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Delaware State Profile Fiscal Year 2010

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Sexuality Education Law and Policy | Recent Legislation | Youth Sexual Health Data | Teen Pregnancy Prevention Initiative | Personal Responsibility Education Program | Title V Abstinence-Only Program | TPPI, PREP, and Title V Abstinence-Only Funding in FY 2010 | Comprehensive Approaches to Sex Education | Points of Contact | Organizations that Support Comprehensive Sexuality Education Organizations that Oppose Comprehensive Sexuality Education | Media Outlets | References

 
Delaware
 
In Fiscal Year 2010[1], the state of Delaware received:
  • Personal Responsibility Education Program funds totaling $250,000
 
In Fiscal Year 2010, local entities in Delaware received:
  • Teen Pregnancy Prevention Initiative funds totaling $589,877
 
 
Sexuality Education Law and Policy
Delaware requires sexuality education as part of health education in kindergarten through 12th grade. This education must be coordinated by an employee in each school district and must be overseen by a District Consolidated Application Planning Committee. The committee must consist of teachers, parents, school nurses, community leaders, law enforcement, and other community members “with expertise in the areas of health, family life and safe and drug free schools and communities.”[2] Sexuality education must include an “HIV-prevention program that stresses the benefits of abstinence from high-risk behaviors.”[3]  Sexuality education courses must also follow the Delaware Health Education Curriculum.
 
Delaware law also sets a minimum number of hours for “comprehensive health education and family life education.”[4] In kindergarten through fourth grade, this minimum is set at 30 hours per grade, ten of which must be dedicated to drug/alcohol education. In grades five and six, the minimum is set at of 35 hours per grade, 15 of which must be dedicated to drug/alcohol education. In grades seven and eight, the minimum is set at 60 hours per grade, 15 of which must be dedicated to drug/alcohol education. In order to graduate, high school students must receive one-half of a credit in comprehensive health education.
 
Delaware does not require parental permission for students to participate in sexuality or HIV/AIDS education nor does it say whether parents or guardians may remove their children from such classes.
 
 
 
 
Recent Legislation
 
SIECUS is not aware of any proposed legislation regarding sexuality education in Delaware
 
 
 
Youth Sexual Health Data
SIECUS has compiled the following data to provide an overview of adolescent sexual health in Delaware. The data collected represents the most current information available.
 
Youth Risk Behavior Survey (YRBS) Data[5]
  • In 2009, 57% of female high school students and 58% of male high school students in Delaware reported ever having had sexual intercourse compared to 46% of female high school students and 46% of male high school students nationwide.
 
  • In 2009, 6% of female high school students and 13% of male high school students in Delaware reported having had sexual intercourse before age 13 compared to 3% of female high school students and 8% of male high school students nationwide.
 
  • In 2009, 18% of female high school students and 24% of male high school students in Delaware reported having had four or more lifetime sexual partners compared to 11% of female high school students and 16% of male high school students nationwide.
 
  • In 2009, 44% of female high school students and 42% of male high school students in Delaware reported being currently sexually active (defined as having had sexual intercourse in the three months prior to the survey) compared to 36% of female high school students and 33% of male high school students nationwide.
 
  • In 2009, among those high school students who reported being currently sexually active, 55% of females and 70% of males in Delaware reported having used condoms the last time they had sexual intercourse compared to 54% of females and 69% of males nationwide.
 
  • In 2009, among those high school students who reported being currently sexually active, 22% of females and 18% of males in Delaware reported having used birth control pills the last time they had sexual intercourse compared to 23% of females and 16% of males nationwide.
 
  • In 2009, among those high school students who reported being currently sexually active, 16% of females and 28% of males in Delaware reported having used alcohol or drugs the last time they had sexual intercourse compared to 17% of females and 26% of males nationwide.
 
  • In 2009, 89% of high school students in Delaware reported having been taught about AIDS/HIV in school compared to 87% of high school students nationwide.
 
