First look at abstinence programs published

By Lisa Kaeser, JD

Senior Public Policy Associate

Alan Guttmacher Institute

Washington, DC

Nearly three years have passed since President Clinton signed into law a new abstinence education program as part of massive welfare reform legislation. Two evaluations of the program’s first year’s implementation have been published recently, providing a closer look at how the states have elected to use the annual entitlement of $50 million in federal funds.

Although the program was technically authorized in August of 1996, it took some time for the federal oversight agency, the federal Bureau of Maternal and Child Health, and the states themselves to draw up plans for spending the money in a manner consistent with the statute. In this instance, Congress was quite specific in its intent, stating that the funds were "to enable the State to provide abstinence education," especially focusing on groups that are most likely to bear children out-of-wedlock, but that such educational programs must teach that "sexual activity is likely to have harmful psychological and physical effects," along with seven other tenets.

Comments were collected

It took some time for the bureau to develop and receive comments on guidelines for the new abstinence program, a key component of which is that programs funded with this money must comply with at least one of the eight tenets but not violate any of them. States then developed their own plans, for many an arduous task since the expectations of a wide range of stakeholders — including Congress, public health experts, and advocates for many viewpoints — had to be met. Much of the debate centered on the message that would be sent to young people and how that message would be delivered. Ultimately, 48 states and the District of Columbia accepted the funds for new abstinence programs; California and New Hampshire turned them down.

The two overviews published to date look at the states’ abstinence programs during fiscal year 1998, the first full year of implementation. They provide some sense of the diversity of the efforts funded that year, making comparative evaluations a challenge. (Funding was provided to evaluate some of the abstinence programs’ activities in separate legislation.) Clearly, however, it is too soon to judge whether the overall program has "worked" in terms of reducing out-of-wedlock births.

Abstinence coordinators surveyed

Earlier this year, the Sexuality Information and Education Council of the United States (SIECUS) in New York City published Between the Lines, a report summarizing its survey of the abstinence program coordinators in each state. The survey found:

• State health departments have primary authority over the abstinence programs in 36 states and Washington, DC; only three governors stepped in to appoint a separate coordinator (LA, CT, ND); the rest shared authority.

• Although the federal statute did not specify the program’s target audience, states generally chose to direct their efforts toward young people ages 10 to 14; 34 states also included parents as intended audiences, 10 focused on one or more specific racial or ethnic groups, and only four focused on low-income populations.

• Programs in 27 states and Washington, DC, included media campaigns, 20 of which were new efforts.

• 38 states made 447 grants to community-based organizations in 1998. These included organizations providing health care services (29 states), youth development activities (27), private social science agencies (19), faith-based institutions (18), and crisis pregnancy centers (11).

• 25 states made 251 grants to schools. Notably, SIECUS concluded that at this point, the program has not disrupted existing sexuality education programs overall. (Iowa, however, did report replacing its program with abstinence education.)

• Besides the federal evaluation effort, evaluations will be conducted in 39 states and Washing ton, DC. Other than outcome measures, many also will measure teen pregnancy rates and whether attitudes toward abstinence have changed.

Since the abstinence program’s funding falls under the auspices of the Title V, the Maternal and Child Health Block Grant, maternal and child health directors within the state departments of health are overseeing most of the state efforts.

Consequently, the Association of Maternal and Child Health Programs in Washington, DC, conducted another survey, "Abstinence Education in the States," that made similar findings to the SIECUS survey while adding some new information. Most of the state directors reported that even though they were already providing abstinence education prior to the law’s enactment, they had responded to the new mandate. Additional findings included the following:

• Most states are using a variety of approaches to meet the federally required match of $3 in state funds for every $4 in federal dollars, including other state dollars, private or foundation funding, in-kind volunteer staffing, facilities and equipment, and matching funds from community-based grantees.

• In general, state legislatures have confined their role to approving the allocation of matching funds, although a few legislators have become involved personally.

• More than 90% of the states that have funded local programs have funded school districts, and some states have collaborated with their state education agencies.

• On average, 5% of states’ total abstinence education budgets are set aside for evaluations. More than half of the states are contracting their evaluation activities out to universities or private contractors.

• States need assistance in finding abstinence curricula that meet the federal law’s mandates as well as comport with public health principles and with responding to media attention.

Taken together, these overviews provide an excellent baseline of information about the early implementation of the federal abstinence education program. However, many questions remain about the program’s ultimate impact on the provision of sexuality education in this country.

Undoubtedly, the next challenge for those interested in what information young people are receiving regarding abstinence and sexuality will be to discover the content of information that is being taught under the abstinence program’s auspices.