Teen pregnancy rates in the United States have been on the decline for many years. According to the U.S. Department of Health and Human Services, the teen birth rate (defined as the number of births per 1,000 teenagers aged 15-19) has fallen 57 percent since 1991. In 2013, the national teen birth rate was an historic low of 26.5 births per 1,000 teenagers. This is good news, because teen mothers are more likely than adult mothers to drop out of school and live in poverty. Their children, in turn, are more likely to become teen parents themselves, perpetuating the cycle of social and economic disadvantage.
In Missouri, teen birth rates have declined 46 percent since 1991. However, the current teen birth rate is higher than the national average, giving Missouri the 22nd highest teen pregnancy rate in the country. In fact, as Figure 1 indicates, several individual counties in Missouri have much higher rates, ranging from a high of 93.6 in Pemiscot County, to a low of 12.0 in Nodaway County (American Community Survey, 2009-13).
In an ongoing effort to reduce teen pregnancy rates in the state, the Missouri Department of Health and Senior Services has again awarded funding for pregnancy prevention programming to sixteen of the state’s highest-risk counties. Missouri’s Personal Responsibility Education Program (PREP) is part of a national initiative to reduce teenage pregnancy rates through the use of evidence-based programs. These programs are designed to increase teens’ self-efficacy, reduce bullying, help teens resist peer pressure, and increase their knowledge about pregnancy prevention.
Since it was implemented in 2012, Missouri’s PREP program has reached 2,855 students through 234 pregnancy prevention and personal efficacy classes. Currently, PREP employs three different curricula, each designed to meet specific programming needs:
Becoming a Responsible Teen (BART) – BART is a comprehensive sex education program consisting of eight lessons taught over an eight-week period. The program focuses on the prevention of teen pregnancy, STIs and HIV/AIDS through effective communication, negotiation, and problem-solving. The target population for BART clubs is African-American students between the ages of 14 and 18.
Making Proud Choices (MPC) – MPC is an eight-session program, which can be implemented in as little as one day, or as long as eight weeks. This program targets youth age 11 to 13. The MPC curriculum focuses on both abstinence and safer sex practices, and on reducing risk for sexually active teens.
Teen Outreach Program (TOP) – TOP is a nine-month adult preparation curriculum that stresses youth development and community service learning. The TOP program is focused on helping teens develop healthy behaviors, life skills, and a sense of purpose. This program has been particularly well-received in rural communities.
Each year, the Institute of Public Policy conducts a four-part evaluation of PREP grant recipients. This includes a process evaluation, a fidelity evaluation, an outcome evaluation, and a community capacity evaluation. The evaluation of PREP Year Four was completed September 30, 2015. The Department of Health and Senior Services uses the evaluation report to monitor program success, and to help make program improvements where needed. PREP is currently in its fifth program year, which began August 1, 2015 and will end July 31, 2016.