Teen Pregnancy, Birth, and Abortion
  • Delaware’s teen birth rate currently ranks 28th in the United States, with a rate of 40.4 births per 1,000 young women ages 15–19 compared to the national rate of 41.5 births per 1,000.[6]  In 2008, there were a total of 936 live births reported to young women ages 15–19 in Delaware.[7]
 
  • In 2005, Delaware’s teen pregnancy rate ranked 7th in the United States, with a rate of 83 pregnancies per 1,000 young women ages 15–19 compared to the national rate of 70 pregnancies per 1,000.[8] There were a total of 2,300 pregnancies among young women ages 15–19 in Delaware.[9]
 
  • In 2005, Delaware’s teen abortion rate ranked 5th  in the United States, with a rate of 27 abortions per 1,000 young women ages 15–19 compared to the national rate of 19 abortions per 1,000.[10]
 
HIV and AIDS
  • Delaware’s AIDS rate ranks 8th in the United States, with a rate of 16.8 cases per 100,000 individuals compared to the national rate of 12.3 cases per 100,000.[11]
 
  • Delaware ranks 34th in number of reported AIDS cases in the United States among all age groups. In 2008, there were a total of 146 new AIDS cases reported in Delaware.[12]
 
  • Delaware’s AIDS rate among young people ages 13–19 ranks 5th in the United States, with a rate of 3.3 cases per 100,000 young people compared to the national rate of 1.8 cases per 100,000.[13]
 
Sexually Transmitted Diseases
  • Delawareranks 14th in reported cases of Chlamydia among young people ages 15–19 in the United States,with an infection rate of 22.52 cases per 1,000 compared to the national rate of 19.51 cases per 1,000.  In 2008, there were a total of 1,393 cases of Chlamydia reported among young people ages 15–19 in Delaware.[14]
 
  • Delawareranks 21st in reported cases of gonorrhea among young people ages 15–19 in the United States,with an infection rate of 4.67 cases per 1,000 compared to the national rate of 4.52 cases per 1,000.  In 2008, there were a total of 289 cases of gonorrhea reported among young people ages 15–19 in Delaware.[15]
 
  • Delawareranks 23rd in reported cases of primary and secondary syphilis among young people ages 15–19 in the United States,with an infection rate of 0.02 cases per 1,000 compared to the national rate of 0.04 cases per 1,000 in Delaware.[16]
 

 
Teen Pregnancy Prevention Initiative
The President’s Teen Pregnancy Prevention Initiative (TPPI) funds medically accurate and age-appropriate programs to reduce teen pregnancy. The U.S. Department of Health and Human Services, Office of Adolescent Health (OAH) administers the grant program, which totaled $110 million in discretionary funding for Fiscal Year 2010. TPPI consists of two funding tiers that provide grants to local public and private entities. Tier 1 totals $75 million and provides funding for the replication of evidence-based programs proven to prevent unintended teen pregnancy and address underlying behavioral risk factors. Tier 2 totals $25 million and provides funding to develop and test additional models and innovative strategies. A portion of the Tier 2 funds, $15.2 million, was allocated for research and demonstration grants to test innovative approaches, while the remaining funding, $9.8 million, was allocated for grants to support communitywide initiatives. TPPI also dedicates $4.5 million in funding to conduct evaluations of individual programs.
 
TPPI Tier 1: Evidence-Based Programs
The TPPI Tier 1 grant program supports the replication of evidence-based programs proven effective through rigorous evaluation to prevent unintended teen pregnancy, underlying behavioral risk factors, or other associated risk factors.
  • There is one TPPI Tier 1 grantee in Delaware, West End Neighborhood House, Inc., which received $589,877 for Fiscal Year 2010.
 
