasons that reducing teen and unintended pregnancy is one of Secretary Kathleen Sebelius's key inter-agency collaborations.
Teen pregnancy is a serious national problem and we need to use the best science of what works to address it...This investment will help bring evidence-based initiatives to more communities across the country while also testing new approaches so we can expand our toolkit of effective interventions.
-HHS Secretary Kathleen Sebelius”
Addressing the Problem: The Teen Pregnancy Prevention Program
In 2010, Congress funded the new Teen Pregnancy Prevention Program, which supports Tier 1 (evidence-based) and Tier 2 (research and demonstration) a series of grant programs that were awarded on September 30th 2010:
What is an Evidence-Based Approach?
The US Department of Health and Human Services defined a set of rigorous standards a program evaluation must meet in order for a program to be considered effective, and therefore eligible for funding as a Tier 1 program. An independent, systematic review was performed to determine which existing program models meet the criteria to be labeled an "evidenced-based" program. The review involved four steps:
- finding potentially relevant studies,
- screening studies to review,
- assessing the quality of the studies and
- assessing the evidence of the studies.
The programs identified reflect a range of program models — including comprehensive sex education, abstinence-based, and youth development models — and target populations — including programs for middle school students, high school students, and other adolescents.
Tier 1: Replication of evidence-based programs
- The Office of Adolescent Health (OAH) competitively awarded $75 million in grants across 75 grantees in 32 States and Washington, D.C. to implement programs that have been proven effective through rigorous evaluation to reduce teen pregnancy, behavioral risk factors underlying teen pregnancy, or other associated risk factors. Grantees will replicate a range of identified evidence-based program models and will be funded for up to five years. To learn more about the funded grantees in Tier 1, view the list of project descriptions.
Tier 2: Research and demonstration programs
- $25 million was allocated to Tier 2 grants to support research and demonstration programs that will develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy. OAH competitively awarded a total of $15.2 million to 19 grantees in 14 states and Washington, D.C. Examples of Tier 2 programs include: combining effective components of program models, culturally adapting models, and the use of social media or text messaging to deliver program messages. Projects focus on areas with high teen pregnancy rates and high-risk, vulnerable and culturally underrepresented youth populations, including youth in foster care, runaway and homeless youth, youth with HIV/AIDS, youth living in areas with high teen birth rates, delinquent youth, and youth who are disconnected from usual service delivery systems. Grants will be funded for up to five years. To learn more about the funded grantees in Tier 2, view the list of project descriptions.
- The remaining $9.8 million supports 8 community-wide teenage pregnancy projects funded in partnership with the Centers for Disease Control (CDC). The purpose of this program is to demonstrate the effectiveness of innovative, multicomponent, communitywide initiatives in reducing rates of teen pregnancy and births in communities with the highest rates, with a focus on reaching African American and Latino/Hispanic youth ages 15—19. To learn more about the goals, components, and the list of funded partners for the community-wide initiatives, view the Teen Pregnancy Prevention 2010-2015 section of CDC's website.
- The final part of Tier 2 is a joint announcement with the Administration for Children and Families (ACF) to use Personal Responsibility Education Program (PREP) funds to test innovative approaches to reduce teen pregnancy and repeat pregnancy among those under the age of 21. ACF competitively awarded $9.7 million to 13 grantees in 12 states.
HHS is committed to conducting high-quality evaluations of program models funded to replicate evidence-based strategies and test new, innovative approaches to reducing teen pregnancy. This is critical to ensuring that programs can be replicated effectively and to expanding our evidence base of what works and what does not, so that we can improve the effectiveness of programs and target resources appropriately. OAH is collaborating on the evaluation efforts with the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
For more information please visit the following site: The Office of Adolescent Health—http://www.hhs.gov/ash/oah/index.html
1Martin, J.A., Hamilton, B.E., Sutton, P.D., Ventura, S.J., Menacker, F., Kirmeyer, S., & Mathews, T.J. Births: Final data for 2006. National vital statistics reports; vol 57 no 7. Hyattsville, MD: National Center for Health Statistics. 2009.
2Martin, J.A., Hamilton, B.E., Sutton, P.D., Ventura, S.J., Mathews, T.J., Kirmeyer, S., & Osterman, M.J.K. Births: Final data for 2007. National vital statistics reports; vol 58 no 24. Hyattsville, MD: National Center for Health Statistics. 2010.
3 Centers for Disease Control and Prevention. Sexually Transmitted Disease Sur veil lance, 2007. Atlanta, GA: U.S. Department of Health and Human Services; December 2008.
4 Maynard, R. (Ed). Kids Having Kids.: Economic costs and social consequences of teen pregnancy. Washington, D.C.: The Urban Institute. (1996)
5 Maynard, R., & Hoffman, S.D. (2008). The costs of adolescent childbearing. In S.D. Hoffman, & R. Maynard (Eds.), Kids having kids: Economic costs & social consequences of teen pregnancy (2nd ed., pp. 359-386). Washington, DC: The Urban Institute Press.