In 1997, intrigued by studies she had been reading on the difference between European and American approaches to adolescent sexuality, Advocates’ Director of Education and Outreach, Barbara Huberman, proposed that the organization lead a European Study Tour. Through such a tour, Advocates’ staff and other U.S. family planning and adolescent reproductive and sexual health professionals would be able to explore directly how some European countries have achieved much lower teen pregnancy and birth rates than those in the United States.

In 1998, Advocates for Youth led its first study tour of the Netherlands, Germany, and France. In each country, Advocates and the European Study tour participants—a group of 40 health care professionals, educators, policy makers, parents, and young people—examined medical and public health systems, listened to lectures from public policy representatives, learned about public education and media campaigns, visited clinics and schools, and conducted a wide range of interviews with parents and youth. From this, they discovered huge contrasts in programs, policies, and attitudes towards adolescent reproductive and sexual health between the United States and Europe.While no single strategy accounts for the successful health outcomes in Europe, contributing factors include:

• A pragmatic approach to adolescent sexual health where science, not religious ideology, dictates public health policies and programs and education is valued, not feared;
• The effective use of mass media public education campaigns;
• A public acceptance of adolescent sexual development as normal and healthy; and
• A societal investment in youth as valued members of their community.
  

The emphasis is on responsibility and respect, not abstinence.

During the closing analysis of the first study tour in 1998, participants noted that in Europe, young people are given rights and responsibility and are treated with respect. Thus Advocates’ 3Rs vision was born and provided the framework through which Advocates’ staff could switch from a constant and fatiguing defensive stance—fighting the other side’s harmful programs and policies—to promoting a positive and empowering message of what normal and healthy adolescent sexual development looks like.

To date, 220 people from 27 states, as well as representatives from Nigeria, Botswana, South Africa, Canada, Columbia, and Peru have attended the European Study Tour.

While exchange rates led to the cancellation of the 2008 tour, Advocates continues to assist communities/states, many led by former European Study Tour participants, who are embracing and integrating the 3Rs into their organizational policies and practices.

Planned Parenthood Health Services of Southwestern Oregon (PPHSSO) continues to be Advocates’ partner and role model for other communities and states such as Iowa; Michigan; Cleveland, OH; Washington; Waco, TX; and San Diego, CA. In these communities, the two organizations have provided consultation, training, and resources to local groups who have or are looking to adapt the 3Rs as their vision and/or roll out 3Rs campaigns in the community.

Advocates and PPHSSO even worked with a former European Study Tour participant who has been bringing the 3Rs to her work to assist HIV-positive teenagers in Romania and physicians, psychologists, social workers, and HIV administrators in the Ukraine.

As one example of impact, Planned Parenthood of San Diego & Riverside Counties trained teachers of San Diego Unified School District on the 3Rs approach, sparking the district to include 3Rs components into its sexuality education curriculum.