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1 1 (September 1, 2022)

handle is hein.crs/goveisv0001 and id is 1 raw text is: Congressional Research Service Informing Ihe lsatve d baL sin e 1914 Federal Teen Pregnancy Prevention Programs Background The U.S. teen birth rate-or the number of births per 1,000 females aged 15 to 19 each year-has steadily declined since the early 1990s. The rate decreased by 75% from the most recent high of 61.8 (in 1991) to the most recent low of 15.4 (in 2020, the most recent data available). Researchers suggest that multiple factors have influenced this decline, and that there is not necessarily a definitive single reason for it. Such factors may include decreasing teen sexual activity, particularly among younger teens, and increasing use of contraceptives among sexually active teens. Despite the downward trend in births among teenagers, Congress continues to be interested in the issue of teen birth because of its high costs. Teen parents tend to have less education and are more likely to live in poverty than peers who are not teen parents. Children of teenage mothers are more likely to have poorer educational and other outcomes than children of mothers who delay childbearing. Teen childbearing can have larger societal impacts, such as costs related to public sector health care and lost tax revenue. In addition, teen pregnancy disproportionately affects certain racial and ethnic groups and selected states and insular areas. Figure 1 shows a map with teen birth rates by quartile for the 50 states, Washington, DC, and four of the insular areas in 2020. Four states had the highest teen birth rates (25 or higher): Mississippi, Arkansas, Louisiana, and Oklahoma. The rates for the insular areas ranged from 15.1 in the U.S. Virgin Islands to 33.0 in Guam. Figure I. Teen Birth Rates by State & Territory, 2020 Source: Congressional Research Service (CRS), based on data from the Centers for Disease Control and Prevention (CDC). Notes: Birth rates are per 1,000 females aged 15 to 19. Multiple HHS agencies established the Teen Pregnancy Prevention Evidence Review pursuant to the FY2010 omnibus appropriations law (P.L. 111-117). The review was active from 2010 to 2019 but is in the process of being reestablished. It used criteria to determine which education models have been shown, through rigorous evaluation, to Updated September 1, 2022 reduce teen pregnancy and related outcomes. HHS encouraged or required grantees for some teen pregnancy prevention programs to use these models. Teen Pregnancy Programs Federal law has authorized programs that provide educational curricula and social supports aimed at helping youth make decisions that will ultimately delay early pregnancy and parenting. Four federal programs focus exclusively on teen pregnancy prevention education: (1) the Teen Pregnancy Prevention program; (2) the Personal Responsibility Education Program; (3) the Title V Sexual Risk Avoidance Education program, authorized under Title V of the Social Security Act; and (4) the Sexual Risk Avoidance Education program, authorized under appropriations laws. The U.S. Department of Health and Human Services (HHS) administers the four programs, which generally target vulnerable teen populations. Youth receive teen pregnancy prevention education in school and other settings. Grantees for the four programs include states and/or other entities. Teen Pregnancy Prevention (T PP) Program P.L. 111-117 initially established and funded the TPP program, and subsequent appropriations laws have provided authority and funding through FY2022. The program competitively awards grants to public and private entities to implement a variety of evidence-based or innovative models that seek to influence adolescent sexual behavior. Such models focus on sexual abstinence or information about the use of contraceptives, among other approaches. After funds are set aside for training and technical assistance, most of the remaining amount (75%) supports Tier 1 grants. Generally, these grantees replicate models determined to be evidence-based through rigorous evaluation studies. Another 25% of the remaining TPP program funds are used for Tier 2 research and demonstration grants that are intended to develop and test additional strategies for reducing teenage pregnancy. Currently, TPP supports 62 Tier 1 grantees and 17 Tier 2 grantees. TPP grantees served 59,244 youth in FY2021. Evaluations of the first cohort of TPP grantees (FY2010- FY2014) showed mixed results. Of 41 evaluations, 12 showed a positive impact in at least one teen pregnancy- related outcome. Another 16 did not have positive impacts and 13 had inconclusive results due to attrition, failure to meet HHS' research standards, or for other reasons. Personal Responsibility Education Program (PREP) The Patient Protection and Affordable Care Act (ACA; P.L. 111-148) established PREP under Section 513 (Title V) of the Social Security Act. The program is a broad approach to teen pregnancy prevention that seeks to educate adolescents aged 10 to 20, and pregnant and parenting youth under age

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