December 2016Vol. 17, No. 9Interim Impacts of the POWER Through Choices Program

An August 2015 report from the Office of Adolescent Health (OAH within the U.S. Department of Health and Human Services evaluates the interim findings regarding the POWER Through Choices (PTC) program, a comprehensive sexual health education curriculum created specifically for youth living in foster care and other out-of-home care settings. This vulnerable population of youth face a multitude of challenges. In particular, youth in the State's care exhibit higher rates of teen pregnancy and sexually transmitted infections (STIs). Unlike their peers in the general population, many youth in out-of-home care lack the necessary access to sexual-health education and services, and they generally report having little knowledge about contraception and reproductive health. The PTC program was funded by the Annie E. Casey Foundation and under the first generation (2010–2016) of Personal Responsibility Education Program Innovative Strategies (PREIS) grant program that is administered by the Family and Youth Services Bureau’s (FYSB) Adolescent Pregnancy Prevention Program with a grant to the Oklahoma Institute for Child Advocacy.

The study sample consisted of 44 residential group homes across California, Maryland, and Oklahoma. Approximately half of the group homes in each State were randomly assigned to a treatment group that offered the PTC program; the other half of participants were assigned to a control group that did not receive PTC program services. The PTC program included 10 90-minute sessions provided once or twice a week over 5 to 10 weeks to small groups of 8 to 20 male and female teens ranging in age from 13 to 18 years. Trained facilitators conducted the sessions in an interactive classroom setting that encouraged group discussion and other skill-building activities.

Two main themes permeated the PTC program:

Empower youth to make informed decisions about sexual risk behavior
Help youth recognize the potential impact of their choices on their future goals

The goals of the PTC program were to build knowledge, develop skills, increase awareness of available health resources, and promote a greater sense of self-empowerment among youth. It is the program's hope that these short-term outcomes lead to longer term benefits, such as delayed onset of sexual activity, fewer sexual partners, increased and correct use of contraception, and, ultimately, reduced incidence of teen pregnancy and STIs among youth in out-of-home care settings.

Interim findings indicate that the PTC program was successful in changing youths' short-term outcomes measured at the conclusion of the program period. Specifically, youth assigned to the treatment group:

Were more likely to report receiving information on reproductive health, pregnancy and STI prevention, and contraception
Reported increased knowledge of reproductive health, pregnancy and STI prevention, contraception, and available health resources
Reported more favorable attitudes for methods of protection
Reported greater sense of self-awareness to avoid unprotected sex
Were more likely to avoid unprotected sex by using condoms and/or planned to use alternate forms of contraception such as the pill

While the immediate post-test data are promising, a future report will examine the longer term impacts of the PTC program on youth sexual risk behavior and if the knowledge, self-awareness, attitudes, and intentions gained during the program were maintained after the program ended.

The project and resulting reports were funded by OAH and FYSB. The August 2015 report, Interim Impacts of the POWER Through Choices Program, by Brian Goesling, Reginald D. Covington, Jennifer Manlove, Megan Barry, Roy F. Oman, and Sara Vesely, is available on the OAH website at http://www.hhs.gov/ash/oah/oah-initiatives/evaluation/Evaluation%20Reports/ptc_short_term_impact.pdf (1 MB). Additional information about the PTC program can be found at http://www.powerthroughchoices.org.