Teen Pregnancy:

State and Federal Efforts to Implement Prevention Programs and Measure Their Effectiveness

HEHS-99-4: Published: Nov 30, 1998. Publicly Released: Dec 14, 1998.

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Pursuant to a congressional request, GAO provided information on: (1) state strategies to reduce teen pregnancy and how states fund these efforts; (2) how welfare reform affected states' strategies; (3) the extent to which programs that are part of states' prevention strategies are evaluated; and (4) what teen pregnancy prevention activities the federal government supports.

GAO noted that: (1) the eight states in GAO's review have, over time, developed teenage pregnancy prevention (TPP) strategies involving numerous programs that fall into six areas; (2) in general, these states targeted high-risk populations and communities and tailored programs to three different groups of teens; (3) while strategies were applicable statewide, states typically relied on local communities to select and implement specific programs from an array of alternatives; (4) states generally gave localities the flexibility to choose the type and mix of programs they wanted to put in place; (5) some communities chose not to implement programs that the state strategy encouraged; (6) all of the states GAO visited relied on federal funding to support their strategies and in many of the states, federal funding exceeded state funding for TPP; (7) the 1996 federal welfare reform legislation had a limited effect overall on these states' TPP strategies, in part, because the states in GAO's review already required that teen parents live at home and stay in school to receive assistance--two key provisions now mandatory under federal welfare reform; (8) only two of the eight states plan to compete for the bonus provided by the law to states that show the greatest success in reducing out-of-wedlock births; (9) the other states are unlikely to compete because they lack the data needed to show reductions or because their prevention efforts focus on teens who account for a relatively small proportion of out-of-wedlock births; (10) although the eight states initially had concerns about the prescriptive nature and administrative requirements of the new law's grant program for sexual abstinence education, the eight states applied for the grants, received funding, and plan to either initiate new abstinence education programs or expand programs that they had already included as part of their strategies to prevent teen pregnancy; (11) although all eight states are tracking changes in teen births, few are evaluating the effect of their TPP programs on teen pregnancy; (12) only four states are attempting to link some of their TPP efforts to changes in teen pregnancies, births, or other closely related outcomes; (13) for fiscal year 1997, the Department of Health and Human Services identified at least $164 million for TPP programs or services; and (14) however, funding specifically for TPP activities could not be isolated at the federal level, primarily because of the flexibility on spending decisions given to states.

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