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ALTIMORE, May 24 — Shannon White used to assume she would become a teenage mother, like her big sister. But at 17, after three years in an experimental afterschool program intended to prevent teenage pregnancy, her expectations are quite different.
"I wasn't thinking about college when I was young," she said. "But I changed when I was about 14. This program changed me. I have a life. I have things to do. I'm going to be a nurse. Will I have babies? No time soon."
The program, created by Dr. Michael Carrera at the Children's Aid Society, offers not just traditional sex education, but also tutoring, SAT preparation, job skills, medical and dental care, sports and creative arts.
And in a field littered with good intentions, heavy doses of morality, and scant evidence of results, the Carrera program is a solid success: a three-year evaluation of its 12 sites in poor neighborhoods nationwide found participants had one-third fewer pregnancies, and births, than those in the control group.
The Carrera program is singled out in a comprehensive report on the available research on teenage-pregnancy programs, to be released on Wednesday by the National Campaign to Prevent Teen Pregnancy, a nonprofit, nonpartisan group in Washington.
The report finds several models of teenage-pregnancy programs that have had positive results as well. Studies of some sex and H.I.V. education programs found that participants delayed sex, increased the use of contraception, and reduced their number of sexual partners, for at least 31 months.
"One important finding is that sex and H.I.V. education do not hasten sexual activity, that education about abstinence and contraception are compatible, and not in conflict with each other," said Doug Kirby, the author of the report. "We also found that making condoms available does not increase sexual behavior. These are issues that a lot of people have worried about."
The report also includes surprising evidence, from several studies, that "service learning" programs can reduce teenage pregnancy. These programs include both voluntary community service projects, like working in a nursing home or tutoring and small-group sessions where students discuss their projects.
Studies of vocational education, however, found no effects on sexual risk-taking or pregnancy among teenagers.
And so far, the report found, abstinence-only education — an approach financed, and favored, by the federal government — has shown no impact on young people's behavior.
The 1996 welfare reform law included $85 million a year in federal and state financing available, for five years, for abstinence-only programs that do not teach contraception. A federally sponsored evaluation of those programs is under way.
While some federal block grants can be used for sex education, it has been left largely to local communities and private sources to support pregnancy-prevention programs.
"We're asked two questions all the time: What works, and how do I get money to pay for what works?" said Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy. "This report offers some answers about what works. And I think more money will be available as people come to understand that you can get results and that reducing teen pregnancy is the most efficient single way to improve overall child wellbeing, and to reduce persistent child poverty."
Mr. Kirby said the Carrera program had proved an important success with high-risk youth.
"This is the only program that had strong evidence of reducing pregnancy and child-bearing, delaying sex, and increasing the use of contraception, for three years," he said.
The Carrera program, and its evaluation, were supported by the Robin Hood Foundation, in New York, and the Charles Stewart Mott Foundation, in Michigan. It is one of the most intensive, and expensive, programs in the field, running to $4,000 per child per year.
Depending on their needs and interests, the young people in the Carrera progam can come after school to get help with their homework, meet with a social worker, fill out forms for work permits, work in the computer lab, or improvise a skit about resisting sexual pressure. At the Grand Street Settlement site on Manhattan's Lower East Side, young people drift in at 4 or 4:30, and some stay as late as 9. When they need medical or dental appointments, someone from the Carrera program will accompany them if their parents cannot.
Elsa Ferreira said her life was changed by the Carrera program.
"They helped me a lot when I was struggling with math," said Ms. Ferreira, who will graduate from high school next month. "I can't do homework at home. We had no insurance, so the medical help was important. They found me my job, tutoring. They gave out free condoms. They told us things my mother and aunt never told us about. My mom didn't finish high school, and my older sister and brother both dropped out. At the time, I didn't think it was a big deal. But now, I want to make sure my little brother and sister stay in school."
Last month, there was applause all around when Ms. Ferreira walked in with the news that she had won a full scholarship to Syracuse University.
While Ms. Ferreira has steadily attended the Carrera program, others are not so constant. Victor Rasuk, a 17-year-old aspiring actor, stayed away for a year. But one tenet of the Carrera program is never to give up on its young people. Warmly welcomed back, Mr. Rasuk now works as an intern at the program office.
By the end of the third year, about 70 percent of the original participants were still involved in the program.
The evaluation of the Carrera program found that unlike the girls in the program, the boys, who made up 43 percent of the participants, did not reduce their sexual risk-taking — and, while the girls' birthrate was cut in half, boys were only slightly less likely than those in the control group to cause pregnancy. In fact, the boys in the program actually were more likely to become fathers.
"The boys, far more than the girls, were likely to have been sexually experienced before they came into the program at 13 or 14," Dr. Carrera said. "We're going to adjust it, for future programs, to start boys at 11 or 12, before they're sexually active, and hope we can do better."
Still, some boys said the Carrera program had filled real needs.
"I used to fight all the time, get in trouble at school and get sent home," said William Little, a Baltimore 17- year-old. "Now I'm calmer, so I can be in school every day. Without this, I didn't have nobody to sit down and talk to."