Current literature shows there is a clear need in the United States for programs to help adolescents when they are pregnant and parenting. Although adolescent sexual activity and adolescent pregnancy rates have declined for the past 15 years, approximately 750,000 adolescents still become pregnant each year. Parenting teens face many obstacles including school drop-out, repeat pregnancy and poverty. Continued funding and support for innovative care, prevention, and research projects are necessary to holistically address the problems associated with early sexual involvement and parenting.
Despite the decreases observed in adolescent sexual activity and pregnancy for the past decade, some adolescents are sexually active and some are becoming pregnant.
Clearly we need to continue testing innovative methods for addressing the needs of pregnant and parenting teens in the context of their family and in various communities. It is important to note that the AFL program is the only Federal program that focuses specifically on comprehensive care programs for pregnant and parenting adolescents. With continued level funding over the past decade, the OAPP has successfully fostered multiple innovative projects that have positively impacted their communities.
AFL Care programs provide and demonstrate an array of health, education and social services, housing, employment and employment training, parenting, and relationship skills training. Care programs also include males and young fathers in an effort to improve their parenting and relationship skills, increase job skills, and provide health and social supports, including activities that help them effectively parent their offspring. Care programs are public health projects that prevent many of the negative consequences associated with adolescent pregnancy, including premature deliveries, low birth weight babies, child abuse and neglect, diseases arising from not having babies immunized, repeat pregnancies, STDs, and dropping out of school as a result of pregnancy, among others. Consequently, Care programs, while positively promoting better health for mothers, infants and families, also help prevent repeat pregnancies among teens. Care activities are all components of a required independent evaluation of the program.
During Fiscal Year 2010, the OAPP issued an RFA for new Care grants. The OAPP received and reviewed 32 eligible applications. Only about $4 million was available to support 9 -10 new projects. This demonstrates a great need for care services for pregnant and parenting adolescents and their families. Funding and support for this population is limited, but the need remains the same. When Care projects are supported and evaluated, multiple parties benefit: the teen mother and father, the infant, the teen's family, siblings of the teens, the school system, and the community. Effective Care projects that target pregnant and parenting adolescents, their families, and their support systems can have a larger impact on the community through higher education rates, fewer subsequent pregnancies, and better child and maternal health outcomes.
AFL funded programs are demonstration projects. This allows for a great deal of flexibility and creates programs that are conducive to adding new approaches and research based activities. Grantees are required to propose an innovative and theory-based program that is independently evaluated. For the past several years, the OAPP has made multiple efforts to improve evaluations of the AFL projects. The AFL legislation requires that 1 to 5 percent of the annual budget is allocated for evaluation efforts. However, since 2003, OAPP has waived the requirement and increased the amount up to 25 percent for intensive evaluations. The OAPP has also implemented a plan for an evaluation contractor to track and provide evaluation feedback and technical assistance for projects. The OAPP has developed and received OMB approval for core data collection instruments. The purpose of these instruments is to provide grantees with common tools for collecting data to assess program outcomes. All new grantees are required to use these instruments for their evaluations.
While all AFL grantees are required by the legislation to conduct independent evaluations, the caliber of the evaluations has ranged widely. The OAPP is moving in a new direction with higher expectations for each grantee and its evaluation. The OAPP is currently developing strategies to improve the quality of AFL evaluations by conducting a cross-site evaluation, identifying resources and knowledge that grantees are lacking, improving the technical assistance offered in the realm of evaluation, and encouraging grantees to publish their findings. Regarding the cross-site evaluation, the purposes are to:
- Improve OPA’s PART rating,
- Provide evaluation data about the AFL program as a whole,
- Inform resource allocation decisions,
- Determine the activities and outcomes of AFL demonstration project efforts, and
- Inform policy decisions about the program.
In order to more fully contribute to the field of adolescent sexual health, the OAPP needs to continue raising the expectations and caliber of AFL evaluations. Through wide dissemination and publication, effective program strategies and evaluation outcomes can benefit the field to further improve the lives of adolescents.