West End Neighborhood House, Inc., $589,877 (20102014)
West End Neighborhood House, Inc. is a Tier I grantee located in Wilmington, Delaware.  Founded in the 1880s, West End began with an aim to assist recent emigrants to the United States. Today, it exists as a non-profit social service agency with a focus on promoting self-sufficiency among individuals in low-income communities. The agency serves over 10,000 individuals, providing services such as employment training, GED preparation, youth and adult socialization, and transitional housing services, among others.[17]
 
West End’s TPPI-funded program targets youth in grades seven through 12, who attend low-income and/or low-performing schools and reside largely in the west side of Wilmington, which historically has had high rates of teen pregnancy, school drop-outs, and juvenile crime. The program aims to increase “attitudes favoring abstinence,” understanding of how to avoid teenage pregnancy, and knowledge about STDs, including HIV, among participants.[18]
 
With its TPPI funding, West End implements the Children’s Aid Society – Carrera Adolescent Pregnancy Prevention Program (CAS Carrera), an evidence-based, positive youth development program designed for underserved students in grades six through 12. The program consists of seven integrated units that can be administered in an after- school or in-school setting over the course of a year. These units include Education, Job Club, Family Life and Sexuality Education, Mental Health, Medical and Dental Services, Self Expression, and Lifetime Individual Sports.[19] The program uses a positive youth development approach to increase developmental competency and identity formation among participants in order to encourage youth to avoid early parenthood and risky sexual behavior. CAS – Carrera runs six days a week throughout the academic year and also includes a summer program component.[20] An evaluation of the program published in Perspectives on Sexual and Reproductive Health found that at a three-year follow-up female participants were significantly less likely to report a pregnancy or report being sexually active than participants in the control group.[21]
 
The program serves as an enhancement to West End’s existing summer camp programming and will serve a minimum of 60 youth annually.  All participants are required to commit to twelve months of the program. The program also includes a mandatory parent component. West End partners with Westside Family Healthcare, Junior Achievement of Delaware, and Jewish Family Services of Delaware in the implementation of the program. These partner organizations will offer comprehensive health care, entrepreneurial training, and mental health counseling and treatment.[22]
 
TPPI Tier 2: Innovative Approaches
The TPPI Tier 2 grant program supports research and demonstration programs in order to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy
  • There are no TPPI Tier 2 Innovative Approaches grantees in Delaware.
 
TPPI Tier 2: Communitywide Initiatives
The TPPI Tier 2 grant program also supports communitywide initiatives to reduce rates of teenage pregnancy and births in communities with the highest rates. The program awards grants to national organizations as well as state- and community-based organizations. Funded national partners provide training and technical assistance to local grantees. The Centers for Disease Control and Prevention (CDC) administer the grant program in partnership with OAH.
  • There are no TPPI Tier 2 Communitywide Initiatives grantees in Delaware.
 
 
 
Personal Responsibility Education Program
The Personal Responsibility Education Program (PREP) totals $75 million per year for Fiscal Years 2010–2014 and is the first-ever dedicated funding stream for more comprehensive approaches to sexuality education. The U.S. Department of Health and Human Services, Administration for Children and Families (ACF) administers the grant. PREP includes a $55 million state-grant program, $10 million to fund local entities through the Personal Responsibility Education Innovative Strategies (PREIS) Program, $3.5 million for Indian tribes and tribal organizations, and $6.5 million for evaluation, training, and technical assistance. Details on the state-grant program and PREIS are included below. At the time of publication, the funding for tribes and tribal organizations had not yet been awarded.
 
PREP State-Grant Program
The PREP state-grant program supports evidence-based programs that provide young people with medically accurate and age-appropriate information for the prevention of unintended pregnancy, HIV/AIDS, and other sexually transmitted infections (STIs). The grant program totals $55 million per year and allocates funding to individual states. The grant does not require states to provide matching funds. Funded programs must discuss abstinence and contraception, and place substantial emphasis on both. Programs must also address at least three of the following adulthood preparation subjects: healthy relationships, positive adolescent development, financial literacy, parent-child communication skills, education and employment skills, and healthy life skills.
  • The Delaware Department of Health and Social Services received $250,000 in federal PREP funds for Fiscal Year 2010.
  • The department has issued an application announcement for available funds under the state’s PREP grant program. At the time of publication, sub-grantees had not yet been determined.
 
