The Inwood House Research Group is directed by an independent evaluator and conducts ongoing, rigorous evaluations of the Teen Choice program and ensures quality improvement for all Inwood House programs. Our Teen Choice research also informs the teen pregnancy and disease prevention field. The Inwood House Research Group presented our Teen Choice study findings at several national conferences during 2000-2001: The American Public Health Association Conference, the Columbia University Mailman School of Public Health/National Campaign to Prevent Teen Pregnancy Conference, and the U.S. Department of Health and Human Services Demonstration Projects Grantees Meeting. The American School Health Association asked Inwood House to write the chapter on school based mental health approaches for Partnerships for Pregnancy Prevention: Coordinated School Health Programs to Prevent Pregnancy and Sexually Transmitted Diseases, a comprehensive national resource for the school community sponsored by the Centers for Disease Control. Family Planning Perspectives, the Alan Guttmacher Institute’s nationally recognized peer-reviewed journal, published Inwood House’s "Long Term Outcomes of a School-Based, Small Group, Pregnancy and Disease prevention program in New York City." The report is based on our findings from the first two years of our Teen Choice evaluation which demonstrates the program’s long-term positive impact on teens’ knowledge, attitudes and behavior regarding sexual activity, including improved relationships with parents.

This study of 312 students attending three New York City middle schools used pretest, post-test, and one year follow-up surveys and included both intervention and comparison groups. The recently published findings provide evidence that that the abstinence-based Teen Choice small group intervention contributes to:

			significantly improved communication and relationships with parents one year after intervention
			significantly improved sense of control over participants' lives one year after intervention
			significantly more desirable attitudes about the appropriateness of teens having sex one year after intervention

These findings led to the expansion of the study to include more Teen Choice schools, and to follow students for a longer period of time.

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Expanded Teen Choice Evaluation: 1998 – Present
The expanded Teen Choice study involves students in a comparison group and in three different levels of the Teen Choice intervention:

1. The abstinence-based Teen Choice model which includes discussion of, but prohibits referrals for, contraceptive services;
   
   
2. The comprehensive sexuality education Teen Choice model which includes referrals for contraceptive services;
   
   
3. The multi-component Teen Choice model which includes the comprehensive sexuality education model with youth development activities, as well as access to contraceptive services via school- and community-based health clinics.

To date, the study has collected pretest and post-test data from more than 1,100 eighth graders during the 1998/1999 and 1999/2000 school years, and one year follow-up data from more than 400 ninth graders. At pretest, the study sample demonstrated high risk for early sexual activity, pregnancy, HIV/AIDS and other STDs. A quarter of the students (24.8%) had already had sex in the 8th grade, before they entered the study; 65.5% indicated that at least some of their friends were sexually active and 46.4% had at least one friend who had been or gotten someone pregnant. Data at short-term post-test and one year after program participation provide further evidence that the Teen Choice small group model, in all of its variations, impacts on a wide array of variables associated with early sexual activity and pregnancy. Comparing students in the Teen Choice small groups with students in the comparison group, preliminary analyses of the data indicate:

			Significantly increased knowledge of pregnancy prevention
			Significantly improved self-esteem
			Significantly improved sense of empowerment (ability to control events in their lives and hope for the future)
			Significantly improved self-efficacy (confidence that they can say no to sex under a variety of circumstances)
			Significantly increased respect for their parents
			Significantly improved relationship with their parents
			Significantly lower intentions to have sex

The study is designed to follow this sample of students, who are currently in the 9th and 10th grades, through the 11th grade and examine the long-term impact of the various levels of the Teen Choice small group intervention. The long-term phase is necessary in order to follow these trends over time and draw conclusions about the effectiveness of different approaches to pregnancy prevention.

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