Programs that Work
Healthy and Safe Children
Youths abstaining from sexual activity or not engaging in risky sexual behavior
Age of Child
Type of Setting
Out of School Time
Community-Based Service Provider
Health Care Provider
Type of Service
Type of Outcome Addressed
Teen Sex / Pregnancy
Evidence Level (What does this mean?)
The Teen Talk program was developed in 1983 to 1984 to help adolescents become aware of the serious negative consequences of teenage pregnancy, the likelihood that they can become pregnant, and the benefits of and barriers to abstinence and contraceptive use. The program is based on two theories of human behavior: the Health Belief Model (viewing actions as dependent on beliefs) and Social Learning Theory (emphasizing actions as proceeding from the behaviors, thoughts, and feelings of others). It is thought that this behavioral model foundation enables Teen Talk to address and measure not only basic knowledge, but also participants' perceptions relating to pregnancy and sexual activity, issues of self-efficacy, and behavioral components. The program is predicated on the assumption that a change in participants' beliefs will translate into real-world behaviors and decision-making.
During its pilot phase, the program was implemented in family planning (such as Planned Parenthood) and health-specific organizations for youth populations. In addition, the curriculum was tested within a single small independent school system consisting of one high school and one middle school. The curriculum combines large group presentations on reproductive health, physiology, and contraception with small group discussion sessions during which participants engage in role-playing and role reversal, and practice decision-making and refusal skills. This combination of approaches is designed to help the students comprehend and personalize the risks and consequences of becoming pregnant as teenagers, develop the skills needed to remain abstinent, and learn and understand more about contraception.
The pilot project served and studied youths aged 13 through 19 from organizations and schools in rural and urban California and Texas. Approximately 80% were low income or from inner cities. In terms of age, 29% of the students were 13 through 14, 67% were 15 through 17, and 4% were 18 through 19. The students came from varied ethnic backgrounds: 53% were Latino, 24% were African-American, 15% were white, and 8% had other ethnic backgrounds.
Based on the diversity of the pilot populations, this program should be applicable to diverse and varied communities nationwide.
A controlled study involving 1,444 teenage males and females 13 through 19 years of age was performed to compare the Teen Talk program with other sexual and pregnancy prevention programs already in place. School classrooms or individual students from community organizations were assigned randomly to classes that used either the Teen Talk curriculum or other school or community-based curricula on the same topics.
All students were assessed via questionnaires at the start of the program, and 92% of the sample participated in all or part of an intervention and completed the immediate follow-up evaluation. Participants were assessed again via interview one year after program completion; 67% of the immediate follow-up sample participated in the one-year follow-up interview. Analysis of collected data was conducted along a fourfold framework, looking separately at program impact on participants who had or had not engaged in intercourse at baseline and at males and females.
Key Evaluation Findings
The research studies by Eisen, Zellman, and McAlister (1990 and 1992) and Eisen and Zellman (1992) found the following:
- The program was more effective for boys than for girls. Researchers hypothesize that this finding may be a direct result of the role-playing and role reversal tactics utilized in the curriculum design.
- Although both experimental and control groups showed an increase in levels of sexual and contraceptive knowledge and health beliefs following the completion of their respective programs, this improvement did not translate into changes in individuals' sexual experience and behavior at the one-year follow-up. In addition, there was no significant difference in the change of beliefs between control and experimental groups. These findings contradict expectations derived from the behavioral model foundation on which the program is based.
- The impact of the curriculum varied significantly according to various demographic characteristics of participants. For example, the results indicate that the program was least effective on Hispanics. This finding highlights the importance of tailoring the program to the specific needs and characteristics of a given population and indicates that the curriculum may not be as effective in dealing with a heterogeneous, diverse population.
- One year after the program ended, of the boys who had no previous intercourse, program participants were significantly more likely to stay abstinent than boys who were not in the program.
- For boys who were sexually active before the program, those participating in the program were significantly more likely to have used contraception at the one-year follow-up than boys not in the program. No difference in contraceptive use was noted for boys who were sexually inexperienced before the program who later decided to become sexually active.
- Of the girls who were sexually active, those not in the program were more likely to have used contraceptives during their last sexual encounter.
- Prior exposure to sex education was linked to increased contraceptive use for all groups in the study at the one-year follow up.
Schools and/or community groups
The original research was funded with assistance from the states of Texas and California.
- Group leaders were thoroughly trained on the program curriculum and on how to conduct effective small group discussions.
