Science-based Approaches to Teen Pregnancy Prevention
1. Comprehensive Children’s Aid
Society-Carrera Model
Developed in the 1980s at the Children’s Aid Society
(Harlem, New York) by Dr. Michael Carrera, this
comprehensive, holistic, intensive, long-term approach
to teen pregnancy prevention serves boys and girls from
high-risk neighborhoods, ages 10-18. Young people enroll
in the program at the beginning of middle school and
remain until graduation from high school. Programming
occurs five days a week after school and throughout the
summer. The model includes six major program components:
• Education
• Family Life & Sex Education
• Employment/Career
• Health/Mental Health
• Self-Expression through the Arts
• Recreation/Lifetime Individual Sports
Underlying the model is a philosophy that creates a
“parallel family” structure, providing ongoing, long-term support,
encouragement, opportunities and skill development with an eye towards
building a productive future.
According to Dr. Carrera, the key to motivating young
people to avoid early parenthood is to offer “concrete and hopeful
alternatives such as decent employment, a bank account, improvement in
school, a place in college, or a meaningful career or vocational track.
These are the elements that produce desirable outcomes in young people
and reduce teen pregnancy, teen violence, and teen substance abuse” (Carrera,
2005).
Consequently, the emphasis is on helping participants
succeed in school; learn about and prepare for the world of work;
abstain from sexual activity, while gaining the knowledge, understanding
and motivation to be sexually responsible and protected should they
become sexually active. Parents and families of the participants are
viewed as partners, and are supported by the staff in the shared goal of
helping young people succeed. Participants’ health and mental health
needs are addressed either through direct services or a case-management
approach. The comprehensive nature of the model includes self-expression
and self-esteem building through the arts as well as lifelong individual
sports that emphasize and teach self-discipline. A qualified, expert and
dedicated staff is essential to the success of such a program. Ideally,
the program is neighborhood-based, located in a safe and accessible
facility that can accommodate the varied nature of the program
activities.
More information on the Carrera model of teen pregnancy prevention
can be found at the Carrera Adolescent Pregnancy Prevention website:
http://stopteenpregnancy.com
2. Service Learning: Teen Outreach Program (TOP)
This positive youth development program, initially established in 1978,
has served thousands of youth across dozens of states, and has been
described as “the best evidence we have that social programs can prevent
teen pregnancy” (Kirby, 1997). Teen Outreach was developed as a
school-based program that involves young people in volunteer activities
in their communities. The volunteer work is linked to a classroom
curriculum that touches on a variety of topics ranging from family
conflict to human growth and development. This blend of activities
allows students to become “help givers” as opposed to “help receivers,”
and thereby empowers participants with an increased sense of autonomy
(Allen, et al., 1990). Evaluation data on the effectiveness of the Teen
Outreach Program have consistently shown a reduction in teen pregnancy
and school failure rates when compared to control subjects (Allen, et
al, 1997).
Teen Outreach is a one-year program targeting boys
and girls between the ages of 12 and 17. The program materials are
available in English only, or with a Spanish adaptation manual. The
program can be implemented in any of four ways: 1) as an in-school
requirement that is part of a core course; 2) as an in-school elective;
3) as an after-school program with volunteer participation; or 4) as a
community-based program aimed at providing enrichment for the program
participants. Teen Outreach is designed for either a school year
calendar or any consecutive 9-month period. In order to reap the maximum
benefits from this approach to teen pregnancy prevention, it is
recommended that small groups of 20-25 youth meet at least once or twice
per week, led by trained facilitators. Participants perform at least 20
hours of community service per school year.
Changing Scenes is divided into developmentally
progressive components targeted to four different age groups: 1) 12-13
year-olds; 2) 14 year-olds; 3) 15-16 year-olds; and 4) 17 year-olds. The
curriculum emphasizes healthy decision-making about life options. Topics
include values; human growth and development; school issues;
relationships; sexuality; dealing with family stress; and issues related
to the emotional and social transitions from adolescence to adulthood.
Communication and decision-making skills are addressed. Group sessions
are interactive and developmentally oriented, and may include use of
videos, guest speakers, art projects, journal writing, and role-playing.
The community service component involves supervised
volunteer opportunities arranged in a variety of settings, depending on
the individual community needs and an individual student’s interests.
