Adolescent Sexual and Reproductive Health

California Health Care Collaborative

The Philip R. Lee Institute for Health Policy Studies (PRL-IHPS) researches and evaluates adolescent sexual and reproductive health (ASRH) efforts in California, nationally, and globally. Over the years, PRL-IHPS researchers have used a range of methods to evaluate adolescent reproductive health programs and policies and to research health needs and disparities. We work to identify best practices in sexual health education, clinical service delivery, and other interventions to improve adolescent sexual and reproductive health. Research from PRL-IHPS in adolescent sexual and reproductive health emphasizes the impact of educational and clinical services, community factors, and social and demographic characteristics on adolescent reproductive health outcomes.
 
Current Projects
 

CA Adolescent Sexual and Reproductive Health Evaluations

We have worked with the State of California’s Department of Public Health on their Adolescent Sexual and Reproductive Health  programs to provide quality technical assistance, program evaluation, and training since 1997. Programs that have been evaluated include the Information and Education (I&E) program, the Community Challenge Grant (CCG) program, the Male Involvement Project (MIP), the TeenSMART Outreach (TSO) program and the California Personal Responsibility Education Program (CA PREP).

CA PREP

The California Personal Responsibility Education Program (CA PREP) uses evidence-based program models (EBPMs) in California counties with high community risk for teen pregnancy and disease transmission. Our team oversees all evaluation activities to document program activities and assess process outcomes. For more information on the CA PREP Evaluation, please see the CA Department of Public Health Maternal, Child and Adolescent Health website and the CA PREP Data Collection page.

I&E

California Health Care Collaborative

For over 40 years, the I&E Program has offered sexual health and life skills education programs in diverse settings, serving youth with the greatest need throughout California. I&E interventions provide youth with comprehensive, medically accurate sexual health education and clinical linkages to sexual and reproductive health services. Our team oversees all evaluation activities to document program activities and assess process outcomes.

Inter-American Development Bank

In conjunction with UCLA’s Blum Center on Poverty and Health, we conducted a systematic review of theory-based interventions in Latin America and globally focusing on four aspects of adolescent health and development: reproductive health and pregnancy, violence, substance use, and idleness (not employed or in school). Across the four areas of interest, we found more rigorously evaluated, theory-based interventions related to adolescent reproductive health in both Latin America and globally compared with youth violence, idleness and substance use. In addition, we found only a few programs targeting a combination of youth risks. This is a positive start, but demonstrates that the field of integrated youth risk prevention is still in development.

Past Projects


World Bank Adolescent Sexual and Reproductive Health Project

Adolescent sexual and reproductive health (ASRH) is an area of focus for the World Bank, which recognizes the importance of addressing ASRH as a development issue with important implications for poverty reduction. The World Bank also stresses the need to address factors both within and outside the health sector that impact economic and social well-being. The main objectives of this project were to: gain a deeper understanding of the multi-sectoral determinants of ASRH outcomes and to identify multi-sectoral programmatic and policy options to improve ASRH outcomes. In this project, we conducted a comprehensive review of social, economic and policy determinants of ASRH for two countries, Ethiopia and Nepal, including interviews with key stakeholders in each country. We also conducted a comparative analysis of Demographic and Health Survey (DHS) data assessing ASRH outcomes and associated socioeconomic indicators in five countries.

TeenSMART Outreach (TSO)

Aimed to increase youth utilization of family planning services, local projects conducted health education and outreach to teens in a variety of settings and assisted participants in utilizing local teen-friendly clinics for sexual and reproductive health services. Funding for this program lasted from 1999-2008. As part of this evaluation, we developed a series of briefs highlighting findings from the field.

  • Innovative Outreach: Findings from the TeenSMART Outreach (TSO) Evaluation:  TSO agencies continuously employed new and innovative outreach strategies to reach teens in their communities. We interviewed TSO coordinator to explore these strategies. Findings in this report can be used to guide other programs.
  • TeenSMART Outreach Voices from the Field: Peer Provider Programs: In this brief, TSO agency coordinators discuss use of peer educators and outreach workers in their efforts to bring youth into their clinics.
  • TeenSMART Outreach Voices from the Field: Media Materials: In this brief, TSO agency coordinators discuss their use of a variety of media materials and methods to reach youth in their communities.
  • TeenSMART Outreach Voices from the Field: Building Relationships between Outreach and Clinic Providers: In this brief, TSO agency coordinators discuss the relationships between program staff and their counterparts in the clinic setting.
     

