Tag Archives: Teen Pregnancy

The Grant World Shifts from the “Community Based Abstinence Education Program” to “Competitive Abstinence Education Grant Program”

In 2008, I wrote a pair of long blog posts about the Community-Based Abstinence Education Program and what happens when a program that is nominally based on “research” has an unfortunate problem: the best available research shows the premise of the program is unlikely to succeed. (The first post is “What to do When Research Indicates Your Approach is Unlikely to Succeed: Part I of a Case Study.”) We wrote a number of funded CBAE programs over the course of a couple years.

Today, however, I was enjoying my usual Sunday jaunt through the Federal Register and found the Competitive Abstinence Education Grant Program. It’s much, much smaller than CBAE, since it only has $4,611,070 available, while CBAE had $40,000,000 in the 2008 funding cycle. In addition, while the new program may have abstinence in the title, description says that applicants should take “medically accurate” approach to sex education, which is quite different than the required CBAE approach, which explicitly forbids medically accurate sex education.

This is the part of the post where a political blogger would make some sort of ideological or political point.* I don’t have one, but I will say that the CBAE to CAEG shift is another example of how smart agencies should be adaptable, as I described in my post “Surfing the Grant Waves: How to Deal with Social and Funding Wind Shifts.” Four years ago, the grant waves were throwing abstinence; this year, they’re throwing comprehensive sex education. Forty years ago, when Isaac was getting started, the emphasis was on “medically accurate” information (like today’s RFP), as he wrote about in “Teenage Pregnancy Prevention and the Replication of Evidence-based Programs: the Research and Demonstration Programs and Personal Responsibility Education Program are Two RFPs that Provide a ‘Madeleine Moment’ for a Grizzled Grant Writer.”

For a lot of agencies, what happens on the ground when they’re trying to educate teenagers probably won’t change much based on the funding stream, since teenagers themselves haven’t changed much since they were invented in the 1920s or thereabouts (read Joseph Kent’s Rites of Passage: Adolescence in America 1790 to the Present and similar books for the history of adolescence as an idea; see also here for a graph depicting the rise of the term “teenager”). Given how fast we produce teenagers, and the gap between what most teenagers really want and what most adults really want them to do, the need for some fashion of sex education is unlikely to go away in the near future, which means federal RFPs are likely to keep being issued—regardless of how they’re labeled.

EDIT: In “Parents Just Don’t Understand: A sociologist says American moms and dads are in denial about their kids’ sexual lives,” Sinikka Elliott argues about comprehensive sex education and abstinence education:

One side is saying, ”Well, they need to abstain. That’s a surefire way that they’re gonna be safe,” and the other side is saying, “They’re not gonna abstain and so they need contraceptive information.” They were basing their argument on the same things: the teen pregnancy rates, the STI rates.

Neither focuses much on pleasure, as Elliott points out.


* I don’t have one, but I will say that the Margaret Talbot’s New Yorker article, Red Sex, Blue Sex is probably the most interesting and comprehensive article I’ve read about the kinds of political differences that shift the funding streams for programs like CBAE and now CAEG.

Health Care Reform Means Green Grass & High Tides for Grant Writers

One of the great ’70s arena anthem songs was the Outlaws’ Green Grass & High Tides, or as it was often misheard, “Green Grass & High Times Forever.” It seems that whichever health care reform bill staggers across the Congressional finish line will make it Green Grass & High Tides for grant writers, since all versions contain lots of hidden grant nuggets. I’m too busy writing proposals for such fun-filled RFPs as HRSA’s Nurse Education, Practice and Retention (NEPR) Program and SAMHSA’s Offender Reentry Program to flyspeck a couple of 2,000 page health care bills looking for prospective grant programs. Fortunately, I came across “Numerous Grant Programs Fatten Cost of Health Care Reform,” which does the heavy lifting for me. Here are some of the new grant programs that may burst forth in 2010:

