Congregations, the Government and Social Justice

Transcript

SESSIONS:
Morning Discussion
Lunch Keynote
Afternoon Session

E.J. DIONNE: This is an extraordinary group, and I refer not only to those who prepared the fine papers and to those thoughtful people who are going to respond to them. I am referring especially to the audience that is gathered here today. You are people with huge experience as scholars and activists and clergy and counselors, public servants; all in all, the doers of community work, and I appreciate your being here.

My hope is that all of you will participate. This is really not an audience; you are participants. I hope you will participate not only by asking questions, but also by offering comments. We are going to structure the program to bring the audience in early. We are going to have Doug give his talk, then have a couple of respondents. And if people have a desire to jump in at that point, please do. Then we will go back to the panel, and we will go back and forth between the panel and the audience. If you have something that you are burning to say that you don't get to in this morning's session, please tell Staci or me before lunch or at lunch and we will bring you in either at the lunchtime discussion or in the afternoon.

I would also like to say that while the subject at hand is a thoroughly legitimate topic for speeches and sermons, I hope out of respect for others, people won't make speeches or sermons and will keep their comments compact. We want to include as many voices as we can. I may have to ask some people to stop talking in the most paternal and compassionate way possible.

Right at the beginning, I want to thank Staci Simmons, whom I think all of you know by now. She's still working back there somewhere. She has done so much good work in bringing you all here and putting this together. At this point, I bet Staci knows more about teen pregnancy than anyone in the room. She's tireless, peerless, a great blessing to all of us who work with her. Whatever goes right today is her responsibility; whatever goes wrong today is my responsibility.

One of my favorite political stories, which my friend Bill Galston has heard me tell too many times, is about Al Smith campaigning in upstate New York when he was governor. From the back of the room a voice shouted out saying, "Tell us all you know, Al. It won't take long."

(Laughter.)

Al Smith snapped back, "I'll tell them all we both know and it won't take longer."

(Laughter.)

Because all of you know so much more than I do about the subject at hand, I won't speak long at all. I want you to talk and to teach and to argue and to reason together. My role is as a moderator and perhaps as the asker of the occasional question. But because you have all been kind enough to give so much time today, I thought it would be fair to explain what this project is about; to paraphrase the good General Stockdale, To explain who are we and why we asked you here.

(Laughter.)

This is the first of five sessions we are planning here at Brookings over the next year or so on the matter of what religious congregations and institutions are doing to solve or alleviate social problems and to assist and organize the needy. Subsequent sessions will deal with crime, neighborhood economic development, child care, and education.

Our purpose is both simple and challenging. We want to look at the good work religious congregations are doing and especially to examine what's working. The questions we want to explore include: What forms of social service and social action are congregations particularly well placed to perform? Which might they accomplish as well as or better than government? What could government do to help and also not to hinder these efforts? What forms of government participation might be dangerous either to congregations or to religious freedom or both?

There is no assumption here that religious congregations could replace most of what the government does, especially in the areas of income, maintenance, health care, and social insurance. But there is an assumption that the churches do a great many good things, that their work needs a great deal more work and encouragement, and that the social situation in America would be far worse without their work.

By focusing on specific social problems such as teen pregnancy today, we hope you will help us surface questions and controversies surrounding faith-based social action in a constructive and concrete way. Beyond that there is no hidden agenda here, or if there is one, then it's hidden as much from Staci and me as it is from anybody else.

(Laughter.)

Our hope is to have a broad dialogue that crosses political and religious and theological lines. Thanks to all of you, today's session will certainly live up to that hope. At the end, we do not expect to resolve all the church/state arguments that divide Americans unless we should luck out and James Madison or his reincarnation walks into the room. Perhaps he is here today. I nominate Bill Galston for that role.

(Laughter.)

For now we can accept that there is a certain confusion on these questions. As Alan Wolfe has written, "200 years after the brilliant writings of Madison and Jefferson on the topic, Americans cannot decide whether religion is primarily private, primarily public, or some uneasy combination of the two."

We do hope, though, that by focusing not simply on abstract, though critical constitutional questions, but on the practical work of the religious congregations and institutions, we might shed light on the broader argument. In any event we do hope we can encourage the good work that's being done and find new ways of supporting it. In the journalistic terms that I'm familiar with, this project is more about reporting than editorializing. Although it just might happen that at the end of all your work, we could reach some useful conclusions.

Each session will be organized as today's is. In the first part, scholars will present papers on what is being done generally in the problem area and what is working. That is Doug Kirby's role today.

In the second, we focus specifically on what the churches are doing about the problem or what is working best; also, what's not working and what's not being done. Deborah Haffner and Pat Fagin will be with us later and have kindly taken on those chores today.

We have our six respondents representing very different experiences and points of view who will comment on the papers. We are hoping they will keep their comments to about five to seven minutes. As I say, I will start up here, go to the audience, and come back here. I am also very grateful that my colleague, Belle Sawhill, who has worked very hard as a scholar and as a citizen on efforts to reduce teen pregnancy, will give a talk at lunch. I am sure she will, as she always does, focus our minds and fill them too. Thank you, Belle.

So, let me begin by introducing Doug Kirby. He is senior research scientist at ETR Associates in California. He has directed nationwide studies of adolescent sexual behavior, sexuality education programs, school-based clinics, school condom-availability programs, and direct mailings of STD and AIDS pamphlets to adolescent males. There is a biography, I think, in some of the packets. Recently he authored "No Easy Answers: Research Findings on Programs to Reduce Teen Pregnancy," which has been widely acclaimed; so widely acclaimed that we asked him today to update it and summarize his findings for us today. We are very glad to have Douglas Kirby. Thank you.

(Applause.)

DR. KIRBY: It is truly a pleasure to be here today for a variety of reasons. First, it is very nice just to be here at the Brookings Institution. It is also nice to see friends in the audience and also new faces. It is also very nice to be here with good news. Some of you who have heard me speak over the last 20 years know that sometimes I have had to report back that certain programs didn't work. That was hard and that was painful. Today I will be talking about programs that do work, because we do have good news and we do have at least two kinds of programs which do have a fair amount of evidence that they really do change behavior in a positive way. I will be focusing upon those programs.

I will be updating "No Easy Answers." I will kind of summarize some of the more recent findings. If I were going to give it a title today, it would not be "No Easy Answers." It would something like "Partial Answers" because we now do have partial answers.

First I want to give a couple of statements and talk a little bit about the problems of teen pregnancy before moving into the partial solutions to teen pregnancy. As many of you know, in this country each year about 890,000 teenagers become pregnant. That is almost a million. Now, it is hard for me to picture 890,000 teenagers. That's a lot of people. If you divide it by the number of days in the year, it is more than 2,000 a day; 2,000 I can picture better. That is a whole school; a whole school of only girls and a full school is getting pregnant every single day of the year.

It is also true that about 40 percent of all teenagers become pregnant before they turn 20; 40 percent. That means if you think of a traditional nuclear family of two parents and two kids — forget the two parents; just think of the two kids — the odds are that one of the kids will get pregnant or will get somebody pregnant before they turn 20. If 40 percent of all females are becoming pregnant before 20, the odds are if you have two children that one of them will become pregnant. That is across the country. That is a staggering statistic in my mind. 85 percent of those pregnancies are unintended. They did not intend to become pregnant. So, it is a real problem.

What is good is that we now have partial solutions to that problem and the teen pregnancy rate and the birth rate have been going down for six years. In some kind of fantasy land, it would be nice to literally be beside every teenager and hold their hand and make sure that they do not have sex or if they did have sex, that they used protection against pregnancy and STD. Obviously that can't happen. Engaging in sex is voluntary. Consequently, we need to look at those factors, the antecedents, the risk factors which affect whether or not they have sex, whether or not they use contraception and whether or not they became pregnant.

What do we find when we look at this? One thing we find is that there are a lot of them. There are over 100 of them. It is not true that pregnancy is restricted to one particular group of people. The best families in the best communities with responsible kids do sometimes engage in unprotected sex and become pregnant.

On the other hand, some groups of youth are more likely to become pregnant than others. What characterizes those groups? Youth who become pregnant are disproportionately likely to live in communities with high-residential turnover, with high poverty rates, with high divorce rates, with high crime rates and high rates of violence. They are disproportionately likely to live in families which have lower levels of education, are poorer; where parents are more likely to have experienced a divorce or separation or to have been never married; where the mothers are more likely to have given birth as adolescents; where the parents provide less supervision; where the siblings are more likely to engage in a variety of problem behaviors and are more likely to accept early childbearing. When we turn to their friends, we see that their friends are more likely to be sexually active or at least the teenagers think that their friends are. When we turn to their partners, we see that they are more likely to have a relationship with a much older male; are more likely to have been sexually abused by somebody.

When we turn to the teenagers themselves, we see that they tend to be older; if they are males, they have higher levels of testosterone; if they are female, they have high earlier onset or menarche. They do more poorly in school; they are less attached to school. They are less attached to religion; they are less involved in their churches. They are more likely to use alcohol and drugs. They are more likely to engage in unhealthful and unconventional behaviors.

