Economic Evaluation of a Comprehensive Teenage Pregnancy Prevention Program

Pilot Program


      Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic support are effective in reducing births among enrolled teenagers. However, there have been limited data on the costs and cost effectiveness of such programs.


      The study used a community-based participatory research approach to develop estimates of the cost–benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents.


      Using data from 1997–2003, an in-time intervention analysis was conducted to determine program cost–benefit while teenagers were enrolled; an extrapolation analysis was then used to estimate accrued economic benefits and cost–benefit up to age 30 years.


      The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage girls, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 years on average, with social benefits outweighing total social costs by age 20.1 years.


      This comprehensive teenage pregnancy prevention program is estimated to provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost effectiveness of similarly comprehensive programs when they are implemented more widely in high-risk neighborhoods.
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        • National Center for Health Statistics
        (Hyattsville MD: CDC)
        • Jolly M.C.
        • Sebire N.
        • Harris J.
        • Robinson S.
        • Regan L.
        Obstetric risks of pregnancy in women less than 18 years old.
        Obstet Gynecol. Dec 2000; 96: 962-966
        • Fraser A.M.
        • Brockert J.E.
        • Ward R.H.
        Association of young maternal age with adverse reproductive outcomes.
        N Engl J Med. 1995; 332: 1113-1117
        • Siegel C.D.
        • Graves P.
        • Maloney K.
        • Norris J.M.
        • Calonge B.N.
        • Lezotte D.
        Mortality from intentional and unintentional injury among infants of young mothers in Colorado, 1986 to 1992.
        Arch Pediatr Adolesc Med. 1996; 150: 1077-1083
        • Overpeck M.D.
        • Brenner R.A.
        • Trumble A.C.
        • Trifiletti L.B.
        • Berendes H.W.
        Risk factors for infant homicide in the United States.
        N Engl J Med. 1998; 339: 1211-1216
        • Maynard R.A.
        Kids having kids: economic costs and social consequences of teen pregnancy.
        Urban Institute Press, Washington DC1997
        • Fergusson D.M.
        • Woodward L.J.
        Maternal age and educational and psychosocial outcomes in early adulthood.
        J Child Psychol Psychiatry. 1999; 40: 479-489
        • Hofferth S.L.
        • Reid L.
        • Mott F.L.
        The effects of early childbearing on schooling over time.
        Fam Plann Perspect. 2001; 33: 259-267
        • Koniak-Griffin D.
        • Walker D.S.
        • de Traversay J.
        Predictors of depression symptoms in pregnant adolescents.
        J Perinatol. 1996; 16: 69-76
        • Barnet B.
        • Joffe A.
        • Duggan A.K.
        • Wilson M.D.
        • Repke J.T.
        Depressive symptoms, stress, and social support in pregnant and postpartum adolescents.
        Arch Pediatr Adolesc Med. 1996; 150: 64-69
        • Annie E. Casey Foundation
        When teens have sex: issues and trends. A Kids Count special report.
        • Zabin L.S.
        • Hirsch M.B.
        • Smith E.A.
        • Streett R.
        • Hardy J.B.
        Evaluation of a pregnancy prevention program for urban teenagers.
        Fam Plann Perspect. 1986; 18: 119-126
        • Vincent M.L.
        • Clearie A.F.
        • Schluchter M.D.
        Reducing adolescent pregnancy through school and community-based education.
        JAMA. 1987; 257: 3382-3386
        • Philliber S.
        • Kaye J.W.
        • Herrling S.
        • West E.
        Preventing pregnancy and improving health care access among teenagers: an evaluation of the children's aid society-carrera program.
        Perspect Sex Reprod Health. 2002; 34: 244-251
        • Allen J.P.
        • Philliber S.
        • Herrling S.
        • Kuperminc G.
        Preventing teen pregnancy and academic failure: experimental evaluation of a developmentally based approach.
        Child Dev. 1997; 68: 729-742
        • Lonczak H.S.
        • Abbott R.D.
        • Hawkins J.D.
        • Kosterman R.
        • Catalano R.F.
        Effects of the Seattle social development project on sexual behavior, pregnancy, birth, and sexually transmitted disease outcomes by age 21 years.
        Arch Pediatr Adolesc Med. 2002; 156: 438-447
        • Robin L.
        • Dittus P.
        • Whitaker D.
        • et al.
        Behavioral interventions to reduce incidence of HIV, STD, and pregnancy among adolescents: a decade in review.
        J Adolesc Health. 2004; 34: 3-26
        • Wang L.Y.
        • Davis M.
        • Robin L.
        • Collins J.
        • Coyle K.
        • Baumler E.
        Economic evaluation of Safer Choices: a school-based human immunodeficiency virus, other sexually transmitted diseases, and pregnancy prevention program.
        Arch Pediatr Adolesc Med. 2000; 154: 1017-1024
        • Child Trends
        Children's Aid Society—Carrera Program Child Trends.
      1. Gold M.R. Siegel J.E. Russell L.B. Weinstein M.C. Cost-effectiveness in health and medicine. Oxford University Press, Oxford England1996
      2. Inflation calculator.

        • Connecticut Department of Public Health Planning Branch
        Vital statistics and population.
        • U.S. Census Bureau
        U.S. Census 2000.
        • U.S. Department of Commerce
        U.S. Census Bureau News.
      3. Indicators of Opportunity in Higher Education, 2005 Stats Report, Pell Institute for the Study of Opportunity in Higher Education.
        • Byrd R.S.
        • Weitzman M.L.
        Predictors of early grade retention among children in the United States.
        Pediatrics. 1994; 93: 481-487
        • U.S. Department of Education
        Mapping out the national assessment of Title I: the interim report—1996. U.S. Department of Education, Planning and Evaluation Service.
        • Swanson C.B.
        Who graduates? Who doesn't? A statistical portrait of public high school graduation, class of 2001. The Urban Institute Education Policy Center.
      4. Minkler M. Wallerstein N. Community-based participatory research for health. Jossey-Bass, San Francisco2003
        • Viswanathan M.
        • Ammerman A.
        • Eng E.
        Community-based participatory research: assessing the evidence.
        (Prepared by RTI—University of North Carolina Evidence-Based Practice Center under Contract No. 290-02-0016). AHRQ Publication 04-E022-2 Agency for Healthcare Research and Quality, Rockville MD2004
        • Coyle K.
        • Basen-Engquist K.
        • Kirby D.
        • et al.
        Short-term impact of safer choices: a multicomponent, school-based HIV, other STD, and pregnancy prevention program.
        J Sch Health. 1999; 69: 181-188