Updated Findings from the HHS Teen Pregnancy Prevention Evidence Review (TPPER)

Support for TPPER

The TPPER is sponsored by the HHS Office of the Assistant Secretary for Planning and Evaluation, the Office of Population Affairs (OPA) within the HHS Office of the Assistant Secretary for Health, and the Family and Youth Services Bureau within HHS’s Administration for Children and Families and identifies evidence-based program models that demonstrate behavioral outcomes for adolescents up to age 19.

What is the TPPER?

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) provides the results of the systematic review, and was created in response to the Congressional requirement that teen pregnancy prevention (TPP) programs eligible for replication in the TPP Program must be “proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors.”¹

In the first update since 2018, the release of the latest findings in 2023, the 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 (for example, whether teens have ever had sex) or reproductive health (for example, teens’ sexual activity, number of sexual partners, contraceptive use, STIs or HIV, or pregnancy). In addition, the supporting research studies must meet established criteria for the quality and execution of their research designs. The review process includes three steps:

Screen available studies for inclusion criteria (for example, quantitative study, behavioral outcome, sample is 19 years old or younger)
Assess the quality of those studies (low, moderate, high)
Assess the evidence in the moderate and high rated studies

Timeline of Updates to the Review

The TPPER identified 28 program models in 2010, and additional models have been added over the years. By 2023, 52 models were identified.

The OPA TPP Program

The Office of Population Affairs (OPA) TPP program is a national, competitive program that provides funding to replicate and scale evidence-based programs and develops and evaluates new and innovative approaches to prevent teen pregnancy, improve adolescent sexual health outcomes and promote positive youth development in communities across the United States. OPA has contributed evidence for 28 of the current 52 programs, including seven of the nine new evidence-based programs reviewed in 2023. These TPP programs address gaps in the existing evidence, provide new research on specific types of innovative practices, specific populations, and settings, which can reduce teen pregnancy and associated sexual and reproductive health outcomes.

When programs can be replicated and proven effective in different settings and with different populations, they demonstrate their strength, reliability, and consistency. This update to the evidence review expands the menu of evidence-based program options available allowing users to access the best available evidence for decision-making and providing effective programming based on science. HHS continues to work on the TPP Evidence Review by tightening the evidence standards for the high and moderate study quality ratings (to improve replicability) but also to expand the number and types of programs added by allowing other kinds of evidence into the Review (for example, core components or small sample sizes). Users can access a database of studies and learn more about programs that might be a good fit for the needs in their communities.

Footnotes