Meta-analysis of Federally Funded Adolescent Pregnancy Prevention Program Evaluations

Area of Science:

• Public Health
• Adolescent Health
• Behavioral Science

Background:

• The U.S. Department of Health and Human Services (HHS) has funded numerous Adolescent Pregnancy Prevention (APP) programs since 2010.
• These programs aim to reduce risky sexual behaviors among adolescents.
• A meta-analysis was conducted on studies completed between 2015 and 2019 to evaluate APP program effectiveness.

Purpose of the Study:

• To conduct a meta-analysis of experimental/quasi-experimental studies evaluating HHS-funded Adolescent Pregnancy Prevention programs.
• To determine the effectiveness of these programs on various sexual behavior and consequence outcomes.
• To explore potential moderators of program effectiveness, such as delivery setting.

Main Methods:

• A systematic review and meta-analysis of 52 studies meeting inclusion criteria (experimental/quasi-experimental design, comparison group, >=10 participants per condition, reported sexual behavior outcomes).
• Data extraction using a standardized protocol, with outcomes coded as log odds ratio effect sizes and transformed to odds ratios.
• Pooled effects were calculated across 7 outcome types, and moderator analyses were performed.

Main Results:

• Pooled effects across 7 outcome types (recent pregnancy, ever had sex, recent sexual activity, recent unprotected sexual activity, ever pregnant, number of sexual partners, proportion of unprotected sexual experiences) were generally small and mixed.
• None of the pooled effects achieved statistical significance.
• Moderator analyses indicated that programs delivered in classroom settings were the least effective (OR = 0.74, 95% CI [0.43, 1.31]).

Conclusions:

• The findings do not provide meaningful support for the overall effectiveness of the evaluated HHS-funded Adolescent Pregnancy Prevention programs.
• The limited generalizability of findings to programs funded by other entities or implemented in different countries should be considered.
• Further research may be needed to identify more effective strategies for adolescent pregnancy prevention.