# 9 {#section .Chapter-#}

# Family Planning

9-1 Intended pregnancy

9-2 Birth spacing

9-3 Contraceptive use

9-4 Contraceptive failure

9-5 Emergency contraception

9-6 Male involvement in pregnancy prevention

9-7 Adolescent pregnancy

9-8 Abstinence before age 15 years

9-8a Females

9-8b Males

9-9 Abstinence among adolescents aged 15 to 17 years

9-9a Females

9-9b Males

9-10 Pregnancy prevention and sexually transmitted disease (STD)
protection

> Condom at first intercourse:

9-10a Females

9-10b Males

Condom plus hormonal method at first intercourse:

9-10c Females

9-10d Males

Condom at last intercourse:

9-10e Females

9-10f Males

Condom plus hormonal method at last intercourse:

9-10g Females

9-10h Males

9-11 Pregnancy prevention education

9-12 Problems in becoming pregnant and maintaining a pregnancy

9-13 Insurance coverage for contraceptive supplies and services

+---------------------+------------------------------------------------+
| 9-1. Increase the   |                                                |
| proportion of       |                                                |
| pregnancies that    |                                                |
| are intended.       |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Sources**           | NCHS; National Vital Statistics System (NVSS), |
|                     | CDC, NCHS; Abortion Provider Survey, The Alan  |
|                     | Guttmacher Institute (AGI); Abortion           |
|                     | Surveillance Data, CDC, NCCDPHP.               |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.2 (Family Planning).            |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 51 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of intended births among females aged   |
|                     | 15 to 44 years.                                |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of live births plus abortions among     |
|                     | females aged 15 to 44 years.                   |
+---------------------+------------------------------------------------+
| **Population        | U.S. resident population; U.S. civilian,       |
| Targeted**          | noninstitutionalized population.               |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Before you became pregnant this time, was  |
|                     |     the reason you did not use any birth       |
|                     |     control methods because you, yourself      |
|                     |     wanted to become pregnant?                 |
+---------------------+------------------------------------------------+
|                     | -   At the time you became pregnant, did you,  |
|                     |     yourself actually want to have a baby at   |
|                     |     some time?                                 |
+---------------------+------------------------------------------------+
|                     | -   So would you say you became pregnant too   |
|                     |     soon, at about the right time, or later    |
|                     |     than you wanted?                           |
|                     |                                                |
|                     |     1\) Too soon\                              |
|                     |     2) Right time\                             |
|                     |     3) Later\                                  |
|                     |     4) Didn't care                             |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Intended pregnancies include births that were  |
|                     | wanted at the time of conception. Births that  |
|                     | were wanted at the time of conception are      |
|                     | those resulting from pregnancies that happened |
|                     | at the right time, later than wanted or those  |
|                     | answering didn't care. All abortions are       |
|                     | considered unintended pregnancies.             |
+---------------------+------------------------------------------------+
|                     | Estimates of pregnancies that were intended    |
|                     | are derived from the following sources: (1)    |
|                     | live births to U.S. residents in 1994; (2) the |
|                     | proportion of recent births that were intended |
|                     | according to the 1995 NSFG; and (3) estimates  |
|                     | of induced abortions based on reports by CDC   |
|                     | and The Alan Guttmacher Institute (AGI). AGI's |
|                     | national estimates of abortions, based on      |
|                     | surveys it conducts of all known abortion      |
|                     | providers, are distributed by age, race,       |
|                     | marital status, and ethnicity according to     |
|                     | estimates prepared by CDC's National Center    |
|                     | for Chronic Disease Prevention and Health      |
|                     | Promotion (NCCDPHP), which are based on        |
|                     | reports from State health departments.         |
+---------------------+------------------------------------------------+
|                     | The proportion of births intended (females who |
|                     | wanted to become pregnant and wanted to have a |
|                     | baby at sometime and became pregnant at the    |
|                     | right time, later, or didn't care) from NSFG   |
|                     | are applied to all resident live births,       |
|                     | divided by all births and abortions combined.  |
+---------------------+------------------------------------------------+
|                     | Information about potential sources of error   |
|                     | in the data sources have been                  |
|                     | published.**^1,\ 2,\ 3^**                      |
+---------------------+------------------------------------------------+
|                     | Known pregnancies that ended in fetal loss     |
|                     | (for example, miscarriage, stillbirth, or      |
|                     | ectopic pregnancy) are excluded. However, it   |
|                     | was found that incorporating information on    |
|                     | the planning status of pregnancies resulting   |
|                     | in fetal loss, as reported in the 1995 NSFG,   |
|                     | had very little impact on the proportions      |
|                     | shown.                                         |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 5.2, which       |
|                     | tracked the proportion of pregnancies that     |
|                     | were unintended. This measure tracks the       |
|                     | proportion of pregnancies that are intended.   |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and NVSS  |
