Adolescent Pregnancy Prevention: Meta-Analysis of Federally Funded Program Evaluations

Area of Science:

• Public Health
• Adolescent Health
• Behavioral Science

Background:

• The US Department of Health and Human Services (HHS) funded over 40 evaluations of adolescent pregnancy prevention interventions starting in 2010.
• Standardized behavioral outcomes were collected to ensure comparability across evaluations.
• Emphasis was placed on rigor and transparency in these government-funded studies.

Purpose of the Study:

• To analyze findings from HHS-funded evaluations using meta-analysis.
• To determine if program elements, implementation features, and participant demographics influence effects on adolescent sexual risk behavior.

Main Methods:

• A random and mixed-effects meta-analysis was conducted on 44 studies from 39 reports, including 51,150 youths.
• Studies with randomized or high-quality quasi-experimental designs were included; those lacking control groups or pretest data were excluded.
• Mixed-effects meta-regressions analyzed aggregate and individual participant data (48,635 youths) to identify associations between characteristics and program effects.

Main Results:

• Overall, studies showed small, statistically insignificant mean effects favoring the programs, with minimal variability.
• Gender-specific (girl-only) programs demonstrated a statistically significant positive average effect size (P < .05).
• Programs with individualized service delivery were more effective than those using small group formats (P < .05).

Conclusions:

• While individual studies showed positive impacts, overall effects were small and not consistently linked to specific program characteristics.
• Individualized, girl-focused interventions show promise, suggesting a need to re-evaluate assumptions underlying coed group approaches.
• Further research is needed to assess long-term effects and to develop and evaluate programs for male adolescents.