Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities

Context: A significant amount of attention has been devoted to the complex issue of teenage pregnancy and to programs for reducing pregnancy among ado lescents. Careful evaluations of such programs are needed to ascertain what strategies will be most effective at reducing teenage pregnancy. Methods: A pretest-posttest comparison group design was used to analyze the effects of a comprehensive multicomponent school and community interventio n on estimated pregnancy rates and birthrates among young people in three K ansas communities: Geary County Franklin County and selected neighborhoods of Wichita. Results: There were high levels of program activity in all three communitie s during the intervention period, including teacher training and sexuality education for students. Survey respondents rated highly such project interv entions as the extension of school-linked clinic hours to accommodate stude nt schedules and support groups established in middle schools. Between 1994 and 1997 the proportions of adolescents reporting that they had ever had s ex decreased significantly among all ninth and 10th graders in Geary County , from 51% to 38% among females and from 63% to 43% among males. In Frankli n County, more males in grades I I and 12 reported using condoms in 1996 (5 5%) than had done so in 1994 (39%). Age at first intercourse remained relat ively stable in Franklin and Geary counties during the intervention period. The estimated pregnancy rate among adolescents aged 14-17 decreased betwee n 1994 and 1997 in Geary Country, while it increased in comparison areas. T he estimated pregnancy rates among 14-17-year-olds decreased in both Frankl in County and ifs comparison communities. The birthrate declined both in on e target area of Wichita and in ifs comparison area from 1991-1993 to 1994- 1996 Over the same time period, the birthrate increased in a second target area of Wichita, while if decreased in the comparison community Conclusions: This evaluation of a comprehensive multicomponent program for adolescent pregnancy prevention contributes to our understanding of this mo del and its replicability in diverse communities. Ongoing program evaluatio n is important for developing initiatives and for refining strategies so th ey respond to local conditions.