Preventing Teenage Pregnancy, Childbearing, and Sexually Transmitted Diseases: What the Research Shows

Abstract

verview Despite a 22 percent decline in the rate of teenagers giving birth in the United States since 1991, adolescent reproductive health remains a pressing social issue. The U.S. teen birth rate, while declining, is still one of the highest among developed nations. For example, the teen birth rate in the U.S. in the mid-1990s was more than double the rate for Canada and more than four times the rate in Germany. Moreover, sexually transmitted diseases (STDs) in the United States, highest among teens and young adults, are higher than STD rates in other industrialized nations. Why does this matter? Because adolescent childbearing and STDs carry significant social costs. These costs are borne by the teenagers themselves, by society as a whole, and-perhaps most poignantly-by the children of teenage mothers, who start out life at serious disadvantage. 52 Beyond the social costs are the financial ones which are measured in the billions of dollars. In this brief, we define improved adolescent reproductive health as involving one of the following behaviors: delaying sexual initiation, reducing the frequency of sexual activity, reducing the number of sexual partners, increasing condom use and overall contraceptive use, and reducing the rate of unintended pregnancy and childbearing, as well as lowering the incidence of STDs among teenagers. To do so, in turn, requires taking a closer look at the range of factors that lead to positive reproductive health behaviors. In this context, Child Trends conducted a review of more than 150 research studies on adolescent reproductive health to identify the factors that contribute to improving adolescent reproductive health. This Research Brief highlights these and other findings from the vantage point of adolescents as individuals and within the context of their families, peers, partners, schools, and communities. In addition, we developed a What Works table (see insert) that identifies specific programs and approaches that have been found successful in improving positive reproductive health behaviors. Experimental studies that focus on reproductive health outcomes discussed in the section on policy implications, show mixed results from evaluations of sexuality education and HIV education programs, which are part of many schools' curriculums. Among programs and approaches found to be successful in improving reproductive health behaviors are those that focus on early childhood development, those that combine sexuality education for older children with positive activities, such as participating in voluntary community service and youth development programs, and those that send nurses to visit with teenage mothers with reducing the likelihood of having another child as a teen as one of their goals. This is the first in a series of Research Briefs based on a comprehensive review of adolescent development research. The American Teens series will cover reproductive health, physical health and safety, social skills, education, mental and emotional health and civic engagement as they relate t...

Generating and using evidence to guide public policy and practice: Lessons from the Campbell Test-bed Project

“…Two focused only on RCTs, and five did not distinguish among various methods for estimating program impacts. The conclusions from the reviews range from fairly encouraging conclusions that there are effective programs for delaying sexual debut and teen pregnancy (Manlove et al 2002) to strong conclusions that there is no evidence that pregnancy prevention programs delay sex, increase use of birth control, or reduce pregnancies (DiCenso et al 2001). The majority of the reviews offer some positive, some negative, and mostly null conclusions (for example, Kirby 2001).…”

Abstinence-Based Versus Service Learning Prevention Education in Small Groups: Effects on the Life Plans of Young Adolescents

“…For example, better results may be obtained if youth-focused programs are embedded in larger and more sustained efforts to involve the whole village in raising the children (Manlove et al 2003). Almost 90% of a nationally representative sample of youth ages 12-19 surveyed in the US in 2003 said it would be much easier to postpone sexual activity and avoid teen pregnancy if they were able to have more open, honest conversations with their parents about sex, contraception, and pregnancy (The National Campaign to Prevent Teen Pregnancy 2003).…”

PASHA: Facilitating the Replication and Use of Effective Adolescent Pregnancy and STI/HIV Prevention Programs

“…The PASHA effective-program list given in Table 2 overlaps significantly with lists developed by researchers independent of PASHA [2][3][4][5]. Differences in the lists are accounted for by program selection criteria (including program goals, prevention approach, and age of target population) and evaluation criteria (including evaluation design, length of follow-up, and sample size) [5].…”

“…The answer to this question is unknown. There is now a growing body of evidence that shows that some (at least a few dozen) of the teen pregnancy prevention programs achieved their goals [2][3][4][5]. Yet, it remains difficult, if not impossible, to estimate precisely the magnitude of the contribution of effective pregnancy prevention programs, taken as a set, to the decline in U.S. pregnancy and birth rates.…”