Today the CDC released a report on the effectiveness of various approaches to teen pregnancy and HIV/STI prevention. The study was conducted by the Task Force on Community Preventative Services, an independent panel convened by the CDC. The report suggests that such prevention programs are most effective when they combine a clear message on the benefits of postponing sexual activity with medically accurate and comprehensive information on how to reduce the risks of pregnancy and STIs among teens who are having sex--including the use of contraception.

Most of the American public gets this. It's common sense. Yet, today's results are debated by many, with some saying they prove comprehensive sex ed programs work and abstinence education programs don't, and some saying the reverse. This debate arises in part because comprehensive sex ed and abstinence-only actually encompass many, many different programs, with varying levels of effectiveness behind them. The debate is fueled as much by ideology as it is by science and will likely continue for some time to come.

For those practitioners, educators and parents looking for a common-sense way forward in the meantime, I suggest focusing on specific programs rather than programmatic approaches. Some, but not all, comprehensive programs have rigorous evidence of positive impacts. These have been well-summarized. To date, none of the abstinence-only curricula have this level of evidence behind them, although that is not to say there may not be some in the future.

Efforts have their best chance of success if they stay grounded in science, whatever the state of the science is at the time. It's also important to realize that, while the reproductive health education we provide our teens in school is critical, no curriculum, regardless of its underlying ideology, is a silver bullet. Communities that truly care about preventing teen pregnancy need a comprehensive approach that includes not only schools, but also parents, community leaders, the media, and teens themselves.

Some scary things to consider this Halloween:

• The teen birth rate is on the rise after 15 straight years of decline.
• Fully seven in ten pregnancies among single 20-somethings are unplanned.
• More than half of pregnancies reported by unmarried men in their 20s are unplanned.
• Rosie O'Donnell is launching a new radio show.
• The magic less sex/more contraception formula that drove down the teen pregnancy rate over the past decade plus now seems to have morphed into a more sex/less contraception formula.
• 3 in ten girls in the United States get pregnant by age 20.
• Mariah Carey continues to record and release music.

What are some things that are scaring you? Let us know.

Sheldon J. Segal is no longer with us. Segal, 83, died October 17 at his home in Woods Hole, MA. Although his work helped millions of women all over the world, he labored and died in relative anonymity.

What gives?

Segal is credited with leading the team that developed the contraceptive implant Norplant. He was also instrumental in the development of the Mirena intrauterine device and copper-bearing IUDs. In other words, Segal played a critical role in what the Centers for Disease Control and Prevention calls one of the greatest public health achievements of the past 100 years---contraception.

You might have missed this news because the front page of several major newspapers featured other such absolutely essential fare as the fight for airplane overhead space (USA Today) and a new opus from Stephen King (Wall Street Journal).

What gives?

Rest in peace, Sheldon Segal, and thank you.

Women currently account for 51% of the overall U.S. population, according to the U.S. Census Bureau. To be precise, there were 154,135,120 women and 149,924,604 men in the United States in 2008. We also know that women, more often than not, are responsible for making decisions about their families' health care.

While I think it would be hard to make the leap that 51 percent of the programs and benefits of health reform should be directly targeted toward women, it's not a stretch to argue that health reform should address the health care needs of women and their families. That includes pregnancy planning and prevention.

Unplanned pregnancies are closely linked to a number of negative health, social, and economic consequences. Family planning services--counseling, gynecological care and screenings, prescription drugs and devices, and related outpatient services--are a cost-effective way to make progress on preventing unplanned pregnancy and improving health outcomes for women and families. As such, family planning should be classified as a preventive benefit with the same cost-sharing protections afforded to other designated preventive benefits in any essential benefit package that is created within the context of health reform.

For health reform to work, it has to be meaningful for everyone, including 51 percent of the U.S. population.

Why is it that some people are better listeners than others? You can tell when someone is listening to you--really listening--when they're actually taking in what you're saying, considering it, and perhaps not even having a response at the ready--not simply planning their next conversational move. Listening is a form of respect, and one that is easily mowed over by the desire to get one's own point across. Like a monologue masquerading as a dialogue.

Since October is "Let's Talk" month (see Bill Albert's post from earlier this month), maybe the added attention will get some parents to move from wanting to talk with their teens about love, sex and relationships to actually doing it. But a critical part of this conversation--and really any conversation with someone you care about--has to be the listening part. We've heard from teens for over a decade now that they are afraid to ask their parents about sex and contraception because they are convinced that mom or dad will freak out and assume that their teen is already 'doing it.' Or that it will be so embarrassing their heads will explode.