Male Involvement Program (MIP)

The MIP aimed to support young males in a variety of ways that go beyond traditional family planning education or services, helping participants to successfully navigate a healthy passage into adulthood. Local projects focused on increasing awareness of the important role that males play in the reduction of teen pregnancies and increasing the ability of young men to assume leadership roles in their communities. Funding for this program lasted from 1995-2008. Our evaluation demonstrated that MIP has been successful in attracting an ethnically and culturally diverse group of young men in multiple community settings. This monograph on MIP offers insights for planning and implementing an expanded set of responsive strategies at the local, state, and national levels. Citation: Brindis, Claire D., et al. "Let's hear it for the guys: California's male involvement program." International Journal of Men's Health 4.1 (2005): 29.

Clinical Services Research

Protecting Adolescent Confidentiality Under Health Care Reform: The Special Case Regarding Explanation of Benefits: Under the Affordable Care Act, adult children now can stay on their parents' health insurance plans until they reach age 26. But because they are dependents on their parents' health insurance, they are not afforded the same confidentiality protections as if they had individual plans. This brief describes strategies and current attempts to achieve a better balance between health care transparency and patient confidentiality.

Decline in Adolescent Female Participation in the Family PACT Program: This study examined the eight percent decline in adolescent female participation in California’s family planning program, Family Planning, Access, Care, and Treatment (Family PACT), between fiscal year 2004-05 and fiscal year 2010-11, as well as possible factors contributing to this decline.

California Health Care CollaborativeSex Education Research

Uneven Progress: Sex Education in California Public Schools: This report summarizes a study of California’s school efforts to implement a 2003 state policy that requires that voluntary sex education taught in schools be comprehensive, evidence-based and culturally appropriate. Although California’s public schools have made great strides in the quality of sexuality education and HIV/AIDS prevention, many districts were found to teach inaccurate information that fails to provide young people with crucial health information and violates state law. As a result of this study and a related legal case by the ACLU and American Academy of Pediatrics vs. Clovis Unified School District, as well as statewide advocacy, California’s legislators passed a new law, begun in January, 2016, requiring that all students receive comprehensive sex education throughout the state.

Selected Publications

Youth Community Health Assessment of Resources and Trends (CHART) Project: Needs Assessment of Fresno County and Sacramento County.

A Call to Action: Developing and Strengthening New Strategies to Promote Adolescent Sexual Health: This paper identifies six promising strategies to address persistent reproductive health disparities among some populations of youth and reduce unintended adolescent pregnancies.

Teen Pregnancy Prevention in California after State Budget Cuts: After 2008, state funding for teen pregnancy prevention (TPP) program was significantly reduced or eliminated. Many agencies have curtailed their TPP programs and reach far fewer sites and participants then before budget cuts. Yet, the benefits of prevention programs extend to families, schools and communities, and long-term program stability depends on state funding.

Identifying Adolescent Sexual and Reproductive Health Efforts in California: This report presents adolescent sexual and reproductive health (ASRH) programs in the state and identifies opportunities for collaboration and service gaps. A database of ASRH services was created. You can download the database, CA Adolescent Sexual and Reproductive Health Efforts: Database of Programs, for use in local planning. 

Teen Births in California: A Resource for Planning and Policy: This report presents the trends in California teen birth rates. Results show variations over time, by racial and ethnic group, and by geographic area.  

A Question of Hope: Reducing Latina Teen Childbearing in California: The film aims to capture the insights, choices, and opportunities of young Latina women in California. It is based on findings from a qualitative study comparing the motivations and life experiences of pregnant and parenting Latina teen mothers to young adult Latinas having their first children (“delayers”).

More Information

For more information on other evaluation activities see the PRL-IHPS Evaluation webpage.

For more information on additional adolescent reproductive health research at UCSF, see the UCSF Bixby Center for Global Reproductive Health webpage.

Adolescent and Young Adult Health National Resource Center

Adolescent Sexual Health Work Group

The PRL-IHPS Adolescent Sexual and Reproductive Health Research Team
 

Claire Brindis, DrPH 

Mara Decker, DrPH, MHS

Abigail Gutmann-Gonzalez, MPH

Melisa Price, MPH

Lana Tilley, MPH

Jennifer Yarger, PhD