Reproductive health needs of adolescent and young adult women with pediatric rheumatic diseases.

BACKGROUND: The purpose of this study was to identify reproductive health knowledge gaps and topics that concern adolescent and young adult (AYA) women with pediatric rheumatic diseases and their parents. METHODS: Data collection occurred in two cohorts. In the first cohort, young women (15-20 years old) with pediatric-onset rheumatic conditions and their parents were recruited from a single, academic pediatric rheumatology center. In the second cohort, young women (18-25 years old) with pediatric-onset rheumatic conditions were recruited from a national conference for families with pediatric rheumatic diseases. This resulted in 20 adolescents and young adults (18.3 ± 2.4 years old), and 7 parent focus group participants. Focus group leaders facilitated discussions centered on reproductive health topics that participants identified as important, their sources of knowledge, and preferences for patient education and ongoing follow-up. Data were summarized independently by 4 researchers to reduce potential bias and subsequently analyzed using rapid qualitative analysis. RESULTS: All participants, regardless of diagnosis, medication, current sexual activity, or current intention to have children, expressed concern about the effect of their rheumatic condition and medications on fertility, risks to mother and child during and after pregnancy, and obtaining safe and effective contraception. Additionally, some participants discussed the burden of disease and its potential impact on motherhood. Finally, participants raised concern around the effect of disease and medication on routine reproductive health care, such as menstrual cycles, feminine self-care, and preventive exams. Three themes emerged: 1) participants had been advised to avoid unplanned pregnancy, however reported receiving inadequate explanation to support this instruction, 2) participants conceptualized reproductive health as tied to rheumatic disease management and thus suggested ways to include family members in discussion, and 3) rheumatology practitioners were not considered a resource of reproductive health information. CONCLUSIONS: Young women and their parents reported dissatisfaction with the availability, quantity, and quality of reproductive health information they received, particularly when related to their pediatric-onset rheumatic disease. These findings provide an initial step in understanding the patient perspective of reproductive health in rheumatology, and how to address these concerns in the care of young women with rheumatic diseases.

Characterisation of induced abortion and consequences to women's health at Hospital Central do Huambo - Angola.

To characterise patients with abortion in Huambo, Angola, we have undertaken a descriptive, longitudinal, prospective survey. A structured questionnaire was applied to 715 patients. The study variables were grouped in socio-demographic and clinical-epidemiological variables. There were 29.8% women were aged 20-24, 45.6% had primary education, 41.1% were single and 26.9% worked as a non-formal salesperson. Menarche occurred at 16-18 years (55.5%), first sexual intercourse at 13-15 years (40.3%) and 74.8% did not use contraceptive methods. Abortion was of indeterminate type in 84.3% and 79.3% had had a previous abortion. Serious complications occurred in 8.0% with six maternal deaths (0.8%). Age of menarche and age at onset of sexual activity are interdependent variables (p ≤ .001), the earlier menarche appears, the earlier sexual activity begins. When there was a history of abortion, new abortions occurred earlier (p ≤ .001) and were of indeterminate type (89%). Indeterminate induced abortion is influenced by socioeconomic, educational and political conditions and continues to be a frequent cause of morbidity and mortality.Impact statementWhat is already known on this subject? Unsafe abortion contributes greatly to maternal morbidity and mortality, principally in countries with restrictive abortion laws. The relationship between socio-educational level and unwanted pregnancies is consensual.What the results of this study add? Early initiation of sexual activity combined with non-contraception contributes to unwanted pregnancy and consequent unsafe abortion. Most of the women had previously had an abortion.What the implications are of these findings for clinical practice and/or further research? It is necessary to develop access to adequate information and family planning to combat unwanted pregnancies. It is also important to evaluate long-term consequences of unsafe abortion.

[Ivory-Coast: Textbooks Misinform on HIV]. / Côte d'Ivoire : la désinformation des manuels scolaires sur l'infection à VIH.

Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority.