The Delaware Department of Health and Social Services, Division of Public Health will sub-grant the state’s PREP award to a local contractor who will be responsible for developing a training institute on adolescent sexual health. The institute will offer educational trainings and supplemental professional development opportunities for teachers and community providers that serve high-risk youth populations. Among its primary goals, the institute will aim to “develop and sustain a professional development infrastructure to empower and promote positive behavior change in adolescents,” and “increase implementation of evidence-based programs in high-risk areas to reduce teen births, STDs and HIV rates for youth in Delaware.”[23]
           
The selected contractor will work in collaboration with the state department of education, the Division of Public Health, and the state’s Teenage Pregnancy Prevention Board to develop the institute, which will be known as the “From Risk to Resiliency: Promoting Teen Health Training Institute.” Teachers from all 19 of the state’s school districts will participate in training by the institute; although, certain areas of the state will be targeted for implementation of evidence-based sexual health programs based on high social and economic disparity and high rates of teen birth and HIV/STD infection. These areas include Bridgeville/Greenwood, lower Christiana, Milford North and South, Millsboro, New Castle, Seaford, Selbyville/Frankford, and the city of Wilmington. Educators will be trained to implement Making Proud Choices!, and Be Proud! Be Responsible!
           
Making Proud Choices! is an evidence-based STD-, HIV-, and pregnancy-prevention curriculum for young adolescents ages 11–13 that is designed for use with African-American, Latino, and white populations.  The curriculum aims to help youth understand the poor reasoning and decision making that can lead to STD/HIV infection and/or unintended pregnancy, as well as to increase their confidence, negotiation skills, and self-efficacy in using condoms. The program consists of eight, one-hour sessions and can be implemented in school- or community-based settings. Making Proud Choices! includes interactive and skill-building activities that are designed to “increase comfort with practicing condom use, address concerns about negative effects of practicing safer sex, and build skills in condom use and negotiation.”[24] Findings from an evaluation of the program published in the Journal of the American Medical Association show that program participants reported more consistent condom use and less unprotected sex as well as a higher frequency of condom use than those in the control group.[25]
           
Be Proud! Be Responsible! is an evidence-based HIV-prevention curriculum designed for urban, African-American males ages 13–18.[26] The curriculum seeks to provide young people with the knowledge, motivation, and skills necessary to reduce their risk of HIV, other STDs, and causing unintended pregnancy. It also aims to impact sexual behavior by equipping youth with negotiation, refusal, and condom use skills. The curriculum uses a “sense-of-community” approach that emphasizes how HIV/AIDS has affected inner-city communities and discusses the importance of protecting the community in order to instill accountability, sexual responsibility, and a sense of pride in participants. Although originally designed for use with small groups of six–12 participants, the curriculum has been used with larger groups and is appropriate for both school-based and community-based settings.[27] An evaluation of the program published in the American Journal of Community Psychology found that the intervention reduced the number of female sexual partners participants had as well as the number of non-monogamous female sexual partners (those who were simultaneously involved with other male partners). In addition, the study found that the intervention decreased the frequency of vaginal intercourse, reduced the incidence of heterosexual anal sex, and increased condom use among participants.[28]
 
Personal Responsibility Education Innovative Strategies (PREIS)
The PREIS Program supports research and demonstration programs to develop, replicate, refine, and test innovative models for preventing unintended teen pregnancy. The ACFadministers the grant program in collaboration with OAH and provides a total of $10 million in funding directly to local public and private entities.
  • There are no PREIS grantees in Delaware.
 
 
 
Title V State Abstinence Education Grant Program
The Title V State Abstinence Education Grant Program (Title V Abstinence-Only Program) allocates $50 million per year to states for Fiscal Years 2010−2014. ACF administers the grant program. The Title V Abstinence-Only Program requires states to provide three state-raised dollars or the equivalent in services for every four federal dollars received. The state match may be provided in part or in full by local groups. All programs funded by the Title V Abstinence-Only Program must promote abstinence from sexual activity as their exclusive purpose and may provide mentoring, counseling, and adult supervision toward this end. Programs must be medically accurate and age-appropriate and must ensure abstinence is an expected outcome.
  • Delaware chose not to apply for Title V abstinence-only funds for Fiscal Year 2010.
 