|                     | and Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-2. Reduce the     |                                                |
| proportion of       |                                                |
| births occurring    |                                                |
| within 24 months of |                                                |
| a previous birth.   |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Not applicable.                                |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 11 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of females aged 15 to 44 years whose    |
|                     | most recent live birth occurred within 24      |
|                     | months of a previous live birth.               |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of females aged 15 to 44 years with at  |
|                     | least one live birth.                          |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   How many times have you been pregnant      |
|                     |     altogether?                                |
+---------------------+------------------------------------------------+
|                     | \[For each pregnancy:\]                        |
|                     |                                                |
|                     | -   In which of the ways did the pregnancy     |
|                     |     end?                                       |
|                     |                                                |
|                     |     \(a\) Miscarriage\                         |
|                     |     (b) Still birth\                           |
|                     |     (c) Abortion\                              |
|                     |     (d) Ectopic or tubal pregnancy\            |
|                     |     (e) Live birth by Cesarean section\        |
|                     |     (f) Live birth by vaginal delivery         |
+---------------------+------------------------------------------------+
|                     | \[For each live birth:\]                       |
|                     |                                                |
|                     | -   On what date was ([baby's                  |
|                     |     name]{.underline}) born?                   |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | A female is considered to have had a birth     |
|                     | within 24 months of a previous birth if she    |
|                     | had consecutive pregnancies ending in a live   |
|                     | birth by Cesarean section or live birth by     |
|                     | vaginal delivery.                              |
+---------------------+------------------------------------------------+
|                     | The interval between consecutive live births   |
|                     | is derived from the date of birth.             |
+---------------------+------------------------------------------------+
|                     | Vaginal delivery includes delivery through     |
|                     | natural or induced labor.                      |
+---------------------+------------------------------------------------+
|                     | Questions addressing how the pregnancy ended   |
|                     | and date baby was born are repeated based on   |
|                     | the number of pregnancies.                     |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-3. Increase the   |                                                |
| proportion of       |                                                |
| females at risk of  |                                                |
| unintended          |                                                |
| pregnancy (and      |                                                |
| their partners) who |                                                |
| use contraception.  |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | 5.12 (Family Planning).                        |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 93 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of at-risk females aged 15 to 44 years  |
|                     | who currently use a method of contraception    |
|                     | other than withdrawal.                         |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of at-risk females aged 15 to 44 years. |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | \[NUMERATOR:\]                                 |
|                     |                                                |
|                     | -   Please write the methods you used each     |
|                     |     month on the calendar. I need to know      |
|                     |     about all the methods you used, so if you  |
|                     |     used more than one method, please write    |
|                     |     down all methods you used that month.      |
|                     |                                                |
|                     |     1\) Birth control pills\                   |
|                     |     2) Condom\                                 |
|                     |     3) Partner's vasectomy\                    |
|                     |     4) Diaphragm\                              |
|                     |     5) Foam\                                   |
|                     |     6) Jelly or cream\                         |
|                     |     7) Cervical cap\                           |
|                     |     8) Suppository, insert\                    |
|                     |     9) Today sponge\                           |
|                     |     10) Female condom, vaginal pouch\          |
|                     |     11) IUD, Coil, Loop\                       |
|                     |     12) Norplant\                              |
|                     |     13) Depo-provera, Injectables\             |
|                     |     14) Morning after pill\                    |
|                     |     15) Rhythm or safe period by calendar\     |
|                     |     16) Safe period by temperature, or         |
|                     |     cervical mucus test, or natural family     |
|                     |     planning\                                  |
|                     |     17) Withdrawal, pulling out\               |
|                     |     18) Respondent sterile\                    |
|                     |     19) Partner sterile\                       |
|                     |     20) Other method (specify)                 |
+---------------------+------------------------------------------------+
|                     | \[DENOMINATOR:\]                               |
|                     |                                                |
