Teen pregnancy prevention programs can include comprehensive sex education, HIV/STI prevention, youth development, service learning, abstinence approaches, or combinations thereof. Programs can be provided in schools, clinics, or community settings and can be targeted to pre-adolescents, adolescents, teens who are abstinent or teens who are sexually active. Programs also often cover a range of behaviors and attitudes; program components vary by implementer and specific model.
Expected Beneficial Outcomes (Rated)
Reduced teen pregnancy
Reduced sexual activity
Increased use of contraception
Reduced incidence of STIs
Other Potential Beneficial Outcomes
Increased condom use
Evidence of Effectiveness
There is some evidence that pregnancy prevention programs reduce sexual activity, increase use of contraceptives, reduce STIs (Goesling 2014*), and reduce teenage pregnancy (Goesling 2014*, Harden 2009*, Cochrane-Oringanje 2009*). However, effects vary by program and additional evidence is needed to confirm effects (Campbell-Scher 2006*).
Programs that focus on specific skills and take place over longer periods of time may be more effective than shorter or more general programs (Robin 2004*). Evidence about the effects of teenage pregnancy prevention programs is strongest for black youth; more studies are needed to confirm effects for other groups, particularly Latinos and small populations at high risk of teenage pregnancy such as youth in foster care and American Indian and Alaska Natives (Goesling 2014*). There are a wide range of teen pregnancy prevention programs. Program effects and effectiveness can vary based upon population and setting, and local community needs are crucial in determining which program is most appropriate (Goesling 2014*).
Service learning programs decrease pregnancy rates among adolescents (CG-HIV/AIDS and pregnancy, Kirby 2007), and may also delay the initiation of sexual intercourse, reduce frequency of sex, and increase the use of condoms and other contraceptives (Alford 2012, Kirby 2007, CG-HIV/AIDS and pregnancy, Urban-Eisen 2000). Youth development (Harden 2009*) and multi-component programs appear to lower the rate of unintended pregnancy among adolescents (Cochrane-Oringanje 2009*, Kirby 2007, Campbell-Scher 2006*). Comprehensive risk reduction programs reduce risk behaviors such as engagement in sexual activity, frequency of sexual activity, number of partners, and frequency of unprotected sexual activity (Underhill 2007, Cochrane-Underhill 2008*, CG-HIV/AIDS and pregnancy, Chin 2012*). Comprehensive programs increase use of contraception (Chin 2012*, CG-HIV/AIDS and pregnancy, Campbell-Scher 2006*, Bennett 2005*) and may also reduce pregnancy (Chin 2012*, Cochrane-Underhill 2008*, Underhill 2007) and sexually transmitted infections (STI) among adolescents (CG-HIV/AIDS and pregnancy, Chin 2012*).
Impact on Disparities
The US Department of Health and Human Service’s Office of Adolescent Health administers a grant program that funds research and demonstration of new and innovative pregnancy prevention programs, as well as replication of 31 selected programs, through the Teen Pregnancy Prevention (TPP) Program. These 31 programs were shown to prevent teen pregnancies or births, reduce sexually transmitted infections, or reduce rates of associated sexual risk behaviors in a DHHS-commissioned study (US DHHS-TPP).
US DHHS-TPP Programs - US Department of Health and Human Services (US DHHS), Office of Adolescent Health (OAH). Teen pregnancy prevention resource center (TPP): Evidence-based programs (31 programs).
Socio-PASHA - Sociometrics. Teen pregnancy (PASHA).
National Campaign-EPD - National Campaign to Prevent Teen and Unplanned Pregnancy. Effective programs database (EPD): Interventions with evidence of success.
SPTW - Social Programs That Work (SPTW). Full list of programs.
CEBC - California Evidence-Based Clearinghouse for Child Welfare (CEBC). Information and resources for child welfare professionals: List of programs.
Citations - Evidence
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Goesling 2014* - Goesling B, Colman S, Trenholm C, Terzian M, Moore K. Programs to reduce teen pregnancy, sexually transmitted infections, and associated sexual risk behaviors: A systematic review. Journal of Adolescent Health. 2014;54(5):499–507.
Harden 2009* - Harden A, Brunton G, Fletcher A, Oakley A. Teen pregnancy and social disadvantage: Systematic review integrating controlled trials and qualitative studies. BMJ. 2009;339:b4254.
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.
Campbell-Scher 2006* - Scher L, Maynard RA, Stagner M. Interventions intended to reduce pregnancy-related outcomes among adolescents. Campbell Systematic Reviews. 2006:12.
Robin 2004* - Robin L, Dittus P, Whitaker D, et al. Behavioral interventions to reduce incidence of HIV, STD, and pregnancy among adolescents: A decade in review. Journal of Adolescent Health. 2004;34(1):3–26.
CG-HIV/AIDS and pregnancy - The Guide to Community Preventive Services (The Community Guide). HIV/AIDS, STIs, and pregnancy.
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.
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.
Urban-Eisen 2000 - Eisen M, Pallito C, Brader C, Bolshun N. Teen risk-taking: Promising prevention programs and approaches. Washington, DC: Urban Institute; 2000.
Underhill 2007 - Underhill K, Operario D, Montgomery P. Systematic review of abstinence-plus HIV prevention programs in high-income countries. PLoS Medicine. 2007;4(9):e275.
Cochrane-Underhill 2008* - Underhill K, Montgomery P, Operario D. Abstinence-plus programs for HIV infection prevention in high-income countries. Cochrane Database of Systematic Reviews. 2008;(1):CD007006.
Chin 2012* - Chin HB, Sipe TA, Elder R, et al. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, Human Immunodeficiency Virus, and sexually transmitted infections: Two systematic reviews for the Guide to Community Preventive Services. American Journal of Preventive Medicine. 2012;42(3):272-94.
Bennett 2005* - Bennett SE, Assefi NP. School-based teenage pregnancy prevention programs: A systematic review of randomized controlled trials. Journal of Adolescent Health. 2005;36(1):72–81.
Citations - Implementation Examples
* Journal subscription may be required for access.
US DHHS-TPP - US Department of Health and Human Services (US DHHS): Office of Adolescent Health (OAH). Teen pregnancy prevention resource center (TPP).
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