  • Demonstration Program to Promote Access for Medicare Beneficiaries With Limited English Proficiency (LEP): Section 1222 of the House bill would create three-year grants for nonprofits to offer interpreter services to help LEP residents communicate with medical providers. This is clearly aimed at Section 330 community and rural health centers that provide Medicaid services, often for LEP populations. We work for lots of Section 330 providers, so we love this program concept.
  • Early Childhood Home Visitation Program: Section 2951 of the Senate bill would authorize grants to nonprofits for early childhood visitation programs. The programs would be aimed at improving maternal and newborn health, preventing child injuries and abuse,improving school performance, reducing domestic violence, and improving family economic self-sufficiency. There is $1.5 billion for this gem over five years. We’ve written tons of proposals over the years for similar programs, which are usually called “demonstration homemaker” services. I’ve never seen any data that suggests that such programs work, but they are great ways of employing lots of low-skill workers, usually low-income women, to go into the homes of other low-income women and tell them how to fold their laundry. This ever popular family support service already exists in most American communities. Since Senators must know this, I can only assume that the program will be “walkin’ around money” for the thousands of nonprofits that provide family supportive services through contracts with city, county and state agencies.
  • Grants to Promote Positive Health Behaviors and Outcomes: Section 2530 in the House bill authorizes the award of grants to promote healthy behaviors in medically underserved areas, including education about the risks associated with poor nutrition, tobacco use, lack of exercise and other health problems. I could list about 25 existing federal program that already do this, but the nice part about the federal trough is that there is always room for one more program.
  • Healthy Teen Initiative Program to Reduce Teen Pregnancy: Section 2526 of the House bill establishes a new program to provide $150 million in grants for schools, non-profits and other groups for educational programs to reduce teen pregnancy and the spread of sexually transmitted diseases (STDs). The feds have been funding various teen pregnancy and STD prevention programs for the past 35 years, vacillating between sex education and abstinence approaches, depending on which party controls Congress. We write teen pregnancy prevention programs regularly, so I am very familiar with the data and have yet to see any evidence that such programs do anything except keep armies of earnest, newly minted college grads employed as health educators.

I could go on, but I think readers will get the idea that there are dozens of new grant horses being saddled up in the health reform effort, as well as other emerging federal legislation. I recently wrote about a huge new education program named i3, in Same As It Ever Was: Investing in Innovation Fund (i3), Student Support Services (SSS), TRIO, and More to Come and am tickled to learn that new health related programs are not far behind. If your organization does job training, not education or health services, and you’re feeling left out of the party, not to worry, Congress feels your pain. The LA Times reports that Democrats Work On Multibillion-dollar Jobs Package, so your time is nigh.

I’m hoping for a resurrection of the Nixon-era Comprehensive Employment and Training Act (CETA), which was perhaps the all time best grant program for nonprofit and public agencies, since all it did was provide money to hire people. I wrote many funded CETA proposals in the ’70s and knew lots of unemployed liberal arts grads who entered the government/nonprofit world through CETA slots and clawed their way into permanent jobs, including the holy grail of civil service status. Unlike the Stimulus Bill, it was easy to count jobs created by CETA, as grantees just had to count new noses around the conference table.

For the past year or so, I’ve written many posts on how this is the best time ever to go after grants and the hits keep on coming. Seliger + Associates stands ready to shoulder the burden of writing proposals for the newest crop of federal grants, which indeed seem to be the same as they ever were.

What to do When Research Indicates Your Approach is Unlikely to Succeed: Part I of a Case Study on the Community-Based Abstinence Education Program RFP

The Community Based Abstinence Education Program (CBAE) from the Administration on Children, Youth and Families is a complicated, confusing, and poorly designed RFP based on suspect premises. That makes it an excellent case study in how to deal with a variety of grant writing problems that relate to research, RFP construction, and your responses.

CBAE is simple: you’re supposed to provide abstinence and only abstinence education to teenagers. That means no talk about condoms and birth control being options. In some ways, CBAE is a counterpoint to the Title X Family Planning funding, which chiefly goes to safe-sex education and materials rather than abstinence education. Its premise is equally simple: if you’re going to have sex, use condoms and birth control. Congress chooses to fund both.

Were I more audacious regarding CBAE proposals, I’d have used George Orwell’s 1984 as a template for the programs, since almost everyone in the novel conforms to the numbing will of an all-powerful state and many belong to the “Junior Anti-Sex League,” complete with scarlet sashes. I hope someone turned in a CBAE application proposing scarlet sashes for all participants.