|                     | -   Is the reason you are not using a method   |
|                     |     of birth control now because you,          |
|                     |     yourself, want to become pregnant as soon  |
|                     |     as possible?                               |
+---------------------+------------------------------------------------+
|                     | -   Many women have times when they are not    |
|                     |     having intercourse at all, for example,    |
|                     |     because of pregnancy, separation, not      |
|                     |     dating anyone, illness, or other reasons.  |
|                     |     Since ([Date]{.underline}), have there     |
|                     |     been any times when you were not having    |
|                     |     intercourse at all for one month or more?  |
+---------------------+------------------------------------------------+
|                     | -   What months and years were those?          |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | A female (and her partner) is considered to be |
|                     | at risk of unintended pregnancy if there is a  |
|                     | negative response to the denominator questions |
|                     | above on wanting to become pregnant (first     |
|                     | question) or not having intercourse (second    |
|                     | question).                                     |
+---------------------+------------------------------------------------+
|                     | "At risk" females are those who had            |
|                     | intercourse in the 3 months prior to the       |
|                     | survey who were not pregnant, nor seeking      |
|                     | pregnancy, nor post partum, nor (themselves or |
|                     | partners) surgically or nonsurgically sterile. |
+---------------------+------------------------------------------------+
|                     | "Currently using" refers to having used any    |
|                     | contraceptive method (categories 1, 2, 4       |
|                     | through 16 above) other than sterilization or  |
|                     | withdrawal in the month of the interview.      |
+---------------------+------------------------------------------------+
|                     | An unintended pregnancy is one that was not    |
|                     | wanted at the time of conception or not wanted |
|                     | at all.                                        |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-4. Reduce the     |                                                |
| proportion of       |                                                |
| females             |                                                |
| experiencing        |                                                |
| pregnancy despite   |                                                |
| use of a reversible |                                                |
| contraceptive       |                                                |
| method.             |                                                |
+---------------------+------------------------------------------------+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Sources**           | NCHS; Abortion Patient Survey, The Alan        |
|                     | Guttmacher Institute (AGI).                    |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | 5.7 (Family Planning).                         |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 13 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of pregnancies that occur within the    |
|                     | first 12 months of reported continuous use of  |
|                     | a reversible contraceptive method among        |
|                     | females aged 15 to 44 years, and their         |
|                     | partners.                                      |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of consecutive months that a reversible |
|                     | contraceptive method was used by females aged  |
|                     | 15 to 44 years, and their partners.            |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Please write the methods you used each     |
|                     |     month on the calendar. I need to know      |
|                     |     about all the methods you used, so if you  |
|                     |     used more than one method, please write    |
|                     |     down all methods you used that month.      |
|                     |                                                |
|                     |     1\) Birth control pills\                   |
|                     |     2) Condom\                                 |
|                     |     3) Partner's vasectomy\                    |
|                     |     4) Diaphragm\                              |
|                     |     5) Foam\                                   |
|                     |     6) Jelly or cream\                         |
|                     |     7) Cervical cap\                           |
|                     |     8) Suppository, insert\                    |
|                     |     9) Today sponge\                           |
|                     |     10) Female condom, vaginal pouch\          |
|                     |     11) IUD, Coil, Loop\                       |
|                     |     12) Norplant\                              |
|                     |     13) Depo-provera, Injectables\             |
|                     |     14) Morning after pill\                    |
|                     |     15) Rhythm or safe period by calendar\     |
|                     |     16) Safe period by temperature, cervical   |
|                     |     mucus test, natural family planning\       |
|                     |     17) Withdrawal, pulling out\               |
|                     |     18) Respondent sterile\                    |
|                     |     19) Partner sterile\                       |
|                     |     20) Other method (specify)                 |
+---------------------+------------------------------------------------+
|                     | -   How many months or weeks had you been      |
|                     |     pregnant when the baby was born/that       |
|                     |     pregnancy ended? (Note: this yields date   |
|                     |     pregnancy began.)                          |
+---------------------+------------------------------------------------+
|                     | From the 1994 Abortion Patient Survey:         |
|                     |                                                |
|                     | -   Before you found out you were pregnant,    |
|                     |     what was the LAST contraceptive method     |
|                     |     that you used to prevent pregnancy,        |
