Meta-Analysis of Federally Funded Teen Pregnancy Prevention Programs: Final Study Report Beginning in 2010, the U.S. Department of Health and Human Services (HHS) funded a variety of interventions and evaluations addressing teen pregnancy prevention. HHS also undertook a quantitative synthesis of the findings from all of these evaluation efforts, using meta-analytic techniques to systematically analyze and summarize the findings. Purpose of the Meta-Analysis The purpose of the meta-analysis—a Data sources for the analysis statistical analysis of data from several evaluations—was to investigate whether The meta-analysis synthesized findings from three HHS-funded grant programs: and how individual elements of program design, program implementation, and/or The Teen Pregnancy Prevention (TPP) participant demographics were Program, funded by the Office of Adolescent associated with program impacts on Health (now the Office of Population Affairs), adolescent sexual behavior. devoted the majority of funding to programs with some evidence of effect (Tier 1); a The findings serve three related smaller portion of funds were dedicated to purposes: (1) to help program model program models that incorporated innovative developers design more effective and untested additions to evidence-based programs; (2) to help practitioners select programs or were previously untested program models most appropriate for approaches (Tier 2). their communities and their local youth populations; and (3) to help guide The Personal Responsibility Education decisions by federal, state, and local Innovative Strategies (PREIS) program, entities. administered by the Family and Youth Services Bureau (FYSB), supported grants How was the study conducted? to implement innovative or untested adolescent pregnancy prevention strategies Researchers extracted data from 53 with a focus on interventions that filled gaps independent evaluations using standard with new, promising programs for high-risk systematic reviewing and meta-analysis youth. procedures. The evaluation samples The Personal Responsibility Education included 57,354 youth and represented Program (PREP), also administered by 45 distinct teen pregnancy prevention FYSB, funded state, Tribal, and competitive program models. The analysis focused grants to support projects to educate youth on behavioral outcomes directly related on both abstinence and contraception, to sex, contraception, and pregnancy including specific high-risk populations. that had been pre-specified in the PREP projects implemented effective, studies’ analysis plans as being the evidence-based program models and most important (“confirmatory”) incorporated adulthood preparation subjects. measures of program success. Office of Population Affairs ▌ Website: www.hhs.gov/opa ▌ Email: OPA@hhs.gov ▌ Twitter: @HHSPopAffairs Findings On average, the HHS-funded programs in the meta-analysis had small favorable effects on their most important outcomes. In particular, these programs significantly reduced risky sexual behaviors as measured by their pre-specified confirmatory outcomes. However, the effect size was modest. There was not much variation in effect sizes across the 53 evaluations, and as a result the researchers had little success identifying the potential sources (e.g., program or population characteristics) of the limited variation. However, researchers identified one program characteristic potentially linked to program effectiveness: program setting. In particular, programs delivered in classrooms were less effective than programs delivered in other settings such as clinics, after-school settings, participants’ homes, and online. There were hints that two other program characteristics may be associated with program effectiveness: programs designed exclusively for girls and programs that delivered services to individual youth rather than groups of youth. The statistical evidence for these findings is weaker, but suggests areas that may be worth further examination in future studies. Strengths and Limitations HHS’s emphasis on rigor and transparency, along with a requirement that grantees collect standardized behavioral outcomes, ensured that findings could be meaningfully compared across evaluations. The number of newly funded evaluations also represented a dramatic expansion of the TPP evidence base. However, the sample is too small to support good estimates of how combinations of factors (such as group composition, age, and participant level of risk) affect success. As a result, most analyses in this report were limited to the effect of a single variable. Conclusions On average, these HHS-funded programs caused a small reduction in risky sexual behaviors and their consequences. This is promising news for the field. The finding that programs delivered in classrooms are less effective than programs delivered in other settings—and hints that programs designed for girls and those programs with individualized delivery may be more effective than other programs—suggest the need for a better understanding of whether combinations of factors ultimately influence engagement in risky behaviors. Increases in the number of well-designed studies can increase our ability to investigate clusters of program and individual characteristics. Disclaimer: This publication was prepared by Abt Associates under Contract No. HHSP233201500069I from the Office of Population Affairs (OPA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of OPA or the U.S. Department of Health and Human Services. Office of Population Affairs ▌ Website: www.hhs.gov/opa ▌ Email: OPA@hhs.gov ▌ Twitter: @HHSPopAffairs