High Stakes. Big Mistake?

Pat Paluzzi

Alexandra Eisler

Please note that as of 05/03/2012, an update to this post, regarding the evaluation of the Heritage Keepers program, has been posted here.

To be clear: this time of evaluating and expanding the public health field to support young people in making healthy decisions about their sexual health is a time to celebrate. This is a time when those with money, power, and sway hold a unique responsibility to back programming that promotes the well-being of all youth and provides them with accurate information that promotes healthy decision-making. The President’s Teen Pregnancy Prevention Initiative and the Department of Health and Human Services (HHS) have played a central role in disseminating effective programs that promote these goals and have stood firm in approaching this work so that it values all young people and their families.

However, with that said, Healthy Teen Network was concerned to find that the expansion of the current list of HHS-vetted programs included Heritage Keepers Abstinence Only Education. HHS itself noted in 2007 that this program not only demonstrated “little or no impact on sexual abstinence or activity” but that its evaluation lacked rigor to determine if the collected behavioral data indicated actual behavior change among participants.[1]*

Looking to other programs on this list, they are rigorously evaluated with their results published in peer-reviewed journals providing a layer of quality control that ensures youth receive high-quality interventions that can save their lives. This program, Heritage Keepers Abstinence Education, has failed to be published. We, as public health professionals, should take pause at this shortcoming. Certainly, there are many quality programs available that have not been published, but those programs are not on this list and therefore not a part of this massive funding stream of tax dollars.

The program’s outcomes appear to be largely based on middle school students’ support of abstinence and expectation to remain abstinent.* Intentions to remain abstinent are a weak proxy to promote the health of our adolescents, and intentions do not necessarily result in a change in sexual-risk taking behaviors. Just look at the research on virginity pledges (82% of those who pledge deny having ever pledged).[2] In fact, the 2007 Mathematica report on this program—submitted to HHS—indicates the following:

  • Youth in the [Heritage Keepers program] and control groups reported similar rates of sexual abstinence. (p. 40)[3]
  • Youth in the [Heritage Keepers program] and control groups did not differ in reported age at first sex. (p. 41)[3]*

The stakes here are incredibly high and we should ask why a program like this would be included in the ranks of effective programs.

Evaluation aside, couching this program in the context of marriage and traditional gender roles flies in the face of championing the health of all communities. Narrowly focused messages like those espoused in this curriculum are at best ignorant of the needs of many youth, in particular LGBTQ youth, and at worst prejudicial and homophobic. Adolescents have the right to learn about their sexual health and determine what is right for them and their families without being bombarded with divisive ideology. For more information on some of the potentially damaging curriculum content, see this review.

As advocates for our young people, we have a responsibility to ensure that they get accurate information that allows them to build the lives that they themselves choose. The inclusion of a program like this in our most notable list of resources reflects poorly not only on the President’s Teen Pregnancy Prevention Initiative, it reflects poorly on all of us. As an organization with young people’s health first and foremost in mind, Healthy Teen Network is outraged and saddened that work of this caliber represents the sexual health profession. This is a time to hold our leaders accountable for promoting programming that places the lives of our youth and our families at risk.

Pat Paluzzi is the President/CEO and Alex Eisler is the Training and TA Coordinator at Healthy Teen Network.

[3] http://aspe.hhs.gov/hsp/abstinence07/HK/report.pdf

*This post has been updated.  These statements regarding evaluation relate to a 2007 review, but these do not appear to be the same evaluation results used in the 2011 review.  See our updated post here.

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  1. Something Fishy On The Menu | APPCNC Blog
  2. The Stakes Remain High « Under the Currents

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