L'éducation scolaire est connue comme l'un des vecteurs les plus efficaces d'éducation sur les maladies sexuellement transmissibles chez les jeunes. Nous rapportons ici les résultats d'une étude de la présentation de l'infection à VIH dans les manuels scolaires en Côte d'Ivoire. De façon surprenante, bien qu'ils aient été imprimés entre 2007 et 2017, ces manuels affirment dans leur quasi-totalité que le VIH conduit à la mort, sans mentionner l'existence de traitements qui permettent de vivre en bonne santé, voire pour certains en affirmant qu'il n'existe pas de traitement. Ceci met en lumière une cause, peut-être majeure, de la réticence des jeunes à se faire dépister. La représentation erronée de l'infection à VIH renforcée par l'enseignement entrave les campagnes d'incitation au passage du test de dépistage, le meilleur argument pour celui-ci étant que connaître son statut positif permet de bénéficier des traitements. Certains des livres étudiés sont utilisés dans toute l'Afrique francophone. Il serait intéressant de mener une étude similaire dans d'autres pays d'Afrique francophone et anglophone. Vérifier le contenu scientifique et adapter le discours des manuels scolaires sur le VIH à la situation actuelle de la lutte contre l'infection devraient être une urgence.

Addressing broader reproductive health needs of female sex workers through integrated family planning/ HIV prevention services: A non-randomized trial of a health-services intervention designed to improve uptake of family planning services in Kenya.

BACKGROUND: Despite considerable efforts to prevent HIV and other sexually transmitted infections (STI) among female sex workers (FSW), other sexual and reproductive health (SRH) needs, such preventing unintended pregnancies, among FSW have received far less attention. Programs targeting FSW with comprehensive, accessible services are needed to address their broader SRH needs. This study tested the effectiveness of an intervention to increase dual contraceptive method use to prevent STIs, HIV and unintended pregnancy among FSW attending services in drop-in centers (DIC) in two cities in Kenya. The intervention included enhanced peer education, and routine screening for family planning (FP) needs plus expanded non-condom FP method availability in the DIC. METHODS: We conducted a two-group, pre-/posttest, quasi-experimental study with 719 FSW (360 intervention group, 359 comparison group). Participants were interviewed at baseline and 6 months later to examine changes in condom and non-condom FP method use. RESULTS: The intervention had a significant positive effect on non-condom, FP method use (OR = 1.38, 95%CI (1.04, 1.83)), but no effect on dual method use. Consistent condom use was reported to be high; however, many women also reported negotiating condom use with both paying and non-paying partners as difficult or very difficult. The strongest predictor of consistent condom use was partner type (paying versus non-paying/emotional); FSW reported both paying and non-paying partners also influence non-condom contraceptive use. Substantial numbers of FSW also reported experiencing sexual violence by both paying and non-paying partners. CONCLUSIONS: Self-reported difficulties with consistent condom use and the sometimes dangerous conditions under which they work leave FSW vulnerable to unintended pregnancy STIs/HIV. Adding non-barrier FP methods to condoms is crucial to curb unintended pregnancies and their potential adverse health, social and economic consequences. Findings also highlight the need for additional strategies beyond condoms to reduce HIV and STI risk among FSW. TRIAL REGISTRATION: Clinicaltrials.gov NCT01957813.

The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa.

BACKGROUND: Adolescents have significant sexual and reproductive health needs. However, complex legal frameworks, and social attitudes about adolescent sexuality, including the values of healthcare providers, govern adolescent access to sexual and reproductive health services. These laws and social attitudes are often antipathetic to sexual and gender minorities. Existing literature assumes that adolescents identify as heterosexual, and exclusively engage in (heteronormative) sexual activity with partners of the opposite sex/gender, so little is known about if and how the needs of sexual and gender minority adolescents are met. METHODS: In this article, we have analysed data from fifty in-depth qualitative interviews with representatives of organisations working with adolescents, sexual and gender minorities, and/or sexual and reproductive health and rights in Malawi, Mozambique, Namibia, Zambia and Zimbabwe. RESULTS: Sexual and gender minority adolescents in these countries experience double-marginalisation in pursuit of sexual and reproductive health services: as adolescents, they experience barriers to accessing LGBT organisations, who fear being painted as "homosexuality recruiters," whilst they are simultaneously excluded from heteronormative adolescent sexual and reproductive health services. Such barriers to services are equally attributable to the real and perceived criminalisation of consensual sexual behaviours between partners of the same sex/gender, regardless of their age. DISCUSSION/ CONCLUSION: The combination of laws which criminalise consensual same sex/gender activity and the social stigma towards sexual and gender minorities work to negate legal sexual and reproductive health services that may be provided. This is further compounded by age-related stigma regarding sexual activity amongst adolescents, effectively leaving sexual and gender minority adolescents without access to necessary information about their sexuality and sexual and reproductive health, and sexual and reproductive health services.

Institutionalizing Sex Education in Diverse U.S. School Districts.

