Federal and State Efforts to Assess the Scientific Accuracy of Materials Used in Abstinence-until- Marriage Education Programs Have Been Limited

Efforts by HHS and states to assess the scientific accuracy of materials  used in abstinence-until-marriage education programs have been limited. ACF—which awards grants to two programs that account for the largest  portion of federal spending on abstinence-until-marriage education—does  not review its grantees’ education materials for scientific accuracy and  does not require grantees of either program to review their own materials  for scientific accuracy. In addition, not all states funded through the State  Program have chosen to review their program materials for scientific  accuracy. In contrast to ACF, OPA has reviewed the scientific accuracy of  grantees’ proposed educational materials and corrected inaccuracies in  these materials. Officials from 5 of the 10 states in  our review reported that their states have chosen to conduct such  reviews. Officials from two of the five states reported that they have found  inaccuracies as a result of their reviews. In addition, this official  cited an instance where materials incorrectly suggested that HIV can pass  through condoms because the latex used in condoms is porous. A Variety of Efforts Have Been Made to Assess the Effectiveness of Abstinence-until- Marriage Education Programs, but a Number of Factors Limit the Conclusions That Can Be Drawn

HHS, states, and researchers have made a variety of efforts to assess the  effectiveness of abstinence-until-marriage education programs; however, a  number of factors limit the conclusions that can be drawn about the  effectiveness of these programs. ACF and OPA have required their  grantees to report on various outcomes used to measure the effectiveness  of grantees’ abstinence-until-marriage education programs, though the  reporting requirements for each of the three abstinence-until-marriage  programs differ. In addition, the results of  some efforts that meet the criteria of a scientifically valid assessment have  varied, and two key studies that meet these criteria have not yet been  completed. HHS, States, and Researchers Have Made a Variety of Efforts to Assess the Effectiveness of Abstinence-until-Marriage Education Programs

Efforts of HHS, states, and researchers to assess the effectiveness of  abstinence-until-marriage education programs have included ACF and  OPA requiring grantees to report data on outcomes of their abstinence- until-marriage education programs; ACF analyzing national data on  adolescent behavior and birth rates; and other HHS agencies, states, and  researchers funding or conducting studies to assess the effectiveness of  abstinence-until-marriage education programs. Several Factors Limit the Conclusions That Can Be Drawn about the Effectiveness of Abstinence-until-Marriage Education Programs

Most of the efforts of HHS, states, and other researchers to evaluate the  effectiveness of abstinence-until-marriage education programs included in  our review have not met certain minimum criteria that experts have  concluded are necessary in order for assessments of program  effectiveness to be scientifically valid. As we noted in the draft report, key studies funded by  HHS that experts anticipate will meet the criteria of a scientifically valid  effectiveness study are not yet completed, but when completed these HHS  funded studies may add substantively to the body of research on the  effectiveness of abstinence-until-marriage education programs.
Why GAO Did This Study

Reducing the incidence of sexually transmitted diseases and unintended pregnancies is one objective of the Department of Health and Human Services (HHS). HHS provides funding to states and organizations that provide abstinence-until-marriage education as one approach to address this objective. GAO was asked to describe the oversight of federally funded abstinence-until-marriage education programs. GAO is reporting on (1) efforts by HHS and states to assess the scientific accuracy of materials used in these programs and (2) efforts by HHS, states, and researchers to assess the effectiveness of these programs. GAO reviewed documents and interviewed HHS officials in the Administration for Children and Families (ACF) and the Office of Population Affairs (OPA) that award grants for these programs.

What GAO Found

Efforts by HHS and states to assess the scientific accuracy of materials used in abstinence-until-marriage education programs have been limited. This is because HHS's ACF--which awards grants to two programs that account for the largest portion of federal spending on abstinence-until-marriage education--does not review its grantees' education materials for scientific accuracy and does not require grantees of either program to review their own materials for scientific accuracy. In contrast, OPA does review the scientific accuracy of grantees' proposed educational materials. In addition, not all states that receive funding from ACF have chosen to review their program materials for scientific accuracy. In particular, 5 of the 10 states that GAO contacted conduct such reviews. Officials from these states reported using a variety of approaches in their reviews. While the extent to which federally funded abstinence-until-marriage education materials are inaccurate is not known, in the course of their reviews OPA and some states reported that they have found inaccuracies in abstinence-until-marriage education materials. For example, one state official described an instance in which abstinence-until-marriage materials incorrectly suggested that HIV can pass through condoms because the latex used in condoms is porous. HHS, states, and researchers have made a variety of efforts to assess the effectiveness of abstinence-until-marriage education programs; however, a number of factors limit the conclusions that can be drawn about the effectiveness of abstinence-until-marriage education programs. ACF and OPA have required their grantees to report on various outcomes that the agencies use to measure the effectiveness of grantees' abstinence-until-marriage education programs. In addition, 6 of the 10 states in GAO's review have worked with third-party evaluators to assess the effectiveness of abstinence-until-marriage education programs in their states. Several factors, however, limit the conclusions that can be drawn about the effectiveness of abstinence-until-marriage education programs. Most of the efforts to evaluate the effectiveness of abstinence-until-marriage education programs included in GAO's review have not met certain minimum scientific criteria--such as random assignment of participants and sufficient follow-up periods and sample sizes--that experts have concluded are necessary in order for assessments of program effectiveness to be scientifically valid, in part because such designs can be expensive and time-consuming to carry out. In addition, the results of efforts that meet the criteria of a scientifically valid assessment have varied and two key studies funded by HHS that meet these criteria have not yet been completed. When completed, these HHS-funded studies may add substantively to the body of research on the effectiveness of abstinence-until-marriage education programs.