The first four years of Title V Section 510 funding for abstinence education have generated a wealth of experience on how local communities and schools have designed and implemented abstinence programs and how youth have responded to them. Interviews with program staff, parents, and students, as well as observations of what and how the abstinence message is conveyed, have yielded rich information on program operations, program models, youth response, and local agency partnership opportunities and challenges. This chapter discusses the experiences of communities, schools, and youth with abstinence education programs, focusing primarily on the 11 programs selected for the evaluation. The analysis also draws on observations of the uses of abstinence education funding more generally. Federal monitoring efforts document the funding allocations and the types of programs supported nationwide. State and local evaluations provide additional detail on how the state grants are dispersed to local communities and the range of programs and activities supported.
The experience of these early years of funding has produced five important conclusions that can guide future fiscal and programmatic decisions:
Funding for abstinence education has contributed to the evolving national struggle to address the social and economic consequences of teenage sexual activity, teenage childbearing, and out-of-wedlock births. Following considerable and sometimes rancorous controversy over whether and how to spend the $50 million in annual abstinence education block grant funds, every state ultimately applied for the money. In each of the successive funding years, nearly all of the states and territories took advantage of the funds available to them.
In 1988, only 2 percent of teachers responsible for sexuality education in public secondary schools reported teaching abstinence as the sole way to prevent pregnancy and STDs; by 1999, this figure had risen to 23 percent of secondary school sexuality education teachers (Darroch, et al. 2000).
Three factors help explain the current extent of acceptance of abstinence education. First, the Section 510 abstinence education programs implemented across the country have gained support because they are more than “Just Say No” programs. They offer a breadth of services and activities designed to support youth, equip them with knowledge and decision-making skills to help them make good choices, and provide them with constructive activities that are fun and widely perceived as good for kids. Second, many programs focus on middle school students, where there is general agreement about the appropriateness of a strong abstinence approach to sexual education. Finally, the coalitions formed at the local level to deliver the abstinence message often bridge a gap in ideological perspectives, allowing abstinence education programs to coexist with other programs that respond in a variety of ways to the needs of teens and their communities.
The Section 510 abstinence education funding supports more than 700 programs nationwide and has resulted in a tremendous range of new programmatic approaches to preventing teen sexual activity and out-of-wedlock pregnancy (Maternal and Child Health Bureau 2000). The amounts awarded to local grantees by states vary widely. For example, among the programs included in the evaluation, annual award amounts range from $50,000 to over $800,000. States have awarded abstinence education grants to community-based organizations, local school districts, local health departments, faith-based organizations, and universities, among others. The funding guidelines encourage states to fund grantees’ efforts directed at local priority needs, and the diversity of uses of funding reflects this intent (Maternal and Child Health Bureau 1997). Local grantees use funds for community-based projects, as well as for evaluation and program monitoring, technical assistance and training, media campaigns, advisory councils, resource and communication networks, toll-free hotlines, and satellite conferences.
| Number of States | Grantees |
|---|---|
| 38 | Community-based organizations |
| 29 | Local Boards of Education/School Districts/Schools |
| 27 | Youth Serving Organizations |
| 23 | Local Health Departments |
| 22 | Faith-Based Organizations |
| 19 | Universities |
| 17 | Local Coalitions/Partnerships/Advocacy Groups |
| 17 | Consultants/Contractors |
| 16 | Media/Research Firms |
| 15 | Health Care Organizations |
| 14 | Non-Profit Organizations |
| SOURCE: Maternal and Child Health Bureau (200). | |
The core of all these efforts is a message about the benefits of abstinence from sexual activity, which most often is delivered through a curriculum-based program in a school setting. This approach, which often has a youth development component, frequently is referred to as character-based education or “assets building.” Other common efforts include adult mentoring, peer mentoring, parent education, before- and after-school programs, and recreational-based activities. More broadly based initiatives include curriculum development, public awareness campaigns, and community partnership development (Maternal and Child Health Bureau 2000).
