Multi-component interventions: pregnancy and STIs

Multi-component interventions are broad-based programs that include a combination of classroom instruction, individual counseling, and community events. 

Expected Beneficial Outcomes (Rated)

  • Reduced teen pregnancy

  • Delayed initiation of sex

  • Increased condom use

  • Increased use of contraception

Other Potential Beneficial Outcomes

  • Reduced risky sexual behavior

Evidence of Effectiveness

There is some evidence that multi-component interventions reduce teen pregnancy (, Kirby 2007, ), delay initiation of sexual intercourse, and increase use of condoms and hormonal contraception (Kirby 2007, Alford 2012). Such interventions may also reduce other risky sexual behaviors, especially among females (Kirby 2007, Alford 2012). Additional evidence is needed to confirm effects.

There are many multi-component interventions, with varying degrees of effectiveness. The Carrera Adolescent Pregnancy Prevention Program demonstrates some of this variability. It has been shown to reduce rates of teen pregnancy and sexual risk behaviors among females but does not appear to have an effect on males (, ). New York City-based efforts run by the program’s founder have been consistently effective among females (, ), whereas attempts to implement the program elsewhere in the US have had more varied results ().

An analysis of the Pathways/Senderos Center in Connecticut suggests that multi-component interventions can be cost effective in the long run ().

Impact on Disparities

No impact on disparities likely

Implementation Examples

The Carrera Adolescent Pregnancy Prevention Program is one example of a multi-component intervention. Originally implemented in New York, the Carrera program has been replicated in nine states and Washington, DC (Carrera).

Implementation Resources

Alford 2012 - Alford S. Science and success, 3rd edition: Sex education and other programs that work to prevent teen pregnancy, HIV and sexually transmitted infections. Washington, DC: Advocates for Youth; 2012.

Kirby 2007 - Kirby D. Emerging answers 2007: Research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy; 2007.

Carrera - Children’s Aid Society. Carrera adolescent pregnancy prevention program.

Citations - Evidence

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Alford 2012 - Alford S. Science and success, 3rd edition: Sex education and other programs that work to prevent teen pregnancy, HIV and sexually transmitted infections. Washington, DC: Advocates for Youth; 2012.

Kirby 2007 - Kirby D. Emerging answers 2007: Research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy; 2007.

Rosenthal 2009* - Rosenthal MS, Ross JS, Bilodeau R, et al. Economic evaluation of a comprehensive teenage pregnancy prevention program: Pilot program. American Journal of Preventive Medicine. 2009;37(6 Suppl 1):S280-7.

Cochrane-Oringanje 2009* - Oringanje C, Meremikwu MM, Eko H, et al. Interventions for preventing unintended pregnancies among adolescents. Cochrane Database of Systematic Reviews. 2009;(4):CD005215.

Philliber 2002* - Philliber S, Kaye JW, Herrling S, et al. Preventing pregnancy and improving health care access among teenagers: An evaluation of the Children’s Aid Society - Carrera program. Perspectives on Sexual and Reproductive Health. 2002;34(5):244-51.

Philliber 2001* - Philliber S, Kaye J, Herrling S. The national evaluation of the Children’s Aid Society Carrera - Model program to prevent teen pregnancy. Accord: Publisher Research Associates (PRA); 2001.

Campbell-Scher 2006* - Scher L, Maynard RA, Stagner M. Interventions intended to reduce pregnancy-related outcomes among adolescents. Campbell Systematic Reviews. 2006:12.

Citations - Implementation Examples

* Journal subscription may be required for access.

Carrera - Children’s Aid Society. Carrera adolescent pregnancy prevention program.

Date Last Updated

Feb 10, 2015