Program Efficacy
| Comprehensive Education About Sexuality | |
| Abstinence-Only-Until-Marriage Programs | |
| What Young People Are Learning |
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| Additional Evaluation Resources |
| PROGRAM EFFICACY |
A lot of research has been done to determine what works when it comes to helping young people adopt protective behaviors such as delaying sexual behavior or using condoms and contraception. This section provides information on the research that has been done on programs designed to educate young people about sexuality, prevent sexually transmitted diseases (STDs), and avoid unintended pregnancy. The research included on this page shows that comprehensive sexuality education works while abstinence-only-until-marriage program have never been proven effective. This section is divided into four parts comprehensive education about sexuality, abstinence-only-until-marriage programs, what young people are learning, and additional evaluation resources. |
| COMPREHENSIVE EDUCATION ABOUT SEXUALITY |
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Numerous studies and evaluations published in peer-reviewed literature have looked at sexuality education programs. Studies have shown that comprehensive education about sexuality, programs that teach teens about both abstinence and contraception/ disease prevention, are an effective strategy to help young people delay their initiation of sexual intercourse, reduce the number of sexual partners they have, and increase condom or contraceptive use when they do become pregnant.
EVALUATIONS The studies listed in this section are reviews of evaluations of interventions designed to prevent HIV, other STDs, and teen pregnancy. Sex and HIV Education Programs for Youth: Their Impact and Important Characteristics Source: Doug Kirby, et. al., Sex and HIV Education Programs for Youth: Their Impact and Important Characteristics (Scotts Valley, CA: ETR Associates, 2006). Description: The researchers gathered information on 83 different studies of effective education programs that showed an ability to reduce risks for HIV, other STDs, or unintended pregnancy. Of the 83 studies reviewed, 56 were based in the United States. Programs targeted young people ages 9–24. Key Findings:
To View this Resource: www.etr.org/recapp/programs/SexHIVedProgs.pdf
Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy Source: Doug Kirby, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy (Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001). Description: The National Campaign to Prevent Teen Pregnancy commissioned a review of programs considered effective at reducing teen pregnancy and/or STD rates among young people. Kirby gathered information on over 250 studies to identify the elements that made the programs effective. Key Findings:
To View this Resource: www.teenpregnancy.org/resources/data/pdf/emeranswsum.pdf
Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections Source: S. Alford, et al., Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections, (Washington, DC: Advocates for Youth, 2003) Description: This paper compiles descriptions of the rigorously evaluated programs that have demonstrated effectiveness at reducing adolescents’ risk for pregnancy and STDs, including HIV. Key Findings:
To View this Resource: www.advocatesforyouth.org/programsthatwork/index.htm
Best-Evidence Interventions: Findings From a Systematic Review of HIV Behavioral Interventions for US Populations at High Risk, 2000–2004 Source: C.M. Lyles, et. al., “Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for U.S. populations at high risk, 2000–2004,” American Journal of Public Health 97(1) (2006): 133-143. Description: Researchers from the Centers for Disease Control and Prevention reviewed U.S.-based HIV-prevention research literature from 2000 through 2004 to identify interventions demonstrating best evidence of efficacy for reducing HIV risk. They found eighteen interventions that met the criteria for “best evidence.” Key Findings:
To View this Resource: This article may be obtained online for a fee. For more information:
If you have difficulty finding this article, you may contact SIECUS at
A Decade in Review: Building on the Experiences of Past Adolescent STI/HIV Interventions to Optimize Future Prevention Efforts Source: J.M. Sales, et. al., “A decade in review: Building on the experiences of past adolescent STI/HIV interventions to optimize future prevention efforts,” Sexually Transmitted Infections 82 (2006): 431-436. Description: Researchers reviewed findings from selected adolescent STD/HIV interventions in the United States between 1994 and 2004. They examined the most current STD risk reduction programs in a wide range of settings: communities, schools, clinics, detention homes, and drug treatment facilities. They then identified the features that were associated with effective programs. Key Findings:
To View this Resource: This article may be obtained online for a fee. For more information: If you have difficulty finding this article, you may contact SIECUS at siecus@siecus.org.