The majority of programs aim their abstinence message at middle school students. However, some target a wider age spectrum, starting younger and persisting longer. Many also target high school youth, and a few target out-of-school youth. Resource constraints lead many programs to limit their selection of a target population.
Focusing on youth of middle school age or younger has helped some communities resolve the debate between those who favor an “abstinence-only” approach and those who favor an “abstinence-plus-contraception” approach. The emerging consensus that the middle school years are an appropriate time to offer these interventions suggests some agreement that a message of abstinence is an important foundation for all efforts at youth risk avoidance and pregnancy prevention.
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A common perception is that abstinence education programs focus narrowly on teaching youth the single message of abstaining from sexual activity before marriage. Observations of the programs participating in the evaluation suggest that many of the programs include multiple components designed to reinforce and support their abstinence message. For example, the program curricula used by the five targeted programs address a broad range of issues, from building self-esteem to understanding and aspiring to healthy marriages and parenthood, and to teaching skills that will help youth make — and follow through on — good decisions (Table 2).
| Topics | FL | MS | SC | VA | WI |
|---|---|---|---|---|---|
| Building Self-Esteem | X | X | X | X | |
| Developing Values/Character Traits | X | X | X | X | X |
| Formulating Goals | X | X | X | X | X |
| Making Decisions | X | X | X | X | |
| Avoiding Risky Behavior | X | X | X | X | X |
| Maximizing Communication | X | X | X | X | X |
| Strengthening Relationships | X | X | X | X | X |
| Understanding Development and Anatomy | X | X | X | X | X |
| Understanding STDs | X | X | X | X | X |
| Withstanding Social and Peer Pressure | X | X | X | X | X |
| Addressing Consequences/Self-Control | X | X | X | X | |
| Resolving Sexual Conflicts | X | X | X | X | |
| Learning Etiquette and Manners | X | X | |||
| Aspiring to Marriage | X | X | X | X | |
| Understanding Parenthood | X | ||||
| Source: Program curricula manuals. | |||||
In addition to the abstinence education curricula, program services illustrate the breadth of activities offered to youth. Weekend summits, community roundtable discussions, lending libraries and websites, essay contests, door prizes at school dances, “abstinence coupon books” for local businesses, summer programs, family retreats, and program recognition ceremonies are examples of the range of activities offered to program participants.
In general, the program curricula, activities, and opportunities provided to youth reflect, either implicitly or explicitly, various underlying theories of adolescent behavior and the implied logic models that explain the knowledge, attitudes, intentions, and behavior of youth. The most influential theories of adolescent behavior incorporate multiple factors believed to shape youth behavior, including:
With varying emphasis, abstinence education programs recognize these social, developmental, and community antecedents and mediators of youth behavior and draw on one or more of four complementary strategies for promoting abstinence and other healthy behavior: (1) Helping youth learn skills to deal effectively with social influences and peer pressure; (2) providing them with information to better assess the benefits and costs of their actions; (3) altering family and community norms and supports; and (4) promoting healthy development through age-appropriate, healthy-activity choices.
Social Influences and Peer Pressures. All 11 abstinence education programs in the evaluation address social and peer pressures. Lessons on decision-making and communication, and active-learning exercises (such as role-playing) often are used to help youth develop and apply critical skills needed in situations that involve peer pressure. Discussions of attitudes, beliefs, and values help youth distinguish themselves from perceived peer norms. The Teens in Control program in Clarksdale, Mississippi, for example, uses videos to depict teens in relevant situations and then engages program youth in role-playing exercises so that they can apply decision-making and communication skills.
Benefits Assessment. Many abstinence education programs seek to reduce the motivation to engage in risky behaviors by teaching youth to recognize the consequences of such behaviors and the benefits of avoiding them. They use various strategies to alter motivation, including exercises to build confidence, self-esteem, problem-solving abilities, and conflict negotiation skills.
