62 Perspectives on Sexual and Reproductive Health

Much evidence has documented the disproportionately high rates of adolescent pregnancy and childbearing and early sexual activity among the siblings of pregnant and parenting teenagers.1 Concern over this problem led to the creation of the California Adolescent Sibling Pregnancy Prevention Program (ASPPP) in 1996. The program is delivered to the brothers and sisters of pregnant and parenting teenagers at 44 nonprofit social service agencies, community-based organizations, school districts and county health depart-ments across California. * Each program site provides a unique combination of services, including individual case management, academic guidance, training in decision-mak-ing skills, job placement, self-esteem enhancement, and con-traceptive and sexuality education. To date, the program has served approximately 6,000 youths.2 This article presents the results of an evaluation that had two goals. First, we sought to determine whether program participants showed more favorable outcomes than com-parison youths at the conclusion of the nine-month evalu-ation. We assessed many outcomes, including the incidence of problem behaviors known to be risk factors for teenage pregnancy; adolescents ’ perceived likelihood that they would engage in pregnancy-related behaviors; and rates of first in-tercourse, contraceptive use and pregnancy. Second, we ex-amined whether positive outcomes were related to the con-tent area of services received, their mode of delivery and the dosage of the intervention. The findings from these analy-ses will highlight which services were most effective at pre-venting pregnancy in this high-risk population