The NCSL Blog


By Emily Heller

Prioritizing programs that are shown to work and are shown to be cost-effective investments will help policymakers “get the most bang for their buck.”

stethescope and money“Putting evidence to work” refers to public policy that is informed by scientific evidence about what works.  Many teen pregnancy prevention programs, for example, are evidence-based, and have been shown to have a positive return on investment for states. More than 35 evidence-based models are shown to be effective in reducing participants’ risk-taking behaviors and the likelihood of becoming teen parents.

The U.S. teen birth rate reached a record low in 2015 of 22.3 births per 1,000 females ages 15 to 19. This represents a 46 percent decline in the teen birth rate between 2007 and 2015, and a stunning 64 percent drop since 1991.

Despite ongoing declines in the teen birth rate in all 50 states, rates are still high in many states and certain groups. While disparities between race and ethnic groups have narrowed in recent years, with the teen birth rate declining by 70 percent among black teens and 64 percent among Hispanic teens since the early 1990s, significant differences remain. The teen birth rate for Hispanic and black teens is still more than twice the rate for white teens.

Disparities also persist by age, with older teens (ages 18-19) four times more likely to become parents than younger teens (ages 15-17). Teens in rural regions, areas of high poverty and foster care also are more likely to become parents.

An increased focus on evidence-based policy—policy informed by scientific evidence about what works—may be one factor behind the recent success that can also help continue to narrow the disparities in teen births between groups.

Since 2010, the Teen Pregnancy Prevention Program (TPPP), administered by the U.S. Department of Health and Human Services’ Office of Adolescent Health, has supported evidence-based teen pregnancy prevention programs across the nation.

The 29 percent fall in the teen birth rate since federal investments in evidence-based teen pregnancy prevention programs (TPPP and the Personal Responsibility Education Program) began in 2010—a decline more than twice as large as any other four-year period—demonstrates the contribution of evidence-based policy and programs.

And in comparison to the public costs of teen childbearing, estimated to be approximately $9.4 billion nationally in 2010, many evidence-based programs are relatively inexpensive to implement. State leaders may look to the TPP Program as an example of evidence-based policymaking and investment in effective interventions that may inform state efforts to prevent teen pregnancy and eliminate persistent disparities.

From 2010 to 2014, the TPP Program funded 102 state agencies, community-based organizations and others grantees, serving nearly 500,000 teens in 39 states and the District of Columbia. Through a second round, the program anticipates serving 1.2 million teens in 39 states and the Marshall Islands between 2015 and 2019.

Currently, the TPP Program offers two types of grants: Tier 1 grants fund organizations replicating proven, evidence-based programs, and Tier 2 grants support research and demonstration projects. Grantees participate in evaluation to achieve continuous quality improvement and to continue to contribute to the evidence base.

Tier 1 grantees may choose from more than 35 evidence-based models shown to be effective in reducing participants’ risk-taking behaviors and the likelihood of becoming teen parents. Models may focus on a variety of approaches, including delaying sex, avoiding risky behaviors, providing contraception information or a combination of strategies.

To promote innovative strategies and address gaps in what is currently known in preventing teen pregnancy, Tier 2 grantees receive funds to develop and test new approaches. These programs may focus on underserved populations or fund innovative, technology-based programs that aim to appeal to tech-savvy teens.

The TPP Program conducted 41 evaluations of the evidence-based programs and new approaches funded since 2010. These evaluations will contribute to the knowledge base about what works by identifying new evidence-based programs and providing valuable information on what programs work in various settings and for different youth.

Full results from the TPP Program evaluations will be released by the Office of Adolescent Health later this month.

“Learn more about evidence-based policymaking and the TPP during an upcoming webinar on June 30

This blog is part of a four-part series that is intended to clarify evidence-based policy for state leaders. The series:

Emily Heller is a research analyst in NCSL's Health program.

Contact Emily.

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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.