So far, I have not talked much about sex. Most of the antecedents I've talked about so far involve things other than sex; they are non-sexual. But there are important sexual antecedents as well. They are more likely to hold permissive attitudes towards pre-marital sex; more likely to have negative attitudes towards condoms or other forms of contraception.

They have lower self-efficacy in terms of getting and using contraception and lower self- efficacy in terms of saying no to sex. Perhaps most important, they are either more likely to want to have a child or to be ambivalent about having a child.

So, to summarize all of that, what does that tell us? That tells us that there is group of antecedents or risk factors or protective factors that are related to sexuality. We need to address those; sex and HIV education programs do that. There is a much larger group that doesn't involve sexuality. There is a much larger group which involves a great many other things and we need to address those. These development programs or some of them do, in fact, address those.

Now I'm going turn to what studies show us about the impact of the first group of programs which only talk about sex in each of the education programs. This one particular slide is a pretty good summary of the evidence. What I have done is to look at studies which evaluated the impact of these three different kinds of programs; sex education programs, AIDS/HIV education programs, and abstinence-only education programs.

What studies are on this list? All those meeting the following criteria. They were conducted in the United States or Canada. They are curriculum-based, as opposed to individual counseling or mentoring. They targeted middle-school youth or high-school-aged youth. They employed experimental or quasi-experimental designs. That means we had program groups, intervention groups, and comparison groups, pre-test data and post-test data and sometimes follow-up data. They measured impact upon actual behavior and not just in terms of attitudes. They have all appeared in peer-review journals or major volumes or major reports. These studies do vary in terms of their quality. But nevertheless, they meet certain minimal standards in terms of peer-review and in terms of characteristics I have just described.

What do we find when we look at them? One thing we might want to ask ourselves is, do they have any basic kinds of impact other than behavior? The answer is that almost all of them increase knowledge. But what about behavior? A concern expressed commonly in this country is, do they increase sexual behavior? That is a real concern. That is not necessarily implausible. After all, the first two groups of programs do talk about sex, do talk about contraception, and do explain exactly how they can have sex and use protection against pregnancy and STD. So, it is plausible that these programs might increase some measure of sexual activity. However, we find out that they don't. So, it is a plausible idea, but it's not a correct idea.

Now, how do we know that? Turning to this graph, we find that there are three different measures which are commonly used to measure impact of programs upon sexual activity: The impact upon the age of initiation of sex; the delay of sex; if they have had sex, the number of sexual partners and their frequency of sex. Those are three good measures.

Turning to these programs, we look at the first column, the initiation of sex. All across in this table a plus sign means that it had a desirable impact. "NS" means that it had no significant impact. The minus sign means that it had an undesirable impact. We see that there were 25 different programs of sex education and HIV/AIDS education which measured impact on initiation of sex; 25 such programs.

Of these 25 programs, 18 of them found no impact; zero studies found that the programs hastened the onset of sex. Similarly, no programs found that they increased the frequency of sex, and no programs found that they increased the number of sexual partners. So the clearest, strongest statement that we can make about almost anything in this field is that sex education programs and AIDS education programs which talk about contraception do not increase any measure of sexual activity. That is very well established by all of these studies.

You can ask the question, do they reduce sexual activity? The answer there is that some do and some don't. 7 out of 25 delayed the onset of sex. 6 out of 16 reduced the frequency of sex. 3 out of 9 reduced the number of sexual partners. These are programs that did talk about contraception and which also emphasized, however, abstinence. We know that almost all programs today do emphasize abstinence. Some also talk about contraception and AIDS, and some do not.

Do they have an impact in terms of increasing protection against STD, AIDS or pregnancy? We find there in the column of use of condoms and use of contraception, some did and some did not. Out of 14 programs, 9 of them increased the use of condoms. Of those, 8 out of the 10 AIDS education programs increased the use of condoms. That's quite a high success rate; 8 out of 10 found that they significantly increased the use of condoms. Turning to contraception, there the success rate is not quite so high among sex-ed programs; 3 out of 13 found that they increased the use of contraception.

I think we can conclude that some of these programs are having a positive effect; none of them are having a negative effect. Fortunately we can distinguish between those which are having a positive effect and those which do not. In a couple of minutes I will talk about what characterizes those that are effective and those that are not effective.

There are two studies, two programs in particular that have particularly strong evidence of their effect. One of them is "Be Proud, Be Responsible." The evidence there is strong for a couple of reasons. The first is there is a strong-research design. They randomly assigned youth, tracked them for three months, and found that it increased the use of condoms. Then they did a second study in which they modified the curriculum a little bit to produce actually two versions. One focused more on safer sex and the other focused more upon abstinence. They tracked the youth for a year. Over that year's period of time, they found in both cases that those two variations had a desirable impact in terms of increasing condom use, also delaying sex and reducing unprotected sex.

So, we have three studies showing that the same intervention with slight modifications did have a positive impact. That is really quite important. It's important to find not just one study is showing that something works; but then to have two additional studies that show that the same program or modifications of it, in fact, had an impact in different settings.

The second program for which I think there is good evidence is called "Reducing the Risks," which was later modified into "Safer Choices." Its initial evaluation showed that it delayed sex and reduced unprotected sex. An independent evaluation in Arkansas by other evaluators and different program people also found that it had the same positive effects. It was then implemented a third time as the first part of a two-year sequence in Texas and California. Again, it was found to have a positive effect.

Here again, we have three studies showing that the same intervention or a slight modification of it had a desirable impact in terms of reducing sex or increasing protection against pregnancy and STD. The last study involved a random assignment of 20 schools and the implementing of the intervention school-wide.

When I look at all these studies, I find them increasingly to be very encouraging and to be increasingly compelling. I think the evidence is strong that these interventions do have a positive impact; increasingly strong, because there is a multitude of studies, because some of them are very well designed with random assignment, long-term follow-up, large sample sizes, measurement of behavior, proper conduction of statistical analysis, balanced recording of results. This is also increasingly compelling because multiple studies are now finding the same curricula to be effective. I find that really very encouraging.

There have been four studies that have measured the impact in terms of delaying sex upon other abstinence-only programs. None of those programs found a statistically significant impact in terms of delaying sex. We go across and we also find that there is not much evidence in this table indicating that abstinence-only programs have had an impact. Therefore, one might be tempted to conclude that abstinence-only programs do not work. I think that conclusion is premature, and I think that, in fact, the jury is still out.

Why do I think that? Abstinence-only programs, in fact, represent a very, very heterogeneous group of programs. Some of them are very short; some are very long. Some have a single component; some have multiple components. "Best Friends," for example, involves a lot of activities like youth-development activities over multiple years with a clear abstinence message. That is very different from one or two hours of didactic presentations about encouraging youth to delay having sex. Some are didactic; some involve a lot of active learning or interactive kinds of activities with the youth to get them involved. Some start with prayer asking for God's guidance and help and end with prayer; others are very secular. What we find is this is incredibly diverse in heterogeneous groups of programs. I don't think that we can conclude that none of those programs work given the studies that are here.

Another reason we cannot conclude that is that some of these studies are, in fact, very limited methodologically. They had small sample sizes; they didn't track youth for an especially long period of time. So, the jury is still out; we don't know.

People ask me, Doug, what do you honestly think? Do you think they work? Do you think they do not work? I think the question is too simple. The answer is probably that some of them do work and some don't. Some work with some groups of youth and not with other groups of youth. We don't yet have the evidence to know which ones do work and which ones don't work. That is evidence that we do need to obtain.

A moment ago said that I recognized that there were some sex and HIV/AIDS education programs which were effective and there were some which were not. We can look at the group that were effective and compare them with the group that were not by looking at the criteria, by looking at how well it was implemented, et cetera. When we do that, we find that there are these ten characteristics. Today I really don't have time to go over these in much detail. I will make just a couple of statements about them.

Most of the characteristics of the effective programs essentially involve good pedagogy, good teaching practices. They actively involved youth. They got youth to think about things to personalize behavior. They gave them knowledge, but they did not just give them knowledge. They taught them skills, they tried to change their norms, they had a very clear goal from the beginning, that very clear goal of changing behavior, and all the activities were directed toward those goals. What's not so important is exactly what these ten characteristics are. What I think is important is that all the programs that have these ten characteristics have been demonstrated to be effective at reducing unprotected sex, either by delaying sex or increasing the use of protection. Knowing that, I think, is very encouraging.

These programs have addressed the sexual antecedents that I mentioned at the very beginning. There is another cluster of programs which address not the sexual antecedents, but the non-sexual antecedents. As kind of broadly defined, we can think of these as youth-development programs. They are a very diverse group.

Before I talk about some of the various individual programs, I wanted to just have us think for a moment about what has happened in our own country and about what has happened throughout the world. If you look throughout the world, one thing that we have found is that as you increase the educational level of young people, you end up increasing their motivation to avoid early childbearing and the teen birth rate goes down. We have seen that in one developing country after another.

