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Title XX Adolescent Family Life

Historically AFL was administered by the Office of Population Affairs; however, in FY 2012 it was moved to the Office of Adolescent Health. This information regarding AFL is archived on the OPA website to support grantees and for historical purposes.

For current program information, please contact the Office of Adolescent Health at (240) 453-2846 or by email at OAH.gov@hhs.gov. You may also visit the OAH website at http://www.hhs.gov/ash/oah

Demonstration and Research Projects

History of Title XX

The Office of Adolescent Pregnancy Programs (OAPP) was created in 1978 to administer adolescent pregnancy programs under Title VI of the Public Health Service Act (P.L. 95-626). This was the first Federal adolescent pregnancy program aimed at providing comprehensive health, education and social services to pregnant and parenting adolescents. In 1981, Title XX of the Public Health Service Act (P.L.97-35), also known as the Adolescent Family Life (AFL) legislation, replaced Title VI and legislated discretionary funds for research, care, and prevention demonstration projects. Since FY 2010, the AFL program was appropriated funds to solely support AFL Care demonstration grants. Throughout the years, OAPP has supported approximately 400 Adolescent Family Life (AFL) care and prevention demonstration projects and nearly 100 research projects.

AFL Care demonstration projects serve pregnant adolescents, adolescent parents, their infants, young fathers and/or male partners and extended families. Care grantees implement and test various methods for caring for pregnant and parenting adolescents that are based on social science theories. In addition to incorporating a strong evaluation design, grantees are expected to develop and follow a thorough logic model. All are required to provide ten core services directly or by referral. These services are comprehensive, easily accessible, and include case management, home visitation, counseling, advocacy, job training, clinic visits, educational services, and social services that emphasize family involvement and assist clients in becoming productive contributors to family and community life. The goals of all care projects are to reduce the number of repeat teen pregnancies, improve infant immunization, and increase educational attainment of clients. Care projects also focus on increasing the positive factors related to good pregnancy outcomes, self-sufficiency, and parenting and provide a variety of services to teen parents, their children, and their families.

All AFL care projects include an evaluation component to be conducted by an independent evaluator associated with a college or university in the grantee's home state. The AFL legislation requires that 1 to 5 percent of the annual budget is allocated for evaluation efforts. However, since 2003, OAPP has waived the requirement and increased the amount up to 25 percent to support more rigorous, long-term, outcome-oriented evaluations, particularly those using experimental or quasi-experimental design. These evaluations test program effectiveness, document challenges encountered, and contribute promising models to the field of adolescent health. AFL core data instruments must be used within these evaluations for all grantees and a uniform End of the Year report template gathers crucial program data that is used to improve AFL evaluation as a whole.

The Title XX statute authorizes research on the causes of adolescent, pregnancy and child rearing (Section 2008). The OAPP funded research projects focus on such issues as adoption, services for pregnant and parenting adolescents, adolescent parenting and child development. These research projects provide important and valued information and data to the field of adolescent sexual health and well-being. As such, the OAPP is able to contribute to this field by providing access to new knowledge to better serve adolescents and their families.

Finally, to ensure that all AFL project staff at the local level has the necessary skills and training to implement these programs, the OAPP conducts numerous technical assistance workshops annually for its grantees.