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School / Community Program for Sexual Risk Reduction among Teens Print

Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV and Sexually Transmitted Infections

Full Study Report [HTML] [PDF]
Executive Summary [HTML] [PDF]

Program Components

  • Sex education integrated into biology, science, social studies, and other courses
  • Graduate level sex education courses for teachers
  • Training of peer educators
  • School-based clinic services, including contraceptive provision as well as referral and transportation to reproductive health care in the community
  • Workshops to develop parents' and community leaders' skills as role models
  • Media coverage on a spectrum of health topics

For Use With

  • Kindergarten through 12th grade
  • Multiethnic youth – especially white and black youth
  • Rural youth

Evaluation Methodology

  • Quasi-experimental design, including treatment and comparison conditions, in rural counties in South Carolina
  • Rural young women, ages 14 to 17 (n=4,800)
  • Estimated pregnancy data (live births plus fetal deaths plus abortions) for the intervention county and three contiguous counties, compared prior to the program (1981-1982), during the two years of the program (1984-1986), and for two years post-program (1987-1988)

Evaluation Findings

  • Long-term: Reduced teen pregnancy rate

Replication Evaluation Methodology & Findings

  • Quasi-experimental design, including treatment and comparison conditions
  • Rural and urban students (n=1,714) in grades nine through 12 in two counties in Kansas during 1994-1996
  • Delayed initiation of sexual intercourse
  • Increased condom use – males only

Evaluators' comments: Our reanalysis strongly suggests that the incidence of adolescent pregnancies… decreased between 1984 and 1986 as a result of the overall efforts of the Denmark program… In 1987-1988, pregnancy rates returned to a higher level, probably because of both the cessation of provision of contraceptive counseling and supplies in school and the loss of momentum of the program.
Source: Koo, Dunteman, George et al, 1994

Program Description

This intensive, school-based intervention has the overall goal of reducing unintended teen pregnancy. Based on social learning and diffusion theories, its behavioral objectives include postponing the initiation of voluntary sexual intercourse among teens and promoting the consistent use of effective contraception, including condoms, among teens that choose to have sex.[18,19]

As originally implemented in Denmark, South Carolina, the program includes several components. Teachers are offered graduate level courses in sex education. Sex education is then integrated into the curriculum for all grades (kindergarten through 12th grade). The intervention offers mini-courses (five sessions of two hours each) for parents, clergy, and community leaders to improve their skills as role models. Students are trained to serve as peer educators. Local media reinforce messages about avoiding unintended pregnancy and highlight special, community events of the initiative. Finally, a school nurse provides contraceptive counseling, condoms to requesting students, and transportation to a local family planning clinic.[18]

Evaluation Methodology

In the mid-1980s, the county was 58 percent black and 42 percent white, lacked public transportation, and was primarily agricultural. Little migration into or out of the county occurred. For evaluation, annual estimated pregnancy rates for the intervention portion of the county (western) were compared with the estimated rates for the non-intervention portion of the county (eastern) and for three other South Carolina counties with socio-demographic indicators similar to the target community. Trends in estimated pregnancy rates were then examined by comparing the average pregnancy rates for the pre-intervention years (1981-1982) with the average rates for the intervention years (1984-1986) and post-intervention years (1987-1988) and comparing changes from pre-intervention to post-intervention between areas.[18]A second evaluation, conducted in the early 1990s, re-examined the impact of the program by comparing pregnancy rates in the intervention community with rates in other portions of the county, and six more counties (contiguous and non-contiguous) that analysis had shown to be most similar to the intervention county.[19]

Long-Term Impact

  • Reduced teen pregnancy rate—Evaluation found that the pregnancy rates in the intervention portion of the county declined significantly as compared to pre-program levels (from 77 pregnancies per 1,000 women ages 14 through 17 in 1981-1982 to 37 per 1,000 women the same age in 1984-1986).[18,19]
  • Teen pregnancy rates in comparison counties—When compared to the marked decline that occurred in the intervention portion of the county, no other county's pregnancy rate showed a similar, large decline. Pregnancy rates in the comparison counties ranged from 74 to 90 pregnancies per 1,000 women ages 14 through 17 in 1981-1982 and from 67 to 82 pregnancies per 1,000 women the same age in 1984-1986.[18]
  • Return to a higher teen pregnancy rate after some program components were discontinued—Reanalysis showed that the pregnancy rate returned to a higher level (66 per 1,000 women ages 14 through 17) in 1987-1988, after the discontinuation of some program components, including the contraceptive services provided by the school nurse during the years 1984-1986.[19]

Replication Evaluation Methodology

In Kansas in 1994-1996, evaluators measured the effects of a replication of the intervention. Replication occurred in Geary and Franklin counties as well as in portions of Wichita. Wichita was not included in the evaluation, because teenage sexual behavior data were not available for the city's youth. In Geary County, the population was 66 percent white, 23 percent black, six percent Hispanic, and four percent Asian. In Franklin County, the population was 97 percent white, two percent Hispanic, and one percent black.[20]

Data for Geary and Franklin counties on teen pregnancies and births were compared to data for 20 similar Kansas counties in 1991-1993 (pre-intervention years) and 1994-1996 (intervention years). Youth's sexual behaviors in the intervention counties were compared across the years, using self-reported data for high school students in both counties at the inception of the program (1994) to self-reported data for high school students at the end of the program in Geary County (1997) and near the end of the program in Franklin County (1996). For this later data, evaluators used responses to the 1993 Youth Risk Behavior Survey and the Adolescent Curriculum Evaluation, given in 1994, 1996, and 1997.[20]

Replication Outcomes

  • Behaviors
    • Delayed initiation of sexual intercourse—In Geary County, students' reports of ever having had sex decreased significantly among males and females in ninth and 10th grades between 1994 and 1997 (down from 51 to 38 percent of females and 63 to 43 percent of males, respectively).[20]
    • Increased condom use—In Franklin County, more male students in the upper grades reported using condoms in 1996 (55 percent) than in 1994 (39 percent).[20]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com
 
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