The Title XX Adolescent Family Life Program



Office of Adolescent Pregnancy Programs (OAPP) 


Overview 

The Office of Adolescent Pregnancy Programs (OAPP) 
was created in 1978 to administer adolescent pregnancy programs under Title VI of the Public Health 
Service Act (P.L. 95-626).This was the first Federal adolescent pregnancy program aimed at providing 
comprehensive health, education and social services to 
pregnant and parenting adolescents. In 1981,Title XX of 
the Public Health Service Act (P.L.97-35), also known as 
the Adolescent Family Life (AFL) legislation, replaced Title VI and legislated discretionary funds for 
research, care, and prevention demonstration projects. Throughout the years, OAPP has supported 
approximately 400 Adolescent Family Life (AFL) care and 
prevention demonstration projects and 80 research projects. In 2007, 57 projects offer prevention services and 39 
offer care services. 

The AFL program is unique in its approach to teen pregnancy and related issues. Care and prevention 
demonstration grants allow organizations to propose and 
test innovative public health methods while requiring a 
comprehensive evaluation component. Successful applicants for AFL funds have comprehensive demonstration 
models based on theory and a series of hypotheses. In addition to incorporating a strong evaluation design, 
grantees are expected to develop and follow a thorough 
logic model. All AFL grants are required to recruit and 
retain both parents and males in their programs. 

AFL Care demonstration projects serve pregnant adolescents, adolescent parents, their infants, young 

fathers and/or male partners and extended families. Care grantees can implement and test various 
methods for caring for pregnant and parenting adolescents 
and are required to provide a set of ten core services. Care 
project activities are comprehensive and easily accessible 
and include health, education and social services that 
emphasize family involvement and assist clients in becoming productive contributors to family and community life. 
These services include case management, home visitation, 
counseling, advocacy, job training, clinic visits, and educational services.The goals of all care projects are to reduce 
the number of repeat teen pregnancies, improve infant immunization, and increase educational attainment of clients. 
Care projects also focus on increasing the positive factors 
related to good pregnancy outcomes, self-sufficiency, and 
parenting and provide a variety of services to teen parents, their children, and their families. 

AFL abstinence education demonstration projects are 
prevention demonstration projects implemented in accordance with the A-H criteria contained in Title V, Section 
510(b)(2) of the Social Security Act, as amended. Prevention grantees implement and test various methods to serve 
preadolescents, adolescents and their families. Projects generally operate through a series of developmentally 
appropriate classroom and/or after school sessions. 
Prevention grantees incorporate abstinence education 
curricula in combination with other youth development 
activities such as sports, community service activities, and 
leadership opportunities to build internal and external assets. Some projects incorporate cultural and holistic 


Department of Health and Human Services • Office of Public Health and Science 
Tower Building • Suite 700 • 1101 Wootton Parkway • Rockville, MD 20852 
PHONE (240) 453-2828 • FAX (240) 453-2829 • opa.osophs.dhhs.gov 


approaches with the abstinence message, i.e., rites of passage. The goal for serving preadolescents and adolescents 
in AFL prevention demonstration projects is to prevent 
teen pregnancy by increasing knowledge about the positive health and emotional benefits of abstinence and 
improving parent-child communication. 

All care and prevention projects funded through the 
OAPP must include an evaluation component to be 
conducted by an independent evaluator associated 
with a college or university in the grantee’s home 
state.The statute allows between 1 percent and 5 percent 
of federal funds to be spent on evaluation. Through 
recent Requests for Applications, the OAPP has waived 
this percentage to allow for up to 20 percent to 25 
percent allocated for more rigorous, long-term, outcome-
oriented evaluations, particularly those using experimental 

or quasi-experimental design.AFL core data instruments 
must be used within these evaluations for all grantees 
funded after 2004 and a uniform End of the Year report 
template gathers crucial program data that will be used to 
improve AFL evaluation as a whole. 

The Title XX statute authorizes research on the causes 
and consequences of adolescent premarital sexual activity, 
pregnancy and child rearing (Section 2008).The OAPP 
funded research projects focus on such issues as premarital 
adolescent sexual relations, adoption, services for pregnant 
and parenting adolescents, adolescent parenting and child 
development.These research projects provide important 
and valued information and data to the field of adolescent 
sexual health and well-being.As such, the OAPP is able to 
contribute to this field by providing access to new knowledge to better serve adolescents and their families. 


Department of Health and Human Services • Office of Public Health and Science 
Tower Building • Suite 700 • 1101 Wootton Parkway • Rockville, MD 20852 
PHONE (240) 453-2828 • FAX (240) 453-2829 • opa.osophs.dhhs.gov