Evidence of Effectiveness
Evaluation Overview
An evaluation of Plain Talk was conducted by Public/Private Ventures (P/PV) to determine if increased communication about sexual issues between youth and knowledgeable adults, combined with an increase in access to contraceptives, positively affected teens’ sexual knowledge and behavior in the Plain Talk communities.
Communities Targeted
The evaluation targeted three Plain Talk communities – Atlanta, San Diego, and New Orleans. In the three communities, changes in youth’s attitudes and behaviors were tracked by surveying 12-to-18-year-olds in 1994 (at the beginning of the Plain Talk initiative) and again in 1998 (at the end of the demonstration period).
Conclusions
Overall, the evaluation found that communication about sexuality between youth and knowledgeable adults, combined with increased access to contraceptives, was positively associated with teens’ accurate sexual knowledge and safer behavior. In 1994, 33 percent of sexually experienced youth had been pregnant or caused a pregnancy. 
Four years later, only 27 percent of sexually experienced youth surveyed had been pregnant or caused a pregnancy. Based on increases in other, similar communities over the same four-year period, it was projected that without the Plain Talk intervention, the pregnancy rate among the second group of teens would have been 38 percent. Analysis of the survey data suggested that most of the 11 percent decrease was due to better communication.
Walkers & Talkers: Success of Peer Educators
The evaluation also found that the two sites using peer-educators (Walkers & Talkers) in conjunction with Home Health Parties had more success educating larger numbers of community adults – 800 in New Orleans and 1,350 in San Diego. Furthermore, sites using Walkers & Talkers as trainers delivered training with more explicit sexual information. Some of the reasons cited for this success were:
- Walkers & Talkers were community residents themselves, so there was less suspicion about their motives and attitudes;
- Walkers & Talkers had access to more people in the community;
- Walkers & Talkers were more comfortable than professional health educators in discussing the difficult aspects of teenage sex with other residents;
- Walkers & Talkers’ discussions were more direct than those of professional health educators; and
- Walkers & Talkers felt that because they were part of the community, they had the moral authority to challenge other community residents with the Plain Talk message.
Improved Communication
The P/PV evaluation found that the Plain Talk framework enabled communities to change the way adults communicated with teens about sexuality. More frequent communication was associated with improvements in community teens’ sexual knowledge, attitudes and behaviors. In particular, the evaluation found:
- Increased levels of communication between adults and sexually active youth.
- Increased levels of youth awareness about where to get birth control
The youth who talked with adults, in comparison to those who did not:
- Knew more about and were more comfortable with contraceptives
- Used birth control more
- Used reproductive health services more
- Were less likely to have an STD or a pregnancy