Pregnancy Prevention Program Starts Early
By Alison Heck, Internet Reporter

Pregnancy prevention is one of the most daunting tasks taken on by educators, parents and authorities today. What is the best way to prevent teenagers from engaging in risky behavior? Sex education classes, students taking baby dolls home for a weekend and providing access to contraceptives are all methods that have been used to delay a teen's engagement in sexual activities. While these efforts have made small strides toward decreasing teen pregnancy rates, other options are showing that a subtle, more long-term approach can have greater success. 

The Children's Aid Society's Carrera Adolescent Pregnancy Prevention Program (CAPPP) not only teaches children about sexual activity and its consequences, it emphasizes the importance of education and employment. The program believes that if children want to succeed in life then that is where pregnancy prevention will begin.

The Children's Aid Society and Dr. Michael Carrera, director of The Children's Aid Society's Stern National Adolescent Sexuality Training Center in New York, created the CAS-Carrera model in 1984 and today there are over 20 replications of the program for low-income youths in the United States.

The Baltimore Health Department decided to bring the program to the city when its teen pregnancy rates became among the highest in the nation. Almost 95 out of every 1,000 teenage girls between the ages of 15 and 19 were becoming pregnant in 1997.

The health department's own funding and financial assistance from a number of local and national foundations allowed the Baltimore CAPPP to open its doors in 1997. Since CAPPP began, it has allowed participants to gain support in both their academic and social lives showing them that working toward their future is an important goal to have. Another aspect of the program that made it attractive was early and long-term involvement with the participants.

"The program supports kids in the way you would support your own kids," said Dr. Pat Paluzzi, Ph.D., Chief of the Bureau of Adult and Adolescent Reproductive Health at the Baltimore Health Department. "It is a pregnancy prevention program but the Carrera model says it is contraception above the waist."

Preventing Baltimore's Children From Having Children

Baltimore's version of CAPPP involves two separate groups of 45 youths, ages 11 to 18, called Carrera East and Carrera West. Carrera West is geared toward African-American youths and Carrera East toward Hispanic youths. The youth participate five to six days a week until they graduate from high school. Although Carrera East and West involve a specific population from a geographical area of the city, the program does not prohibit anyone from participating.

There are several ways a child is recruited into the program; fliers are posted throughout the community, teachers within the school system can recommend the program and some participants are patients of the health department clinic and are referred by staff. After they are recruited into the program they must obtain parental permission. 

The children arrive for the program after school and participate in three 45-minute sessions after they are given an hour of social time. One of the sessions each day is dedicated to education and tutors are on hand to provide help with homework. Various activities are rotated throughout the other two sessions.

CAPPP sessions are made up of several components, addressing medical and mental health, education, employment, family life and sex education, lifetime/individual sports and creative expression.

Although education is the primary focus of the CAPPP, program staff emphasize the other activities as well. Recently, the Carrera West children were able to learn about African culture through African dance drums and music. Field trips to museums, bowling and ice-skating are just a few other activities that the children experience through the program. 

"We expose them to the greater world beyond their local community, opportunities they otherwise wouldn't have." said Dr. Cynthia Mobley, M.D., Director of the Healthy Teens and Young Adults Center.

During their summer vacation, children come earlier and only five days a week. The continued instruction allows the children to maintain the educational structure they are used to during the school year.

When a participant graduates from high school they also graduate from the CAPPP program. There is a special ceremony that family and friends can attend to commemorate their accomplishment. And an effort is also to maintain contact with the graduates afterwards.

"Some we follow into their first year of college or other areas," said Mobley. "Some young people come to work with us."

It is the family atmosphere and long-term commitment of the staff that makes CAPPP unique and successful. 

Intervention Early and Often

Previous tries by the city to address teen pregnancy were less successful in part because the program began with youth who were already sexually active and their behavior was almost impossible to reverse. The early intervention - at 11 - by CAPPP was important to Baltimore officials.

"The consistency of starting at such an early age and seeing them all of the way through helps so much," said Mobley. "So many of them have constant changes and upheaval in their lives."

Another component that makes CAPPP unique is the aggressiveness in keeping children involved in the program. If a child is late or absent from the program, calls are made to track down the child and find out why they are missing that day. Mobley said the children are given endless chances to stay in the program. 

"Children aren't just tossed out of this program," said Paluzzi. "We go the extra mile to turn a crisis into an opportunity."

In addition, the program staff provide a stable environment for the children. Both Mobley and Paluzzi said that having a permanent staff allows children to build and keep relationships with the adults. 

"We're almost surrogate parents," said Mobley. "We provide longevity and stability."


For more information about the Carrera Adolescent Pregnancy Prevention Program, go to

To contact Baltimore's Carrera After School Program, call (410) 396-0353.

For more information on the Baltimore Health Department, go to:
159 Burgin Parkway | Quincy, MA 02169
617-471-4445 | Fax 617-770-3339