Guiding the evaluation of the Title V, Section 510 programs is a logic model describing how the funded programs aim to reduce teen sexual activity and related risk behaviors (Figure I.1). Beginning in Box A, the logic model assumes that adolescent decision-making is influenced by numerous antecedents, including their own backgrounds and experiences and the characteristics of their schools and communities. Youth decision-making may also be influenced by the formal education services that they receive (Box B). As one of these possible services, the Title V, Section 510 abstinence programs aim to change the health, family-life, and sex education that youth normally receive (Box C). This change, in turn, is hypothesized to have favorable impacts on several intermediate outcomes that may serve as mediators of behaviors (Box D). For example, youth participating in the programs might develop more positive views towards abstinence and marriage or improve their knowledge of sexual activity risks. Through these and other changes, programs are ultimately hypothesized to affect longer-term behavioral outcomes (Box E). Among these outcomes are the rate of sexual abstinence and the potential consequences of sexual activity, such as STDs and pregnancy.
A series of evaluation reports has studied the pre-behavioral components of the logic model, spanning Boxes A through D. In an initial DHHS study report, Devaney et al. (2001) examined Boxes A and B of the logic model describing the populations served by the programs and the characteristics and implementation experiences of programs funded through Title V, Section 510. In two subsequent DHHS study reports, Maynard et al. (2005) and Clark and Devaney (2006) examined Boxes C and D of the logic model measuring the first-year impacts of five selected Title V, Section 510 programs on the services youth received and on selected intermediate outcomes that may influence risk behavior.
Building on these earlier findings, the current report focuses mainly on the behavioral outcomes of youth, summarized in Box E of the logic model. The report addresses three questions:
- What impacts do programs have on behavioral outcomes? Do the four selected Title V, Section 510 abstinence education programs affect behavioral outcomes summarized in Box E rates of sexual abstinence and sexual activity and risks of STDs and pregnancy?
- What impacts do programs have on possible mediators of behavior? Do the four programs improve knowledge of pregnancy and STD risks, knowledge of the health consequences of STDs, and other possible mediators of behavior, such as views toward abstinence and relations with peers, which were a focus of earlier DHHS study reports as well?
- What are the links between possible mediators and behavior? How well do the potential mediators (Box D), measured after the first program year, predict the rates of sexual abstinence and sexual activity three to five years later? This analysis provides valuable insight into whether the intermediate outcomes that programs seek to affect (such as self-esteem and skill building) are in fact associated with future behavior.
The next chapter (Chapter II) describes the four programs that are the focus of this report, highlighting their common features and key differences. This is followed, in Chapter III, by a description of the research design and analytic methods used to measure the programs' impacts. Chapters IV through VI present the report findings, addressing respectively each of the three research questions listed above. Finally, Chapter VII summarizes the main study findings and considers the implications of these findings for future policy and research.