In this country, in the mid-1950s, the teen birth rate was twice as high as it was about 20 years later. We cut our teen birth rate approximately in half between the mid-1950s and the mid-1970s. Several things happened during that period of time. One factor that happened was the increased availability of contraception. Another important factor was that during that period of time, an increase in proportion of young women in this country decided that they did not want to give birth when they were young teenagers. They wanted to delay childbearing; they wanted to pursue college, higher education and careers. They did so. So, a variety of things led to a greater motivation to delay childbearing. That is what I think some of these youth-development programs do.

When we look at them, there are five or six, depending upon exactly what criteria we use for measuring the impact. One of the early ones was the "Youth-Incentive Entitlement Program." Basically this was an employment program among inner-city, low-income, African-American youth. It took place in four different communities, in four comparison communities. They guaranteed every high-school aged young person a job in the community. That was basically the program. It guaranteed them a part-time job during the school year and a full-time job during the summer with the understanding that they had to remain in high school. What happened? Employment among youth increased. Drop-out from high school, the drop-out rates decreased. Birth rates also decreased community-wide in those communities in comparison with the relative communities.

The second program was not community-wide. Rather it involved the random assignment of individual youth. This is a teen-outreach program. In the teen-outreach program, youth did volunteer service in the community. They did at least 20 hours per year, which is not a huge amount, but at least 20 hours and some did many more than that. They also engaged in weekly discussions of a whole variety of topics. These discussions were about what they, themselves, were getting out of this experience, what they wanted to do with their lives, decision-making, values, communication skills, relationships, community resources, et cetera. There were a whole variety of things. The curriculum was not well followed. So, it was not that it had a great curriculum. Rather the belief is that it was the quality of the community service and the reflection upon that service that made a difference. The teens who participated in that following year were less likely to become pregnant, were less likely to drop out of school, and had higher school performance.

The "Quantum Opportunities Program" is the only one I will mention that did not have a statistically significant impact at the .05 level. Everything I have talked about today has been at the .05 level or better. This was .09; it had a small sample size. The "Quantum Opportunities Program" had a whole cluster of activities including computer-based instruction, family life and education curriculum. Again there was community service and a variety of different kinds of things. What we found was that the participants in that program had lower birth rates; again the peak was .09 level during the following couple of years.

The next program was the "American Youth and Conservation Corps." It is now a part of AmeriCorps, but it is the youth who participated again doing projects in the community. This time they were paid. Sometimes this was residential; sometimes it was not. They received remedial vocational and academic education. In a random-assignment large study, what did we find? African-American women who participated had lower birth rates than those who did not participate.

A quite different kind of program is the "Seattle Social Development Program." This was designed to increase attachment or bonding between youth and schools or between youth and their families. So, there was a component to change the way the teachers taught, to change the climate in the classroom. There was also a component to change the way that parents related with their kids and also to change some of their parenting techniques, et cetera. What did we find when we followed for ten years those who participated? The schools that participated in the program had lower pregnancy rates and a lower drug-use rate and a lower drop-out rate, et cetera than in the school that did not participate.

These programs are diverse, and there are others which don't have such strong evidence, but also indicate the same thing. A common quality across these programs is that there is greater involvement with adults of some kind; greater attachment with the schools, with the parents, with the communities. Another common quality in many of them is the idea of doing voluntary service in the community. Having some experiences in which you are doing some good may increase your belief that you can do something with your life. It may just make you feel good. We don't yet understand the dynamics that are operating. But what is true is that we now have five or six studies, all of which showed that this collection of programs, quite diverse, nevertheless had a reduction in either pregnancy or childbearing rates. I think this is very encouraging.

I didn't talk much about the kinds of programs for which we don't have strong kinds of evidence. There are many studies that have been done now of school-based clinics, of school condom-availability programs, of programs to increase child and parent communication, of media programs, et cetera.

One thing is clear from all those studies: even when you make condoms or contraception available in schools, the measures that measure the same three levels of sexual activity do not increase. Making condoms available does not cause kids to go out and have sex or to have sex with more partners or to have sex more frequently. The data consistently show that that is not the case. On the other hand, the data is inconsistent in terms of whether or not these programs increase the use of contraception. Some studies show that they do; other studies show that they don't. We don't really know why we are getting differing results. Maybe they work in some places but not others. It may be other limitations of methodology.

What we do have is two kinds of programs which I think we now have quite strong evidence that they have a desirable effect upon youth, either by delaying sex, increasing the use of contraception with protection against STD and HIV, or reducing actual pregnancy and childbearing rates. Those two kinds of programs are the STD and HIV/AIDS education programs and the youth-development programs. They do address the different sets of antecedents. In my mind both kinds of programs are needed in order for us to have a comprehensive and more effective approach to reducing teen pregnancy and teen childbearing in this country.

What I think is quite encouraging for this conference in particular is that quite a number of these programs can, in fact, be implemented by faith-based communities. We can tell them that here are some things that you really can, in fact, do that will have a desirable effect on behavior.

Thank you very much.

(Applause.)

DIONNE: Thank you very much. I would like to introduce our respondents and they will talk to you in the order that I introduce them. As I said, I may interrupt the respondents to go to the audience. So, after the first two respondents, if someone has a burning desire to jump into the conversation, please feel free to do so at that point. Then we will go back to the respondents.

Bill Galston, as I said, is my nominee for the James Madison walk-on in this session. He is the chair of the Task Force on Religion and Public Values at the National Campaign Teen Pregnancy. He is a professor in the School of Public Affairs at the University of Maryland, College Park. He was deputy assistant to President Clinton for Domestic Policy. He worked on a lot of political campaigns, both victorious and otherwise.

MR. GALSTON: Mainly otherwise.

(Laughter.)

DIONNE: He has been working on this issue for a long time.

Angela Greene is the senior research analyst at Child Trends, Inc. She joined the staff in 1994. She is currently working on a collaborative research initiative designed to study the association between measures of religiosity and adolescent outcomes including sexual activity and teen pregnancy.

Sister Mary Rose McGeady is a member of the Daughters of Charity, one of the most famous nuns in America. She has been president and chief executive officer of Covenant House since 1990. I have to mention that she got her degree in sociology from Emmanuel College in Boston, because that is where my sister went to college. In 1981 she became provincial president of the Daughters of Charity — that means she was the boss — and served six years in that post. As many of you know, Covenant House has been around for 26 years; it's served 480,000 children and adolescents.

Patricia Funderburk Ware is here for her expertise, but fortunately she adds drama and glamour to the program, which I certainly won't provide. She is, among other things, a former actress. She's also been a consultant for the National Endowment for the Arts and institutions and agencies across the country. She is now president and CEO of PFW Consultants which provides training in the areas of teen sexuality, pregnancy, and HIV/AIDS prevention. She is the former director of Educational Services for Americans for a Sound AIDS/HIV Policy.

The Reverend Carlton Veazey is President and CEO of the Religious Coalition on Reproductive Choice. He has been in that post since July of 1997. He is pastor of the Fellowship Baptist Church in Washington, D.C. He has been in successful political campaigns including his own. He was a member of the D.C. City Council from 1970 to 1973. For more than two decades he served in D.C.'s Department of Employment Services.

Finally John Buehrens is himself a walking embodiment of religious dialogue. He's been married since 1972 to the Reverend Gwen Langdon Buehrens, who is a parish priest in the Episcopal Church. He is the president of the Unitarian Universalist Association. He has served in that post since 1993. He has also had a successful political campaign. He was re-elected for a second four-year term as president of the UUA in 1997. He is responsible to the UUA Board of Trustees for administering staff and programs. He also act as a principal spokesman and minister-at-large for the association. Afterward I want to find out how you become a minister-at-large. I like that idea.

(Laughter.)

Let me turn first to Bill Galston.

MR. GALSTON: Well, let me begin by saying that I am certainly not here to argue statistics or program evaluations with Doug Kirby. That would be a fool's errand because, in fact, nearly everything I know about the social science of this area I learned from Doug.

I do want to say at the outset that I think that the summary of program effectiveness that you have just received is as close to being comprehensive and authoritative as anything that is out there. I do want to emphasize that this represents an enormous change in our knowledge in a very few years.

One of the first things I did when I entered the White House in January of 1993 was to say to myself, and then to a few other people, We need to get more active in this area of teen pregnancy reduction and prevention. What do we know? So I phoned over to the Department of Health and Human Services, assuming that they would have a file somewhere of what we knew; they didn't. There were various reasons why they didn't, but one reason was we did not know all that much in 1993. So I spent a number of months phoning around the country to people responsible for particular programs and for people who were doing bits and pieces of evaluation to find out what was going on and to begin to piece together only a small fragment of the much richer evidentiary tapestry that Doug has presented.

The first point I want to make is that in 1999, as opposed to 1993, we are way up on the learning curve. I think Doug and the organizations that have supported him, including the one that has Belle Sawhill as president, deserve a lot of the credit for making this happen.

In the next five minutes, I want to meditate on something I do know a little bit more about independently, namely the relationship between the body of evidence with which you have just been presented and faith communities. I want to put that issue on the table in a very preliminary way, and we can return to it more fully in the afternoon.

