Multi-component interventions: pregnancy and STIs
Community in Action
Multi-component interventions are broad-based programs that include a combination of classroom instruction, individual counseling, and community events.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Reduced teen pregnancy
Delayed initiation of sex
Increased condom use
Increased use of contraception
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced risky sexual behavior
What does the research say about effectiveness? This strategy is rated some evidence.
There is some evidence that multi-component interventions reduce teen pregnancy1, 2, 3, delay initiation of sexual intercourse, and increase use of condoms and hormonal contraception2, 4. Such interventions may also reduce other risky sexual behaviors, especially among females2, 4. 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 males5, 6. New York City-based efforts run by the program’s founder have been consistently effective among females5, 6, whereas attempts to implement the program elsewhere in the U.S. have had more varied results5.
An analysis of the Pathways/Senderos Center in Connecticut suggests that multi-component interventions can be cost effective in the long run7.
How could this strategy impact health disparities? This strategy is rated 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, D.C.8.
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.
Carrera - Children’s Aid Society. Carrera adolescent pregnancy prevention program.
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.
Footnotes
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1 Cochrane-Oringanje 2016 - Oringanje C, Meremikwu MM, Eko H, et al. Interventions for preventing unintended pregnancies among adolescents. Cochrane Database of Systematic Reviews. 2016;(2):CD005215.
2 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.
3 Campbell-Scher 2006 - Scher L, Maynard RA, Stagner M. Interventions intended to reduce pregnancy-related outcomes among adolescents. Campbell Systematic Reviews. 2006:12.
4 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.
5 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.
6 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.
7 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.
8 Carrera - Children’s Aid Society. Carrera adolescent pregnancy prevention program.
Related What Works for Health Strategies
To see citations and implementation resources for this strategy, visit:
countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/multi-component-interventions-pregnancy-and-stis
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countyhealthrankings.org/whatworks