Contact Name
Barbara Dietsch
562-985-9488

Contact Email
bdietsc@WestEd.org

Rebecca A. Maynard, Ph.D.
Project Director and Co-investigator
University Trustee Professor, University of Pennsylvania

Barbara L. Devaney, Ph.D.
Co-investigator
Senior Fellow
Mathematica Policy Research, Inc.

Abstinence works. It is the only sure way to prevent pregnancy and sexually transmitted diseases. Yet, we are far from consensus as to what works to promote abstinence among youth.

The Personal Responsibility and Work Opportunity Reconciliation Act (P.L. 104-193) authorized federal expenditures of $50 million annually for five years beginning in fiscal year 1998 to support state efforts promoting abstinence-only education. The programs funded and administered under the Section 510, Title V Block Grant Program1 represent the first major federal effort to actively support state and local efforts to teach youth the benefits of abstinence from sexual activity and other high-risk behaviors.

A congressionally authorized evaluation of abstinence-only education programs funded under Section 510 should strengthen considerably our understanding of the potential benefits of various abstinence-only education approaches. The evaluation, which is funded by the U.S. Department of Health and Human Services, has three primary goals. The first is to document and understand the nature and underlying theories of the abstinence-only education strategies that are being implemented in efforts to reduce adolescents' sexual activity and other risk-taking behavior and to encourage youth to delay sexual activity until marriage. The second goal is to determine the extent to which, and in what ways, various abstinence-only education strategies affect youths' behaviors. The third major goal is to examine the effects of community-wide abstinence-only education initiatives in improving outcomes for youth, and to study the role of the local environment in enhancing or impeding the ability of these initiatives to achieve their intended objectives.

Federal Funds for Programs. Federal funds are distributed to states based on their share of low-income children and their willingness to provide $3 in local matching funds for every $4 of federal funds. Maximum state allotments for fiscal year 1998 range from a low of $69,000 for Vermont to a high of $5.7 million for California. All but a handful of states drew down their full allotment of funds during the first program year, and many matched the federal funds at a higher rate than required. Within and across states, there is great diversity in the manner in which funds are distributed, the nature of the programs supported, and the youth most aggressively targeted. (See Dan Daley's article, States' Implementation of the Section 510(b) Abstinence Program in this issue.)

Evaluation. The conceptual framework for the evaluation builds on theoretical models of teenage risk-taking behavior and a sizable body of research that highlights important links between the backgrounds of youth, abstinence-only interventions and other mediating factors, and key behaviors and related outcomes: teen and out-of-wedlock sexual activity; teen pregnancies and births; and sexually transmitted diseases.

There are two major study components-one focused on measuring the efficacy of abstinence-only education programs targeted at specific identifiable groups of youth, and another examining community-wide abstinence education initiatives. To measure the effectiveness of targeted abstinence-only education initiatives, the study will compare program youth with randomly selected control groups not offered the abstinence-only education. To examine questions about the behavioral consequences of more comprehensive, community change initiatives, the study will monitor community youths' knowledge, attitudes and behaviors over time. For both study components, complementary qualitative research will ensure that the interventions are well documented and it will support an understanding of the nature of the interventions, how they induced behavioral changes, the types of contextual influences that affected the local programs and their outcomes, and the conditions and strategies needed for replication of effective programs.

In order to understand the range of programs being offered, the evaluation team at Mathematica Policy Research and the University of Pennsylvania have visited numerous Section 510-supported programs. Drawing on this review, the researchers will select for study 5 to 10 strong targeted programs representing different intervention strategies and implementation settings. The selected programs will range from curriculum-based programs in school settings with little or no "booster" activities to multiyear, multipronged efforts in both schools and communities. The majority of the selected programs will use nationally disseminated abstinence-only education curricula, but some will have developed their own.

Depending on the strength of the intervention and the age of the target youth, the study sample will range from roughly 500 to as many as 1,500 youths per site, about evenly divided between program participants and control youth. Youths will be enrolled in the study beginning fall 1999 and, in some cases, continuing through fall 2000. Sample members for the targeted program evaluation component will be interviewed at baseline, shortly after the intervention (or at the end of the school year for those in multi-year interventions), and again in spring 2001.

The evaluation also will examine two to four community-wide initiatives with a special focus on learning about effective strategies for building community coalitions to support abstinence and abstinence education. However, this study component also will document the pace of change in community knowledge, norms, and behaviors as the coalition efforts mature. For this purpose, repeated cross-sections of youth in the program areas will be surveyed at two intervals during the study.

The data collection schedule for the study balances two considerations. One is the need to gather data at critical intervals in terms of the timing of the interventions and their expected impacts on behaviors. The other is the need, under the authorizing legislation for the evaluation, to complete the study by September 2001.

Next Steps and Products. The study team has been working with a diverse group of strong programs to explore strategies for implementing the evaluation with minimal intrusion on program operations, while maximizing the benefit of the study findings for policymakers and practitioners. Partnerships are being formed this spring in preparation for full study implementation in fall 1999.

The evaluation will provide much-needed, scientific evidence to aid federal, state, and local policymakers in better understanding the issue of teen sexual activity and the role of abstinence-only education in lowering its incidence. Quite importantly, the study will provide a rich source of data on the efficacy of different models of abstinence education, each of which will have its own set of strengths and weaknesses when considered for adoption in a specific community, depending on the community's needs; its social, political, and economic context; and its norms and preferences.

1 This program is administered by the Maternal and Child Health Bureau within the U.S. Department of Health and Human Services.