Funding from the Office of Adolescent Health in 2010 provided
the opportunity for CSS and HiTOPS to implement Teen
PEP in the context of a rigorous randomized control evaluation
design5 and a formal implementation study. At the time of this
writing, a total of seven high schools are participating, with four
schools implementing Teen PEP as members of the “treatment
group” and three “control group” schools that will begin implementation
after a 2-year delay. All the participating schools are
located in rural North Carolina Piedmont communities. For
young women 15e19 years of age, pregnancy rates in participating
counties (in 2011) ranged from a low of 32.26 to a high of
67.4 per 1,000, whereas teen birth rates ranged from 24.8 to 55.7
per 1,000. Table 1 lists a comparison of birth rates in the United
States, New Jersey (where Teen PEP was developed), and North
Carolina (where Teen PEP is being replicated). As at the national
level, teen birth rates have been declining in North Carolina,
although one participating county’s rates for teen
pregnancy and teen births were increasing immediately before
study participation. There was great variation in the availability
of sexual health resources in the participating counties, ranging
from somewhat comprehensive programming to no services at
all for school-age youth. In our study focus groups, youth
consistently reported that they did not receive information about