Monday, August 28, 2017
False Claims vs. The Facts
False Claim: The TPP Program is proven effective.
The Facts: The TPP Program is not working.
The TPP Program funded 41 rigorous evaluation studies of which 37 conveyed results for a 2016 report, available on the Office of Adolescent Health website. In summary:
- Overall, of the 37 funded and evaluated projects, 73% either had no impact or had a negative impact on teen behavior, with some teens more likely to begin having sex, to engage in unprotected sex, or to become pregnant. Very few positive results were sustained over time.
- Of greatest interest are the 18 funded projects that replicated curricula found on the TPP Program’s approved list, and for which the TPP Program promised positive results.[i] These projects utilized nine separate curricula from this approved list. Fourteen of the 18 projects (78%) produced no impact or negative impact on teen behavior, 3 had mixed results, and only 1 showed sustained positive effect, (but the same curricula used in that program was used in a separate program that demonstrated no impact).
- Despite the results, these 9 curricula all remained on the TPP approved curricula list for the second round of replication grants, begun in 2015. Seven of the nine curricula evaluated in the 2010-2014 summary report continue to be replicated by grantees. Six of those seven did not demonstrate effectiveness in the 2010-2014 replication. Only one showed sustained positive impact – and in only one of two program evaluations. The second evaluation of the same curriculum showed no impact.
Given the strong evidence of negative impact or no impact for these programs, continuing the TPP Program in its current state is not a reasonable option. The evidence stands in stark contrast to the promised results, jeopardizing the youth who were served, while also proving to be a poor use of more than $800 million in taxpayer dollars.
False Claim: The TPP Program is responsible for the drop in teen birth rates.
The Facts: The TPP Program cannot be the reason for the drop in teen birth rates.
The contemporary rate of decline began in 1992 (prior to the start of the TPP Program).[ii] Further, the TPP Program only serves between 0.15% and 1% of the teen population. In other words, even if the program were proven effective, at least 99% of the teen population is not served by the TPP Program.[iii]
False Claim: The TPP Program is a good use of taxpayer money.
The Facts: Continuing the TPP Program as it is currently structured would be a waste of taxpayer money.
The evidence tells us that most of these programs are not working. It is precisely for this reason that HHS chose to end the current implementation of the TPP Program. The Department intends to follow the science, especially when the health of our nation’s children is at stake. We have spent close to a billion dollars ($800 million) on these failed programs. This is a waste of taxpayer money.
False Claim: Cutting funding for the TPP Program is unprecedented.
The Facts: The TPP Program was created by prematurely ending the Community-Based Abstinence Education (CBAE) Program.
The Teen Pregnancy Prevention (TPP) Program was created by the U.S. Congress in FY 2010 by prematurely ending and then eliminating more than 150 Community-Based Abstinence Education (CBAE) Program grants and repurposing the monies. This action resulted in grantees losing their funding midstream in the grant cycle, thus permitting these funds to be diverted to the newly created TPP Program. Far from unprecedented, the TPP Program was literally created by hastily ending the CBAE Program.
False Claim: The TPP Program is good for youth.
The Facts: HHS is serious about helping youth, so maintaining the status quo cannot be an option.
At its core, the program should help students avoid teen pregnancy and other associated risks. Communities were promised consistent, positive results, but the program has failed to deliver. On July 1, HHS awarded 81 continuations for TPP Program awards, totaling over $86 million dollars. Current TPP grantees were given a project end date of June 30, 2018. This action gives the Department time to continue its review of the program and the evidence. Youth behavioral trend data and health research that identifies important predictors for youth thriving will play a key role in future discussions regarding the TPP Program. The good news is that the majority of teens have not had sex, far fewer in fact than 25 years ago.[iv] Teen birth rates are at record lows, but sexually transmitted disease and infections are at record highs.[v] Public health messaging must address youth sexual risk more holistically to ensure that teen pregnancy prevention is one, but not the only, goal of the program. Should Congress continue to fund the TPP Program, decisions by the Department will be guided by science and a firm commitment to giving all youth the information and skills they need to improve their prospects for optimal health outcomes.
[ii] Child Trends (nd) Birth rates for females ages 15 to 19, by race and Hispanic origin: selected years, 1960-2014. Accessed at https://public.tableau.com/profile/childtrends#!/vizhome/BirthRatesper1000forFemalesAges15to19byRaceandHispanicOriginSelectedYears1960-2014/Dashboard1. Note: The recent peak was in 1991 and the drop began in 1992. There was an upward blip for one year in 2006 and then the descent continued the following year, indicating that 2006 was an anomaly. Therefore, the recent drop in teen birth rates began in 1992 and has been steady ever since. For more information, see Child Trends (2016). Data Bank: The birth rate for females ages 15-19 has fallen to historic lows among all tabulated racial/ethnic groups. Accessed at https://www.childtrends.org/wp-content/uploads/2016/11/13_Teen_Birth.pdf
[iii] In FY 2016, TPP served 65,788 youth, with 69% being age 14 and below. (FY2018 HHS GDM Budget Req.) A typical year serves between 300,000-500,000 students (ASPE). 2016 census data estimates 42,717,000 population between 10-19. Census data found 10-14: 20,677,000; 15-19: 22,040,000 = 42,717,000.
[iv] CDC. (2015). Youth Risk Behavior Survey: US 1991-2015 Results. YRBS trend data shows the percentage of teens who have never had sex increased from 45.9 in 1991 to 58.8 in 2015. The same data shows that the percentage of teens who have never had sex increased from 53.2 in 2013 to 58.8 in 2015. Additionally, teens are waiting longer to have sex. More than half haven’t had sex by 11th grade and 42% haven’t had sex by 12th, up from 33% in 1991 for 11th graders and up from 27% for 12th graders in 1991.
[v] CDC (2017, September). CDC (2015, Nov). STD Surveillance, 2016. Atlanta: USDHHS. NCHHSTP. Accessed 10-11-2017 at https://www.cdc.gov/std/stats16/default.htm. “During 2015–2016, rates of reported chlamydia increased in all regions of the United States.. In 2016, 468,514 gonorrhea cases were reported for a rate of 145.8 cases per 100,000 population, an increase of 18.5% from 2015…During 2015–2016, the P&S syphilis rate increased among both men and women in every region of the country; overall, the rate increased 14.7% among men and 35.7% among women.”
CDC (2016). Reported cases of STDs on the rise, some at alarming rate. NCHHSTP Newsroom. Acessed 8.15.17 at http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html. Although young adults (age 15-24) only account for about 25% of the sexually active population, the newest data shows that they account for nearly 2/3 of all reported cases of chlamydia and gonorrhea. “America’s worsening STD epidemic is a clear call for better diagnosis, treatment, and prevention,” said Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention.” The press release also stated: “Reported cases of three nationally notifiable STDs – chlamydia, gonorrhea, and syphilis – have increased for the first time since 2006.”