PURPOSE: This paper describes the Working to Institutionalize Sex Education (WISE) Initiative, a privately funded effort to support ready public school districts to advance and sustain comprehensive sexuality programs, and examines the degree to which WISE has been successful in increasing access to sex education, removing barriers, and highlighting best practices. METHODS: The data for this study come from a set of performance indicators, guidance documents, and tools designed for the WISE Initiative to capture changes in sex education institutionalization at WISE school districts. The evaluation includes the analysis of 186 school districts across 12 states in the U.S. RESULTS: As a result of the WISE Initiative, 788,865 unique students received new or enhanced sex education in school classrooms and 88 school districts reached their sex education institutionalization goals. In addition to these school district successes, WISE codified the WISE Method and toolkit-a practical guide to help schools implement sex education. CONCLUSIONS: Barriers to implementing sexuality education can be overcome with administrative support and focused technical assistance and training, resulting in significant student reach in diverse school districts nationwide.

Herpes simplex virus 1 and 2 educational assessment of young adults in rural southwest Virginia.

PURPOSE: Herpes simplex virus 2 (HSV-2) causes genital herpes, one of the most common sexually transmitted infections (STIs) in the U.S. HSV-1, commonly associated with cold sores, is increasing as a cause of genital herpes. Abstinence-only sexual health classes, commonly taught in Virginia, generate young adults who are under-educated in sexual health, increasing STI risks. College students in southwest Virginia were surveyed to assess comprehensiveness of high school health education regarding HSV-1 and HSV-2 and to identify students' preferred methods for STI education. METHODS: To obtain data on knowledge of HSV, comprehensiveness of sexual health education in high school, and preferred learning methods, 237 college students participated in an online questionnaire and 28 students were interviewed using structured interviews. RESULTS: Questionnaire and interview data indicated that Family Life Education classes need to include more comprehensive information on prevention, viral transmission, and differences between HSV-1 and HSV-2. The majority of total respondents (both the questionnaire and interview) (65%) reported non-comprehensive high school sexual health education. The majority of interview (79%) and questionnaire (55%) respondents wished they had learned more about herpes and other STIs in high school. Education preferences of both interviewed and surveyed respondents included interactive internet programs or games, more realistic lectures, and learning about STIs later in high school when students reported greater sexual activity. CONCLUSION: Our results indicate that more comprehensive sexual health education is needed and wanted by students in southwest Virginia. More relevant educational programs should be implemented for VA high school students utilizing technology and interactive methods to improve student engagement in sexual health education. IMPLICATIONS AND CONTRIBUTION: These studies provide information on knowledge of herpes simplex viruses among college students, comprehensiveness of sexual health education received in high schools, and preferred methods to learn about HSV and other STIs. These studies inform the facilitation of improved health education practices and programs for high school and college students.

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

BACKGROUND: Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. METHODS: The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. RESULTS: Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). CONCLUSIONS: Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall coverage for practices such as ensuring confidentiality (22% in Malawi, 47% in Kenya and 12% in Haiti), discussion of sexually transmitted infections (18%, 25%, 17%, respectively), and providing services to youth (53%, 27%, 32%, respectively).

Family Planning American Style Redux: Unintended Pregnancy Improves, Barriers Remain.

This article discusses barriers to reducing unintended pregnancy. Numerous factors may explain the high rate of unintended pregnancy in the United States, including inadequate sex education, confusing media messages about sex, cultural attitudes about sex and young parenting, conflation of contraception with abortion, inadequate health care access, burdensome contraceptive dispensing practices, and hospital merger limitations on care. Successful and promising approaches to expanding access to reproductive health care and reducing unintended pregnancy are discussed.

Family Planning and Preconception Health Among Men in Their Mid-30s: Developing Indicators and Describing Need.

The Centers for Disease Control and Prevention and Healthy People 2020 call for improvements in meeting men's reproductive health needs but little is known about the proportion of men in need. This study describes men aged 35 to 39 in need of family planning and preconception care, demographic correlates of these needs, and contraception use among men in need of family planning. Using data from Wave 4 (2008-2010) of the National Survey of Adolescent Males, men were classified in need of family planning and preconception care if they reported sex with a female in the last year and believed that they and their partner were fecund; the former included men who were neither intentionally pregnant nor intending future children and the latter included men intending future children. Men were classified as being in need of both if they reported multiple sex partners in the past year. About 40% of men aged 35 to 39 were in need of family planning and about 33% in need of preconception care with 12% in need of both. Current partner's age, current union type, and sexually transmitted infection health risk differentiated men in need of family planning and preconception care (all ps < .01) and participants' race/ethnicity further differentiated men in need of preconception care (p < .01). More than half of men in need of family planning reported none of the time current partner hormonal use (55%) or condom use (52%) during the past year. This study identified that many men in their mid-30s are in need of family planning or preconception care.