The Not Me Not Now program in Monroe County, New York, has as its cornerstone a media campaign that makes adolescents, parents, and the community more aware of the consequences of teenage sexual activity and stresses positive future options for teens to motivate them to remain abstinent. The media campaign includes paid television and radio advertising, billboards, 5,000 posters in schools, mouse pads for public school students ages 9 to 14, t-shirts, educational materials for parents and schools, and a quarterly newsletter mailed to youth ages 9 to 14. Parents are targeted through workshops, as well as through a widely distributed pamphlet and video. The advertisements convey the program’s message by drawing on local youth to act in the commercials. Local youth also serve on an advisory panel to help shape the media messages and gauge response.
Several of the programs work to alter benefits assessments through teaching about the values in and what constitutes a good marriage. The very heavy emphasis on the institution of marriage in some of the programs reflects a belief that the lack of understanding of, or role models for, marriage results in its being undervalued. This undervaluing of marriage is believed to contribute to casual and early sexual relationships. The ReCapturing the Vision program in Miami, Florida, is an example of a program that attempts to change knowledge about and the perceived value of marriage. The topic of marriage is covered over a period of more than a month of daily classes in which program participants paint their own small “hope chests,” discuss extensively what makes for a good partner in life, “plan” for their own weddings, and hold a mock wedding at a local hotel. The selected “bride” draws on the lessons on relationships and partner qualities in selecting the “groom.” Parents of the bride and groom, as well as program participants from all schools, attend the mock “wedding,” which culminates in vows of chastity until a real wedding.
Family and Community Norms and Support. Particularly the community-wide programs and the more intensive targeted programs often attempt to enhance youth’s involvement with their families, peer groups, schools, and community through offering a multifaceted set of services, activities, and educational and training opportunities. They may be designed to mobilize broad, interrelated factors within the larger community to strengthen positive influences on individual behavior.
The Families United to Prevent Teen Pregnancy (FUPTP) program in Milwaukee, Wisconsin, and the ReCapturing the Vision program in Miami, Florida, for example, both work hard to improve parent-child communication and to enhance participants’ involvement with their families through means such as monthly parent meetings, a weekend family retreat, and home visits. The ReCapturing the Vision program seeks to develop positive peer relationships by running a class-appointed “court system” for students who cause problems and an annual Teen Talk Symposium in which teen and celebrity panelists address questions on relationships and sexual issues.
Both FUPTP and the ReCapturing the Vision programs aim to strengthen participants’ commitment to school through a heavy emphasis on school performance, with report card checks and dedicated homework/tutoring time. Both programs are intensive; they meet daily throughout the school year and offer program participants the opportunity to enroll for more than one year. They address skills needed to support community engagement, with opportunities for community service and lessons on social etiquette through dining at local restaurants. These programs aim to provide youth with a value system that will help them develop their decision-making skills, communication skills and relationships, and goal setting. In addition to participants’ attitudes and values, they also focus on self-esteem. For example, one strategy used by ReCapturing the Vision, an all-girls program, is to provide participants with “makeovers” to improve their self-image.
FUPTP “PLEDGE”
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Developmental Needs. Many programs offer age-appropriate activities and supports designed to fill unmet psychological and emotional needs, develop psychosocial competence, and ease teenagers’ transition to positive, independent, and productive adulthood. For both the ReCapturing the Vision and the FUPTP programs, a primary vehicle for engaging youth is giving them a strong sense of identity with a group that embraces positive values, such as community, responsibility, leadership, trust, and respect for others. This group identity is achieved in a number of ways. In the ReCapturing the Vision program, a local business pays to have suits designed and tailor-made for each program participant. Both programs help foster a sense of identity in the public’s eyes through highly publicized public rallies to support the choice of abstinence. In the FUPTP program, participants write their own “raps” that reflect what they’ve learned from the program and each day recite a program pledge.
