Since 2010, the Office of Management and Budget has provided guidance to federal agencies encouraging the use of evidence in program decision-making, grant-making, innovation, and evaluation. The Teen Pregnancy Prevention (TPP) Program, administered by the Office of Adolescent Health (OAH) within the US Department of Health and Human Services, is one of several tiered evidence grant programs funded by Congress, along with similar initiatives targeting education, prenatal and early childhood services, employment services, and others. The goal of these efforts is to maximize the impact of federal dollars by funding programs that have demonstrated evidence of effectiveness, while also funding and evaluating new programs to continue building the evidence base.
This supplemental issue of AJPH includes a subset of the TPP Program’s 41 studies along with editorials that provide context to the evaluation activities and findings. The research articles are categorized into two groups according to their funding purpose.
The first set describes findings from replications of programs that were previously identified as having evidence of effectiveness. These frequently implemented evidence-based programs include the HIV/sexually transmitted infection (STI) prevention curriculum, Becoming A Responsible Teen (Jenner et al., p S78); an HIV/STI prevention curriculum tailored for Latino youths, ¡Cuídate! (Kelsey et al., p S70); an HIV/STI/pregnancy prevention program, It’s Your Game…Keep it Real (Potter et al., p S60); the sexual health education curriculum, Reducing the Risk (Barbee et al., p S85; Kelsey et al., p S45); a clinic-based program, Safer Sex Intervention (Kelsey et al., p S53); and a youth development program, Teen Outreach Program (Robinson et al., p S39; Francis et al., p S32).
The second set of research articles presents findings from new and innovative programs that were rigorously evaluated for the first time. These include a positive youth development program, Be the Exception 6th Grade Program (Piotrowski et al., p S132); a sexual health education curriculum, Health Teacher (Goesling et al., p S125); a sex and relationship education program, Healthy Futures (Calise et al., p S103); an adolescent pregnancy and healthy relationships program, Love Notes (Barbee et al., p S85); a sexual health education program, Need to Know (Gelfond et al., p S97); an adolescent pregnancy and STI prevention program that is culturally responsive to Hawaiian youths, Pono Choices (Abe et al., p S110); a sex education adolescent pregnancy prevention program, Positive Prevention PLUS (LaChausse, p S91); and a text-messaging program enhancement, Youth All Engaged (Bull et al., p S117).
The editorials in this volume complement the research articles. Several editorials describe the TPP Program, its evaluation portfolio (Kappeler et al., p S5; Farb and Margolis, p S9), and the intensive evaluation technical assistance activities that supported the evaluation studies (Cole et al., p S22; Knab et al., p S26; Zief et al., p S24). Three editorials provide additional discussion and context for understanding what we can learn from this collection of studies and how to interpret the mixed findings (Cole, p S15; McLeroy et al., p S17; Goesling, p S7). Four editorials expand on themes that emerged from the evaluation studies. For example, Coyle and Glassman (p S20) indicate a need to identify outcomes measures that are predictive of sexual risk behavior for youths who are not yet sexually active. Downs et al. (p S29) highlight potential benefits and limits of using technology to deliver an intervention and to collect data. Kaufman et al. (p S18) discuss challenges implementing a program and evaluation study with American Indian youths. Jenner and Walsh (p S28) question the popular theories underpinning many adolescent pregnancy prevention programs, given inconsistent impacts and relationships between mediators and behavior.
Taken together, the research articles and editorials in this issue build a body of evidence for individual program models and expand what we know about program effectiveness in the context of high-quality implementation and rigorous evaluation.