 
 
Delaware TPPI, PREP, and Title V Abstinence-Only Funding in FY 2010
Grantee
Award
Fiscal Years
Teen Pregnancy Prevention Initiative (TPPI)
TPPI Tier 1: Replication of Evidence-Based Programs
West End Neighborhood House, Inc.
$589,877
2010–2014
TOTAL
$589,877
 
Personal Responsibility Education Program (PREP)
PREP State-Grant Program
Delaware Health and Social Services (federal grant)
$250,000
2010
TOTAL
$250,000
 
 
GRAND TOTAL
$839,877
2010
 
 
 
Comprehensive Approaches to Sexuality Education
SIECUS has identified some examples of model programs, policies, and best practices being implemented in Delaware public schools that provide a more comprehensive approach to sex education for young people.[29]
 
Comprehensive Sex Education Programs in Public Schools
The Delaware Department of Education works to ensure that all school districts provide “age-appropriate, culturally sensitive HIV-prevention education” in middle and high schools in compliance with state policies and regulations.[30] Through funding from the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH), the department provides professional development on HIV-prevention curricula to school educators across the state.[31]  School districts in the state with high poverty rates, percentage of minority students, and those with schools failing to make annual progress on providing sex education are targeted for professional development training by the department. Currently, the department provides services to all 19 public school districts and 13 charter schools.  The Department of Education contracts with Planned Parenthood of Delaware to assist with providing these trainings.[32]
           
The department recommends Making Proud Choices!, an STD/HIV-prevention curriculum, and Healthy Sexuality, a comprehensive sex education curriculum, for use with middle school students.  It suggests Removing the Risk and Reducing the Risk, HIV-prevention education curricula, for use in high schools. (Please see the PREP State-Grant Program section above for a description of Making Proud Choices!.)
 
Healthy Sexualityis a skills-based curriculum that emphasizes abstinence and provides information on STDs, including HIV and HPV.  The curriculum consists of 11 activity-based lessons that help “define and promote healthy relationships,” “increase family communication about sexuality,” and “promote positive peer pressure regarding sexuality.”  The program also provides students with assistance in developing supportive networks and opportunities to practice communication and decision-making skills.[33]
 
Removing the Risk is an abstinence-only, HIV-prevention program for high school students.  The curriculum includes 10 lessons that focus on helping teens develop the interpersonal and social skills needed to postpone sexual activity, build healthy relationships that do not involve sexual intercourse, and avoid high-risk behaviors associated with unintended pregnancy, STDs, and HIV infection.[34]
 
Reducing the Risk: Building Skills to Prevent Pregnancy, STD and HIV is an evidence-based, sexuality education curriculum designed for classroom use with students in the ninth and tenth grades. It is appropriate for use with multi-ethnic populations.[35]  Reducing the Risk aims to reduce high-risk behaviors among participants and emphasizes strategies for abstaining from sex or practicing safer sex. The 16-lesson curriculum addresses both abstinence and contraception use and includes experiential activities that teach students to develop refusal, negotiation, and communication skills. An evaluation of the program published in Family Planning Perspectives found that it increased parent-child communication, especially among Latino youth, delayed the initiation of sexual intercourse, and reduced incidence of unprotected sex among lower-risk youth who participated in the program.[36]
 
With funding from the Personal Responsibility Education Program state grant, Delaware will also develop a statewide training institute to equip teachers and community providers to administer evidence-based sexual health programs in schools and community-based settings. (Please see the PREP State-Grant Program section above for more information on the project.)
 
We encourage you to submit any updated or additional information on comprehensive approaches to sex education being implemented in Delaware public schools for inclusion in future publications of the SIECUS State Profiles.  Please visit SIECUS’ “Contact Us” webpage at www.siecus.org to share information. Select “state policy” as the subject heading.
 
