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Translating Research into Practice
Rigorously evaluated programs that demonstrate positive outcomes are eligible to be implemented by TPP grant recipients in communities with the greatest need.
The HHS Office of Population Affairs' (OPA) Teen Pregnancy Prevention (TPP) program is a national, evidence-based program that funds diverse organizations working to prevent teen pregnancy across the United States. OPA funds the exploration, development, testing, and rigorous evaluation of new and innovative interventions to significantly reduce teen pregnancy disparities and advance the field of adolescent sexual health. Investing in teen pregnancy prevention programs helps adolescents reach their full potential. Connecting youth to services and opportunities can help prevent teen pregnancy.
OPA funded the development and rigorous evaluation of TPP programs to expand the available research and evidence base in the field of teen pregnancy prevention. OPA’s TPP Tier 2 grant recipients develop, replicate, refine, and rigorously evaluate programs and innovative strategies to reduce teen pregnancy.
These TPP programs address gaps in the existing evidence, reduce disparities in teen pregnancy and associated sexual and reproductive health outcomes, and/or serve diverse communities. Individually, these TPP programs provide new research on specific types of innovative practices (e.g., using technology to deliver information, joint family programming) or specific populations and settings (e.g., LGBT+ students, rural areas), which can support greater equity in TPP programming. As a collective, these programs and the evaluation results further emphasize OPA’s contributions to the TPP field.
Since 2009, the U.S. Department of Health and Human Services (HHS) has sponsored a systematic review of research on teen pregnancy prevention to identify programs with evidence of effectiveness in favorably having an impact on reducing (1) teen pregnancy and sexually transmitted infections (STIs) and (2) sexual risk behaviors. The HHS Teen Pregnancy Prevention Evidence Review (TPPER) currently identifies 52 programs that meet the review criteria for evidence of effectiveness. These criteria require programs to show evidence of at least one favorable, statistically significant impact on at least one outcome of interest reflecting sexual behavior or reproductive health.
The 2023 review identified nine new programs, seven from OPA, as showing evidence of effectiveness. These programs aim to improve sexual and reproductive health outcomes, promote positive youth development, and advance health equity for adolescents, their families, and communities.
Explore the TPP Programs and Evaluation Results
The following OPA TPP programs released new research that identifies effective innovative approaches for teen pregnancy prevention. The programs below join the ranks of TPP programs that have experienced positive outcomes when evaluated for effectiveness. When TPP programs show favorable impacts, they are then considered evidence-based and become eligible to replicate in communities across the country.
Girl2Girl: Harnessing Text Messaging to Reduce Teen Pregnancy Among LGB+ Girls
Girl2Girl is a 20-week teen pregnancy prevention program delivered daily via text messaging to cisgender female youth ages 14 to 18, who self-identify as lesbian, bisexual, gay, or other non-heterosexual sexual identity (i.e., do not exclusively identity as heterosexual). Girl2Girl participants are also paired with another participant (a Text Buddy) for support throughout the program. They have access to an on-demand advice text line, G2Genie, which shares information about sex, relationships, and the lesbian, gay, bisexual, and queer/questioning (LGB+) community. Girl2Girl content focuses on pregnancy prevention, communication skills, behavioral skills (for example, using a condom and HIV testing), and healthy and unhealthy relationships. Brief online videos reinforce behavioral skills content.
Girl2Girl participants who had been sexually active were more likely to use a condom after the intervention than those who did not participate. Read the full Girl2Girl evaluation results.
High School FLASH: A Public Health Approach to Sex Education
High School FLASH (FLASH) is a 15-session comprehensive sexual health curriculum designed for classroom settings in grades 9 to 12. FLASH uses a harm reduction and behavior change framework and rests on the theory of planned behavior. The curriculum covers the following topics: the reproductive system, pregnancy, sexual orientation and gender identity, healthy relationships, coercion and consent, online safety, abstinence, birth control, preventing human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), condoms, STI testing, communicating and decision making, and improving school health.
High School FLASH was found to be effective at reducing sex without a condom or birth control among sexually inexperienced youth. Additionally, participants had improved ability to refuse sex and self-efficacy to get and use condoms. Read the full FLASH evaluation results.
