Sexual Health Education

About the Teen Pregnancy Prevention (TPP) Program

This tiered, evidence-based program administered by the Office of Population Affairs (OPA) provides competitive grants to a broad range of organizations and agencies. Polling data has shown widespread support for the TPP Program, and the program has been is featured as one of 20 success stories in the Bipartisan Policy Center's Evidence Works: Cases Where Evidence Meaningfully Informed Policy.

In November 2021, OPA announced evidence of effectiveness of 7 new program models from TPP Tier 2 grantees. The results help to fill gaps in knowledge by providing insight into effective ways of engaging specific populations / setting, including Black and Latinx youth, non-exclusively heterosexual female youth, and youth in rural areas.

The TPP Program and the Personal Responsibility Education Program (PREP) are complementary federal funding streams for teen pregnancy prevention education. Read more about these and other federal funding streams for sexual and reproductive health education.

Each year, funding must be secured for the program. Up to 10% of TPP Program funds can be used for training and technical assistance, evaluation, and other program support. Of the remaining funds:

• 75% go to Tier 1 grants to replicate teen pregnancy prevention programs that have shown to be effective through rigorous evaluation. 
• 25% go to Tier 2 grants to develop, replicate, refine, and rigorously evaluate additional models and innovative strategies to reduce teen pregnancy.

What Can You Do to Support TPP?

Take action now and tell your members of Congress to fund the TPP Program at $150 million for the remainder of fiscal year 2024.

Appropriations

FY 2024 (October 1, 2023 - September 30, 2024) - Status: In Process 

Most recent action: On November 15, the House and Senate passed a continuing resolution (CR)—a stopgap measure to keep the government funded at current levels. The CR funds defense and security related appropriations through January 19, 2024, and domestic appropriations bills—including Labor, Health, and Human Services and Education (LHHS), which funds the Teen Pregnancy Prevention (TPP) Program—through February 2, 2024. It is important to continue to remind members of Congress about the significance of this program for your community.

What happened previously:

• At the end of September, Congress passed, and President Biden signed a CR to keep the government funded at current levels through November 17, 2023.
• On June 27, the Senate Appropriations Committee passed its FY 2024 LHHS Appropriations bill, which maintains level funding ($101 million) for the TPP Program. In contrast, the U.S. House LHHS Subcommittee advanced a bill earlier in July, that eliminates funding for the TPP Program.
• On Thursday, March 9, President Biden released his budget request for the 2024 fiscal year (FY). It proposes increasing funding for the TPP Program from its current level of $101 million to $111 million. The president's budget proposal is just that, a proposal. Congress ultimately has the power of the purse. Read Power to Decide's statement on the president's FY 2024 budget proposal and appropriations request to Congress.

FY 2023 (October 1, 2022 - September 30, 2023) - Status: Complete

On December 29, the President signed an Omnibus Appropriations bill into law. The bill funds the federal government through the remainder of fiscal year 2023. Unfortunately, the bill provides flat funding for key programs that provide reproductive health care services and education, including the TPP Program--which is funded at $101 million. Please read Power to Decide’s full statement on the Omnibus Appropriations bill. 

Resources

• FY 2024 Appropriations Request Letter - explains why increased funding for the TPP Program is a priority. 
• FY 2022 - FY 2024 Budget Chart. 
• Report: Final one from the Bipartisan Commission on Evidence-Based Policymaking cites the TPP Program as an example of a federal program “developing increasingly rigorous portfolios of evidence” (see page 94).
• Polling Data: Demonstrates widespread support for the TPP Program (and PREP).

About the Personal Responsibility Education Program (PREP)

PREP funds evidence-based programs dedicated to educating adolescents on both abstinence and contraception to prevent pregnancy and STIs. PREP also educates youth on adulthood preparation topics, such as healthy relationships, parent-child communication, and financial literacy. The program targets youth ages 10–19 who are experiencing homelessness, in foster care, live in rural areas or in geographic areas with high teen birth rates, or come from racial or ethnic minority groups, as well as pregnant and parenting youth. PREP includes formula grants to states (or competitive grants to organizations in the states that decline the formula grants), grants to tribes and tribal organizations, and grants for research and demonstration projects to implement and evaluate innovative strategies. Polling data has shown that PREP has widespread support. You can see an overview of the program in our fact sheets, PREP at a Glance and Pregnancy Prevention Among Youth in Foster Care.