The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals.

Assessment of exposure to sexually explicit materials and factors associated with exposure among preparatory school youths in Hawassa City, Southern Ethiopia: a cross-sectional institution based survey.

BACKGROUND: According to the 2007 Ethiopian census, youths aged 15-24 years were more than 15.2 million which contributes to 20.6% of the whole population. These very large and productive groups of the population are exposed to various sexual and reproductive health risks. The aim of this study was to assess exposure to Sexually Explicit Materials (SEM) and factors associated with exposure among preparatory school students in Hawassa city, Southern Ethiopia. METHODOLOGY: A cross-sectional institution based study involving 770 randomly selected youth students of preparatory schools at Hawassa city. Multi stage sampling technique was used to select study subjects. Data was collected using pre-tested and self-administered questionnaire. Data was entered by EPI INFO version 3.5.1 and analyzed using SPSS version 20.0 statistical software packages. The result was displayed using descriptive, bivariate and multivariate analysis. Statistical association was done for independent predictors (at p < 0.05). RESULT AND DISCUSSION: About 750 students were participated in this study with a response rate of 97.4%. Among this, about 77.3% of students knew about the presence of SEM and most of the respondents 566(75.5%) were watched SEM films/movies and 554(73.9%) were exposed to SE texts. The overall exposure to SEM in school youths was 579(77.2%). Among the total respondents, about 522(70.4%) claimed as having no open discussion on sexual issues with in their family. Furthermore, About 450 (60.0%) respondents complained for having no sexual and reproductive health education at their school. Male students had faced almost two times higher exposure to SEM than female students (95 % CI: AOR 1.84(C.I = 1.22, 2.78). Students who attended private school were more than two times more likely exposed to SEM than public schools (95 % CI: AOR 2.07(C.I = 1.29, 3.30). Students who drink alcohol and labelled as 'sometimes' were two times more likely exposed to SEM than those who never drink alcohol (95 % CI = AOR 2.33(C.I = 1.26, 4.30). Khat chewers who labelled "rarely", "sometimes" and "often" had shown higher exposure (95 % CI: AOR 3.02(CI = 1.65, 5.52), (95 % CI: AOR 3.40(CI = 1.93, 6.00) and (95 % CI: AOR 2.67(CI = 1.46, 4.86) than those who never chew khat, respectively. Regarding SEM access, school youths with label 'easy access were exposed in odds of six folds than youths of no access (95 % CI: AOR 5.64(C.I = 3.56, 8.9). CONCLUSION: High number of students was exposed to sexually explicit materials. Sex, school type, substance use and access to SEM were observed independent predictors of exposure to SEM. MOTIVATION: The current generation of young people is the healthiest, most educated, and most urbanized in history. However, there still remain some serious concerns. Most people become sexually active during adolescence. Premarital sexual activity is common and is on the rise worldwide. Rates are highest in sub Saharan Africa, where more than half of girls aged 15-19 are sexually experienced. Millions of adolescents are bearing children, in sub-Saharan Africa. More than half of women give birth before age 20. The need for improved health and social services aimed at adolescents, including reproductive health services, is being increasingly recognized throughout the world. Approximately 85 % of world adolescents live in developing countries. Each year, up to 100 million becomes infected with a curable sexually transmitted disease (STI). About 40 % of all new global human immunodeficiency virus (HIV) infections occur among 15-24 year olds; with recent estimates of 7000 infected each day. These health risks are influenced by many interrelated factors, such as expectations concerning early marriage and sexual relationships, access to education and employment, gender inequities, sexual violence, and the influence of mass media and popular culture. Furthermore, many adolescents lack strong stable relationships with parents or other adults whom they can talk to about their reproductive health concerns. Despite these challenges, programs that meet the information and service needs of adolescents can make a real difference. Successful programs help young people develop life-planning skill, respect the needs and concerns of young people, involve communities in their efforts, and provide respectful and confidential clinical services. Accordingly, the government of Ethiopia now works on improving adolescent's health as one part of MDG (Goal VI-halting transmission of HIV/AIDS, STI, and other communicable diseases) with a focus on adolescents, since they are most affected population. This finding, therefore, will benefit the government to partly evaluate the goal achieving through adolescents exposure status to sexually explicit materials and improvement of sexual issues free talk with in school with class mates and their family at home. For that matter, we authors decided to publish this finding in BMC Reproductive Health Journal so that on line access will be easy to all governing bodies that they use to re-plan their strategies for better product of plan. Moreover, Researchers, Practitioners, policy makers, Students, school leaders and professionals will also benefit from this finding for their future researches references, knowledge gain and practice.