|                     |     including rhythm, withdrawal or condoms?   |
|                     |                                                |
|                     |     \(a\) Pill\                                |
|                     |     (b) Condom, rubber (for males)\            |
|                     |     (c) Female condom, vaginal pouch\          |
|                     |     (d) Diaphragm with or without jelly or     |
|                     |     cream\                                     |
|                     |     (e) Sponge (TODAY)\                        |
|                     |     (f) Foam/cream/jelly\                      |
|                     |     (g) Suppository, insert (Semicid, Encara   |
|                     |     Oval)\                                     |
|                     |     (h) IUD, coil, loop\                       |
|                     |     (i) Rhythm/natural family planning\        |
|                     |     (j) Withdrawal\                            |
|                     |     (k) Norplant, implants in the arm\         |
|                     |     (l) Depo-Prevera, injectables, shot\       |
|                     |     (m) Emergency contraception/morning-after  |
|                     |     pill\                                      |
|                     |     (n) Other method (specify)\                |
|                     |     (o) Never used a method before this        |
|                     |     pregnancy                                  |
+---------------------+------------------------------------------------+
|                     | -   In what month and year did you stop using  |
|                     |     that method?\                              |
|                     |     \_\_\_\_\_\_/\_\_\_\_\_\_Month Year        |
+---------------------+------------------------------------------------+
|                     | -   For about how many months in a row had you |
|                     |     been using that method?                    |
|                     |                                                |
|                     |     Less than 1 month\                         |
|                     |     1 month\                                   |
|                     |     2 months\                                  |
|                     |     3 months\                                  |
|                     |     4 months\                                  |
|                     |     5 months\                                  |
|                     |     6 months\                                  |
|                     |     7 months\                                  |
|                     |     8 months\                                  |
|                     |     9 months\                                  |
|                     |     10 months\                                 |
|                     |     11 months\                                 |
|                     |     12 months\                                 |
|                     |     13 months\                                 |
|                     |     14 months\                                 |
|                     |     15 months\                                 |
|                     |     16 months\                                 |
|                     |     17 months\                                 |
|                     |     18-24 months\                              |
|                     |     25-26 months\                              |
|                     |     27-28 months\                              |
|                     |     29-36 months\                              |
|                     |     37 or more months (3 or more years)        |
+---------------------+------------------------------------------------+
|                     | -   Had you ever used that method before the   |
|                     |     months specified above?                    |
+---------------------+------------------------------------------------+
|                     | -   Had you stopped using all methods to       |
|                     |     prevent pregnancy before you became        |
|                     |     pregnant this time?                        |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Pregnancies include live births, miscarriages, |
|                     | or induced abortions.                          |
+---------------------+------------------------------------------------+
|                     | Females are considered to have experienced     |
|                     | pregnancy despite use of a reversible method   |
|                     | if there was continuous method use (in         |
|                     | 12-month intervals) and they became pregnant   |
|                     | during a month of use of one or more of the    |
|                     | following methods: birth control pills, condom |
|                     | (rubber), diaphragm, foam/jelly/cream,         |
|                     | cervical cap, suppository, insert, Today^TM^   |
|                     | sponge, female condom (vaginal pouch), IUD,    |
|                     | coil, loop, Norplant, Depo-provera,            |
|                     | injectables, withdrawal (pulling out),         |
|                     | rhythm/natural family planning, or emergency   |
|                     | contraception/morning-after pill.              |
|                     |                                                |
|                     | NSFG data are adjusted for underreporting of   |
|                     | abortions according to AGI's Abortion Patient  |
|                     | Survey. Detailed information on adjustment     |
|                     | procedure, contraceptive methods and failure   |
|                     | rates have been published by AGI.**^4^**       |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+
| 9-5.                |                                                |
| (Developmental)     |                                                |
| Increase the        |                                                |
| proportion of       |                                                |
| health care         |                                                |
| providers who       |                                                |
| provide emergency   |                                                |
| contraception.      |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | An operational definition could not be         |
|                     | specified at the time of publication.          |
+---------------------+------------------------------------------------+
|                     | A proposed national data source is The Alan    |
|                     | Guttmacher Institute (AGI).                    |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