I want to make three points. The first point is that the topic that E.J. has called us together to discuss today is absolutely critical because faith communities are at the heart of America's civil society. They are not at the heart of every country's civil society, but they are at the heart of America's civil society. If you ask what keeps us in the lead as a nation of joiners if you look at the international statistical comparisons, the answer to that question is it is our distinctive propensity to ban together in faith-based communities. There are other countries in Europe that actually have denser per-capita representations of secular communities and organizations. What gives us the edge is the extraordinary diversity and the strength and pervasiveness of faith-based communities in America.

So, to the extent one is talking in America about civil society as a complement to public-sector activity, one is inevitably talking about this topic to a much greater degree than one would be talking about it in France, Germany, Sweden, Italy, et cetera. In some neighborhoods, faith communities are the dominant institutions. In those neighborhoods, many of which are located in America's cities, that is really where the center of the action is. Not to look at this carefully would be to ignore the greatest reservoir of energy and commitment and hope in many parts of America today.

Here is my second point. If we asked why faith communities are potentially important in imbibing some social science lessons that Doug and others have presented us with in helping us to make progress in this issue, there are some things that it seems to me emerge not only from common sense but from the social science literature itself. Faith communities are a very important part of the process of cultural change in the United States, and cultural change is an important part of social change. One thing that Doug did not mention in his presentation is that since the early 1990s there has been a significant and, some would say, providential reduction in early teen sexual activity and in teen pregnancy, statistically quite significant, and to some of the pessimists of the late '80s and early '90s, quite startling. If you ask why that has occurred, I don't think we can say that all these successful programs put together would account for the change. We could have an interesting discussion of what percentage of the change would be accounted for by these successful programs. My intuition is a relatively small percentage. There is something larger in the air that's happening, and faith communities historically in America and up to the present day have been a very important part of changing a climate of opinion, changing moral and human assumptions.

I think the faith communities, secondly, are very important in establishing care, connection and community. A lot of what we know of the social science literature suggests that young people who are connected to something outside themselves are more likely to grow up positively. Similarly, there is a growing body of social science evidence that suggests that there is a connection between serving others and caring for one's self. Faith-based communities are in a distinctive, but not entirely unique position to forge and strengthen that connection. I would also argue that faith-based communities are in a distinctively strong position to engage the whole person in the whole process of growth and renewal and not to treat a young person as a client and to minister to a small piece of that person's life.

My third and final point concerning the relationship between faith communities and social science is that, in my judgment, there is a complex relationship between faith communities and social science that we need to think about very carefully and pay attention to the complexity. Here I will make three points very briskly.

First of all, from the standpoint of faith communities, the issue is in part the effectiveness of the particular program, but also in part the consistency of that program with one's specific faith tradition. So, it is entirely possible that from a perspective of a particular faith community a program will be effective as measured by the canons of social science, but nonetheless inappropriate, given the specific commitments of faith traditions. Given the extraordinary religious diversity in the United States, one would expect that that diversity would be — and I would argue from the faith perspective should be — mirrored in the varieties of approaches that they adopt. So, the national campaign has used a slogan here as elsewhere "Unity of Ends, Diversity of Means" to talk about the faith communities in this area and not only the faith communities.

In addition, faith-based action, by the very definition and meaning of faith itself, will and perhaps ought to get out in front of social science. After all there are some traditions that teach us that faith is the evidence of things unseen; not mine, but some. That is a distinctive kind of evidence. It may be that that evidence over time will turn out to have power.

Can this be justified? I think it can be, because as Doug's presentation emphasized, it is not infrequent that our demonstrable knowledge of program effectiveness lags behind the effectiveness or the actual effectiveness of individual programs. So, a faith community may be doing something that works, even though from a social science perspective we cannot tell the rest of the social science community that it's working.

There are all of these complexities in the relationship between social science findings and faith communities, none of which gainsay the decisive importance of knowing from a social science perspective what works and what does not work.

Thank you.

DIONNE: Thank you so much, Bill. Could I call on Angela Greene, please.

MS. GREENE: Yes. Good morning. I would first like to point out that, as E.J. Dionne mentioned in my intro, we are beginning a research initiative at Child Trends Designs to examine the association between religiosity and adolescent sexual activity. So my participation in this round-table discussion is particularly timely. These papers have really, truly provided a great introduction to this area of research.

We had the benefit of actually reading the full papers before this round-table discussion. So some of my points may be more related to the paper than what Dr. Kirby noted up here today. I found his paper to be an extremely informative review based on methodologically sound evaluations. I am coming from a social science research perspective and I was, therefore, looking for methodologically focused types of interventions.

The main criteria of the seven that he named were quasi-experimental designs with both interventions and comparison-control groups; pre-test, post-test data; and a sample size of at least 100. Because of the very rigorous methodological criteria that was used, we can be generally confident that the effects that Dr. Kirby noted on adolescent behavior can be attributed to the intervention itself rather than other factors.

I want to begin by summarizing very briefly a few of the points that he made that I considered to be particularly salient. First, despite some beliefs to the contrary, sex and HIV education programs that include open discussion about sexual activity and the use of condoms do not lower the age of first sexual intercourse or increase the frequency of sexual intercourse or the number of partners. In fact, as Dr. Kirby showed us, there is evidence that these 7 programs have impacts on the age of first sex, actually delaying the initiation of first sex, and 6 of 16 programs reduce the frequency of sexual activity, and 3 of 9 reduce the number of partners.

Secondly, many of the sex and HIV education programs also increase the use of contraception, specifically condoms among teens. The majority of these programs were AIDS and HIV education programs. These findings may be particularly important to the implementation of programs in church settings. Some may not realize this, but some research suggests that many actively involved youth who are involved in churches are also sexually experienced. In addition to the threat of pregnancy, there is also the potential for the spread of sexually transmitted diseases, which as many of you know can lead to major health problems such as infertility and cancer, not to mention the devastation of AIDS.

Thirdly, Dr. Kirby points out that abstinence-only programs, at least thus far, have not been found to be successful. He explains some of the reasons why we may not be able to document the success of these programs. One of the things that he noted in his paper, however, that I thought was particularly interesting was that one program called "Best Friends" combines the focus on abstinence with a very strong youth development kind of curricula. That may be found under another evaluation right now, I think. It may be effective in postponing the initiation of first sex. Dr. Kirby in his paper recommended that sex or AIDS education programs emphasize abstinence and encourage the use of contraception among sexually active youth. He also provided a list of ten characteristics of effective curricula that can be adopted by churches.

Finally, Dr. Kirby described a second set of successful programs that fall under the category of youth development. As he explained, these programs employ a holistic approach by focusing on the improvement of the youth's life skills and options as they transition into adulthood. Child Trends did a review of factors associated with teen parenthood. As Dr. Kirby noted earlier, there are over 100 factors overall. In this case, there were four broad types of risk factors that were identified in the review that we focused on. They were early school failure, early behavior problems, family dysfunction, and poverty. So, we are talking about many singular ones under these broad headings.

What I consider to be a possible thing that is going on with the efficacy with the youth development programs in particular is that they may be addressing some of these risk factors in those domains as Dr. Kirby pointed out. This is achieved by increasing the motivation of children to actually delay childbearing and actually showing them the potential of a very promising future by getting them involved in the various activities. Also helpful is linking them with adults in a mentoring capacity, getting them involved in community programs. For that reason I believe that the youth development approach may be particularly appealing to churches and faith leaders because it can be implemented with or without a sex education component. It is also consistent with the efforts of most faith traditions to enhance the whole person. I thought that was very interesting because Dr. Kirby used that term, the whole person. I consider that to be another possible feature of that. Youth development curricula can be incorporated into existing church youth programs and can be combined with religious teachings and church doctrine.

I also agree with Dr. Kirby's assessment in his paper about the merits of combining youth development and sex education, realizing that they may be more effective in combination than separately. I agree that faith leaders can play and important role in this task. Faith leaders may be encouraged to seek a sex education curricula that is both effective and suitable for the youth of their congregation.

For instance, this was something that was not particularly focused on in the paper and I understand for time purposes this was not included in the discussion, but one of the issues was whether the efficacy of the various approaches that were highlighted here differ by factors like the youth's race, ethnicity, family income, or urban or suburban residence.

Finding curricula that is appropriate and consistent with the prevailing values of the congregation is necessary, and it may be important to include parents in decision-making about curricula. Alternatively, faith leaders can refer their youth to existing, effective community programs. This strategy requires that community program directors reach out to faith leaders or vice versa so the congregations can become familiar with all aspects of the program so that they can work together effectively. That way churches can then assume the role of provider or alternatively refer you to and support other community organizations.

It is particularly important to raise the awareness of faith leaders regarding the issues of teen pregnancy and sexual risk-taking and the availability of resources such as effective programs and curricula on both youth development and sex education. I thought perhaps Dr. Kirby's paper, which I consider to be a really good introduction, should be made available to faith communities, especially the ten characteristics of effective curricula.

I consider this paper and presentation to be illustrative that science and religion do not have to be in conflict, but instead can be mutually reinforcing.

DIONNE: Thank you very much. I was raised to be both admiring of and deferential toward nuns. So, I am now going to give my seat to Sister Mary Rose McGeady. Before I go to her, however, I just want to see if anyone in the audience wants to jump in here.

Ma'am?

