Association for Public Policy Analysis & Management

In 2010, the U.S. Department of Health and Human Services, Office of Adolescent Health (OAH) launched the Teen Pregnancy Prevention (TPP) Program to fund medically accurate and age appropriate programs focused on preventing teen pregnancy and reducing disparities. In 2015, OAH awarded a second round of five-year grants, with most of the funding supporting 50 organizations in 31 states and the Marshall Islands to replicate evidence-based programs (EBPs) to scale in communities with the greatest need.

The “Tier 1B” grant program recognizes that EBPs alone are not enough to effect behavior change, and calls for a community-wide strategy that mobilizes stakeholders around a shared vision, integrates EBPs into multiple types of settings, and increases access to youth-friendly services. This multi-component approach aims to change the broader social environment that shapes individual behavior, targeting outcomes at multiple levels. While the specific ways a grantee translates the grant requirements varies, all are required to include these guiding core components:

• Evidence-based programs - Deliver EBPs with fidelity in at least three types of settings.
• Community mobilization - Engage the community around a shared vision to increase the ability of the community to prevent teen pregnancy and improve adolescent health. Community Advisory Groups (CAG) and Youth Leadership Councils (YLC) lead the effort.
• Linkages and referrals - Recruit a network of youth-friendly, accessible service providers, develop a referral system, and connect youth to needed services.
• Inclusive, safe, supportive environments - Create program environments free from physical and emotional harm or threat; ensure interactions with youth are trauma-informed and offer opportunities for positive youth development.

To understand how grantees and their community partners applied the main components of the Tier 1B strategy, Abt Associates documented the early planning and implementation phase of all Tier 1B grants. The study team conducted 143 semi-structured telephone interviews (all 50 grantee project directors and a purposive sample of 93 community partners) between October 2016 and March 2017. The findings reflect plans and progress made mid-way through the second grant year and first year of full implementation.