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)
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Reduced teen pregnancy
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Delayed initiation of sex
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Increased condom use
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Increased use of contraception
Other Potential Beneficial Outcomes
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Reduced risky sexual behavior
Evidence of Effectiveness
There is some evidence that multi-component interventions reduce teen pregnancy (Oringanje C, Meremikwu MM, Eko H, et al. Interventions for preventing unintended pregnancies among adolescents. Cochrane Database of Systematic Reviews. 2009;(4):CD005215.
Link to original source (journal subscription may be required for access)Cochrane-Oringanje 2009, Kirby 2007, Scher L, Maynard RA, Stagner M. Interventions intended to reduce pregnancy-related outcomes among adolescents. Campbell Systematic Reviews. 2006:12.
Link to original source (journal subscription may be required for access)Campbell-Scher 2006), 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 (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.
Link to original source (journal subscription may be required for access)Philliber 2002, 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.
Link to original source (journal subscription may be required for access)Philliber 2001). New York City-based efforts run by the program’s founder have been consistently effective among females (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.
Link to original source (journal subscription may be required for access)Philliber 2002, 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.
Link to original source (journal subscription may be required for access)Philliber 2001), whereas attempts to implement the program elsewhere in the US have had more varied results (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.
Link to original source (journal subscription may be required for access)Philliber 2002).
An analysis of the Pathways/Senderos Center in Connecticut suggests that multi-component interventions can be cost effective in the long run (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.
Link to original source (journal subscription may be required for access)Rosenthal 2009).
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
* Journal subscription may be required for access.
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
- Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
- Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
- Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
- Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
- Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
- Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results.