Adolescent Pregnancy Prevention and Sexual Risk Avoidance Research and Evaluation Snapshot

In 2018, the number of births to females aged 15-19 in the U.S. was 179,607, down eight percent from 2017.[1] Despite recent declines in teen childbirth rates, teen pregnancy rates in the U.S. are much higher than in other western industrialized nations[2] and racial/ethnic and geographic disparities in teen birth rates persist.[3] More research and programming innovations are needed to identify effective ways to decrease rates of teen sexual risk behavior and associated negative outcomes.

Since 2009, ACF has supported research and evaluation efforts in teen pregnancy prevention and, more recently, sexual risk avoidance. Past ACF research includes the completion of a multi-component evaluation which included multiple sub-studies, including national descriptive and performance analysis studies and an impact and implementation study of four PREP sites. Key findings from the 2018-2019 performance measures show that 141,586 youth were served during that reporting period. The most commonly implemented APS by grantees were healthy relationships, healthy life skills, and adolescent development. Nearly 90 percent of the youth reported that they felt respected as people (89 percent) and that the material presented was clear (88 percent) most or all of the time. Large majorities of youth reported that the discussions or activities helped them to learn program lessons (85 percent) and that they had a chance to ask questions (81 percent) most or all of the time.

[1] Hamilton, B. E., Martin, J. A., Osterman, M.J.K, & Rossen, L. M. (2019). Births: Provisional data for 2018. National Center for Health Statistics Vital Statistics Rapid Release (007), 1-25. https://www.cdc.gov/nchs/data/vsrr/vsrr-007-508.pdf  (PDF)

[2] Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. Journal of Adolescent Health, 56(2), 223-30. https://doi.org/10.1016/j.jadohealth.2014.09.007

[3] Romero, L., Pazol, K., Warner, L., et al. (2016). Reduced Disparities in Birth Rates Among Teens Aged 15-19 Years — United States, 2006-2007 and 2013-2014. MMWR Morbidity and Mortality Weekly Report, 65(16), 409-414. http://dx.doi.org/10.15585/mmwr.mm6516a1

In setting sexual risk avoidance and adolescent pregnancy prevention research and evaluation priorities, ACF takes into account legislative requirements and Congressional interests; the interest and needs of ACF, HHS, and Administration leadership; program office staff and leadership; ACF partners; the populations served; researchers; and other stakeholders. ACF routinely interacts with these stakeholders through a variety of engagement activities. These activities inform our ongoing research and evaluation planning processes.

Who

• State, territory, tribal, local, and non-profit PREP and SRAE administrators and staff
• PREP and SRAE training and technical assistance providers
• Curriculum developers, including those working on PREP and SRAE curricula
• Youth, including those served by PREP and SRAE programs, and their parents 
• Federal partners in HHS and other agencies, such as the Office of the Assistant Secretary for Planning and Evaluation (ASPE), the Office of Global Affairs (OGA), the Office of Population Affairs in the Office of the Assistant Secretary for Health (OASH/OPA), and the Division of Reproductive Health at the Centers for Disease Control and Prevention (CDC/DRH)
• Researchers and policy experts
• National organizations, such as Power to Decide and Ascend
• Partners in the fields of adolescent development, healthy relationships, healthy life skills, parent-child communication, education and career success, and financial literacy

How

• Conferences and meetings, such as the Society for Research in Adolescence (SRA), Research and Evaluation Conference on Self-Sufficiency (RECS), National Association of Relationship and Marriage Education (NARME), Association for Public Policy Analysis and Management (APPAM), American Evaluation Association (AEA), and the American Public Health Association (APHA)
• APP Grantee Conference, webinars, and group calls with grantees
• Engagement with PREP and SRAE training and technical assistance networks
• Surveys, focus groups, interviews, and other activities conducted as part of research and evaluation studies
• Interagency collaborations, such as the Teen Pregnancy Prevention Evaluation Coordination Workgroup
• Structured mechanisms for broad stakeholder engagement, such as the Sexual Risk Avoidance Education National Evaluation (SRAENE) project, which is soliciting stakeholder feedback on the research and evaluation project plan; and webinars and websites for PREP and SRAE grantees to ask questions, request technical assistance, and offer feedback (e.g., PrepEval , SRAE PAS , SRAENE , and The Exchange )