QUESTION: Sarah Brown came to the American College of OB/GYN two years ago and said the public health approach to teen pregnancy prevention has failed, and I could not agree more. What we need to do is to look at values. Now, Dr. Kirby, your paper really puts it all on the same line, even though you are talking about safer-sex programs versus abstinence programs. Nevertheless, you are using the same criteria. I think we need to step back a bit and find out, you know, okay, whose idea is it to prevent teen pregnancy? Is it the adults? Is it the society that's paying for it? Or is it the kids? Does anybody ask them? I have a lot more things I would like to say but not now. Thank you.

DIONNE: Do you want to say something to that, Doug?

DR. KIRBY: I think it is probably all of the groups that wish to reduce teen pregnancy. Certainly our society does; certainly adults do. The fact that 85 percent of the pregnancies are unintended certainly suggests to me that the teens themselves are not desiring to be pregnant at that age. There is also other data indicating that many of them wish that they had not become pregnant and many of them wish that they had initiated sex at a later age.

In terms of a public health approach as opposed to values, I don't think they are antithetical. I think you can combine the two very much. There are lots of values that all faith communities share as well as health professionals, values about planning ahead of time and being prepared for something as important as giving birth to a child. All groups would share that value and all groups would share other kinds of values. So, I don't think they are necessarily in opposition. I think there is a lot of overlap.

DIONNE: There is a lady over here. Yes, ma'am?

QUESTION: I'm from the Delaware Division of Public Health, Adolescent Health Director. I just wanted to ask a couple of questions.

Dr. Kirby, when you listed the characteristics of effective programs, one of those characteristics was that it had to last for a significant period of time. Yet one of the curricula that you pointed out was the "Be Proud, Be Responsible," which we use in Delaware and I like very much. But people have challenged us on that because it only lasts for six hours. So, what is a significant period of time?

DR. KIRBY: Sure. The answer is that it depends.

(Laughter.)

No easy answers and no simple answers. It depends in part upon how it is being taught. An interesting aspect of "Be Proud, Be Responsible," which is short, is that it is conducted in very small groups, typically groups of about six to eight youths. That's the size of the groups that have been used in the evaluations. When you work with a small group of youth, you can be more efficient in terms of time than when you are dealing with a large classroom.

Another important characteristic of the young people that are involved in the study is that they all volunteered. If youth volunteer, then they are probably more open to a message, probably more receptive to it than they are if they are in a classroom where they are forced to be there and they are a captive audience.

Now, being in a classroom has an advantage; you have a captive audience and you can reach lots of youth easily. Nevertheless, if they are a captive audience, it may take more time to work through. If they are volunteer and you are in small groups, you can have an impact in a shorter amount of time.

QUESTION: The other point Ms. Greene mentioned as from your paper and I wanted to make sure that this is, in fact, what you did say in that paper. I have been calling around the country, because Delaware does not happen to be one of those states where we have falling teen pregnancy rates. We have rising teen pregnancy rates. So, we are really searching very diligently trying to find programs that work. She was addressing the issue of youth development and excluding the sexuality component. Did you, in fact, say that you would recommend that? Did I hear that correctly? You said that they could implement the youth development without the sexuality component.

MS. GREENE: What I said was that his recommendation was that the two be put together because they would be more effective together?well, Dr. Kirby can tell you what he believes anyway.

(Laughter.)

QUESTION: Okay, I was asking because I have made phone calls across the country to people who have national youth development programs that have received some level of recognition. I have asked them, If you had to cut some of this out because we can't do all of it, what do you think is the core that necessarily has to be there? And every single time they have said, You have got to leave the sexuality education component in there. Now, those are the people that I have talked with. I've talked with people in the Denmark, South Carolina, program; the New Britain, Connecticut, program.

DR. KIRBY: My response would be that it depends in part upon the program. It's certainly true that for some of the youth development programs, the sexuality component is a key component. Then for a couple of others, it is not. There are some youth development programs — the first one I mentioned which was an employment program — to the best of my knowledge they never ever talked about sexuality. There was no classroom component. It was basically an employment program which kept youths in school and gave them jobs. Probably, and we don't know why, that increased their belief in the future. Probably that increased the relationship, their contact with adults. It also to a slight extent, of course, reduced the amount of free time that they that they might have spent having sex. We don't know why, but it did not have a strong sexuality component. The evidence suggests but does not prove that it worked. Others do have strong components.

DIONNE: I want to ask people to hold their questions. I would like to have a couple of more respondents, and then I will go back to you. It's an honor to cede my chair to Sister Mary Rose.

SISTER MARY ROSE: Good morning. I would like first of all to thank Dr. Dionne for the chair.

(Laughter.)

Secondly, I would like to thank him for sponsoring today's meeting. I think these are critical issues in our culture. It's wonderful that we have the opportunity to get together to talk them over.

I would like to begin by just saying that I think it is very important as a society to give some consideration to the question of why we are so interested in reducing the teen pregnancy rate. Depending on whom you ask that question to, you get a very wide variety of answers. Are there social considerations that there is a very negative impact in the research both on the child and on the mother resulting for adolescent childbearing and that their futures are very heavily clouded in terms of positive aspects? Is that why we want to protect the child and the mother from teen pregnancy? Is it a medical consideration that many of these kids are physically immature; they're not ready for childbearing? There are many miscarriages among teenagers that get pregnant. Are there economic reasons because of the high impact on our culture and the public responsibility for funding and caring for these teenaged mothers?

We all know the impact that teen pregnancy has had on our national welfare system. I am very concerned about what the future is going to look like for children that are coming out of teen pregnancies because of the changes in the welfare system. Are we worried about the costs of delivery, of pre- and post-natal care, of caring for these children? Are we worried about the cost of day care? I think all of those are real considerations.

Are the primary motives moral motives? Do we see teen pregnancy as a violation of morality, of behaviors that are very contrary to religious teachings about marriage and sex and so forth? Are there cultural considerations coming from what has been a traditional stigma in this country of being an out-of-wedlock child or of bearing an out-of-wedlock child?

I think all of those considerations are part of the dialogue that as a culture we have to deal with all of those various motives for looking at the teen pregnancy considerations. One of the members of our Religion and Values Task Force said at one of our meetings, "You know, we have to be very careful not to throw the baby out with the bath water. We have to be very careful as a society that we don't begin to look upon the baby as a bad result of a bad action by a teenager and to continue as a culture to love and care for those babies and love and care for those mothers of those babies because this is a very, very important piece of our culture."

In many, many cultures, teen pregnancy is a very acceptable reality. That is why it is important for us to deal with the reasons why we want to limit it and what methods we are willing to use to control it. Because I deal with troubled children almost exclusively, I would like to talk a little about the whys that I see from the viewpoint of the teenagers themselves.

First of all, we now have 14 Covenant Houses in the United States, 2 in Canada, and 6 in Mexico and Central America. In every one of those cultures, teenaged mothers is a growing reality for us. Unfortunately, the number of kids that we are seeing who are teen mothers or who are pregnant is not reducing. In fact, it is growing. I was recently in New Orleans at our Covenant House. I met a 19-year-old girl who was on the verge of delivering her fourth baby. Talk about a challenge in terms of planning for this kid. She went only to about the 8th grade. Her achievement level is on about 4th grade. To really try to give this kid hope, to help her to plan a healthy future for herself and her four children is a tremendous challenge for us.

When I look at these kids, I see kids who have very few satisfactions in their lives. I think that is one of the reasons that some of them turn to sex. This is one area where they can achieve, because by and large their lives have been characterized by failure, by lack of achievement. Dr. Kirby's paper pointed out very, very well the characteristics of large parts of the population of teenagers who get pregnant that I see in these kids very few experiences in their lives that are calculated to build self-esteem. Often they come from families that are characterized by internal conflict, by breakdown. A lot of these kids are kids that have been passed around all their lives.

By the way, the latest foster-care statistics say that kids who age out of foster care at 18, within a year 50 percent of them are homeless and 50 percent of the girls are pregnant. This is another antecedent that we need to keep looking at as to what is really contributing to the reality of teen pregnancy. It is very rare that we see a kid that is coming out of a happy home. Very frequently we see that these kids are school failures or almost school failures. There's a very high dropout rate.

I just put the staff in a public high school in the Bronx, at their request. This school admitted 1,400 freshmen on the first day of school. Only 90 seniors came back out of a class that just three years ago had had 1,400 freshmen in it. The dropout rate in that high school is 88 percent. The graduation rate for last year was only 6 percent. We need to look at what is happening that such a high percentage of our high school kids are quitting school. We need to look at how we can build more success into the lives of our teenagers, because from my experiences to deal with teen pregnancy is to deal with a small piece of the problem. For girls that come into Covenant House pregnant, we cannot deal with the pregnancy per se. We need to deal with the whole person. I am delighted that that is coming out of this group as a key phrase — that we need to help her deal with her pregnancy, but we need to help her deal with her whole life and to put things together in a better perspective.

Also, when it comes to churches, I think it is very important to become a significant other in the life of these kids, they need more than religious education, they need more than help with worship, they need more than to develop a religious identity. They need a relationship with God. They need to hear that there is a God who loves them, who created them, to whom they can pray, who really cares about them.

