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University of Texas Health Science Center at Houston

Strong Partnerships for Implementing Evidence-based Curriculum Assist with the Decline in Teen Pregnancies in Harris County, Texas

Problem Overview

Unintended teen pregnancy remains a serious public health concern in the United States. A report released in April 2012 by the National Center for Health Statistics denotes that the national level of teen pregnancies is 34.3 teenage births per 1,000 women between the ages of 15-19. 1 In Harris County, Texas, which has a teen birth rate 50 percent higher than that of the nation, adolescent females are especially at high risk of unintended pregnancy.2

Harris County comprises 22 school districts that have more than 180 middle schools, with approximately 178,000 middle school students. The University of Texas Health Science Center at Houston (UTHealth) partners with other county organizations to promote widespread adoption and implementation of evidence-based teen pregnancy prevention programs throughout the county to reduce teen pregnancies. Partnering presented a unique challenge for all involved entities because the leadership, principals, administrators, and teachers of each school district had to agree to participate and allocate resources, time, and physical space to support implementation of these programs.

Program Description

For the past 20 years, UTHealth has had ongoing partnerships with school districts across Harris County to develop and evaluate It's Your Game…Keep It Real (IYG), an evidence-based sexual health education curriculum targeting middle school students.3 IYG is a classroom and computer-based HIV, STI, and pregnancy prevention program for 7th and 8th grade students. An evaluation of IYG found that, in the spring of 9th grade, one year after the program ended, students who received the program were significantly less likely to report having initiated sexual activity.4

In 2010, the U.S. Department of Health and Human Services' Office of Adolescent Health awarded UTHealth funds to implement IYG within nine Harris County school districts and one charter school system. UTHealth staff worked closely, through School Health Advisory Committees and individual meetings with school leaders, principals, administrators, and teachers in these districts, to prioritize the problem of teen pregnancy while emphasizing the importance of using an evidence-based teen pregnancy prevention program to alleviate the problem. A Program Champion was identified in each of the 10 districts to facilitate district approval and implementation of IYG.

Program Impact

In 2011, UTHealth trained 279 teachers who piloted IYG in 63 middle schools reaching 90 percent of students in each school. In 2012, implementation of IYG has reached approximately 20,000 youth in the 63 schools in the 10 districts in Harris County; this will continue annually. According to reports, school leaders, teachers, students, and parents are largely supportive of IYG.

In spring 2012, UTHealth developed a Teacher Advisory Group (TAG) consisting of teachers who represent each of the 10 participating districts. Teachers were asked to sit on the advisory group to provide feedback and insight on IYG implementation during the pilot year. The TAG proved to be successful as UTHealth discovered that teachers felt that the IYG training and the curriculum improved their ability to engage students as well as to assist their ability to be a valid sexual health resource to others in their school community. TAG provided further insight on survey questions for all implementing teachers that will be used in the upcoming year. These questions will allow UTHealth to understand how many teachers have been positively impacted by the IYG program. UTHealth also convened small groups of parents in spring 2011 to assess parental attitudes towards IYG and sexual health; they found that parents were supportive of IYG and would like more opportunities to improve their communication skills with their children.

Contact Information

Susan Tortolero
Title: Program Director
Organization: The University of Texas Health Science Center at Houston
Phone: (713) 500-9634
Email: Susan.Tortolero@uth.tmc.edu

Melanie Thiel
Title: Research Coordinator
Organization: The University of Texas Health Science Center at Houston
Office: (713) 500-9645
Email: Melanie.A.Thiel@uth.tmc.edu

Print the full success story here.


1 Hamilton BE, Ventura SJ. Birth rates for U.S. teenagers reach historic lows for all age and ethnic groups. NCHS data brief, no 89. Hyattsville, MD: National Center for Health Statistics. 2012. Retrieved May 17, 2012, from http://www.cdc.gov/nchs/data/databriefs/db89.htm.
4 Tortolero, S. R., Markham, C. M., Fleschler Peskin, M., Shegog, R., Addy, R. C., Escobar-Chavez, S. L., & Baumler, E. (2010). It’s your game: Keep it real: Delaying sexual behavior with an effective middle school program. Journal of Adolescent Health, 46(2), 169–179.
Content created by Office of Adolescent Health
Content last reviewed on December 15, 2016