The Trump administration is cutting teen pregnancy prevention programs
Yet many researchers, program directors, youth advocates and city health officials argue for them to stay
Most teenagers feel uncomfortable talking about sex, but not 16-year-old Bryanna Ely.
As a youth leader for the Buffalo, New York-based teen pregnancy prevention program HOPE Buffalo, Ely talks to not only other teens but also adults. She explains how they can help teens when it comes to their emotional, physical and sexual health, abstinence and birth control.
“It’s definitely made me more comfortable around health providers, because I was very nervous and not willing to talk about it, but then once I joined HOPE Buffalo, it’s an easy subject to talk about. Well, not that easy, but it’s easy enough to talk about that I don’t feel so uncomfortable,” said Ely, who will be entering her junior year in high school this month.
While volunteering with HOPE Buffalo at a local community center, Ely said, she remembered meeting another teenage girl, sharing sexual health information with her and feeling like she made a difference.
“She took in all the information, and she said she would not get pregnant until she was 28 or 30,” Ely said. “I joined HOPE Buffalo because I wanted to make a change in my community and make sure that these teenagers who didn’t have a voice had a voice.”
Yet federal funding for such teen pregnancy prevention programs in the United States is now on the chopping block.
Instead, the US Department of Health and Human Services said in a statement that it’s continuing to review best approaches, which it says “will be guided by science and a firm commitment to giving all youth the information and skills they need to improve their prospects for optimal health outcomes.”
Among the leadership within the Department of Health and Human Services, Secretary Tom Price and Valerie Huber, chief of staff to the Office of the Assistant Secretary for Health, have been proponents of abstinence-only education programs.
’Took me completely by surprise’
Around the Fourth of July, Stan Martin, project director of HOPE Buffalo, received a notice from Health and Human Services’ Office of Adolescent Health that indicated funding would end next June, after just three years, instead of continuing to fund the program for the expected five years.
Other grant recipients of the Teen Pregnancy Prevention program across the country received the same notice.
The Office of Adolescent Health’s Teen Pregnancy Prevention Program currently funds 84 grants to reduce teen pregnancy across clinics, schools and communities, by implementing and evaluating prevention programs and supporting technology- and program-based approaches, according to the office’s website. Their end date is now June 30.
Meanwhile, funding for “capacity-building” assistance providers that help organizations develop and deliver programs was eliminated effective immediately, said Lauren Ranalli, director of the Adolescent Health Initiative at the University of Michigan, which provides assistance to HOPE Buffalo and other teen pregnancy prevention programs across the country.
“This news took me completely by surprise,” Ranalli said.
“My immediate thought was really about all of the incredible work that was in progress with grantees in South Carolina and Oklahoma and Baltimore and Buffalo and Los Angeles and so many other locations,” she said.
Martin said HOPE Buffalo will be turning to local partners for help. The organization already partners with community centers, public schools and faith-based groups.
“The community itself, they’re demanding that adolescents have access to these resources, to this information, regardless of funding,” Martin said.
Moving forward, “our youth leadership team, they’re heavily involved in every decision that we make. They’ll be educating the community in terms of what this program means to them,” he said. “I think it’s our duty as caring adults that we provide a sense of purpose or hope for adolescents.”
Ely hopes HOPE Buffalo continues, she said. “It has changed my life completely.”
Officials spar over teen pregnancy
Health and Human Services said in an emailed statement to CNN that an evaluation of previous first-round teen pregnancy prevention programs, which were active from 2010 to 2014, revealed that those programs were not as effective as thought.
“The very weak evidence of positive impact of these programs stands in stark contrast to the promised results, jeopardizing the youth who were served, while also proving to be a poor use of more than $800 million in taxpayer dollars,” the statement said.
“The poor evaluation results were the reason that the Trump Administration, in its FY 2018 budget proposal, did not recommend continued funding for the TPP program and HHS hit the pause button on it,” the statement said. “This action gives the Department time to continue its review of the program and the evidence, to ensure that should Congress continue it, the program provides positive reinforcement of the healthy decisions being made by a growing majority of teens.”
Many researchers, program directors and city health officials argue against hitting “the pause button.”
“If the justification for cutting short the current grants is the result from the last round of grantees, then it misses two key big points,” said Bill Albert, chief program officer of the National Campaign to Prevent Teen and Unplanned Pregnancy, a grantee of federal funds.
When analyzing the results from the first round of evaluations from a scientific perspective, those previous results were actually impressive, Albert said, “and (the Office of Adolescent Health) learned from the evaluation results and is using that knowledge to strengthen the current projects.”
“Once the first round of evaluation results were published, the Office of Adolescent Health transparently shared results and strongly encouraged grantees to shift to the most effective models. Grantees have done that, which means that the models that current grantees are implementing are very different and stronger than the mix of models used in the first round,” Albert said.
“The way that OAH has learned from results and used them to strengthen the TPP Program is exactly what you’d expect of a high-quality evidence-based initiative,” he said.
In other words, he said, it is important not to confuse the success of the overall learning and development process with individual program models that were evaluated.
Members of the Big Cities Health Coalition, a coalition of health officials from the 28 largest cities in the US, wrote a joint letter to Price last month urging him to reconsider the decision to cut the project period and funds.
The letter indicated that teen birth rates in the US dropped to a record low last year, following a long-term trend, and the letter suggested that reducing funding for teen prevention programs might reverse that trend.
“Cutting TPPP funding and shortening the project period will not only reverse historic gains made in the US in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation,” the letter said.
On the other hand, the Health and Human Services statement said that while teen birth rates are at record lows, sexually transmitted disease and infections are at record highs, according to data from the Centers for Disease Control and Prevention.
Still, Albert said that “there are plenty of reasons” not to give up on the existing teen pregnancy programs quite yet.
’Another attack on women’
“Rates of pregnancy and births among teens in this country far, far outstrip those in other comparable countries. Our rates, for example, are twice as high as in England, about seven times as high as in Japan,” Albert said.