  ---------------------- ------------------------------------------------
  9-6. (Developmental)   
  Increase male          
  involvement in         
  pregnancy prevention   
  and family planning    
  efforts.               

  **Comments**           An operational definition could not be specified
                         at the time of publication.

                         A proposed national data source is the National
                         Survey of Family Growth (NSFG), CDC, NCHS.

                         Proposed questions to be used to obtain the data
                         are scheduled to be included in the 2001 NSFG.

                         NSFG collect comparable data on males aged 15 to
                         49 years starting with data collected in 2001.

                         See Appendix A for focus area contact
                         information.
  ---------------------- ------------------------------------------------

+---------------------+------------------------------------------------+
| 9-7. Reduce         |                                                |
| pregnancies among   |                                                |
| adolescent females. |                                                |
+=====================+================================================+
| **National Data     | Abortion Provider Survey, The Alan Guttmacher  |
| Sources**           | Institute (AGI); Abortion Surveillance Data,   |
|                     | CDC, NCCDPHP; National Vital Statistics System |
|                     | (NVSS), CDC, NCHS; National Survey of Family   |
|                     | Growth (NSFG), CDC, NCHS.                      |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | 5.1 (Family Planning).                         |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Rate.                                          |
+---------------------+------------------------------------------------+
| **Baseline**        | 68 (1996).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of pregnancies among females aged 15 to |
|                     | 17 years.                                      |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of adolescent females aged 15 to 17     |
|                     | years.                                         |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population; U.S. resident population.          |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   (For fetal losses) In which of the ways    |
|                     |     did your pregnancy end?                    |
|                     |                                                |
|                     |     1\) Miscarriage\                           |
|                     |     2) Stillbirth\                             |
|                     |     3) Abortion\                               |
|                     |     4) Ectopic or tubal pregnancy\             |
|                     |     5) Live birth by Cesarean section\         |
|                     |     6) Live birth by vaginal delivery\         |
|                     |     \[Responses 1 and 2 are used as indicators |
|                     |     of fetal loss.\]                           |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Adolescent pregnancies are the sum of all U.S. |
|                     | resident live births, induced abortions, and   |
|                     | fetal losses to females aged 15 to 17 years.   |
+---------------------+------------------------------------------------+
|                     | Data on live births are counts of all births   |
|                     | to U.S. residents occurring in the United      |
|                     | States. Estimates of induced abortion are      |
|                     | based on reports by CDC and The Alan           |
|                     | Guttmacher Institute (AGI). AGI's national     |
|                     | estimates of abortions, based on surveys it    |
|                     | conducts of all known abortion providers, are  |
|                     | distributed by age and race according to       |
|                     | estimates prepared by CDC's National Center    |
|                     | for Chronic Disease Prevention and Health      |
|                     | Promotion (NCCDPHP), based on reports of       |
|                     | induced abortions from selected State health   |
|                     | departments.                                   |
+---------------------+------------------------------------------------+
|                     | Estimates of fetal losses are estimates from   |
|                     | the 1995 NSFG. Females participating in this   |
|                     | survey were asked to report the dates and      |
|                     | outcomes of each of their pregnancies in the   |
|                     | past 5 years, including spontaneous fetal      |
|                     | losses (miscarriages, stillbirths) from        |
|                     | recognized pregnancies.                        |
+---------------------+------------------------------------------------+
|                     |                                                |
+---------------------+------------------------------------------------+
|                     | Fetal losses refer to pregnancies that end in  |
|                     | miscarriage or stillbirth.                     |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and NVSS  |
|                     | and Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

9-8. Increase the proportion of adolescents who have never engaged in
sexual intercourse before age 15 years.

