Updated Findings from the HHS Teen Pregnancy Prevention Evidence Review (TPPER)

Support for TPPER

The TPPER is sponsored by the HHS Office of the Assistant Secretary for Planning and Evaluation, the Office of Population Affairs (OPA) within the HHS Office of the Assistant Secretary for Health, and the Family and Youth Services Bureau within HHS’s Administration for Children and Families and identifies evidence-based program models that demonstrate behavioral outcomes for adolescents up to age 19.

What is the TPPER?

Since 2009, the U.S. Department of Health and Human Services (HHS) has sponsored a systematic review of research on teen pregnancy prevention to identify programs with evidence of effectiveness in favorably having an impact on reducing (1) teen pregnancy and sexually transmitted infections (STIs) and (2) sexual risk behaviors. The HHS Teen Pregnancy Prevention Evidence Review (TPPER) provides the results of the systematic review, and was created in response to the Congressional requirement that teen pregnancy prevention (TPP) programs eligible for replication in the TPP Program must be “proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors.”1

In the first update since 2018, the release of the latest findings in 2023, the TPPER currently identifies 52 programs that meet the review criteria for evidence of effectiveness. These criteria require programs to show evidence of at least one favorable, statistically significant impact on at least one outcome of interest reflecting sexual behavior (for example, whether teens have ever had sex) or reproductive health (for example, teens’ sexual activity, number of sexual partners, contraceptive use, STIs or HIV, or pregnancy). In addition, the supporting research studies must meet established criteria for the quality and execution of their research designs. The review process includes three steps:

  1. Screen available studies for inclusion criteria (for example, quantitative study, behavioral outcome, sample is 19 years old or younger)
  2. Assess the quality of those studies (low, moderate, high)
  3. Assess the evidence in the moderate and high rated studies

Timeline of Updates to the Review

The TPPER identified 28 program models in 2010, and additional models have been added over the years. By 2023, 52 models were identified.

The OPA TPP Program

The Office of Population Affairs (OPA) TPP program is a national, competitive program that provides funding to replicate and scale evidence-based programs and develops and evaluates new and innovative approaches to prevent teen pregnancy, improve adolescent sexual health outcomes and promote positive youth development in communities across the United States. OPA has contributed evidence for 28 of the current 52 programs, including seven of the nine new evidence-based programs reviewed in 2023. These TPP programs address gaps in the existing evidence, provide new research on specific types of innovative practices (using technology to deliver information) or specific populations (LGBTQ+, Black and Latina females, families) and settings (over text, clinics), which can reduce disparities in teen pregnancy and associated sexual and reproductive health outcomes, support greater equity in TPP programming, and reach diverse communities.

The Nine New Evidence-Based TPP Programs (2023)

*Project funded by OPA

  • Girl2Girl* is a 20-week teen pregnancy prevention program delivered daily via text messaging to cisgender female youth ages 14 to 18, who self-identify as lesbian, bisexual, gay, or other non-heterosexual sexual identity. Read the full Girl2Girl evaluation results.
  • High School FLASH*, version 3.0 is a 15-session comprehensive sexual health curriculum designed for classroom settings in grades 9 to 12. Read the full FLASH evaluation results.
  • IN-clued* is a LGBTQ+-centered sex education program and consists of two workshops: one for clinical staff and one for LGBTQ+ youth. Read the full IN·clued evaluation results.
  • LeadHer is a female leadership and sexual health program designed for African American and Latina girls ages 14–19. Read the full LeadHer evaluation results.
  • Linking Families and Teens (LiFT)* is an innovative program designed for families and youth ages 13 to 19 in rural communities. Read the full LiFT evaluation results.
  • Peer Group Connection-High School (PGC-HS)* is a peer-to-peer group mentoring program for 9th grade students designed to facilitate the transition from middle school into high school. Read the full PGC-HS evaluation results.
  • Plan A* is a 23-minute video intervention designed for African American and Hispanic/Latinx women ages 18 to 19 that promotes effective contraceptive use, condom use for dual contraception and HIV/STI prevention, and HIV/STI testing. Read the full Plan A evaluation results.
  • Pulse* is a web-based mobile health application for Black and Latinx women ages 18 to 20. Read the full Pulse evaluation results.
  • Vision of You (VOY) is a comprehensive sexual education program for youth ages 13-19 that is an online, self-paced, interactive curriculum. Read the full VOY evaluation results.

The Previously Reviewed Programs with Past and New Evidence of Effectiveness

Included in this most recent review are previously reviewed programs with past evidence of effectiveness that now have additional supporting evidence.

  • Making Proud Choices!, an abstinence and safer sex HIV risk-reduction program for African American adolescents, found that youth participants reported having had sex fewer times in the past three months, six months after the end of the program. Read the full Making Proud Choices! evaluation results.
  • Power Through Choices, a program implemented in group homes, found that youth in the intervention were less likely to have had sex without using birth control in the preceding three months, six months after participating in the program. Read the full Power Through Choices evaluation results.
  • Families Talking Together, a parent-based program designed for African American and Hispanic caregivers of youth ages 10–14, found that youth in the intervention group were less likely to report having had vaginal sex in the past 12 months and having had sex for the first time in the past 12 months. Read the full Families Talking Together evaluation results.

The latest summary of findings memo, all past summary of findings briefs, review protocols, and other publications along with a searchable database of over 600 reviewed studies with their rating information can be found at the Teen Pregnancy Prevention Evidence Review on Youth.gov.

When programs can be replicated and proven effective in different settings and with different populations, they demonstrate their strength, reliability, and consistency. This update to the evidence review expands the menu of evidence-based program options available allowing users to access the best available evidence for decision-making and providing effective programming based on science. HHS continues to work on the TPP Evidence Review by tightening the evidence standards for the high and moderate study quality ratings (to improve replicability) but also to expand the number and types of programs added by allowing other kinds of evidence into the Review (for example, core components or small sample sizes). Users can access a database of studies and learn more about programs that might be a good fit for the needs in their communities.


1 2010 Consolidated Appropriations Act. back to top