Choosing the Best

2024 — Choosing the Best on Federal Evidence-Based List
of Teen Pregnancy Prevention (TPP) Programs

Shown to Reduce Teen Sex by 25%

Upon completion of its 2024 Teen Pregnancy Prevention Evidence Review (TPPER), the U.S. Department of Health and Human Services (HHS) announced that Choosing the Best would be placed on its list of Evidence-Based Programs for Teen Pregnancy Prevention.¹ A 2023 analysis of an earlier rigorous, independent study of Choosing the Best found that students receiving Choosing the Best were significantly — 25% — less likely to initiate sex versus students in the control group who did not receive the program, nine months after baseline (treatment).² The study — a cluster, randomized, controlled trial rated “high quality” by TPPER — evaluated 1,143 ninth graders across six Georgia high schools. The purpose of the study was to evaluate the impact of the Choosing the Best curriculum on sexual activity. In the new analysis, independent researchers re-evaluated the short- and long-term effects of Choosing the Best on sexual initiation.

TPPER’s review criteria require programs to show evidence of at least one favorable, statistically significant impact on at least one outcome of interest reflecting sexual behavior (e.g., whether teens have ever had sex) or the consequences of sexual behavior (e.g. STIs, HIV, or pregnancy). Additionally, the supporting studies must meet established criteria for the quality and execution of their research designs. The study of Choosing the Best met all these criteria for evidence of effectiveness.³

¹ https://youth.gov/evidence-innovation/tpper/studies/pprer0s23023
² Ibid. See also Floren, M., & Floren, K. (2023) and Lieberman, L & Su, H. (2012)
³ https://youth.gov/sites/default/files/2024-09/TPPER-Findings-Technical-Brief-2024_1.pdf

Click here to view the new 2023 analysis. (188KB)

Click here to view the full, peer-reviewed, published study. (340KB)

2005 U.S. Department of Health and Human Services — Longitudinal/Behavior Outcome Study

An independent evaluation of Choosing the Best WAY, PATH, and LIFE was conducted by Dr. Stan Weed. The study, funded by a Federal SPRANS grant, began in 2002 and concluded in 2004. Using a quasi-experimental design, 7th, 8th and 9th grade students in a south metro Atlanta high school and its feeder middle school received either Choosing the Best (CTB) or the health textbook abstinence education curriculum that complies with state guidelines. The students were administered a 58-item survey prior to the study, immediately after receiving CTB or the health textbook material, and again twelve months later. Three hundred eighteen students were able to be tracked and matched at the pre-test and 12 month follow-up and had usable sexual activity status data. After one year, results among those students receiving CTB (treatment group) vs. those receiving the health textbook (comparison group) indicated a:

• Statistically significant decrease in the initiation of teen sex of 47%;
• Statistically significant improvements in five of the six intervening attitudinal variables associated with delaying sexual intercourse.

Click here to view full study. (124KB)

1994-95 Northwestern University Medical School—Pre-/Post test analysis

This study evaluated 3,840 Illinois middle school students who completed both theChoosing the Best curriculum and surveys before and after the program. It identified four variables that place students at higher risk for being sexually active. Key program outcomes include:

• 75% of all students indicated an intention to be abstinent until marriage
• 60% of students who had previously had sex indicated an intention to be abstinent

For expanded information on this study, click here.

To download complete report on this study, click here. (37KB)

1995-96 Northwestern University Medical School—Longitudinal Study

To assess the changes that take place over a year with Choosing the Best program “graduates,” this study evaluated 2,541 Illinois public school students aged 13-16. Key program outcomes include:

• 54% were no longer recently sexually active one year following the program.
• The number of newly sexually active students was smaller than would have been predicted without exposure to the Choosing the Best curriculum.
• Positive changes in attitudes toward abstinence that occurred persisted in the follow-up survey.

For expanded information on this study, click here.

To download complete report on this study, click here. (38KB)

1995 Muscogee County, Georgia—Study

This study evaluated the short- and long-term impact of the Choosing the Best curriculum in changing attitudes toward adolescent sex. It involved eighth-grade students in 10 schools and 79 classes: 1,425 pretest takers, 1,282 immediate posttest takers, and 1,078 delayed posttest takers; 243 students formed a control group. Evaluator Dr. Naresh Nalhotra, Regents Professor, Georgia Institute of Technology reported:

• Choosing the Best had a short- as well as long-term positive effect in changing attitudes towards abstinence teenage sexual activity.
• These positive effects were observed even for the high-risk sexually active teenagers.

For expanded information on this study, click here.

2001 Muscogee County, Georgia—Follow-Up Study

This analysis of Choosing the Best’s effectiveness in reducing teen pregnancies in middle schools compared data from Muscogee County with that of other large school districts in Georgia that had not used Choosing the Best. All eighth-grade students in the County—1,600 to1,800 students per year—had participated in the program since 1996. Research results from 1997 to 1999 conclude:

• Muscogee County experienced a 38% reduction in teen pregnancies in middle school students over this period.
• Other large school districts in Georgia not using Choosing the Best experienced an average of 6% reduction in teen pregnancies in middle school students during the same period.

For expanded information on this study, click here.