IN·clued – Inclusive Healthcare: Youth & Providers Empowered
IN·clued is the first evidence-based LGBTQ+-centered sex education program. The IN·clued program consists of two workshops: one for clinical staff and one for LGBTQ+ youth. The program is delivered by adult facilitators and teen peers to LGBTQ+ youth ages 15 to 19 and the health center staff who work with them. The in-person workshop for LGBTQ+ youth covers topics such as safer sex for LGBTQ+ youth, how to access and navigate sexual health services, and how to advocate for yourself with a provider. Participating youth can also opt-in to receive text messages of health tips and reminders to visit a health center. Health center staff and providers in the IN·clued program receive a three-hour workshop that shares best practices for working with LGBTQ+ youth.
IN·clued was found to be effective at decreasing sexual risk behaviors and increasing knowledge of sexual health in LGBTQ+ youth, and self-efficacy to advocate for their needs with health care providers. Read the full IN·clued evaluation results.
Linking Families and Teens: Reducing Teen Pregnancy by Increasing Family Connectedness and Youth Self-Efficacy
Linking Families and Teens (LiFT) is an innovative program designed for families and youth ages 13 to 19 in rural communities. It aims to reduce unplanned teen pregnancies by increasing family connectedness and increasing youth’s self-efficacy, knowledge, and skills related to sexual health. LiFT is a two-module curriculum workshop for youth and their parenting adults. Topics for youth include communication skills, condom use, and skill building to access sexual health care resources. For parenting adults, topics include building a climate of trust and open communication with youth about sexual health. Facilitators encourage youth and parenting adults to opt-in to receive weekly texts that offer resources and suggestions for ways families can communicate.
Youth participants in LiFT were less likely to have ever been pregnant or caused a pregnancy. Read the full LiFT evaluation results.
Peer Group Connection-High School: Helping 9th Graders Transition to High School
Peer Group Connection-High School (PGC-HS) is a peer-to-peer group mentoring program for 9th grade students designed to facilitate the transition from middle school into high school. It also seeks to improve students’ social and emotional learning (SEL) skills, engagement, and educational outcomes. PGC-HS integrates into the school day. Once per week, pairs of 11th and/or 12th grade peer leaders meet with small groups of 9th grade students for outreach sessions designed to strengthen relationships across grades. Outreach sessions occur during regularly scheduled classes; they include hands-on activities and discussions to build group cohesion and improve the SEL skills of group members. Peer leaders are trained through a daily, for-credit leadership course taught during regular school hours.
Peer Group Connection-High School showed reductions in vaginal sex over one year. Additionally, participants had improved decision-making skills and connections with peers over one year. Read the full PGC-HS evaluation results.
Plan A: A Video Intervention to Promote Effective Sexual and Reproductive Health Decisions
Plan A is a 23-minute video intervention designed for African American and Hispanic/Latinx women ages 18 to 19 that promotes effective contraceptive use, condom use for dual contraception and HIV/STI prevention, and HIV/STI testing. The video aims to improve knowledge of sexual health and self-efficacy for communicating with providers about different contraceptive options that have been proven effective, such as long-acting reversible contraception (LARC). The video is delivered in a private room or area of a reproductive health clinic, just before a reproductive health visit. The waiting time before a clinic visit is a moment when the target group will be most receptive to the informational and motivational messages of the intervention.
In the follow-up months, youth who watched Plan A were more likely to get tested for STIs and less likely to have sex without a condom than those who did not watch the video. Read the full Plan A evaluation results.
Pulse: A Web-Based, Teen Pregnancy Prevention Mobile App Intervention
Pulse is a web-based mobile health application. Participants are Black and Latinx women ages 18 to 20. Pulse provides comprehensive, medically accurate sexual and reproductive health information, in English and Spanish, through engaging interactive and multimedia features. These features include dynamic text and graphics; self-assessments; comics that present sexual and reproductive health scenarios; and videos of racially diverse peers that model real-life scenarios, including short films promoting birth control use and clinic use. Pulse has six sections covering material such as birth control methods and reminders, healthy relationships and consent, STIs, finding a provider, and pregnancy.
Pulse participants had a statistically significant reduction in recently having sex without a hormonal or long-acting reversible contraceptive. Read the full Pulse evaluation results.