 
 
 
Points of Contact
 
Adolescent Health Contact[37]
Fred MacCormack
Director of Adolescent Health
Division of Public Health
Delaware Department of Health and Social Services
Jesse Cooper Building
P.O. Box 637
Dover, DE 19903
Phone: (302) 744-4822
 
PREP State-Grant Coordinator
Fred MacCormack
Director of Adolescent Health
Division of Public Health
Delaware Department of Health and Social Services
Jesse Cooper Building
P.O. Box 637
Dover, DE 19903
Phone: (302) 744-4822
 
 
 
Organizations that Support Comprehensive Sexuality Education
ACLU of Delaware
Wilmington, DE
Phone: (302) 654-3966
 
Delaware Women’s Conference
Newark, DE
Phone: (302) 577-5287
 
AIDS Delaware
Wilmington, DE
Phone: (302) 652.6776
 
Planned Parenthood of Delaware
Wilmington, DE
Phone: (302) 655-7296
 
Camp Rehoboth Community Center
Rehoboth Beach, DE
Phone: (302) 227-5620
 
 
 
 
 
Organizations that Oppose Comprehensive Sexuality Education
 
Delaware Pro-Life Coalition
Newark, DE
Phone: (302) 368-0329
 
Intercollegiate Studies Institute
Wilmington, DE
Phone: (302) 652-4600
 
Delaware Right To Life
Wilmington, DE
Phone: (302) 832-9600
 
 
 
 
Media Outlets
 
Newspapers in Delaware[38]
Dover Post
Dover, DE
Phone: (302) 678-8291
 
The News Journal
Wilmington, DE
Phone: (302) 324-2851
 
 
Political Blogs in Delaware
Delaware Watch
 
Delaware Politics
 
Paul’s Progressive Postings
 
 
 
 