"They just know": the epistemological politics of "evidence-based" non-formal education.

Community education and outreach programs should be evidence-based. This dictum seems at once warranted, welcome, and slightly platitudinous. However, the "evidence-based" movement's more narrow definition of evidence--privileging randomized controlled trials as the "gold standard"--has fomented much debate. Such debate, though insightful, often lacks grounding in actual practice. To address that lack, the purpose of the study presented in this paper was to examine what actually happens, in practice, when people support the implementation of evidence-based programs (EBPs) or engage in related efforts to make non-formal education more "evidence-based." Focusing on three cases--two adolescent sexual health projects (one in the United States and one in Kenya) and one more general youth development organization--I used qualitative methods to address the questions: (1) How is evidence-based program and evidence-based practice work actually practiced? (2) What perspectives and assumptions about what non-formal education is are manifested through that work? and (3) What conflicts and tensions emerge through that work related to those perspectives and assumptions? Informed by theoretical perspectives on the intersection of science, expertise, and democracy, I conclude that the current dominant approach to making non-formal education more evidence-based by way of EBPs is seriously flawed.

Improving sexuality education: the development of teacher-preparation standards.

BACKGROUND: Teaching sexuality education to support young people's sexual development and overall sexual health is both needed and supported. Data continue to highlight the high rates of teen pregnancy, sexually transmitted disease, including human immunodeficiency virus (HIV) infections, among young people in the United States as well as the overwhelming public support for sexuality education instruction. In support of the implementation of the National Sexuality Education Standards, the current effort focuses on better preparing teachers to deliver sexuality education. METHODS: An expert panel was convened by the Future of Sex Education Initiative to develop teacher-preparation standards for sexuality education. Their task was to develop standards and indicators that addressed the unique elements intrinsic to sexuality education instruction. RESULTS: Seven standards and associated indicators were developed that address professional disposition, diversity and equity, content knowledge, legal and professional ethics, planning, implementation, and assessment. CONCLUSIONS: The National Teacher-Preparation Standards for Sexuality Education represent an unprecedented unified effort to enable prospective health education teachers to become competent in teaching methodology, theory, practice of pedagogy, content, and skills, specific to sexuality education. Higher education will play a key role in ensuring the success of these standards.

From mission to measures: performance measure development for a Teen Pregnancy Prevention Program.

The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process. Issues faced, challenges encountered, and lessons learned have broad applicability for other federal agencies and, specifically, for TPP programs interested in assessing their own performance and progress.

Office of Adolescent Health medical accuracy review process--helping ensure the medical accuracy of Teen Pregnancy Prevention Program materials.

The Office of Adolescent Health (OAH) developed a systematic approach to review for medical accuracy the educational materials proposed for use in Teen Pregnancy Prevention (TPP) programs. This process is also used by the Administration on Children, Youth, and Families (ACYF) for review of materials used in the Personal Responsibility Education Innovative Strategies (PREIS) Program. This article describes the review process, explaining the methodology, the team implementing the reviews, and the process for distributing review findings and implementing changes. Provided also is the definition of "medically accurate and complete" as used in the programs, and a description of what constitutes "complete" information when discussing sexually transmitted infections and birth control methods. The article is of interest to program providers, curriculum developers and purveyors, and those who are interested in providing medically accurate and complete information to adolescents.

Historical context for the creation of the Office of Adolescent Health and the Teen Pregnancy Prevention Program.

In Fiscal Year 2010, Federal funds were dedicated to support evidence-based approaches to effectively target teen pregnancy prevention and resulted in the establishment of the Office of Adolescent Health (OAH) and the Teen Pregnancy Prevention (TPP) Program. Through the tiered TPP Program, OAH supports replication and evaluation of programs using models whose effectiveness has been demonstrated through rigorous evaluation and the development and testing of promising or innovative pregnancy prevention strategies and approaches. This article documents the creation of OAH and the development of the TPP Program, the identification of a TPP evidence base, current program and evaluation efforts at OAH, and government coordination and partnerships related to reducing teen pregnancy. This article is of interest to those working to improve the health and wellbeing of adolescents.