SOURCES OF EFFECTIVE PROGRAMS ReCAPP (ETR Associates): Evidence-Based Programs This web resource provides practical tools and information to effectively reduce sexual risk-taking behaviors. Health educators will find up-to-date, evaluated programming materials to help with their work with teens. A section on Evidence-Based Programs identifies curricula that have shown evidence of changing adolescent sexual risk-taking behavior. To View this Resource: See ETR's Resource Center for Adolescent Pregnancy Prevention (ReCAPP) at: www.etr.org/recapp/
DEBIs: Diffusion of Effective Behavioral Interventions This project was designed to help community-based service providers as well as state and local health departments provide effective, science-based, HIV-prevention initiatives. The website contains detailed information on interventions including: Healthy Relationships, Holistic Health Recovery, MPowerment, Safety Counts, Street Smart, and many others. To View this Resource: www.effectiveinterventions.org
PASHA: Program Archive on Sexuality, Health and Adolescence This archive created by Sociometrics provides a collection of promising teen pregnancy and STD/HIV/AIDS prevention programs that have demonstrated effectiveness. Educators can obtain a package containing all of the materials needed for program implementation. In addition, it provides three evaluation resources that give program developers a starting point for re-evaluating the promising program. To View this Resource: www.socio.com/pasha.htm
Compendium of HIV Prevention Interventions with Evidence of Effectiveness This compendium was compiled by the Centers for Disease Control and Prevention (CDC) to help educators locate effective HIV-prevention interventions for drug users, heterosexual adults, men who have sex with men, and youth. The CDC determined rigorous evaluation requirements to ensure that only effective interventions would be included. This document contains summaries of those interventions that met these criteria.
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| ABSTINENCE-ONLY-UNTIL-MARRIAGE-PROGRAMS |
Abstinence-only-until-marriage programs have gained popularity in recent years in large part because the federal government continues to sink over $170 million each year into such programs. These programs have never been proven effective and often rely on fear, shame, and misinformation. In addition, virginity pledges, a cornerstone of many of these programs, have been shown to be ineffective at best and possibly harmful.
ANALYZING DEFINITIONS AND CURRICULA As abstinence-only-until-marriage programs have gained popularity many new curricula and resources have been created. A number of researchers and organizations have reviewed these materials and found that they rely on fear and shame, include medical inaccuracies, and are inconsistent in their definitions of abstinence. In addition to the resources listed in this section, see SIECUS’ reviews of some of the more popular abstinence-only-until-marriage curricula at http://www.communityactionkit.org/curricula_reviews.html. A Review of 21 Curricula for Abstinence-Only-Until-Marriage Programs Source: K.I. Wilson, et. al., “A review of 21 curricula for abstinence-only-until-marriage programs,” Journal of School Health 75(3): 90–98 (2005). Description: The researchers reviewed 21 curricula for abstinence-only-until-marriage programs used in middle school grades (fifth to eighth) or with middle school-aged audiences (ages 9–13). Key Findings:Abstinence materials were found to “vary considerably” in terms of overall quality.
To View this Resource: This article may be obtained online for a fee. For more information:
If you have difficulty finding this article, you may contact SIECUS at www.siecus.org/feedback.html.
Defining Abstinence: Views of Directors, Instructors, and Participants in Abstinence-Only-Until-Marriage Programs in Texas Source: Patricia Goodson, et. al., “Defining abstinence: views of directors, instructors, and participants in abstinence-only-until-marriage programs in Texas,” Journal of School Health 73(3)(2005): 91-96. Description: The researchers evaluated how program directors, instructors, and teens in eight Texas abstinence-only-until-marriage education programs define the term “abstinence.” Key Findings:
To View This Resource: This article may be obtained online for a fee. For more information:
If you have difficulty finding this article, you may contact SIECUS at www.siecus.org/feedback.html.