PREP and the Teen Pregnancy Prevention (TPP) Program are complementary federal funding streams for teen pregnancy prevention education. They are high-quality examples of tiered, evidence-based grant making that use evidence to inform awards and continuous program improvement.

Funding Status

Status: Funded through FY 2023

The Consolidated Appropriations Act of 2021, an omnibus bill, includes a measure to extend the Personal Responsibility Education Program (PREP) for three years (through FY 2023) at $75 million annually. It also reauthorizes the mandatory Sexual Risk Avoidance (SRA) Program at $75 million annually for three years. Please see Power to Decide’s full statement on the passage of the omnibus appropriations bill.

What Can You Do to Protect PREP?

If you are part of an organization that would like to protect evidence-based sex education, please consider signing on to our 2022 Letter in Support of the TPP Program and PREP and joining the nearly 100 groups who support increased funding for these critical programs.

Resources

• Developing Effective Sustainable Personal Responsibility Education Programs (from The Exchange).
• Adolescent Pregnancy Prevention in Underserved Populations: The Way Forward. American Journal of Public Health Special Supplement: Vol. 108, No. S1. February 2018. https://ajph.aphapublications.org/toc/ajph/108/S1
• Multi-Component PREP Evaluation 2011 – 2018.

About the HHS Teen Pregnancy Prevention Evidence Review

The HHS Teen Pregnancy Prevention Evidence Review is an independent, systematic, and rigorous review of evaluation studies conducted by Mathematica Policy Research and managed by the HHS Assistant Secretary for Planning and Evaluation (HHS' evidence and evaluation experts). The evidence review has identified a growing number of evidence-based teen pregnancy prevention program models that represent a variety of approaches.

Most State PREP grantees use models identified by the evidence review. Tier 1 TPP Program grantees (FY 2010 - FY 2014 & FY 2015 - FY 2019) also used these models—and it serves as a resource for communities around the country.

In April 2018, HHS released updated findings for the Teen Pregnancy Prevention Evidence Review. You can see a handy summary here. In November 2021, OPA released evidence of effectiveness for 7 new program models that resulted from TPP Tier 2 grantees.  

The Teen Pregnancy Prevention Evidence Review is included in the Results First Clearinghouse Database, a project of the Pew-MacArthur Results First Initiative.

About the Real Education and Access for Healthy Youth Act (REAHYA)

The Real Education and Access for Healthy Youth Act (REAHYA), which was first introduced in Congress in 2021, would make essential investments in inclusive and honest sex education programs. The bill would also provide funding to help young people facing the greatest barriers to sexual health services get access to quality and culturally responsive care. You can read our full statement for more. 

The bill did not receive a vote during the 117th Congress (2021-22) so it will need to be reintroduced during the next session of Congress (January 2022 – December 2023). 

The Pregnancy Assistance Fund (PAF) was administered by the Office of Population Affairs. It provided $25 million annually from FY2010–2019 for competitive grants to states, tribes, and territories to support pregnant and parenting teens and women, and combat violence against pregnant women. Projects helped teens in high schools and community service centers and young women in institutions of higher education complete school and gain access to health care, childcare, family housing, and other critical supports. In the most recent period, there were 23 grantees in 22 states. Read more information about PAF here. 

Current Status: Funding for PAF ended on June 30, 2020. 

Latest Action

• President Biden’s first two budgets (FY 2022 and FY 2023) recommended funding PAF, but Congress ultimately controls what programs are funded.
• In December 2020, Reps. Spanberger (D-VA) and Cole (R-OK) introduced a bipartisan stand-alone bill HR 8862 to reauthorize PAF for 5 years. 
• In July 2019, Senators Murkowski (R-AK) and Casey (D-PA) introduced a bipartisan stand-alone bill to reauthorize PAF for five years, at $25 million annually (S 2296).