1. Who is participating in PREP and SRAE programs and how are they faring?
2. How can PREP and SRAE programs use data and evidence to strengthen their program implementation in order to improve outcomes?
3. Which components of PREP and SRAE programs or curricula can be identified as effective in order to inform others? How can they be shared?
4. How do PREP and SRAE programs build data capacity and support local evaluations?
5. In what ways are PREP and SRAE programs associated with youth outcomes and how can these associations be measured?

• Sexual Risk Avoidance Education National Evaluation (SRAENE): is a rigorous evaluation comprised of three sub-studies: (1) National Descriptive Study to provide a nationwide description of how grantees and provider organizations implement SRAE programs, (2) Program Components Impacts Study to implement innovative evaluation designs to assess the effectiveness of SRAE programs/components, and (3) Data and Evaluation Support to both build grantee data capacity and support local evaluations. (#1) (#2) (#3) (#4) (#5)
• Sexual Risk Avoidance Education Performance Analysis Study (SRAE PAS): is a multi-component project to: (a) finalize and/or revise SRAE performance measures; (b) develop an SRAE Performance Measures Portal for submission of program implementation performance measures annually and individual-level participant performance measures biannually; (c) develop an SRAE Performance Dashboard; (d) support and provide technical assistance to grantees to collect, submit, and interpret SRAE performance data; and (e) analyze, report, and disseminate SRAE performance data. (#1) (#2) (#4) (#5)
• Personal Responsibility Education Program Multi-Component Evaluation (PREP-MCE): is a multi-component evaluation that aimed to (1) document how programs funded through the State PREP program were designed and implemented in the field, (2) collect and analyze performance data for all State, Tribal, and Competitive PREP grantees, and (3) conduct random assignment impact and in-depth implementation evaluations in four specific PREP-funded sites. (#1) (#2) (#3) (#5)
• PREP Promising Youth Programs (PYP): is a collaborative effort to (1) support the local evaluations of the second cohort of Tribal PREP and PREIS grantees through training and technical assistance and (2) develop curricula to address the sexual health and other PREP-related needs of underserved youth populations. (#1) (#3) (#4) (#5)
• PREP Studies of Performance Measures and Adulthood Preparation Subjections (PMAPS): is a multi-component study to revise measures used for PREP grantee reporting of performance data; to collect, analyze, and report on performance data; to create a performance dashboard tool that supports stakeholders in monitoring data quality and performance related to the PREP programs; and to develop APS conceptual models that demonstrate how inclusion of APS topics can enhance or expand on the outcomes for youth participating in PREP programs. (#1) (#2) (#3) (#5)

The broad questions listed above will continue to drive much of ACF’s research and evaluation activity in this area. Future activities will also be informed by emerging findings from ongoing research and evaluation activities, other learning activities, and continued engagement with adolescent pregnancy prevention and sexual risk avoidance stakeholders.

Examples of activities planned for the next few years include:

• Analyzing grantee, provider, and youth participant data from grantees receiving PREP and SRAE funds
• Analyzing promising program approaches of SRAE grantees, and the effectiveness of individual SRAE programs/components
• Building capacity for PREP and SRAE grantees to collect and use their data for grantee-funded evaluations to ultimately inform programming and evaluation efforts
• Collecting data on how the COVID-19 pandemic affects operations, programming, and service delivery for PREP and SRAE grantees
• Developing evidence-informed curricula for underserved youth, including parents of youth in foster care and youth with intellectual disabilities
• Providing training and technical assistance to support local evaluations of Tribal PREP and PREIS grantees