[1]This refers to the federal government’s fiscal year, which begins on October 1st and ends on September 30th.  The fiscal year is designated by the calendar year in which it ends; for example, Fiscal Year 2010 began on October 1, 2009 and ended on September 30, 2010.
[2]Del. Admin. Code title 14, § 851(1.1.2 <http://regulations.delaware.gov/AdminCode/title14/800/851.pdf>
[3]Del. Admin. Code title 14, § 851(1.1.4) <http://regulations.delaware.gov/AdminCode/title14/800/851.pdf>
[4]Del. Admin. Code title 14, § 851(1.1.3.1), <http://regulations.delaware.gov/AdminCode/title14/800/851.pdf>
[5]Unless otherwise cited, all statistical information comes from:  Danice K. Eaton, et. al., “Youth Risk Behavior Surveillance—United States, 2009,” Surveillance Summaries, Morbidity and Mortality Weekly Report, vol. 59, no. SS-5 (4 June 2010): 98–109, accessed 4 June 2010, <http://www.cdc.gov/mmwr/pdf/ss/ss5905.pdf>.  
[6]“Births: Final Data for 2008,” National Vital Statistics Report, vol. 59, (Atlanta, GA: Centers for Disease Control and Prevention, December 2010), accessed 29 June 2011, <http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_01.pdf>, Table 12.
[7]“VitalStats: Birth Data Files by State, Age of Mother in Years, 2008,” (Atlanta, GA: Centers for Disease Control and Prevention), accessed 30 June 2011, <http://www.cdc.gov/nchs/data_access/vitalstats/VitalStats_Births.htm>.
[8]U.S. Teenage Pregnancies, Births, and Abortions: National and State Trends and Trends by Race and Ethnicity, (Washington, DC: Guttmacher Institute, January 2010), accessed 5 March 2010, <http://www.guttmacher.org/pubs/USTPtrends.pdf>, Table 3.1.
[9]Ibid., Table 3.2.
[10]U.S. Teenage Pregnancies, Births, and Abortions: National and State Trends and Trends by Race and Ethnicity., Table 3.3.
[11]HIV Surveillance Report, 2008, (Atlanta, GA: Centers for Disease Control and Prevention, June 2010), accessed 28 June 2011, <http://www.cdc.gov/hiv/surveillance/resources/reports/2008report/pdf/2008SurveillanceReport.pdf>, Table 20.
[12]Ibid.
[13]Slide 18: “Rates of AIDS Diagnoses among Adolescents Aged 13–19 Years, 2009—United States and Dependent Areas,” HIV Surveillance in Adolescents and Young Adults, (Atlanta, GA: Centers for Disease Control and Prevention, July 2011), accessed 27 September 2011, <http://www.cdc.gov/hiv/topics/surveillance/resources/slides/adolescents/index.htm>.
[14]“Wonder Database: Selected STDs by Age, Race/Ethnicity, and Gender, 1996-2008 Results,” (Atlanta, GA: Centers for Disease Control and Prevention), 30 June 2009, accessed 5 March 2010, <http://wonder.cdc.gov>; see also Table 10: “Chlamydia: Reported Cases and Rates Per 100,000 Population by Age Group and Sex: United States, 2004–2008,” Sexually Transmitted Disease Surveillance 2008, (Atlanta, GA: Centers for Disease Control and Prevention, Division of STD Prevention, November 2009), accessed 5 March 2010, <http://www.cdc.gov/std/stats08/surv2008-Complete.pdf>, 95.
[15]Ibid; see also Table 20: “Gonorrhea—Reported Cases and Rates per 100,000 Population by Age Group and Sex: United States, 2004–2008,” Sexually Transmitted Disease Surveillance 2008,106.
[16]Ibid; see also Table 33: “Primary and Secondary Syphilis—Reported Cases and Rates per 100,000 Population by Age Group and Sex: United States, 2004–2008,” Sexually Transmitted Disease Surveillance 2008, 121.
[17]“Our History,” West End Neighborhood House, accessed 14 April 2011, <http://www.westendnh.org/history/>.
[18]“Teenage Pregnancy Prevention: Summary of Funded Evidence-Based Programs for 2010,” U.S. Department of Health & Human Services, accessed 14 April 2011, <http://www.hhs.gov/ash/oah/prevention/grantees/models_2010_programs.html>.
[19]“Our Program,” The Children’s Aid Society – Carrera Adolescent Pregnancy Prevention Program, accessed 1 July 2011, <http://stopteenpregnancy.childrensaidsociety.org/our-program>.
[20]Ibid.
[21]“Pregnancy Prevention Intervention Implementation Report: Children’s Aid Society (CAS) – Carrera,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/cas_carrera.html>.
[22]“West End Announces New Teen Pregnancy Prevention Program,” West End Neighborhood House, Inc., 22 October 2010, accessed 14 April 2010, <http://www.westendnh.org/2010/10/22/west-end-announces-new-teen-pregnancy-prevention-program/>. 
[23]“Request for Proposal – Developing and Sustaining a Statewide Professional Development Partnership to Promote Healthy Outcomes and Reduce Sexual Risk Behaviors among Adolescents in Delaware,” State Department of Health and Social Services, Division of Public Health (November 2010). Information provided by Gloria James, Director of the Division of Public Health, 7 February 2011.
[24]“Making Proud Choices!” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 15 April 2010, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=128>.
[25]Ibid.
[26]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 1 July 2011, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 56–59.
[27]“Be Proud! Be Responsible!” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=1&PageTypeID=2>; see also “Pregnancy Prevention Intervention Implementation Report: Be Proud! Be Responsible!” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/be_proud_responsible.html>.
[28]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections, 56–59.
[29]This is by no means a complete list of all comprehensive programming and policies related to sexuality education, but rather some examples of best practices and model programs that SIECUS identified.
[30]“State Agencies: Delaware”, Healthy Youth! (Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion), accessed 23 May 2010, <http://www.cdc.gov/HealthyYouth/states/de.htm>.
[31]Ibid.
[32]Information provided by Janet Ray Arns, school health programs education associate for the Delaware Department of Education, 17 February 2010.
[33]“Health Sexuality: An Abstinence-Based Curriculum for Middle School,” Rocky Mountain Center for Health Promotion and Education, accessed 24 May 2010, <http://www.rmc.org/Training/health_sexuality.html>.
[34]“Removing the Risk” Evidence Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 24 May 2010, < >.
[35]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 30 March 2010, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 22.
[36]Ibid., 23–24.
[37]The person listed represents the designated personnel in the state responsible for adolescent reproductive health.
[38]This section is a list of major newspapers in the state and is by no means exhaustive of local print outlets.
 
National Coalition to Support Sexuality Education National Coalition to Support Sexuality Education