Challenging the evidence base: The impact of teen pregnancy prevention curricula on disconnected youth

Background/Purpose.  Rates of pregnancy and sexually transmitted infections are substantially higher for youth in foster care, juvenile detention, homeless shelters and substance use rehabilitation facilities.  However, these “disconnected youth” face multiple barriers in accessing sexual health information.  This study uses data from a multi-site federally funded project to examine the usefulness and effectiveness of teen pregnancy prevention evidence based programs (EBPs) with youth in high risk settings. 

Methods/Approach. Paired sample t-tests are used to measure the change in behavioral intent and knowledge related to sexual activity (n=592).  Process evaluation components include individual interviews with youth (n=15) and interviews with agency staff (n=5) that were analyzed using conventional content analysis.

Findings.  Youth who receive EBPs are reporting significant changes in their knowledge and behavioral intent.  They improve scores on validated measures related to sexual health trauma and report that they are less likely to have sex within the next three months.  However, findings from the process evaluation suggest that youth have negative views of sex and sexuality, lack understanding of consent and have unrealistic views of relationships.  Additionally, they report portions of the EBPs to be uncomfortable likely based on their prior trauma histories.

Implications.  Study findings suggest that there are unique barriers to implementing EBPs in more high risk settings where youth have likely experienced trauma.  While agencies look to implement EBPs based on funding patterns, it is important to supplement programming to include topics related to positive sexuality, consent and healthy relationships, particularly for youth who have experienced trauma.