Author: Tamar Lewin
Publication: The New York Times
Date: May 30, 2001
Shannon White used to assume she
would become a teenage mother, like her big sister. But at 17, after three
years in an experimental afterschool program intended to prevent teenage
pregnancy, her expectations are quite different.
"I wasn't thinking about college
when I was young," she said. "But I changed when I was about 14. This program
changed me. I have a life. I have things to do. I'm going to be a nurse.
Will I have babies? No time soon."
The program, created by Dr. Michael
Carrera at the Children's Aid Society, offers not just traditional sex
education, but also tutoring, SAT preparation, job skills, medical and
dental care, sports and creative arts.
And in a field littered with good
intentions, heavy doses of morality, and scant evidence of results, the
Carrera program is a solid success: a three-year evaluation of its 12 sites
in poor neighborhoods nationwide found participants had one-third fewer
pregnancies, and births, than those in the control group.
The Carrera program is singled out
in a comprehensive report on the available research on teenage-pregnancy
programs, to be released on Wednesday by the National Campaign to Prevent
Teen Pregnancy, a nonprofit, nonpartisan group in Washington.
The report finds several models
of teenage-pregnancy programs that have had positive results as well. Studies
of some sex and H.I.V. education programs found that participants delayed
sex, increased the use of contraception, and reduced their number of sexual
partners, for at least 31 months.
"One important finding is that sex
and H.I.V. education do not hasten sexual activity, that education about
abstinence and contraception are compatible, and not in conflict with each
other," said Doug Kirby, the author of the report. "We also found that
making condoms available does not increase sexual behavior. These are issues
that a lot of people have worried about."
The report also includes surprising
evidence, from several studies, that "service learning" programs can reduce
teenage pregnancy. These programs include both voluntary community service
projects, like working in a nursing home or tutoring and small-group sessions
where students discuss their projects.
Studies of vocational education,
however, found no effects on sexual risk-taking or pregnancy among teenagers.
And so far, the report found, abstinence-only
education - an approach financed, and favored, by the federal government
- has shown no impact on young people's behavior.
The 1996 welfare reform law included
$85 million a year in federal and state financing available, for five years,
for abstinence-only programs that do not teach contraception. A federally
sponsored evaluation of those programs is under way.
While some federal block grants
can be used for sex education, it has been left largely to local communities
and private sources to support pregnancy-prevention programs.
"We're asked two questions all the
time: What works, and how do I get money to pay for what works?" said Sarah
Brown, director of the National Campaign to Prevent Teen Pregnancy. "This
report offers some answers about what works. And I think more money will
be available as people come to understand that you can get results and
that reducing teen pregnancy is the most efficient single way to improve
overall child wellbeing, and to reduce persistent child poverty."
Mr. Kirby said the Carrera program
had proved an important success with high-risk youth.
"This is the only program that had
strong evidence of reducing pregnancy and child-bearing, delaying sex,
and increasing the use of contraception, for three years," he said.
The Carrera program, and its evaluation,
were supported by the Robin Hood Foundation, in New York, and the Charles
Stewart Mott Foundation, in Michigan. It is one of the most intensive,
and expensive, programs in the field, running to $4,000 per child per year.
Depending on their needs and interests,
the young people in the Carrera progam can come after school to get help
with their homework, meet with a social worker, fill out forms for work
permits, work in the computer lab, or improvise a skit about resisting
sexual pressure. At the Grand Street Settlement site on Manhattan's Lower
East Side, young people drift in at 4 or 4:30, and some stay as late as
9. When they need medical or dental appointments, someone from the Carrera
program will accompany them if their parents cannot.
Elsa Ferreira said her life was
changed by the Carrera program.
"They helped me a lot when I was
struggling with math," said Ms. Ferreira, who will graduate from high school
next month. "I can't do homework at home. We had no insurance, so the medical
help was important. They found me my job, tutoring. They gave out free
condoms. They told us things my mother and aunt never told us about. My
mom didn't finish high school, and my older sister and brother both dropped
out. At the time, I didn't think it was a big deal. But now, I want to
make sure my little brother and sister stay in school."
Last month, there was applause all
around when Ms. Ferreira walked in with the news that she had won a full
scholarship to Syracuse University.
While Ms. Ferreira has steadily
attended the Carrera program, others are not so constant. Victor Rasuk,
a 17-year-old aspiring actor, stayed away for a year. But one tenet of
the Carrera program is never to give up on its young people. Warmly welcomed
back, Mr. Rasuk now works as an intern at the program office.
By the end of the third year, about
70 percent of the original participants were still involved in the program.
The evaluation of the Carrera program
found that unlike the girls in the program, the boys, who made up 43 percent
of the participants, did not reduce their sexual risk-taking - and, while
the girls' birthrate was cut in half, boys were only slightly less likely
than those in the control group to cause pregnancy. In fact, the boys in
the program actually were more likely to become fathers.
"The boys, far more than the girls,
were likely to have been sexually experienced before they came into the
program at 13 or 14," Dr. Carrera said. "We're going to adjust it, for
future programs, to start boys at 11 or 12, before they're sexually active,
and hope we can do better."
Still, some boys said the Carrera
program had filled real needs.
"I used to fight all the time, get
in trouble at school and get sent home," said William Little, a Baltimore
17- year-old. "Now I'm calmer, so I can be in school every day. Without
this, I didn't have nobody to sit down and talk to."
