Children's Aid Society Carrera Program 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

  • Youth development program
  • Daily after-school activities, lasting three to five hours, and including
    • Job club and career exploration
    • Academic tutoring and assistance
    • Comprehensive sex education, including information about abstinence and contraception
    • Arts workshops
    • Individual sports activities
  • Summer program, offering enrichment activities, employment assistance, and tutoring
  • Comprehensive health care, including primary care and also mental, dental, and reproductive health care
  • Family involvement
  • Activities to develop interpersonal skills
  • Access to social services

For Use With

  • Youth at risk[*]
  • Socio-economically disadvantaged youth
  • Urban youth, ages 13 through 15
  • Black and Hispanic young women

Evaluation Methodology

  • Experimental design, including treatment and control conditions, in seven community-based service agencies in New York City
  • Urban youth ages 13 through 15 (n=600 at baseline; n=484 at three-year follow-up)
  • Pre-test and annual follow-up in each of three succeeding years

Evaluation Findings

  • Delayed initiation of sexual intercourse – females only
  • Increased resistance to sexual pressure – females only
  • Increased use of dual methods of contraception (condoms plus another effective method of contraception) – females only
  • Increased use of reproductive health care
  • Long-term: Reduced rates of teen pregnancy

Evaluators' comments: Our study clearly documents the effectiveness among females of a comprehensive program to prevent adolescent pregnancy. Although our analyses cannot determine the relative importance of the model's components, the philosophy, structure, and specific staff roles may each contribute to the successful long-term relationships that a large proportion of the young people formed with the program and its staff.
Source: Philliber, Williams, Herrling et al, 2002

Program Description

This is a sex education, pregnancy prevention, and youth development program for urban youth considered to be at high risk. The comprehensive intervention rests on six principles:

  1. Staff treats young participants as if they were family.
  2. Staff views each young person as pure potential.
  3. The program offers holistic services and comprehensive, integrated case management.
  4. The program includes continuous, long-term contact with participants.
  5. The program involves parents and family.
  6. All services are available under one roof in a non-punitive, gentle, generous, and forgiving environment.[34]

The program has five activity components and two service components. Activity components include:

  1. Job Club, offering stipends, help with bank accounts, employment experience, and career awareness
  2. Academics, including individual assessment, tutoring, PSAT and SAT preparation, and assistance with applying to colleges
  3. Comprehensive family life and sex education
  4. Arts, including weekly music, dance, writing, and drama workshops
  5. Individual sports activities that emphasize impulse control, such as squash, golf, and swimming.[34]

The two service components are 1) mental health care and 2) medical care, including primary care, reproductive health care, and dental care.34

Throughout the school year, program activities run all five weekdays, generally for about three hours per day. Participants are divided into groups which rotate among the five major activities offered. One group might receive sex education on Tuesdays and Thursdays, for example, while another group attends Job Club. On Monday and Wednesday, the groups would be reversed. Most students participate in sports and creative activities at least once a week and receive academic assistance daily. Over the summer, program activities include maintenance meetings to reinforce youth's sex education and academic skills. Also during the summer, participants receive job assistance and participate in social events, recreational activities, and cultural trips.[34]

Evaluation Methodology

A multi-site evaluation compared youth in the Children's Aid Society Carrera Program to youth recruited at six other service agencies throughout New York City. Youth were randomly assigned to the Children's Aid Society Carrera Program or to an alternative program. At most sites, the alternative was the agency's regular program for youth. Young people (n=600 at baseline; n=484 at three-year follow-up) ranged in age from 13 to 15. Fifty percent of participants were male. Among females, 54 percent of participants were black and 46 percent were Hispanic. Among males, 47 percent were black and 53 percent were Hispanic. The majority of the youth (55 percent) lived in single parent homes. The program's effectiveness was assessed using annual surveys.[34]

Outcomes

  • Knowledge—Overall after three years, program participants' knowledge of sexual health issues rose by 22 percent, compared to 11 percent among control youth, a statistically significant difference. Male participants showed higher sexual health knowledge gains than did control males (18 and six percent, respectively).[34]
  • • Behavior—
    • Delayed initiation of sexual intercourse—Program young women were significantly less likely than control females to have ever had sex; 46 percent had never had sex versus 34 percent of control females.[34]
    • Increased resistance to sexual pressure—Females in the program were significantly more likely than those in the control group to say they had successfully resisted pressure to have sex (75 percent and 36 percent, respectively).[34]
    • Increased use of contraception and condoms together—Sexually experienced program females were significantly more likely than control females to have used a condom along with another effective method of contraception (i.e., the pill, injection, or implant) at most recent sex (36 percent and 20 percent, respectively).[34]
    • Increased receipt of good health care—Both male and female participants had significantly increased odds of receiving good health care. Among sexually experienced males, the proportion who had made a visit for reproductive health care was significantly higher among program than control males (74 and 46 percent, respectively).[34]
    • Other findings related to young men—Overall, program males showed no positive, significant behavioral differences relative to control males, except increased receipt of good health care. Program males were less likely than control males to report use of dual methods of contraception at most recent sex.[34]

      Researchers speculated that the program effects may have been weaker among young men, in part because:
      1. Young men who had initiated sex prior to enrolling in the program were the least likely to attend regularly.
      2. Strong social norms among these inner-city young males might stress the benefits of early sexual intercourse and parenthood.
      3. Program males may not have repeated the program's messages to their non-enrolled female partners.[34]

      The data suggest that reaching young men sooner may strengthen outcomes, and, as a result, the Children's Aid Society has begun implementing programs with 11- and 12-year-old males.[34]

Long-Term Impact

  • Reduced rates of teen pregnancy—At third-year follow-up, females in the Children's Aid Society—Carrera Program had significantly lower rates of pregnancy and births than did control females.[34]

For More Information, Contact

* In this program, youth at risk are defined as ‘disadvantaged, inner-city populations’ who are not already enrolled in an after-school program AND were neither pregnant or parenting at enrollment.