USING BEHAVIORAL THEORIES TO DESIGN ABSTINENCE PROGRAMS

If adolescents abstain from sex, or delay having sex, the risk of preg nancy is essentially zero, and the sexual transmission of a communicab le disease is diminished substantially. Whatever other, nonpublic heal th reasons one may have for preferring abstinence as an approach to th e prevention of teen pregnancy, the potential for a sizable reduction in rates of adolescent pregnancy supports abstinence as a reasonable s trategy. The issue of abstinence as an approach has less to do with th e desirability of the goal than with figuring out successful ways to p ersuade adolescents to comply. While numerous abstinence programs have been implemented, no ''silver-bullet'' strategies have been identifie d to date. Abstinence interventions (like most efforts to prevent teen pregnancy) are usually ad hoc, implemented opportunistically, or desi gned on the basis of a personal hunch. Few programs have been evaluate d, and among those with evaluations, most have shown very little effec t on the timing of sexual debut, When effects are found, they have bee n fairly small, with teens delaying sex for a matter of months, when t he goal is to delay sex for years. While hunches and experience in the field provide useful insights, it is time to be more systematic in de veloping new intervention approaches and incorporating research knowle dge and theory. This paper highlights scientific evidence regarding th e factors most likely to influence the onset of sexual activity during adolescence and examines program strategies with the greatest potenti al to affect adolescent sexual behavior given research findings, The i mportance of rigorous evaluations, and suggestions for strengthening t he evaluation of abstinence-focused interventions and adolescent pregn ancy prevention programs in general, is discussed.