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Youth tend to respond especially positively to programs when the staff are unambiguously committed to abstinence until marriage and when the program incorporates the broader goal of youth development. Young teachers who are public about their own commitment to abstinence appear to be very successful in engaging program youth. The Heritage Keepers Program in South Carolina, for example, uses teachers who demonstrate this unqualified endorsement of abstinence until marriage. The program trains these teachers to be direct and to communicate their commitment to abstinence. Observations during site visits suggest that committed and outspoken teachers are effective in capturing the attention of students and getting them to listen and question.
Most programs have limited resources and so must make trade-offs between the intensity and duration of services they provide each participant and the overall number of youth they serve. As observed in classrooms and reported during focus groups, youth seem to respond especially favorably to the intensive programs because they are tailored to the developmental needs of youth and provide services and activities that go far beyond the classroom curricula. These programs often include field trips, weekend activities, end-of-the-year celebrations, and local and national motivational speakers, all of which are geared to helping youth make informed choices about their behaviors. During focus groups, students in one program reported that they are learning about goals; values; high and low self-esteem; high- and low-risk behaviors; good and bad consequences; responsibility; social skills; and abstinence from sex, drugs, and alcohol — and learning not to become a teen parent.
Not all programs have met with enthusiasm, however. The less intensive programs, in particular, more often fail to engage students fully and encounter dissatisfaction among youth with program services. Participants in one such program complained that the class was boring and was “just another class” that “didn’t offer much benefit.” Students in another site acknowledged that some students make fun of the program’s slogan.
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Abstinence programs face real challenges in addressing peer pressure and the communication gulf between parents and adolescents. Testimony from youth about their perceptions of what is going on among their peers reflects, among other things, the extent to which they have been inundated with media messages, images, and thoughts about sexual activity at a very young age. Youth are observing, thinking about, and using sexual activity as a system for peer classification.
Student Reports of Peer Sexual Activity I think there are three different groups… in our school. We have divided into the popular people, the kind-of-popular people, and the not-popular people, and the kind-of-popular people are like maybe they’ll give a peck on the cheek, but then the popular people are already like touching. It [depends] on the person… because there’s some people who, you know, our age now maybe don’t want to be so fast, but it is some fast people our age who, you know, do whatever, whenever, however. Most people I know, if they’re… being pressured, they’ll just do it. They won’t — I don’t know anybody who would say, like, “You know what? I can’t do this,” or “You know what? We need to talk about this.” My school, it’s like they hang out a lot outside of schools. Our relationships tend to be the kids, not the seventh grade, but the eighth grade they are really, really close and they go past kissing a lot.… Either you’re in the don’t-do-it, you-want-to-do-it, or you-are-doing-it crowd, and a lot of people fall into that are-doing-it crowd, and those would be the popular kids in our school. They’ll like go home on the bus, they live in the same neighborhood, and they know their parents aren’t coming home to like six. They come over, one of them goes over to their house, and she said they have oral sex… most of the time it’s just oral sex. It’s not like hardcore, real sex. SOURCE: Focus groups held in Rochester, New York, for the Not Me Not Now program, conducted by Harris Interactive, Inc. Sessions were held separately with boys and girls, and included youth in grades 5 and 6, and in grades 7 and 8, from a range of urban and suburban schools. |
Constructive activities, particularly during after-school hours, can be an antidote to peer pressure, but such activities are not always available to youth. During focus group sessions, youth acknowledged that sexual activity takes place during unsupervised hours after school, as well as at large parties and on “dates” or in small gatherings of friends on weekends. When asked about what they usually do after school, many said they are bored. Many go home and watch television, talk on the phone, do homework, or baby-sit siblings. In one community, parents and their children both said, “We just don’t have anything here,” indicating few options or places for youth to go after school. In another community, there is a youth recreation center, but not within walking distance of the school.
Good communication between parents and adolescents can also counter peer pressure (Miller 2001; and Blum and Reinhart 2001). Recognizing this, many programs try to bridge the gap in parent-child communication in any of three ways. First, they often try to help youth feel more comfortable discussing with their parents issues related to sex. Second, they may try to engage parents actively in the programs, inviting them to program events with their children. Third, many have special parent-focused components that aim to strengthen the parents’ ability to interact more effectively with their children.
