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

• Individualized case management
• Some combination of services, possibly including academic guidance, access to health care, sports, and activities to improve social skills and competency
• Sex education, including information on abstinence and contraception

For Use With

• Siblings of pregnant and parenting teens
• Youth at high risk[*]ages 11 through 17
• Hispanic youth
• Economically disadvantaged youth

Evaluation Methodology

• Quasi-experimental design, including treatment and comparison conditions, at 16 Adolescent Sibling Pregnancy Prevention Program (ASPPP) social service agencies across the state of California
• Urban and rural, mostly Hispanic youth, ages 11 through 17.25
• Siblings of pregnant or parenting adolescents; average age 13.5; (n=1,594 at baseline; n=1,271 at nine-month post-test; n=1,466 at final evaluation)
• Pretest and follow-up after nine months

Evaluation Findings

• Delayed initiation of sexual intercourse – females only
• Increased use of contraception – males only
• Long-term: Reduced teen pregnancy rate

Evaluators' comments: California's special sibling program was effective at reducing the pregnancy rate and several pregnancy-related behaviors in this high risk sample… Although such specially targeted programs are certainly a challenge to implement, they hold great promise for significantly lowering rates of teenage pregnancy and births.
Source: East, Kiernan, Chavez , 2003

Program Description

In 1996, California created the Adolescent Sibling Pregnancy Prevention Program (ASPPP). It operates at 44 nonprofit social service agencies, community-based organizations, school districts, and county health departments throughout California. ASPPP targets the brothers and sisters of pregnant and parenting teens. Each program site provides some combination of services that may include individual case management, academic guidance, decision-making skills, job placement, self-esteem enhancement, and sex education, including information on abstinence and contraception. The overall goal of the program is to reduce rates of teen pregnancy among young adolescents.[33]

No specific program services are required of providers other than to have at least one face-to-face contact with each client each month. Program personnel are expected to implement a variety of services to prevent pregnancy and related risk behaviors. Sample programs offer:

• Counseling about abstinence and contraception;
• Access to quality reproductive health care;
• Transportation to health care facilities;
• Incentives to avoid sexual risk-taking;
• Tutoring and assistance with library research;
• Advocacy at expulsion and court hearings;
• Assistance in meeting with teachers, school administrators, and counselors;
• Help in acquiring medical insurance;
• Access to sports;
• Education about media messages regarding body image and sexual behavior;
• Field trips; and
• Group activities to improve social skills and social competency.[33]

Evaluation Methodology

When evaluation began, approximately 3,300 youth were participating in ASPPP at all the program sites across the state. Sixteen sites were selected to participate in the evaluation. The 16 sites served 1,011 youth (31 percent) participating in ASPPP. Sites were chosen on the basis of being representative geographically, by area of residence (urban or rural), and by clients' age and race / ethnicity. Overall, clients at chosen sites were more likely than all ASPPP clients to be urban, Hispanic, and younger than average. However, the gender breakdown was identical to overall gender representation in ASPPP (60 percent female, 40 percent male).[33]

Evaluation involved a group of current participants and a comparison group of youth not in ASPPP. Overall, 1,594 youth were enrolled in the evaluation: 1,011 ASPPP participants and 583 comparison youth. All youth (participants and comparisons) were ages 11 to 17.25, had never been pregnant or caused a pregnancy, and were the biological teenage sibling (half or full sibling) of another teen who was pregnant or parenting and also enrolled in California's Adolescent Family Life Program. Adolescents in the participating group also had to be currently enrolled in ASPPP. Comparison youth were usually identified through providers' existing caseloads, since providers were normally familiar with the families and siblings of teens already enrolled in their programs. Neither comparison youth nor their siblings could ever have been enrolled in ASPPP. Post-test data were collected nine months after enrollment from 1,271 adolescents. In final evaluation, the information from 731 program participants was compared with a weighted sample of 735 comparison youth.[33]

Characteristics of program and comparison groups included the following: program youth were 77 percent Hispanic, 10 percent black, eight percent white, and five percent ‘other’. Comparison youth were 71 percent Hispanic, 11 percent black, nine percent white, and nine percent ‘other’. The groups differed in that 59 percent of ASPPP youth spoke Spanish at home while 46 percent of comparison youth did so. Sixty-six percent of participating youth had a family that currently received public assistance, while 75 percent of comparison youth did so. Youth were mostly urban (71 percent of participants and 70 percent of comparison youth) or rural (17 and 18 percent, respectively). Slightly over half lived in two-parent households. Mean age of all youth participating in the evaluation was 13.5 for participants, 13.6 for comparison youth; mean grade in school was eighth. The program was assessed using data from an enrollment survey and a post-test at nine months after enrollment.[33]

Outcomes

• Attitudes and perceptions—At nine months post-test, participating females scored significantly higher than comparison females on intentions to practice abstinence.[33]
• Behaviors—
  • Delayed initiation of sexual intercourse—A significantly lower proportion of participating females than comparison females initiated sex over the nine-month study period (seven and 16 percent, respectively).[33]
  • Increased use of contraception—Sexually active participating males were significantly more likely than sexually active comparison males to have increased their consistency of contraceptive use. Over time, comparison males were more likely to decrease their consistent use of contraceptives.[33]
  • Decreased rate of truancy—Program females' frequency of truancy (staying out of school without permission) declined from pretest to post-test while it rose among comparison females.[33]

Long-Term Impact

• Decreased teen pregnancy rate—A significantly lower proportion of participating than comparison females experienced pregnancy during the nine-month study period. The reduced pregnancy rate among participating females versus comparison females (four and seven percent, respectively) translates into a 43 percent reduction in teenage pregnancy.[33]

For More Information, Contact

• California Department of Health Services, Maternal & Child Health Branch: 714 P Street, Room 750, Sacramento, CA 95814; Phone: 1.866. 241.0395
  
  This program is not available for purchase. Please note the California Department of Public Health no longer implements this program. With the permission of the California Department of Public Health, Advocates for Youth has made available an overview of the program and a sample scope of work.

* In this program, high risk teens are defined as those who have pregnant or parenting siblings that also participate in California’s CAL-LEARN program.