Selecting, Implementing, and Evaluating Teen Pregnancy Prevention Interventions Lessons Learned from the Community Coalition Partnership Programs Presented by Darlene L. Shearer DrPH, Susan L. Gyaben MPH, Lorraine V. Klerman DrPH, and Kaia Gallegher, PhD

Study Purpose and Objectives To investigate decision-making processes used by 13 CDC-funded communities to prioritize, select, implement and evaluate their interventions To describe barriers experienced and lessons learned during implementation and evaluation Major Focus on reproductive health services, reproductive health education, parent-child communication, male involvement, and programs for pregnant and parenting teens

Definitions RHS - Reproductive Health Services - interventions aimed at teens to directly modify their sexual behavior through the provision of clinic- type services RHE - Reproductive Health Education - interventions aimed at modifying teen sexual behavior through the provision of sexuality- related education PPT - Pregnant and Parenting Teens - interventions aimed at assisting teens medically or educationally to prevent subsequent pregnancies before reaching milestones such as high school graduation MI - Male Involvement - interventions aimed directly at young males PCC - Parent Child Communication - interventions aimed primarily at increasing comfort levels, frequency, and style of communications between teens and parents

Methodology Review of semi-annual reports (SARs) to identify interventions implemented by each of 13 CDC-funded community programs Developed a telephone survey instrument Conducted telephone interviews with Program Director, Program Evaluator, and Coalition Chairperson from each of the 13 communities.

Study Questions What factors influenced community decisions to develop or not to develop interventions within 5 categories (RHS, RHE, PPT, MI, and PCC)? How important were community needs and assets assessments (NAAs) and community action plans (CAPs) in selection of interventions? Who were the key entities in decision making? What is the current status of each intervention, what sources of funding have been used for each and what specific barriers have been encountered?

Analysis Responses were entered into SPSS and analyzed in two ways: - by type of respondent - by the intervention category Because responses to questions were not independent of each other only descriptive analyses were done.

Study Results  Thirty individuals were interviewed: 13 Program Directors, 12 Program Evaluators, and 5 Coalition Chairs u Identified 82 interventions in the 5 categories, an average of 6 per grantee. u Interventions by category: RHS 13%, RHE 43%, MI 12%, PCC 24% and PPT 7% Interventions by grantee RHE 92%, PCC 85%, MI 54%, RHS 46%, and PPT 39%

Key Decision-Makers in Selection

Importance of NAA in Selection (as reported by Project Directors)

Reason for Selection of Category

Reason for Not Selecting a Category

Implementation Barriers

Conclusions Grantees relied heavily on their Needs and Assets Assessments in making decisions about intervention selection. n Teens were infrequently utilized, while program staff were the most frequent cited decision-makers. n The most frequent reason given for not implementing interventions in a particular category was that similar programs already existed. n About two-thirds of the interventions are being evaluated by process or outcome measures or a combination of both. n Many respondents did not feel that the (82) interventions reflected their investment of time and money or emphasized the importance of their community-mobilizing and community- awareness activities.