For those of us who are in the role of caretaker, we need to model the love of God for those kids. We need to care about them in a holistic way. We need to really try to make them happy when they are with us and to help them to plan for a future of happiness. When it comes to relationships, these kids are starved for relationships. So many of the significant others in their lives have been the people who let them down. Oftentimes they have had very poor or very temporary relationships with their parents. The number of kids who are going into foster care every year is increasing. Many of these kids have relationship histories that are histories of disaster. So, first of all we need to model relationships and then begin to say to them, You can develop a relationship with God.

I have had kids say to me, "Why are you nice to me? What's in it for you?" That's kind of the kind of patterning in their relationships with people that have been a part of their history. They are not used to having relationships with people that are positive and caring and contributing to their ego. I feel, therefore, that to deal effectively with the sexuality issues, it has to be in the context of total caring.

One of the things that we are very happy about in our Covenant Houses is that oftentimes we have these girls for as long as two years during which we help them to finish high school, to get job training, to get a job, to get ready for independent living for themselves and their babies. It is very rare that we have a second pregnancy among those girls. We attribute that to the fact that we created a total context for life for those kids in a caring atmosphere. Definitely we teach them the morality of sexuality, that it is very much part of their relationship with God and what he expects of them, and how they need to care for themselves because God expects that from them, too. But you cannot do that in a unitary way; it has to be a part of a whole package.

I will stop there. Thank you.

DIONNE: Thank you for that very moving discussion. I would now like to turn to Patricia Funderburk Ware, otherwise known as Pat Ware.

MS. WARE: I want to add just a few things to my introduction so those of you who may not know me will not think my only credentials are that I have been an actress.

(Laughter.)

DIONNE: Like I said, more than an actress.

(Laughter.)

MS. WARE: I know, but sometimes, especially when I'm talking to youth groups, that's just all they can remember, the whole thing. But I did direct the Office of Adolescent Pregnancy Programs for the U.S. Department of Health and Human Services. I do serve on a number of boards and committees that deal with young people. One that I am most proud of is Reaching the Youth of America, which is an organization out of San Antonio, Texas, that provides caring services for homeless teenaged moms or pregnant teens. These are girls from the age of 12 to about 16 who are on the street because they are pregnant or they are parents. I also lived in a very devastated inner-city community as a single mom. That's where people tell me I got my passion for these issues on teen pregnancy and drug abuse and that kind of thing.

The presentation this morning, Dr. Kirby, was fascinating. I appreciated having a copy of the speech prior to coming here. It reminded me of a session that I had with a group of African-Americans who are very interested in economic development issues, because I have also been very involved in revitalizing inner-city communities and have created an organization that helps people who are on welfare to actually get off welfare, buy their own homes, go into businesses and all of that. I understand completely about youth development organizations that deal with the total person, the total entity.

We had a meeting not too long ago of these people, and we talked about research findings, not simply teen-pregnancy-prevention programs, but other kinds of programs that particularly affect African-American, economically disadvantaged people. Once we dissected the findings, we walked away with something very different than perhaps was explained to us by a social scientist that reviewed the report, not saying there was anything wrong with the reviews or the ways in which they had been interpreted.

For example, Dr. Kirby, with these programs that you reviewed, we were fortunate enough to have other researchers who also looked them to help us interpret them a little better. We walked away feeling, yes, they may have had some impact on behavior. But is this the level of impact that we, the people who are tremendously concerned about the health of our kids, think that is enough or is the kind of program we want to replicate.

One first things we are doing is to help our people understand the research findings to know how to interpret them for ourselves, look at what has gone on in the program, and to determine if, indeed, we would make the same conclusions that perhaps someone else would make.

I think it would be very fascinating to have some of the other researchers with whom we have talked to be in a room with Dr. Kirby so that they could look at these together, because we have seen these same programs interpreted a little differently for us. In the session that I was in, it continued some of the suspicions that we, particularly as African-Americans, have about research findings and how they are interpreted. One of the things we are challenging ourselves to do again is to learn how to look at these findings and make conclusions for ourselves based on what is there. I appreciate, Dr. Kirby, that you did say that the jury is still out on abstinence-only programs, that we don't know. However, the paper doesn't say that. The paper is very conclusive. It says, "However, at this point there are no abstinence-only programs that are known to be effective at changing behavior."

Now, that's the kind of line that is going to make The New York Times and The Washington Post. It will affect a lot of people, but thank goodness, there will be a lot of those who are out there working in the fields with people, with young people especially. Some of the organizations that I serve on like "Best Friends" who know because they are there, the thousands of people who are impacted by that program. But there are, indeed, programs that work.

Dr. Kirby is right; the jury is still out, and we are working to do all we can to correct some of the mistakes of these programs. Number one, not having these evaluations that could be in peer-review journals. Unfortunately statements are made about very few programs — I think there are four — that were looked at. So, sweeping statements are made that no abstinence-only programs work because of these four programs, three of which I understand did not have great evaluations.

But I would like to put something on the table here. I think, indeed, we probably have more information about abstinence-only programs working than any other type programs that are out there. We are going to hear some more about that later this afternoon. We have thousands of abstinence-only programs that are doing a great job not marginally, not just statistically significantly, but tremendously affecting the sexual behavior of people. Those programs provide their interventions all over this country on Sunday mornings, Sunday evenings, Wednesday night Bible study or prayer meetings and Thursday morning Bible study. According to the data, just going to churches, just showing up on a frequent basis is a great predictor of whether a teen will be a virgin or not — just going there. I will tell you I will guarantee you that the majority of these abstinence-only programs on Sunday morning are, indeed, that. I will guarantee you the pastors don't stand up and say, "Well, when you go out tonight and have sex, be sure to put your condom on." I will guarantee you they get a very clear message of abstinence.

I think as we look more closely this evening at that research and that data that we need to be asking the churches, the faith-based communities, What are you guys doing right? Help us to do a better job at it or helping them to look at what they are doing right and then how to build on that.

In this very fine publication that the Brookings Institution did, "What's God Got to Do with the American Experience?" there were two statements that I wrote that I wanted to quote quickly. "Scholars such as Seider, Undrew, and Amy Sherman have found the most spiritually demanding programs appear to produce the best results. There is legitimate worry that supporting the religious groups with the highest success rates will entail government aid to precisely those organizations that require the strongest level of religious commitment from participants."

Why is the church having success in actually helping young people, and when they come with their fathers, as the data will show, they have an even better rate of being virgin? Why is the church having such success? Because they stick to what they know, the scriptures which is a lot of what Sister Mary Rose was saying. We need to be looking at it. What principles are there that we can bring into our programs because even the successful ones that we talk about in the secular world have marginal successes, and oftentimes not very long-term.

DIONNE: Thank you so much. Pat Ware has anticipated some of the themes of Pat Fagan's paper that we are going to hear this afternoon. For the benefit of The Washington Post and The New York Times, do you have a response on the issue of abstinence programs? Then I want to go to the audience for a few comments.

DR. KIRBY: I think several things are true. I do state in the paper, and as I said in my presentation, that an important reason why we do not find that abstinence-only programs have had an impact upon behavior is that the studies, all except for one of them that were done, had very severe limitations. We definitely do need better research. I did say verbally, but did not say in the paper that I think probably some of the programs do have an impact and some don't.

During my first 10 to 12 years of doing research in this field, I evaluated a lot of programs, programs that I believed in, programs that were very, very plausible, programs which were espoused by people who also truly believe in them. What did I find? My research quite clearly demonstrated that the programs were not having the positive impact we all had hoped they would have. That was very disappointing and very painful to report that honestly in a balanced way back to the public.

I think there are lots of us in the country who still are fervent believers of particular kinds of programs and are convinced that they work, and some of them do work. I do also believe that we really do need good research to find out which ones worked and which ones don't. I think some abstinence-only programs do work and others do not. So far, we don't know which ones do; we need the research to do that.

DIONNE: Thank you.

QUESTION: Doug and I shared a wall during those early years of research. I must say I don't know that The New York Times or The Washington Post can find quotable quote out of Doug's research, because Doug does, in fact, take such great care with his language to be factual, to be accurate, and to be fair. That has been true of Doug from the outset today. So, I think it's an unfair suggestion otherwise.

My question actually relates to your presentation and your, I think, fair analysis that there was in the '80s, when you were doing much of your early research, a question as to whether or not it was plausible that exposure to sex education that included comprehensive information about contraception could, indeed, lead to more sexual activity. You just described that, yes, indeed, that was plausible, but the research repeatedly has found that it was not true.

I think there is a paradigm question here in the '90s and as we enter the new millennium as well, which is sort of the flip-side of the coin with respect to abstinence-only education which is, is it plausible that participation in abstinence-only programming could result in harmful effects? I don't think we have sufficient research in this arena.

I want to ask you about that because I am aware of only one very recent piece, Germott's work in the Journal of American Medical Association, which suggests, in fact, the real possibility that this plausible argument of harm is true. It was only 659 adolescents in a middle school program, but it indicates that particularly for the sexually active kids who are participating that participation in abstinence-only versus a safer-sex program showed that the safer-sex program helped and the abstinence-only program harmed.

