Comprehensive Programs for Pregnant Teenagers and Teenage Parents: How Successful have they Been?

Abstract

A number of recent studies have raised questions about the effectiveness of comprehensive service programs designed to respond to the problem of teenage pregnancy and childbearing in the US. All the programs studied fell short in some respects of the ideal represented by the comprehensive model. Even the very best were limited in geographic coverage, numbers served, scope, duration and intensity of services offered. Nonetheless, there were notable differences between those programs that met the criteria of comprehensiveness and those that failed to do so. The more resource-rich, better-served communities are the most likely to be able to overcome the constraints and to develop comprehensive programs. State policies, backed with program funds, were found to be a crucial determinant of program development. However, they tend to be awarded to localities that in some ways need them the least. The current federal legislation erroneously assumes that dissemination of various comprehensive program models will bring about their local adoption, even without government assistance. Federal incentive grants to states, based on some measure of need and capacity, could spur the development of programs in regions of the country that are otherwise unlikely to be able to afford them. School-based program models have considerable appeal. However, this evaluation revealed the significant obstacles such programs face. An alternative approach would have to start with improved health and welfare services similar to those found in most other advanced, industrial nations. Comprehensive programs, despite their many virtues, are not the magic bullets that will solve the problems associated with unintended teenage pregnancy and parenthood. The empirical evidence of the past 15 years suggests that there is no single solution to the problems associated with adolescent sexuality, pregnancy and parenthood. While family planning and abortion services have proven significant in limiting adolescent pregnancies and births, a more informed policy approach would seek to provide a broader range of services.