More on point, however, page two of the RFP says:

Pursuant to Section 510(b)(2) of Title V of the Social Security Act, the term “abstinence education,” for purposes of this program means an educational or motivational program that: […]

(B) Teaches abstinence from sexual activity outside marriage as the expected standard for all school age children

Who is enforcing this “expected standard?” Society in general? A particular person in society? But it gets better:

(D) Teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity;

This requirement ignores decades of anthropological research into indigenous societies as well as plenty of research into our own society, which Mary Roach described in Bonk, Alfred Kinsey described using imperfect methods in his famous but flawed research in the 50’s, and that Foucault described in his History of Sexuality. It also ignores the sexuality of other cultures and even our own, as discussed in books like Conceiving Sexuality: Approaches to Sex Research in a Postmodern World, or, better yet, Culture, Society and Sexuality: A Reader, which describes the way societies and others build a social model of sex. Through the CBAE program, Congress is building one such model by asserting it is true and using “expected standard” language, without saying who is the “expecting” person or what is the “expecting” body. It’s an example of what Roger Shuy calls in Bureaucratic Language in Government and Business a term that “seems to be evasive,” as when insiders “use language to camouflage their message deliberately, particularly when trying to avoid saying something unpleasant or uncomfortable.” In this case, the evasion is the person upholding the supposed standard.

Furthermore, the abstinence conclusion isn’t well supported by the research that does exist, including research from previous years of the program, which is at best inconclusive. A Government Accountability Office report (warning: .pdf file) says things like, “While the extent to which federally funded abstinence-until-marriage education materials are inaccurate is not known, in the course of their reviews OPA [Office of Population Affairs] 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.”

The one comprehensive study that has been conducted by a nonpartisan firm is called “Impacts of Four Title V, Section 510 Abstinence Education Programs” by Mathematica Public Research, which was spun off from the guys who brought us the Mathematica software. The study was prepared for DHHS itself, and it says such encouraging things as, “Findings indicate that youth in the program group were no more likely than control group youth to have abstained from sex and, among those who reported having had sex, they had similar numbers of sexual partners and had initiated sex at the same mean age.” The programs it studied are based around the same methods that the CBAE demands organizations use, all of which boil down to inculcating a culture of fear of sex outside of marriage. The social stigma the program recommends is based around STDs and whether you’ll get into college (although an editorial in the L.A. Times argues otherwise), and, to a lesser extent, altering peer norms. Still, even in Puritan times this was not entirely effective, as Bundling by Henry Stiles explains. The practice meant sleeping in the same bed with one’s clothes on, as a solution to the problems of inadequate heat and space. But, as Jacques Barzun says in From Dawn To Decadence: 500 Years of Western Cultural Life, “Experience showed the difficulty of restraint and […] the rule was made absolute that pregnancy after bundling imposed marriage […] So frequent was this occurrence that the church records repeatedly show the abbreviation FBM—fornication before marriage.”

There are counter-studies that purport to show abstinence education as effective, like this one from a crew that, not surprisingly, is selling abstinence education materials. But it, like most others, has little bon mots amid its intimidating numbers and verbose language like, “In addition, the high attrition rate limits our ability to generalize the findings to a higher-risk population” (strangely enough, the .pdf file is set to disallow copying and pasting, perhaps to discourage irate bloggers like myself). But the study doesn’t list the attrition rate, making it impossible to tell how severe the problem is. In addition, even if it did, the population selected might also suffer from cherry picking problems of various kinds: that is to say, organizations are more likely to serve the participants who are most likely to be receptive to services and, concomitantly, less likely to do things like have early sex. This is an easy and tempting way to make a program look good: only let the kids in who are likely to benefit. And it’s a hard problem to tease out in studies.