Both the Abstinence Education Initiative (AEI) Coalition of Equipping Youth in Cedar Rapids, Iowa, and the Not Me Not Now program in Monroe County, New York, report increases in parent-child communication as a result of homework assignments requiring parent participation. Testimony from parents during focus groups confirms that programs are experiencing some success at improving parent-child communication. In focus groups, parents report that youth are becoming more comfortable talking about sensitive topics, “asking questions that they didn’t ask before” and “opening up conversations.” One parent commented that she is “embarrassed to talk about some of these things, but [her son] talks and makes [her] more comfortable.” Another parent said, “My son has calmed down a lot; we talk to each other more.” Particularly in the intensive programs, parents generally agree that the program is having a positive effect on their children by giving them some important skills, or “building blocks,” with which to have positive interactions and communication with others, including themselves.
Program efforts to involve parents in special program events with their children often succeed in bringing parents to the events. For example, parents attend weekend rallies held by the FUPTPprogramin Milwaukee, Wisconsin, by Heritage Community Services program in South Carolina, and by ReCapturing the Vision in Miami, Florida.
On the other hand, promoting and sustaining active involvement in parent education and enrichment programs has been difficult. Despite widespread parent enthusiasm for programs, getting more than a small fraction actively involved has proven to be a major challenge for virtually all programs. In the Not Me Not Now program in Monroe County, New York, and the Youth Abstinence Education Program in Tooele, Utah, workshops on parent-child communication have been widely advertised, but attendance has not measured up to the extensive outreach campaign. Free pamphlets and videos have been made available to parents in local supermarkets, but these too have not been taken at the rate expected. The Not Me Not Now program is now considering ways to work within existing parent groups, such as those convened by local churches or local adult education programs.
Even when a program includes a focus on the whole family, engaging parents can be a struggle. In FUPTP, staff members often register students for the program through a home visit, during which they explain the importance of parental involvement. The program holds monthly meetings for parents for which they provide food, transportation, and child care. They send home a regular newsletter and provide parents with progress reports. The curriculum uses take-home handouts for parents. Despite these efforts, parent involvement remains low.
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Local schools are usually important partners in abstinence education programs. Schools provide unparalleled access to youth as a captive audience. Other than through the media, there is really no other way to reach so many youth on a regular basis. Furthermore, although the media can reach extraordinary numbers of youth, they do not have the targeted focus on youth development that many educators feel is critical to decisions regarding sexual attitudes and behaviors. However, establishing partnerships with schools is sometimes difficult.
Based on observations and reported experiences of the programs visited during site selection and more in-depth examination of the 11 sites that are the focus of the evaluation effort, it appears that schools generally become partners in abstinence education funding through one of four models of organizational structure. Three involve cooperation between the grantee (the local agency that received Section 510 funding from the state) and others (Figure 1):
The fourth model, though not used by any of the programs selected for the evaluation, is a single-agency model. For example, a school that receives funds to redesign its own sex education curriculum may operate independently rather than in a cooperative relationship with any other organization.
Regardless of the organizational structure, creating and sustaining partnerships between abstinence education programs and local schools often requires enormous persistence and resources. All the programs in the evaluation have established such partnerships, but with varying degrees of challenge and success. Some programs have been welcomed and given extensive support. Some have had to pursue partnership agreements on numerous fronts over long periods of time, conducting community discussions, seminars with parents, and repeated conversations with principals, district superintendents, and local school boards. Still others have received little ongoing support or have been denied access and forced to seek partnerships in other districts or with other organizations.
