Carrera Adolescent Pregnancy Prevention Program

Evidence Rating: Top Tier

Highlights

Program: A comprehensive youth development program for economically disadvantaged teens, a key component of which is reproductive health care.
Evaluation Methods: A large, multi-site randomized controlled trial (RCT) with a sample of 1,163 teens, ages 13-15.
Key Findings: For girls, 40-50% reductions in pregnancies and births three years after random assignment (at average age 17). For boys, no effect on causing a pregnancy. Evidence of effects on high school completion and college enrollment are promising but not yet Top Tier due to study limitations.

Sponsored by the Children’s Aid Society, the Carrera Adolescent Pregnancy Prevention program is a comprehensive youth development program for economically disadvantaged teens who enter the program at ages 13-15 and usually participate for three years, sometimes longer. The program is provided after school at local community centers, and runs for about three hours each weekday. [1] It includes five main activities, as follows:

Daily academic assistance (e.g., tutoring, homework help, assistance with college applications);
Job Club 1-2 times per week, including such activities as learning to complete a job application and interview for a job;
Family life and sex education 1-2 times per week, led by a reproductive health counselor;
Arts activities 1-2 times per week (e.g., music, dance, writing, or drama workshops); and
Individual sports activities 1-2 times per week (e.g., tennis, swimming, martial arts).

The program also provides free mental health and medical care through alliances with local health care providers. A key component is reproductive health care, including physical exams, testing for sexually transmitted infections, a range of contraceptive options, and counseling. Carrera program staff schedule the teens’ appointments and accompany them on their visits.

The program costs approximately $5,464 per teen per year to implement (2017 dollars).

Click here for Carrera Adolescent Pregnancy Prevention Program’s website.

References

[1] The program now works with 10-12 year-olds in addition to 13-15 year-olds. It has also developed an in-school (as opposed to after-school) model that provides similar activities but costs less to administer. The evidence in this summary, however, applies only to the program for 13-15 year-olds, delivered after school in community centers.

Philliber, Susan, Jackie Kaye, and Scott Herrling, The National Evaluation of the Children’s Aid Society Carrera-Model Program to Prevent Teen Pregnancy, Philliber Research Associates, May 2001. Click here for a link to this study.

Philliber, Susan, Jackie Kaye, Scott Herrling and Emily West, ͞Preventing Pregnancy and Improving Health Care Access Among Teenagers: An Evaluation of the Children’s Aid Society-Carrera Program, Perspectives on Sexual and Reproductive Health, Vol. 34, No. 5, 2002, pp. 244-251.

Philliber Research Associates, ͞The Children’s Aid Society Adolescent Pregnancy Prevention Program: High Graduation and College Admission Results,͟ 2007, and follow-up correspondence with researcher Jackie Kaye.

http://www.stopteenpregnancy.com/news/news_results.html

To see our full evidence summary:

Download PDF

Top Tier

Programs shown in well-conducted RCTs, carried out in typical community settings, to produce sizable, sustained effects on important outcomes. Top Tier evidence includes a requirement for replication – specifically, the demonstration of such effects in two or more RCTs conducted in different implementation sites, or, alternatively, in one large multi-site RCT. Such evidence provides confidence that the program would produce important effects if implemented faithfully in settings and populations similar to those in the original studies.
Near Top Tier

Programs shown to meet almost all elements of the Top Tier standard, and which only need one additional step to qualify. This category primarily includes programs that meet all elements of the Top Tier standard in a single study site, but need a replication RCT to confirm the initial findings and establish that they generalize to other sites. This is best viewed as tentative evidence that the program would produce important effects if implemented faithfully in settings and populations similar to those in the original study.
Suggestive Tier

Programs that have been evaluated in one or more well-conducted RCTs (or studies that closely approximate random assignment) and found to produce sizable positive effects, but whose evidence is limited by only short-term follow-up, effects that fall short of statistical significance, or other factors. Such evidence suggests the program may be an especially strong candidate for further research, but does not yet provide confidence that the program would produce important effects if implemented in new settings.

Related Programs

Near Top Tier

Carrera Adolescent Pregnancy Prevention Program

Highlights

Related Programs

Teen Options to Prevent Pregnancy

Nurse-Family Partnership

Health Care Program for First-Time Adolescent Mothers and their Infants