The Waxman Report Source:Prepared for Rep. Henry A. Waxman, The Content of Federally Funded Abstinence-Only Education Programs (Washington, DC: United States House of Representatives, Committee on Government Reform, Minority Staff, Special Investigations Division, 2004). Description: This Congressional report prepared for Representative Henry Waxman (D-California) found that widely used federally funded abstinence-only curricula distort information, misrepresent the facts, and promote gender stereotypes. Key Findings:
To View this Resource: http://oversight.house.gov/investigations.asp
The GAO Report Source: Abstinence Education: Efforts to Assess the Accuracy and Effectiveness of Federally Funded Programs Report GAO-07-87 (Washington, D.C.: Government Accountability Office, 2006). Description: In 2006, the Federal Government Accountability Office (GAO) concluded that government-approved evaluations of abstinence-only programs fail to follow scientific guidelines. Key Findings:
To View this Resource: http://www.gao.gov/new.items/d0787.pdf
PROGRAM EVALUATIONS There are no published studies in the professional literature that show that abstinence-only programs will result in young people delaying sexual intercourse. Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy Source: Doug Kirby, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy (Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001). Description: The National Campaign to Prevent Teen Pregnancy commissioned a review of programs considered effective at reducing teen pregnancy and/or STD rates among young people. Kirby gathered information on over 250 studies to identify the elements that made the programs effective. Key Findings:
To View this Resource: http://www.teenpregnancy.org/resources/data/pdf/emeranswsum.pdf
The Mathematica Report Source: The Evaluation of Abstinence Education Programs Funded Under Title V Section 510: Interim Report (Washington, D.C.: Mathematica Policy Research, Inc., 2005). Description: Mathematica has been hired by the federal government to conduct an evaluation of programs funded under the Title V Welfare Reform funding stream. Of the more than 700 federally funded abstinence-only programs, the interim evaluation looked at 11 programs, only four of which were evaluated for attitudinal impact. The other six programs evaluated are community-wide interventions and were reviewed for implementation and process analysis only. None was evaluated for behavioral impact. Key Findings:
To View this Resource: http://www.mathematica-mpr.com/publications/PDFs/evalabstinence.pdf
Five Years of Abstinence-Only-Until-Marriage Education: Assessing the Impact Source:D. Hauser, Five Years of Abstinence-Only-Until-Marriage Education: Assessing the Impact (Washington D.C.: Advocates for Youth, 2004). Description: As of 2004, 11 states had made the results of evaluation of their state-wide abstinence-only-until-marriage programs available for review. This review summarizes the results from state-wide evaluations in Arizona, California, Florida, Iowa, Maryland, Minnesota, Oregon, Pennsylvania, and Washington. Key Findings:
To View this Resource: http://www.advocatesforyouth.org/publications/stateevaluations/index.htm
VIRGINITY PLEDGES Although they were once the sole province of religious organizations, many secular groups and schools now host events where students sign “virginity pledges” as a way to promote pre-marital abstinence. Today, virginity pledges are also part of most abstinence-only-until-marriage curricula and programs. Research has found these pledges to be ineffective and potentially harmful. Promising the Future: Virginity Pledges and the Transition to First Intercourse Source: Peter Bearman and Hanah Brückner, “Promising the Future: Virginity Pledges and the Transition to First Intercourse,” American Journal of Sociology 106.4 (2001): 859-912. Description: Researchers used data from the National Longitudinal Study of Adolescent Health, a nationally representative study of students enrolled in grades 7–12 in 1995, to determine the impact of virginity pledges on young people’s sexual behavior. Key Findings:
To View this Resource: This article may be obtained online for a fee. For more information:
If you have difficulty finding this article, you may contact SIECUS at
After the promise: The STD consequences of adolescent virginity pledges Source: Peter Bearman and Hanah Brückner, “After the promise: The STD consequences of adolescent virginity pledges,” Journal of Adolescent Health 36.4 (2005): 271-278. Description:Researchers used data from the National Longitudinal Study of Adolescent Health, a nationally representative study of students enrolled in grades 7–12 in 1995, to determine how virginity pledges impacted the rates of sexually transmitted diseases among young people who took them. Key Findings:
To View this Resource: This article may be obtained online for a fee. For more information:
If you have difficulty finding this article, you may contact SIECUS at
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| WHAT YOUNG PEOPLE ARE LEARNING |
This study looks at what young people are learning in the classroom and how this has changed over the years. Changes in Formal Sex Education: 1995–2002 Source: L. D. Lindberg, et. al., LD, “Changes in formal sex education: 1995–2002,” Perspectives on Sexual and Reproductive Health 38(4) (2006): 182-189. Description: The researchers used data from the 1995 National Survey of Adolescent Males, the 1995 National Survey of Family Growth (NSFG), and the 2002 NSFG, to examine changes in male and female adolescents’ reports of the sex education they have received from formal sources. Key Findings:
To View this Resource: http://www.guttmacher.org/pubs/journals/3818206.html
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| ADDITIONAL EVALUATION RESOURCES |
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The American Evaluation Association The AEA is one a professional organization whose mission is to promote high-quality, trustworthy evaluations. AEA has approximately 4,000 members representing all 50 states in the United State as well as over 60 foreign countries. The website can help you learn about evaluation standards, find an evaluator, and discover additional publications and training opportunities. To View this Resource: http://www.eval.org/
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