Where districts and schools are reluctant to support abstinence education programs, it is often because of conflicts over the sex education curriculum. In an effort to appear even-handed, the Cedar Rapids, Iowa, school district excluded from its classrooms both the abstinence educators and educators from Planned Parenthood. Still, the AEI Coalition of Equipping Youth program steadily expanded its access to county schools as the positive reputation of its school-based program in one school district spread. The public schools in Waco, Texas, rejected the abstinence education funds. As a result, the McLennan County Abstinence Education Project focuses its school-based services in surrounding school districts and works with faith-based and other community service organizations to reach high-risk youth in the city. And in South Carolina, the Heritage Keepers program was rejected in some communities that did not want abstinence education as the sex education curriculum in their schools.
Lack of support from school staff is often a factor jeopardizing a school-based abstinence education program. Based on the reported experiences of leaders of the 11 programs in the evaluation, as well as a number of other abstinence education programs visited during site selection, skepticism can emanate from the principal or from classroom teachers. Even when principals invite a program into a school, unless they work to underscore its merit, classroom teachers may withhold support. Teachers’ resistance to a program’s mission or unwillingness to coordinate with program staff, as many sites have reported, can undermine the effectiveness of program operations.
Waning support can result from the emergence of new priorities. For example, in Powhatan, Virginia, an increase in school violence usurped much of the principal’s time and resources, so that the abstinence program received less attention. The current national emphasis on school accountability for student achievement is increasing the priority given to “core” rather than “non-core” courses, and abstinence education programs often struggle in this environment.
Lack of support from a principal also can emerge as a result of staff turnover. As in several schools participating in the evaluation, the principal who invited the program into the school leaves, and the new principal’s agenda and priorities do not include strong support for the abstinence education program or the organization that runs it. The Teens in Control program in Mississippi, for example, worked very hard for an entire year to gain the full cooperation and welcome from two of the three districts in which it planned to operate. In one of these districts, a state takeover resulted in a new principal being hired to “turn the school around.” As a result, the new principal had extremely limited opportunity or incentive to give any priority to the abstinence program.
Lack of dedicated space for the abstinence program can be a symptom of weak school support. Unless an abstinence program is replacing an existing school offering, space availability is often an issue. Several of the programs involved in the evaluation face space constraints and often get shuffled around. This instability in physical location can further undermine support for the program, even among program participants. Uncertainty regarding program location and the inability to establish a secure “home” (either to leave materials/resources or to create a physical identity for the program) can create frustration and ultimately jeopardize the interest and commitment of students and teachers.
Programs can strengthen their partnerships with schools through visibility. They can do this by making sure that the principal and the teachers understand the program’s mission and curriculum, and that they are regularly informed on issues related to the program and its participants. For programs with time and flexibility, providing a direct link to the needs of classroom teachers — such as through the provision of time for homework or tutoring assistance, as is done in the FUPTP program in Milwaukee — can help integrate the program into the school’s existing agenda. Finally, most schools will welcome programs that achieve visibility through popularity with participants and parents; those that make a real investment in youth will be rewarded. An example is the success of the grassroots efforts of parents from the Iowa College Community School District in convincing the school board to adopt the abstinence education program offered through the AEI Coalition of Equipping Youth.
Among the partners of programs participating in the evaluation, some principals and schools have been deeply committed to the abstinence education initiative. In such cases, positive, mutually beneficial relationships for all — the school, the program, the participants, and the parents — have generally emerged.
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The collective state and local abstinence education program experiences from across the country now constitute a sizable body of information to inform the dialogue over approaches to reducing teen sexual activity. The level of attention now focused on teen sexual attitudes, behaviors, and consequences should help determine how best to assist communities in selecting programs to meet their local needs. This attention can, as noted in the Charleston Post and Courier, create “a healthy dialogue among teachers, clergy, parents, health professionals and students to share experiences from each perspective and come to a consensus of what’s best for the children” (Lawrence 2001).
Getting the most out of these experiences depends critically on learning what impacts various approaches to abstinence education have for the youth they serve. The findings from the impact evaluation component of this evaluation will be critical to shaping the future policies and programs to best meet the needs and interests of youth.
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