Examples of activities include work as aides in hospitals or nursing
homes, participation in walk-a-thons, peer tutoring, outdoor projects,
such as neighborhood clean up or beautification work, etc. Volunteer
events may be arranged for individual participants, small groups or
large groups, depending on the nature of the activity and/or setting.
The service learning experiences are discussed during the regular group
meetings, and include: planning and preparing for the volunteer
opportunities; exploring issues such as self-confidence, social skills,
assertiveness, self-discipline; and reflecting on their own and others’
volunteer experiences. (Allen, 1997)
Classroom discussions are led by trained
facilitators. Groups meet one to three times per week. Staffing patterns
for this model include a classroom facilitator and a community service
coordinator. An Advisory Steering Committee convenes on a regular basis
to plan and develop the local Teen Outreach Program. Committee members
serve as resources, with emphasis on identifying developing community
service sites, which are key to the program’s success.
More information on the Teen Outreach Program can be found at
www.wymanteens.org.
3. Service Learning: Reach for Health (RFH)
Reach for Health (RFH) was originally developed in 1994 at two middle
schools in Brooklyn, New York. RFH was specifically developed for
African-American and Hispanic youth living in urban areas. As in the TOP
program described above, the RFH program combines a classroom component
with community service work. This intervention targets 7th and 8th grade
middle school students, both male and female.
Students participate in RFH over the course of two full school years.
Participants are assigned to a supervised community placement, where
they spend approximately three hours per week for 30 weeks. In addition
to that off-site work, students attend weekly health lessons--35 lessons
in the seventh grade and 30 in the eighth grade. These weekly sessions
are designed for groups of 20-25 boys and girls, and are meant to
supplement a traditional health class curriculum. The health curriculum
utilized by RFH is Teenage Health Teaching Modules. A trained
facilitator/educator conducts the weekly group meetings. The curriculum
focuses on three primary health risks: drug and alcohol use, violence,
and sexual behaviors that may lead to pregnancy, sexually transmitted
diseases or HIV infection. During these weekly group sessions, students
also share and reflect upon their community service experiences.
Implementation of the RFH program requires collaboration between middle
schools and community service sites. In the original implementation of
RFH, a full-time, on-site coordinator was hired to manage activities
between school and community sites as well as communication among
various agents, including students, parents, school administrators,
teachers, field site mentors and other community site staff. At the
middle school, health teachers delivered the classroom component of RFH.
However, RFH may also be offered as an after-school program.
More information on Reach for Health can be found at
www.socio.com
References
Allen, J.P., Kuperminc, G.P., Philliber, S. & Herre, K. “Programmatic
Prevention of Adolescent Problem Behaviors: The Role of Autonomy,
Relatedness, and Volunteer Service in the Teen Outreach Program”
(American Journal of Community Psychology 22: 617-638) 1994.
Allen, J.P. & Philliber, S. “Who Benefits Most from a Broadly
Targeted Prevention Program? Differential Efficacy Across Populations in
the Teen Outreach Program” (Journal of Community Psychology 29: (6)
637-655) 2001.
Allen, J. P., Philliber, S., Herrling, S. and Kuperminc, G. P.,
“Preventing Teen Pregnancy and Academic Failure: Experimental Evaluation
of a Developmentally-based Approach” (Child Development 64: 729-742)
1997.
Carrera, Michael A. (2005). Carrera Adolescent Pregnancy Prevention
Program website. Available at: http://stopteenpregnancy.com. New York:
Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program
Kirby, D. (1997) No Easy Answers: Research Findings on Programs to
Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen
Pregnancy.
Kirby, D. (2001). Emerging Answers: Research Findings on Programs to
Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen
Pregnancy.
Maynard, Rebecca A., Ed. (1996). Kids Having Kids: A Robin Hood
Foundation Special Report on the Costs of Adolescent Childbearing. New
York, NY: The Robin Hood Foundation.
O’Donnell, L.O., Stueve, A., O’Donnell, C., Duran, R., San Doval, A.,
Wilson, R., Haber, D., Perry, E. & Pleck, J.H. “Long-term Reductions in
Sexual Initiation and Sexual Activity Among Urban Middle Schoolers in
the Reach for Health Service Learning Program” (Journal of Adolescent
Health 31(1): 93-100) 2002. |
