Introduction
Although the proportion of teenagers engaging in sex has declined in recent decades, teen pregnancies and sexually transmitted infections (STIs) are still a concern. Nationally, 38 percent of high-school—age youth have had sex, and some of them engage in behavior that increases their risk of pregnancy and STIs (Centers for Disease Control and Prevention 2020). For example, 46 percent of sexually active youth did not use a condom during their most recent sexual intercourse, and more than half of all reported STI cases were among youth between the ages of 15 and 24 (Centers for Disease Control and Prevention 2022).
To help reduce teen pregnancies and STIs and their negative consequences, Congress authorized the Personal Responsibility Education Program (PREP). The Family and Youth Services Bureau (FYSB) within the Administration for Children and Families (ACF) of the U.S. Department of Health and Human Services administers PREP. FYSB funds formula and competitive grants to U.S. states, territories, tribes, and local organizations to provide programming on adolescent pregnancy prevention and adulthood preparation subjects (APSs). PREP legislation requires grantees to incorporate content in their programming from three of six APS: healthy relationships, financial literacy, healthy life skills, adolescent development, parent-child communication, and education and career success.
PREP grants are awarded through four funding streams: State PREP, Tribal PREP, Competitive PREP, and Personal Responsibility Education Innovative Strategies (PREIS).
FYSB and ACF’s Office of Planning, Research, and Evaluation contracted with Mathematica to conduct the PREP Studies of Performance Measures and Adulthood Preparation Subjects.
Purpose
As part of the studies, this report uses grantee-submitted data on performance measures to describe PREP programs that operated from 2017 to 2021. Specifically, this report addresses the following questions:
- How did grantees operate and support PREP programs?
- What were the characteristics of PREP programs, and how did grantees and providers implement them?
- What were the characteristics of youth participants?
- How did youth respond to the PREP programs?
The report also highlights how the COVID-19 pandemic influenced PREP operations.
Key Findings and Highlights
- PREP operated at a large scale: 94 grantees operated about 500 programs each year and served more than 380,000 youth across four years. Grantees supported program implementation by providing training and ongoing technical assistance and monitoring program implementation.
- Most grantees implemented evidence-based programs and covered at least three APSs. About three-quarters of youth received 75 percent of the intended program dosage each year.
- PREP programs served a diverse group of youth, including those at the highest risk of engaging in early and risky sexual activity, such as African American, Hispanic, and Tribal youth, youth in foster care, youth experiencing homelessness, and adjudicated youth.
- PREP participants had positive impressions of the program and said participating in PREP affected their intended behaviors. For example, more than half reported that as a result of being in the program, they planned to abstain from sexual intercourse for at least the next three months, and many others reported that PREP programming decreased their likelihood of having risky sex in the next three months.
- Many characteristics of the grantees, the programs they implemented, and the youth they served remained stable over time and were similar across funding streams. The most notable changes were related to the COVID-19 pandemic. Most grantees reported interruptions in programming because of the pandemic, and the number of youth served declined. In addition, during the years affected by the pandemic, many programs shifted from operating in schools to providing virtual programming.
Methods
This report analyzed measures that PREP grantees submitted for the 2017—2018, 2018—2019, 2019—2020, and 2020—2021 reporting periods. Data on PREP performance measures are reported at three levels: (1) grantee, (2) provider, and (3) program. Some measures are collected from individual participants in entry and exit surveys, but results are combined to the program level. Grantees submit performance measures to ACF through a web-based system. They submit measures of structure and support for program implementation annually. Submission of other measures shifted from annual to biannual in 2019—2020, but these measures are aggregated annually for analysis. Included are measures of program attendance, reach, and dosage, and measures of youth participants’ characteristics, sexual risk behaviors before the start of programming, experiences during the PREP programming, and perceptions of program effects. Analyses in this report are aggregated findings across grantees, providers, and programs.
Citation
Hulsey, Lara, Diletta Mittone, Katie Hunter, Mindy Scott, Asari Offiong, and Lauren Murphy. (2023). PREP Performance Measures 2017—2021, OPRE Report # 2023-027, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
Glossary
- PREP:
- Personal Responsibility Education Program
- FYSB:
- Family and Youth Services Bureau
- STIs:
- Sexually transmitted infections
- APS:
- Grantees were required to incorporate activities from at least three adulthood preparation subjects (APSs): (1) healthy relationships, (2) adolescent development, (3) healthy life skills, (4) parent-child communication, (5) educational and career success, and (6) financial literacy.