Congress created the Personal Responsibility Education Program (PREP) in 2010 to help reduce teen pregnancies and their negative consequences. State PREP programs are expected to be evidence-based, provide education on both abstinence and contraceptive use, and educate youth on at least three of six adulthood preparation topics. States are also encouraged to target their programming to high-risk populations, such as youth residing in geographic areas with high teen birth rates, adjudicated youth, youth in foster care, minority youth, and pregnant or parenting teens. This report documents key decisions made by state grantees about the design of their programs. It is the first report from the PREP Multi-Component Evaluation, conducted by Mathematica Policy Research.