So be wary of dueling studies: if you don’t read these carefully, it’s easy to accept their validity, and even if you do read them carefully, it’s easy to nitpick. This is why peer review is so helpful in science and also part of the reason evaluations are so difficult. Furthermore, many of the studies, including Heritage’s, come from biased sources, a problem Megan McArdle writes about extensively in a non-abstinence-related context. (See her follow-up here). Most of you justifiably haven’t followed the blizzard of links I put up earlier or read the books I cited for good reason: who has the time to sift through all this stuff? No one, and even pseudoscience combined with anecdote like this article in New York Magazine has an opinion (hint: be wary of anyone whose title has the word “evolutionary” in it).

Given this research, which is hard to miss once you begin searching for information about the efficacy of abstinence instruction, how is a grant writer to create a logic model that, as page 44 says, should list “[a]ssumptions (e.g., beliefs about how the program will work and is supporting resources. Assumptions should be based on research, best practices, and experience)”? (emphasis added).

Two words: ignore research. And by “ignore research,” I mean any research that doesn’t support the assumptions underlying the RFP. If you want to be funded, you simply have to pretend “Impacts of Four Title V, Section 510 Abstinence Education Programs” or the GAO study don’t exist, and your proposal should be consistent with what the RFP claims, even if it’s wrong. This is, I suspect, one of the hardest things for novice grant writers to accept, which is that you’re not trying to be right in the sense of the scientific method of discerning the natural world through experimentation. You’re trying to be right in the Willie Stark sense of playing the game for the money. No matter how tempting it is to cite accurate research that contradicts the program, don’t, unless it’s to knock the research.

Remember too that the grant writer is to some extent also a mythmaker, which is a subject Isaac will address more fully in a future post. The vital thing to consider is that the mythology you need to create isn’t always the same as the reality on the ground. As in politics, the way events are portrayed are often different than how they actually are. David Broder wrote an article on the subject of inventing political narratives, which occasionally match reality; your job as a grant writer is inventing grant narratives. We hope these match reality more often than not. Sometimes the myth doesn’t, as in this application, and when that happens, you’re obligated to conform to the RFP’s mythology, even if it isn’t your own.

The second part of this post continues here.

Links for 8-13-08

* Imagine our surprise at seeing a client on the front page of CNN:

“AIDS in America today is a black disease,” says Phill Wilson, founder and CEO of the institute and himself HIV-positive for 20 years. “2006 CDC data tell us that about half of the just over 1 million Americans living with HIV or AIDS are black.”

We wrote a two-million dollar funded CDC Capacity Building Assistance to Improve the Delivery and Effectiveness of Human Immunodeficiency Virus (HIV) Prevention Services for Racial/Ethnic Minority Populations grant for the Black Aids Institute in 2004.

* I discussed how to attract and retain grant writers by relying on Joel Spolsky’s Joel on Software for guidance. He also wrote a short book, Smart and Gets Things Done: Joel Spolsky’s Concise Guide to Finding the Best Technical Talent on the subject. To reiterate my earlier point: although Spolsky is writing about programmers, much of what he says is equally applicable to any intellectual worker—including grant writers. Buy a copy and put it on your bookshelf next to Write Right!.

(37signals has a good article on environment and productivity echoing Spolsky’s points.)

* The L.A. Times ran an article attempting something unusual—fresh perspectives on teen pregnancy:

Teenage motherhood may actually make economic sense for poorer young women, some research suggests. For instance, long-term studies by Duke economist V. Joseph Hotz and colleagues, published in 2005, found that by age 35, former teen moms had earned more in income, paid more in taxes, were substantially less likely to live in poverty and collected less in public assistance than similarly poor women who waited until their 20s to have babies. Women who became mothers in their teens — freed from child-raising duties by their late 20s and early 30s to pursue employment while poorer women who waited to become moms were still stuck at home watching their young children — wound up paying more in taxes than they had collected in welfare.

Eight years earlier, the federally commissioned report “Kids Having Kids” also contained a similar finding, though it was buried: “Adolescent childbearers fare slightly better than later-childbearing counterparts in terms of their overall economic welfare.”

To evade the set of angry e-mails and comments likely to follow, I’ll point out that the thrust of the article isn’t that teen pregnancy is a great idea—it’s those involved, rhetorically and otherwise, in the issue might want to consider alternate viewpoints and explanations rather than go back to the usual birth control and sex ed versus abstinence debate.