+---------------------+------------------------------------------------+
| 9-8a. Females.      |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.4 (Family Planning) (also 18.3  |
| 2000 Objective**    | and 19.9).                                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 81 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of females aged 15 to 19 years who had  |
|                     | no sexual intercourse with a male before age   |
|                     | 15.                                            |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of females aged 15 to 19 years.         |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   At any time in your life, have you ever    |
|                     |     had sexual intercourse with a man, that    |
|                     |     is, made love, had sex, or gone all the    |
|                     |     way?                                       |
+---------------------+------------------------------------------------+
|                     | \[If yes:\]                                    |
|                     |                                                |
|                     | -   Please look at the calendar and think back |
|                     |     to the very first time in your life that   |
|                     |     you ever had sexual intercourse with a     |
|                     |     man. In what month and year was that?\     |
|                     |     \_\_\_\_Month \_\_\_\_Year                 |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Females are considered to have never had       |
|                     | sexual intercourse before age 15 if they       |
|                     | report that they either never had sexual       |
|                     | intercourse with a male or their age at first  |
|                     | intercourse was greater than 15 years.         |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from Healthy People  |
|                     | 2000 objective 5.4, which tracked the          |
|                     | proportion of adolescents aged 15 to 17 years  |
|                     | who engaged in sexual intercourse. This        |
|                     | measure tracks the proportion of females aged  |
|                     | 15 to 19 years who have never engaged in       |
|                     | sexual intercourse.                            |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-8b. Males.        |                                                |
+=====================+================================================+
| **National Data     | National Survey of Adolescent Males (NSAM),    |
| Source**            | Urban Institute.                               |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.4 (Family Planning) (also 18.3  |
| 2000 Objective**    | and 19.9).                                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 79 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of males aged 15 to 19 years who had no |
|                     | sexual intercourse with a female before age    |
|                     | 15.                                            |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of males aged 15 to 19 years.           |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Adolescent    |
| Obtain the National | Males:                                         |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had sexual intercourse with  |
|                     |     a female (sometimes this is called "making |
|                     |     love," "having sex" or "going all the      |
|                     |     way")?                                     |
+---------------------+------------------------------------------------+
|                     | \[Followed by a question of when the           |
|                     | intercourse occurred, similar to that used in  |
|                     | objective 9.8a\]                               |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Males are considered to have never had sexual  |
|                     | intercourse before age 15 if they report that  |
|                     | they either never had sexual intercourse with  |
|                     | a female or their age at first intercourse was |
|                     | greater than 15 years.                         |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from Healthy People  |
|                     | 2000 objective 5.4, which tracked the          |
|                     | proportion of adolescents aged 15 to 17 years  |
|                     | who engaged in sexual intercourse. This        |
|                     | measure tracks the proportion of males aged 15 |
|                     | to 19 years who have never engaged in sexual   |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | NSFG will collect comparable data on males     |
|                     | aged 15 to 49 years starting with data         |
|                     | collected in 2001 and will thereby replace     |
|                     | NSAM for tracking of this measure.             |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

9-9. Increase the proportion of adolescents who have never engaged in
sexual intercourse.

+---------------------+------------------------------------------------+
| 9-9a. Females.      |                                                |
+---------------------+------------------------------------------------+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.4 (Family Planning) (also 18.3  |
| 2000 Objective**    | and 19.9).                                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 62 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of females aged 15 to 17 years who had  |
|                     | never had sexual intercourse with a male.      |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of females aged 15 to 17 years.         |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   At any time in your life, have you ever    |
|                     |     had sexual intercourse with a man, that    |
|                     |     is, made love, had sex, or gone all the    |
|                     |     way?                                       |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | This objective is adapted from Healthy People  |
|                     | 2000 objective 5.4, which tracked the          |
|                     | proportion of adolescents aged 15 to 17 years  |
|                     | who engaged in sexual intercourse. This        |
|                     | measure tracks the proportion of females aged  |
|                     | 15 to 17 years who have never engaged in       |
|                     | sexual intercourse.                            |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+
| 9-9b. Males.        |                                                |
+---------------------+------------------------------------------------+
| **National Data     | National Survey of Adolescent Males (NSAM),    |
| Source**            | Urban Institute.                               |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.4 (Family Planning) (also 18.3  |
| 2000 Objective**    | and 19.9).                                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 57 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of males aged 15 to 17 years who had    |
|                     | never had sexual intercourse with a female.    |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of males aged 15 to 17 years.           |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Adolescent    |
| Obtain the National | Males:                                         |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had sexual intercourse with  |
|                     |     a female (sometimes this is called "making |
|                     |     love," "having sex" or "going all the      |
|                     |     way")?                                     |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | This objective is adapted from Healthy People  |
|                     | 2000 objective 5.4, which tracked the          |
|                     | proportion of adolescents aged 15 to 17 years  |
|                     | who engaged in sexual intercourse. This        |
|                     | measure tracks the proportion of males aged 15 |
|                     | to 17 years who have never engaged in sexual   |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | NSFG will collect comparable data on males     |
|                     | aged 15 to 49 years starting with data         |
|                     | collected in 2001 and will thereby replace     |
|                     | NSAM for tracking of this measure.             |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

**9-10. Increase the proportion of sexually active, unmarried
adolescents aged 15 to 17 years who use contraception that both
effectively prevents pregnancy and provides** barrier protection against
disease.