My only question for you is whether or not, indeed, the research being structured around abstinence-only is going to be revelatory with respect to this particular question looking at the possible flip-side.

DIONNE: I think one could say now that the fat is in the fire.

(Laughter.)

DR. KIRBY: Sure. To do a very short paraphrase of that, there's been a group of people concerned about comprehensive sex-education programs and STD/HIV-education programs who are concerned that talking about contraception might lead to youth having a greater amount of sex. The reverse is also true. There's a group of people who are concerned that talking only about abstinence will give the message that contraception is not effective and, indeed, some but not all abstinence-only programs do make the statement that condoms and other forms of contraception are not very effective. So, the concern is that if you hear only that, that then they will be less likely to use contraception once they have an impact.

It's that one is the flip-side of the other. Studies which are underway are examining both effects, the impact of programs upon delaying sex and also the impact upon the use of contraception. I said studies; again, some studies are and some are not. Most of them in the past have not; a couple have. The largest study that's been done, in fact, did measure the impact and did not find a negative or a positive impact upon the use of contraception; did not find a positive or negative impact on any kind of behavior, including the initiation of sex.

You referred to the Germott study, and goodness, there are so many studies that I may be forgetting a couple of details on one of them. My recollection — and I might be wrong — is that there were two versions. One was an abstinence-based version and that version did not do harm, but it was less effective than the safer-choices version which both delayed sex and increased the use of contraception.

QUESTION: I just wanted to make a point regarding what Pat noted in her presentation. We really have to keep in mind that the types of rigorous evaluations that make it into peer-review journals that Dr. Kirby included in his report are more expensive than some of the smaller programs are going to be able to afford. So, oftentimes I believe there is a potential to miss what is a good program which may be a program that has the potential to be very effective or is, in fact, having some impact, large or small, on the lives of kids in a particular community because that program maybe didn't even have the manpower or the expertise at the onset to set up a design that could then be "scientifically" evaluated at the end.

So, if we don't have those kinds of things in place already, we can't say specifically that that program did this for this group of kids. That is still not to say that if we had the ability to set up those kinds of programs in other communities, we would not see impacts or we would not be able to document them. I just think that's really important to keep in mind because the African-American community is historically a community that has had programs working with children, and we may be missing or not have the benefit of knowing exactly what is going on in some of those cases.

DIONNE: I want to thank you for that point. This is, I think, the third time in the last month dealing with completely different areas that I have heard the point that the problem is we don't have the money to evaluate our program, even though we think it's working. That is a really important and a common problem.

MS. LEAR: Julia Lear, George Washington University. Two points: just quickly, Doug, a school-based health center is not an intervention in and of itself. It is a place where interventions might occur. As to Ms. Ware, I wanted to follow up on an early point she made. I thought it was an interesting one; I had heard the same point made when I was at a conference in Atlanta. I thought where you were going with your comments was that researchers, when looking at an intervention of a particular focus — we were talking about Head Start yesterday, but it was applied with teen pregnancy — tend to compare impacts between the intervention and the control group.

Yet if you are in a community severely impacted by a problem, what you want to know is really the dimension of change you get if you actually implement the effective intervention. In other words, will 50 percent of the kids, the teens who are getting pregnant not be pregnant or will only 5 out of 100? The reason I go to this is because in working with faith communities and churches, they will have to rely on Doug Kirby and others to tell them what they can reasonably expect from interventions.

I think it means that when we get into this area of partnering the research with the faith community, it is going to have to be very clear what people are buying. I'd like to see a little more in that realm just for the guidance of churches. That would be very helpful. Thank you.

MS. WARE: I would like to respond to that. That's exactly what I was talking about, that the comparisons are between program and control. We, as people in the community, don't really know what that means. I remember the awe struck faces of some of the people in the group that I was with when they really heard numbers, programs that were supposed to be very successful in preventing teen pregnancy or increasing contraceptive use.

The numbers do not relate the same as words like statistically significant or successful, and that is why one of the first projects this national organization will do is to help train people so that they can interpret data and don't necessarily have to depend on other people to interpret it for them. I think it is a very valuable service.

DIONNE: Doug, did you want to respond?

DR. KIRBY: Sure. I'd like to make two points. First, it involves the magnitude of the impact. It's a question that is commonly asked. "You know, Doug, aside from being statistically significant, it has a really small impact or a really large impact."

Unfortunately we don't know for sure, and unfortunately it varies with what group we are talking about and which program. So, again it is a complicated answer; there is no simple answer. There are certainly many people in this country — and I count myself among that group at various times in my life — who hoped and believed that, yes, we have the solution right here. If we do this one thing for 10 hours or 15 hours or whatever, our pregnancy rate is going to drop by half. A 56-percent reduction is a reduction I had mentioned in many speeches many years ago from a program.

That is not realistic. There is no single intervention that is just going to cut pregnancies in half, that we know of today. If it is out there, we don't know what it is and, goodness, we sure want to find and evaluate it and then demonstrate this. What we do find, though, is that some programs that seem to be the more effective programs do have what I would call a programmatically meaningful reduction in either initiation of sex or in unprotected sex. Some of the better ones seem to reduce unprotected sex, either again by delaying sex or reducing frequency or increasing the use of protection, by 25- to 35 percent, as best we can tell. That is kind of a soft figure. But that is roughly the magnitude of some of the more effective ones. It varies with the group we are depending upon. It turns — and I think this is good news — that no solid proof that it appears that programs are more effective with higher-risk youth than with lower-risk youth. I say that I think that is good news because our higher-risk youths are the ones that we should be most concerned about.

(INAUDIBLE QUESTION)

DR. KIRBY: It's true for reducing the risk and safer choices. It depends upon what measure you look at, and to those there was a reduction of up to about 35 percent. For the "Be Proud, Be Responsible," I can't tell you, but my memory is roughly in that order of magnitude. But don't quote me on that.

The phrase "abstinence-only" is distinct from abstinence-based. Most programs in the country are abstinence-based in the sense that they all emphasize that abstinence is truly the safest choice. There is no choice that abstinence is more effective in preventing sex if you really do abstain than if you had sex —

(Laughter.)

DIONNE: You don't need social science for that.

(Laughter.)

DR. KIRBY: — as well as pregnancy and STD, and that is emphasized in every program. So, they are almost all abstinence-based. Abstinence-only refers to the category of programs that is a very heterogeneous group of programs that either talk only about abstinence or they suggest that contraception and condoms are not very effective.

(INAUDIBLE QUESTION)

DR. KIRBY: Well, there is certainly tremendous polarization in the field. I personally would very much like to see more of a middle ground and see people coming together and agreeing that it is both a good idea to delay sex certainly through high school, and also agree that if young people do have sex, then they do need to use some form of protection. Not everybody agrees with that, however.

The national campaign is trying to bring people together. Other groups are as well. I do see some movement, but there is great polarization in the country.

DIONNE: Belle Sawhill will offer the grand synthesis at lunchtime.

(Laughter.)

I want to say just for the record that in Doug Kirby's paper — I am hoping with everybody's permission that the papers will be available to anybody who wants them — he says some good things about "Best Friends" precisely because it does merge, as you know, sexual education with a lot of youth development. Let me turn to the Reverend Veazey and thank him for his patience.

REVEREND VEAZEY: Thank you, E.J. I could almost just say, Amen, to everybody else's comments. I want to thank you for bringing us together and also for inviting me to participate.

The Religious Coalition, for those of you who may not know, is an organization of 43 denominations and religious organizations. In fact, John Buehrens is a member of that group and he has been a member for some time. I know Deborah Haffner just from my work with the Coalition.

Let me just also say — you mentioned that I was a member of the city council at one point. I was never elected; I was appointed. So, I was one of the first city council members in Washington. I was appointed in 1973.

DIONNE: And then Bill worked on your re-election campaign and you lost.

(Laughter.)

REVEREND VEAZEY: Right, right. Also I have been in Washington for 41 years and in the pastorate for 39. I have come to this work which I have found to be extremely interesting, and it is really an extension of my ministry. The Religious Coalition asked me to come aboard three years ago, partly because they wanted to access the black community and involve the community in the work of the Coalition in many areas and not just on choice. They wanted to identify areas of interest in the black community that we could address.

One of the major areas was the area of teen pregnancy. Reverend Fauntroy and I worked together on some issues. One of the things we noted was that it was amazing in the black community that in 1964 when we had the Civil Rights Act and everything looked up for us after breaking down doors and integration, et cetera, we thought we were on the upward track. Teen pregnancy just escalated from that point. There has been an encouraging reduction over the past few years, but it has been one of the areas that we really have to address.

I come from a government background as well as from a religious background. I enjoyed all of your paper, Doug, and I think we must incorporate both. Government has something to do because I drive through Southeast Washington and I look at the conditions, the terrible conditions that the young people grow up; they are born in. Then we wonder why they don't have any self-esteem. So, I think that government has a vital part to play. That has nothing to do with the religious community playing their part. Even if we have the best schools, if we have the best housing, we still have to have a moral fiber. I think that is important.

