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1 1 (April 30, 2018)

handle is hein.crs/govzec0001 and id is 1 raw text is: iinformr gthe' IJis Niv deat sincr11 April 30, 2018 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 67% from the most recent high of 61.8 (in 1991) to the most recent low of 20.3 (in 2016). 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 minority communities and selected states and territories. Figure 1 shows a map with 2016 teen births rates by quartile for the 50 states, Washington DC, and five of the territories. The highest rates were in 12 states, mostly in the South, and the territories. Figure I. Teen Birth Rates by State & Territory, 2016 I if ~ - 60m N !-ir a na American Puerto Fitu HVri A Md M D DC M cnl , iitesbystawe 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. Teen Pregnancy Programs Given the consequences associated with teen births, Congress has authorized programs designed to delay sexual activity and prevent pregnancies among teenagers. Four federal programs focus exclusively on teen pregnancy prevention education: (1) the Teen Pregnancy Prevention (TPP) program; (2) the Personal Responsibility Education Program (PREP); (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. Multiple HHS agencies established the related Teen Pregnancy Prevention (TPP) Review pursuant to the FY2010 omnibus appropriations law (P.L. 111-117). The review uses criteria to determine which education models have been shown, through rigorous evaluation, to reduce teen pregnancy and related outcomes. Teen Pregnancy Prevention (TPP) Program P.L. 111-117 established and initially funded the TPP program, and subsequent appropriations laws have provided funding. 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. HHS has taken steps to discontinue funding for the current cohort of grantees. 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 identified as part of the TPP Evidence Review. Another 25% of the remaining TPP program funds are used for Tier 2 research and demonstration grants that are intended to develop and refine additional strategies for reducing teenage pregnancy. Currently, TPP supports 58 Tier 1 grantees in 28 states, Washington, DC, and the Marshall Islands; and 26 Tier 2 grantees in 11 states and Washington, DC. TPP grantees served 65,788 youth in FY2016. 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. 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 21 on both abstinence and/or contraceptives to prevent pregnancy and sexually transmitted infections (STIs). PREP includes four types of grants: (1) State PREP grants, (2) Competitive PREP grants, (3) Tribal PREP, and (4) PREP- ttps://crsreports.congress.gov

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