“Teenage Childbearing and Its Life Cycle Consequences: Exploiting a Natural Experiment” uses a very clever method to get around the correlation-is-not-causation problem in research areas like this, and it’s one of the academic papers underlying the article. You can read it at Duke economist V. Joseph Hotz’s website (warning: .pdf link).

EDIT: In addition, compare these pieces to our later post, What to do When Research Indicates Your Approach is Unlikely to Succeed: Part I of a Case Study on the Community-Based Abstinence Education Program RFP.

* The Wall Street Journal has done excellent reporting on the housing perhaps-crisis, as Isaac mentioned previously. Now comes “Philadelphia’s Housing Woes May Provide Lesson for Lawmakers:”

One point is being missed in this squabble: No matter what Congress does, some cities will end up owning more crumbling houses as owners fail to pay taxes and do their maintenance. Taxpayers will foot the bill. The bigger question is: How can cities quickly get this property back into productive use?

For perspective on this debate, it helps to stroll through Philadelphia’s Ludlow neighborhood, about a mile north of the city center. In this neighborhood and others like it, the Philadelphia Housing Authority became one of the main property owners in the 1970s and 1980s, acquiring homes through foreclosures after owners failed to pay their mortgages or taxes.

One thing you can be sure the solution will involve: grants.

* Well-run career programs that incorporate college counseling and prep classes help low-income students according to a study cited by the New York Times. This is at least a somewhat better study than most, as the New York Times says:

To compare similar students, all those who volunteered to join a career academy at each school were randomly assigned either to participate in the academy or to serve as part of a control group outside the academy.

Nonetheless, it still suffers from the cherry-picking flaw most grant-funded programs do, and it’s encapsulated in one word: volunteered. Those who are at least smart and willing enough to seek help are be definition more likely to do better than those who don’t. Nonetheless, that the group receiving services did better still than the control group is encouraging.

* Freakonomics discusses advice to young and ludicrously rich philanthropists who don’t know much about the world:

They believed that poverty was largely a result of resource deficiencies and organizational inefficiencies: if the poor had more money and their service providers could simply manage their giving more efficiently, change would happen. None placed much emphasis on feelings of self worth, the long-term nature of behavioral change or, most important, that staying above water is itself an accomplishment for a poor household. Everyone modeled their expectations after their family business or other corporate workplaces where they saw the “bottom line” motivate people to meet certain standards of achievement.

* For those of you interested in the academic and systematic aspects of philanthropy more generally, check out the heavy hitters at Creative Capitalism, including Bill Gates, Richard Posner, Gary Becker, Clive Crook, Larry Summers, Ed Glaeser, and Gregory Clark. Alternately, if you want to wait, a book based on the discussions is supposed to be released in 2009. Conor Clarke explains why you might pay for something you can get free online.

* What’s mystery ingredient X for improving school outcomes? Marginal Revolution considers.

* More on parsing RFPs: The Partnerships for Innovation program wants you to:

1) stimulate the transformation of knowledge created by the research and education enterprise into innovations that create new wealth; build strong local, regional and national economies; and improve the national well-being; 2) broaden the participation of all types of academic institutions and all citizens in activities to meet the diverse workforce needs of the national innovation enterprise; and 3) catalyze or enhance enabling infrastructure that is necessary to foster and sustain innovation in the long-term.

That’s not easily understood and doesn’t answer the essential “what” question that an RFP should: what does the program demand that an Institute for Higher Education (IHE) do? The answer is probably “nothing,” and the National Science Foundation (NSF) probably could’ve just said, “We’re giving walking around money to universities so they can use it to fund research or donut eating. Enjoy!”

* An unintentionally funny RFP called the Sexually Transmitted Infections Cooperative Research Centers says:

The purpose of this Funding Opportunity Announcement (FOA) is to stimulate multidisciplinary, collaborative research that is focused on control and prevention of sexually transmitted infections (STIs) […]

Surely I can’t be the only one to read a certain double meaning into “stimulate” in this context, given its juxtaposition with the program title.

* Slate points to a study that found TV watching among the very young might cause or contribute to autism.