After I came aboard the Religious Coalition, I set about to bring together black religious leaders across the country. In our religious community, there has always been a taboo about sex and the church. It is just not talked about, not preached about. I think that it is preached about some now, but really it is one of those subjects that is better left alone. Because of that, there is no real teaching about it. So we decided to bring together religious leaders in what we called the Black Religious Summit on Sexuality at Howard University Divinity School in 1997. We had over 400 religious leaders to come together. We called that session "Breaking the Silence." We were going to open up and talk about the real issues facing us. We got to that part about abstinence-only and we had to open up and say that many people realize that most of these young people are not in the church. So, then what do we do with those who are out of the church?

You don't win them — and please note that I have the greatest respect for my religion — but you don't win them by simply saying, Jesus saves. It's got to be more and you have got to interpret that so they understand what that means. It does not mean a shibboleth; it's not a cliché. But you have got to bring it into context of how you explain this to young people.

We had that dialogue for two days. Then again in 1998 we had over 500 religious leaders to come. Now we are planning this year in July and we are already trying to find additional space because people think it is time now to really talk about this matter in real terms, not what we think it ought to be. In fact, the director of my multi-cultural program sent over a new program that she wants you to look at. We are field-testing it now; it's called "Keeping It Real." We believe in abstinence first, but we incorporate in it how we deal with young people who are already sexually active. We deal with the real problems that they face in self-esteem, et cetera.

I am encouraged by what I have heard here today, and I am encouraged by the kind of insight that you have given to me with these other programs. I do think that, as the sister has said, we believe in a holistic ministry. It's got to involve the total person. It's can't just be one area. I look at my years of ministry. I believe that once you give a person a sense of being a creation of God with dignity and try to give them that sense of self-esteem spiritually, many things fall into place. You cannot talk about these issues without talking about values. That is what we tried to do.

I just want to say that I have been tremendously encouraged by our program, "Keeping It Real." We have it in Los Angeles; we have it in Atlanta, Georgia; it's in Washington, D.C. Next year we are going to expand with additional funding to place it in other cities because it was designed by church leaders; it was designed by seminary deans who said this is what we need. By the way, five seminaries are going to incorporate sexuality education into their core curriculum next year. That's the way you change the culture. That's the way you change the thinking. Most of the reasons why we don't discuss it is because we are not prepared to discuss it. So, I think what we are trying to do at the Coalition will bear fruit. I look forward to working with you and keeping you informed about what we are doing at the Religious Coalition.

Thank you very much.

DIONNE: Thank you very much. I have learned since I have gotten interested in this area that PR guys and headline writers have nothing on this community. I know now there are programs called "Keeping It Real," "Our Whole Lives," "True Love Waits," and actually the list is even longer than that.

(Laughter.)

I want to give John Buehrens a chance to talk and then we will go back.

REVEREND BUEHRENS: Thanks, E.J. I first want to answer your question about how you get to be a religious leader at-large like Carlton, the good sister and myself. My friend, Cliff Kirkpatrick, who is the Clerk of the Presbyterian Church belongs with me to a group of religious Pooh-Bahs of various denominations. He explained in a self-introduction that when he was working his way through seminary, he did so as a baseball umpire. So, one of the other people, of course, asked him, "I guess that means that you learned early on to call like you see them?" To which Cliff replied, "Oh, no. We were all sent to umpire school and we learned you've got to call them whether you see them or not.

(Laughter.)

I am not a social scientist. I am a religious leader who has to make moral calls about the issues at stake here, both on the personal and the public level. Part of my experience here is grounded in my wife's ministry, as well in the parishes in Knoxville, Tennessee; Dallas, Texas; and New York City where we raised our two teenaged daughters, living over the shop where Gwen ran a neighborhood center that included an after-school program, an AIDS hospice, a senior feeding program, a shelter for the homeless, and many other such things. We were also parents of a teenaged foster daughter back in our first ministry in Knoxville.

I think that this whole field is potentially steeped with sin, not of the sort that we associate with sex, but of the spiritual sort. It is steeped in self-righteousness, temptations to finger-pointing and projective anger, and misconstruing of both idealism and realism. I want to say a little bit about my faults in that regard.

My parish ministry led me to start out angry in this field, quite angry. I began working 30 years ago with the Clergy Consultation Service of Problem Pregnancy. When I was in Knoxville, my wife and I had a steady series of young women in our living room, with our two daughters in their cribs upstairs. My wife — this was before the Episcopal Church got enlightened on really accepting women in the ministry — was ordained a deacon in the church and she took her ministry of preaching the gospel and serving the poor into the field of working as a case worker with young women who were going to place their children for adoption. I got angry at doing my ministry in an area where the church was dominant in the culture. My heavens, in Knoxville, they said at the clergy meetings that a survey by the Tennessee Council of Churches had determined that there were more members of Baptist Churches in that state than there were people.

(Laughter.)

But the number of problems associated with the failures of the church and its denials got me angry. Where I am now is I'm afraid of the polarization that is possible in this field. I am actually glad that many of the more conservative churches are beginning to do programs of sexuality education that arise out of their own values.

I worry a bit, as I think many people do in this room, that they are single-goal oriented rather than dealing with the multiplicity of potential goals, including reduction of the early onset of sexual activity, reduction of numbers of partners, failure to use available contraception, and the like. I think a failure to be realistic about issues of sexuality is a spiritual sin.

It would be a mistake in public policy to expect that the church, in this highly secularized society where media penetrates every aspect of our young people's lives, can have the solution either in the comprehensive sexuality and HIV education programs that we have championed for 30 years or with the more conservatively oriented abstinence-only programs. For one thing, we are going to miss a lot of kids. They are mostly outside the churches. But my heavens, I do think we can lay some common ground for a public dialogue about approaches to those kids that the churches can't reach.

We worked with the United Church of Christ over the last five years to develop a comprehensive sexuality-education program that suits our values. I should add that over the course of my parish ministry, I guess I have probably done about 20 funerals for people with AIDS, almost all of them from people outside the congregations I was serving, rejected by their own faith communities and families. I have done almost a dozen funerals for young people, teens or people in their 20s, who took their own lives, a distressing number of them because they were confronting the homophobia in society.

I am very concerned about the spirit in which we go about doing this work. I think that the tendency in those who want to influence government, the politicians, to polarize religious people, the churches, has reached such a state in our society that we are really in common danger of not bringing both our proper ideals, which could include just a reduction in the rate of teen pregnancy. I would join the sister in yearning for reduction in the frequency of abortion, though I have been involved with RCRC for years. We are in danger of losing that common ground to those who for their own advancement would divide us and distract us.

So, what I want to bring to the table today is really a concern for the spirit in which we have our discussions and a realism about the possibility of the churches making an impact. We have tried to design that comprehensive sexuality-education curriculum so that it can be used not only in the voluntary setting of the church where we get fairly explicit and where we want to talk about all of the sexual feelings and the relational issues and the dilemmas that people have. We have also, however, designed it so that in a more basic, less-explicit way parts of the curriculum can be used in much broader, more public settings. I think the church can contribute something out into the middle ground, the gap that the polarized religious community is in danger of missing. I hope that we will begin to move the discussion here toward the area where that might happen.

Thank you.

DIONNE: Thank you very, very much. I think the Reverend Buehrens raises a very interesting issue because at least it is my experience that one of the central arguments here is, in fact, over the question what constitutes realism.

REVEREND BUEHRENS: Yes, that's right.

DIONNE: I think that is something that we are going to be talking about. I also think, and I hope Deborah Haffner is going to talk about this some, that there is a fascination when you put up the "Our Whole Lives Program" against the "True Love Waits Program" that the Southern Baptists are doing, you get a sense of the very different approaches and inspirations that are involved here.

QUESTION: I happened to have read Germott's paper, to go back to the point that was brought up. There was such a structural flaw with that, but not only students but teachers were randomized either the abstinence or the safer-sex tracks. It ignored the value. In other words, you can't put, for instance, a safer-sex track on somebody who wants to be abstinent. And you can't do the opposite either because it is not going to work.

It may be wonderful from a research point of view, but it is nutty. For those of us who have worked with teenagers and who know it just doesn't work like that. Also I don't like the polarization between abstinence-only or, quote, safer sex. I have a program which obviously looks at the body, the person, the feelings, the emotions. We talk about everything because otherwise you can't make an informed choice. Yet we do find that less than 3 percent of virgins who are age 14 and 15 transition, and about half of the ones who are sexually active stop by the CDC definition of no intercourse within the last three months. So, to me it is not and either/or situation. I think as long as you have a wonderful algorithm, it may work well on your computer for evaluating but I am afraid it is not going to meet the reality. Thank you.

DIONNE: Yes?

QUESTION: Yes, I would like to comment on the latter part of your comments on what John was saying. It is important that we do work together and to build around common ground. I think, however, that there may be some issues that, of course, we may not ever agree on. The polarization, if you will, may come from a very fundamental question as to what you think about sex outside of marriage. There is a fundamental question there. If you can talk about contraception and condoms without saying that act or premarital sex is okay — the abstinence programs talk about it.