- The small group facet was utilized for activities such as role-playing and role reversal activities and discussion. This component was thought to give participants a safe forum in which to practice developing skills and discover how they may react in real-life situations. As indicated in the findings, the practice afforded by the small group sessions is a likely reason why the program proved so effective for boys.
The Teen Talk program consists of a six-session curriculum offered over a two- to three-week period for a total of 12 to 15 hours. Components include a minimum of two large group lectures addressing reproductive health, physiology, and contraception. In addition, adult facilitators lead small group sessions of six to eight students focusing on the factual realities of teenage pregnancy and parenthood, games, discussions, script writing, videos, role-playing, and role reversals. The small groups must meet for a minimum of eight hours and provide the students a forum in which to practice decision-making and refusal skills as well as give them an opportunity to explore their beliefs, feelings, and values. The sessions encourage active participation and discussion.
A lecturer and small group discussion leaders are needed to staff the program. Family planning agency educators and school staff led the sessions for the pilot project. An intensive two-day training session trains potential staff to be group leaders and facilitators.
Issues to Consider
This program received a "promising" rating. Evaluations indicate that the program produced some positive results, however the results are somewhat inconsistent and fluctuate greatly within and between test groups. Analysis of program data was conducted along a fourfold framework, looking separately at participants who had or had not engaged in intercourse at baseline and at males and females. The results indicated that effectiveness varied widely among these four groups (female baseline virgins and nonvirgins and male baseline virgins and nonvirgins). Effectiveness was shown to vary according to other demographic characteristics as well, such as ethnicity and risk-status (for example, lower income). This would suggest that the curriculum should be tailored to the unique and specific characteristics of the given population in order to maximize effectiveness.
Although in most cases the Teen Talk curriculum was shown to have a positive effect, in some instances at least as great if not greater results were found among participants in the comparison group. For example, use of an effective method of contraception at last sexual encounter among girls who had initiated intercourse after the start of the study period was 62% in the comparison group versus 38% in the experimental group (Eisen, Zellman, and McAlister, 1992). It is possible that the proven effectiveness of the comparison programs may be resulting from the fact that in many instances the comparison programs were modified from their usual structure to meet the length of the experiment curriculum. As such, the comparison programs were likely to be as in-depth and comprehensive as the experiment, although different methodologies of implementation were employed. An additional possible explanation is given in Frost and Forrest (1995), suggesting that the alternative curricula were themselves often newly instituted and innovative programs that included small group discussions and addressed decision-making issues.
In addition to identified benchmarks, research (Eisen and Zellman, 1992) on Teen Talk indicates that the program generates other significant results. Through the encouragement of safe sex practices and education on sexuality, reproductive health, and the use of appropriate forms of birth control, the program impacts students' knowledge regarding sexually transmitted diseases and, in encouraging the use of condoms, reduces the number of teens exposed to such diseases. The program may also affect the emotional and psychological well-being of participants through its focus on judgment and decision-making skills.
Texas and California.
Shobana Ragupathy, Ph.D.
Senior Research Associate
Program Archive on Sexuality, Health and Adolescence (practitioner support)
170 State Street, Suite 260
Los Altos, CA 94022-2812
Phone: (650) 949-3282, x209
Toll free: 1 (800) 846-DISK
A Teen Talk program package from the Sociometrics Corporation includes a user's guide, curricula guides, handouts/overheads, sexually transmitted disease (STD) facts pamphlets, staff training and evaluation materials, videos, directory of evaluation consultants, and phone technical support for a year. Program training sessions also are available.
Eisen, M., G. Zellman,
"A Health Beliefs Field Experiment: Teen Talk," in Miller, B., et al., eds., Preventing Adolescent Pregnancy, Newbury Park, Calif.: Sage Publications, 1992, pp. 220-264.
Eisen, M., G. Zellman, and A. L. McAlister, "A Health Beliefs Model-Social Learning Theory Approach to Adolescents' Fertility Control: Findings from a Controlled Field Trial," Health Education Quarterly, Vol. 19, No. 2, 1992, pp. 229-262.
Eisen, M., G. Zellman, and A. L. McAlister, "Evaluating the Impact of a Theory-Based Sexuality and Contraceptive Education Program," Family Planning Perspectives, Vol. 22, 1990, pp. 261-271.
Frost, J.J., and J. Darroch Forrest, Understanding the Impact of Effective Teenage Pregnancy Prevention Programs, Family Planning Perspectives, 1995. Vol. 27, No. 5, pp. 188-195.
National Academy of Sciences, The Best Intentions: The Causes, Consequences and Prevention of Unintended Pregnancy, Washington, D.C.: National Academy Press, 1995.