The long awaited results of the first set of evaluation findings from the Office of Adolescent Health (OAH) Teen Pregnancy Prevention (TPP) Program grantees are available, and the results are an affirmation of the importance of investing in the future of our nation’s young people. The results are encouraging—eight new programs were identified as evidence based; 40% of evidence-based programs that were replicated were done so successfully; and we learned a great deal more about what works with whom and under what conditions.

“All in all, these results are a great next step in using evidence to inform what we do, and to support better sexual and reproductive health outcomes for young people,” notes Healthy Teen Network President & CEO Pat Paluzzi, CNM, DrPH.

When sharing these results with your communities and partners, Healthy Teen Network offers the following points to help others understand how this investment in research has made a difference in the lives of young people.

1. Investing in Evidence, Innovation, and Young People

In 2010, President Obama launched an initiative to support the implementation of evidence-based programs to prevent teen pregnancy. The move to require federally funded programs to achieve results—confirmed through rigorous evaluation—was a much needed step in helping the field focus on the best practices to achieve better outcomes for youth. Evidence-based strategies and approaches are effective ways to achieve positive outcomes; innovation is an equally critical component of a comprehensive strategy to respond to the dynamic lives of adolescents and young adults.

“Healthy Teen Network has long proposed a comprehensive approach that moves us beyond an individually-based prevention approach to one that promotes healthy sexual and reproductive outcomes for all youth,” Paluzzi emphasizes. “We have to do better, and by investing in research and young people—to find out what works, for whom, and how—we can indeed support better sexual and reproductive outcomes for all youth.”

In the recently released OAH TPP Program evaluation results, communities were funded through the OAH TPP Program to implement programs previously proven through rigorous evaluation to reduce teen pregnancy and sexual risk-taking behaviors. And building on these evidence-based programs, communities were funded to develop and evaluate new and innovative approaches to prevent teen pregnancy. The programs were diverse—sex education, youth development, abstinence education, and clinic-based programs, as well as programs designed to meet the needs of diverse youth and settings.

Source: OAH

From OAH’s press release announcing the findings, OAH Director Evelyn Kappeler notes, “Using rigorous evaluations helps build a body of evidence for where, when, and with whom specific programs are most effective. OAH’s findings are giving communities a wider array of programs with demonstrated effectiveness from which to choose.”

As a result, 41 rigorous evaluation studies were produced, building the body of evidence. Eight new programs demonstrated, through rigorous evaluation, positive changes in teen sexual behavior, such as helping young people delay sex and improving contraceptive use among sexually active teens. And four of 10 evidence-based programs were replicated with positive results.

To make the most of our investment in programs and services, we need research like this to demonstrate the programs that are most effective in achieving better outcomes for young people. These evaluation studies are a boon to our field, building our knowledge of what works to support adolescent sexual and reproductive health.

2. Fit Matters

The work we do is complicated, youth are complicated, and replicating programs with new populations and in new settings is complicated. A repository of research and evidence-based programs is not a list where communities can pick and choose based on the program that is the most convenient, shortest, cheapest, or does not include a condom demonstration.

Selecting a program that addresses the relevant risk and protective factors and sexual risk-taking behaviors of the young people in one community—based on a needs and resource assessment—is of critical importance. Programs that have positive findings in one setting/population may not necessarily work with other settings or populations. (Check out Healthy Teen Network Fit resources in our Center for Evidence and Innovation for more information on program selection and fit.)

The successful replication of four of 10 evidence-based programs is indeed a success; in fact, a 40% success rate is not uncommon in similar evaluation studies. This investment builds our science and knowledge base and supports program selection that fits with the needs of the youth and community. The original evaluation studies for these evidence-based programs still hold true—they are proven effective, still, at reducing sexual risk-taking behaviors in the settings and with the youth populations originally tested. These results underscore the importance of selecting a program that fits, a program that meets the needs of the youth population and the community, and the appropriate capacity-building assistance is provided for staff.

Fit matters: programs must be carefully selected to meet the unique needs of the youth and community. We must continue to invest in innovation to ensure have new evidence-based programs—proven effective programs designed for diverse settings and populations, so we can appropriately select for fit.

3. Translating Research to Practice

None of this research or rigorous evaluation matters if we do not put it into practice. And again, it can be complicated. Results that may appear less than anticipated on the surface provide us an opportunity to learn.

What does it mean, in practice, to say that fit matters? And once we understand the importance of fit, how do we appropriately assess the needs and resources of a youth population and community? How do we map those findings to select an existing evidence-based program? Or design an innovative program for a unique population, which applies the lessons learned from evidence-based programs?

The answer here is capacity-building assistance. When professionals have the training, technical assistance, resources, and tools to apply the lessons learned, then we leverage the investment in research to continue to improve our programs and services.

We must invest in the translation of research to practice and build the capacity of our youth-supporting professionals.

4. How and Where Youth Live, Learn, and Play Matters

We cannot do better for our young people without changing our approach. We have to move beyond a focus on individual behavior change to consider the importance of context. Certainly, TPP programs that educate our young people about sex, along with access to effective contraception are necessary to prevent teen pregnancy and STIs. They are not, however, sufficient to address the needs of all youth.

Healthy Teen Network promotes a holistic approach to adolescent health through our Youth 360° initiative for holistic health promotion. Social determinants associated with teen pregnancy, such as low parental educational attainment, and limited opportunities for education and employment are more common in communities with higher proportions of racial and ethnic minorities, contributing to health disparities.[1]

How and where youth live, learn, and play matters. We cannot meet the needs of all youth without employing Youth 360⁰ holistic health promotion.

Where Do We Go From Here?

Healthy Teen Network congratulates HHS on its commitment to evidence and innovation and investing in our nation’s young people. The most recent TPP Program results affirm that while we have indeed made a difference in the lives of young people, as demonstrated by the dramatic recent drop in teen birth rates, we must…

1) Invest in research to support evidence and innovation;

2) Select and implement programs that fit our communities and young people;

3) Invest in capacity-building assistance to support the translation of research to practice; and

4) Invest in approaches that support Youth 360⁰ holistic health promotion.

What are your key takeaways from the latest OAH TPP Program results? How are you talking about and sharing the news?