+---------------------+------------------------------------------------+
| 9-10a. Condom at    |                                                |
| first intercourse:  |                                                |
| Females.            |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.6 (Family Planning).            |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 67 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of sexually experienced, unmarried      |
|                     | females aged 15 to 17 years who used a condom  |
|                     | at first intercourse.                          |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of sexually experienced, unmarried      |
|                     | females aged 15 to 17 years.                   |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   What is your current marital status? Are   |
|                     |     you\...                                    |
|                     |                                                |
|                     |     1\) Married\                               |
|                     |     2) Widowed\                                |
|                     |     3) Divorced\                               |
|                     |     4) Separated, because you and your husband |
|                     |     are not getting along\                     |
|                     |     5) Have you never been married?            |
+---------------------+------------------------------------------------+
|                     | \[Following a series of questions on when      |
|                     | sexual intercourse with a man occurred and     |
|                     | whether or not the sexual intercourse was      |
|                     | voluntary:\]                                   |
+---------------------+------------------------------------------------+
|                     | -   The very first time you ever used a birth  |
|                     |     control method, which method did you use?  |
|                     |     If you used more than one method that      |
|                     |     first time, please tell me about it.       |
|                     |                                                |
|                     |     1\) Birth control pills\                   |
|                     |     2) Condom\                                 |
|                     |     3) Partner's vasectomy\                    |
|                     |     4) Diaphragm\                              |
|                     |     5) Foam\                                   |
|                     |     6) Jelly or cream\                         |
|                     |     7) Cervical cap\                           |
|                     |     8) Suppository, insert\                    |
|                     |     9) Today sponge\                           |
|                     |     10) Female condom, vaginal pouch\          |
|                     |     11) IUD, Coil, Loop\                       |
|                     |     12) Norplant\                              |
|                     |     13) Depo-provera, Injectables\             |
|                     |     14) Morning after pill\                    |
|                     |     15) Rhythm or safe period by calendar\     |
|                     |     16) Safe period by temperature, or         |
|                     |     cervical mucus test, natural family        |
|                     |     planning\                                  |
|                     |     17) Withdrawal, pulling out\               |
|                     |     18) Respondent sterile\                    |
|                     |     19) Partner sterile\                       |
|                     |     20) Other method (specify)                 |
+---------------------+------------------------------------------------+
|                     | -   Thinking again of the very first time you  |
|                     |     used a method of birth control, was it the |
|                     |     first time you had intercourse?            |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Unmarried females are considered to have used  |
|                     | a condom at first intercourse if they reported |
|                     | they were sexually active and partner used a   |
|                     | condom (rubber) at their first intercourse.    |
+---------------------+------------------------------------------------+
|                     | Sexually experienced refers to females who had |
|                     | their first premarital voluntary intercourse   |
|                     | in the past 5 years.                           |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 5.6, which       |
|                     | tracked the proportion of sexually active,     |
|                     | unmarried people aged 15 to 19 years who used  |
|                     | contraception at first intercourse. This       |
|                     | measure tracks the proportion of females aged  |
|                     | 15 to 17 years who used a condom at first      |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-10b. Condom at    |                                                |
| first intercourse:  |                                                |
| Males.              |                                                |
+---------------------+------------------------------------------------+
| **National Data     | National Survey of Adolescent Males (NSAM),    |
| Source**            | Urban Institute.                               |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.6 (Family Planning).            |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 72 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of sexually experienced, unmarried      |
|                     | males aged 15 to 17 years who used a condom at |
|                     | first intercourse.                             |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of sexually experienced, unmarried      |
|                     | males aged 15 to 17 years.                     |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Adolescent    |
| Obtain the National | Males:                                         |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | \[Following a question on marital status:\]    |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had sexual intercourse with  |
|                     |     a female (sometimes this is called "making |
|                     |     love," "having sex" or "going all the      |
|                     |     way")?                                     |
+---------------------+------------------------------------------------+
|                     | -   That time (the first intercourse) did you, |
|                     |     yourself, use any method of contraceptive  |
|                     |     to prevent pregnancy or sexually           |
|                     |     transmitted disease?                       |
+---------------------+------------------------------------------------+
|                     | -   What method did you use?                   |
|                     |                                                |
|                     |     1\) Condom, rubber\                        |
|                     |     2) Withdrawal, pulling out\                |
|                     |     3) Combination of methods, specify\        |
|                     |     4) Other, specify                          |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Unmarried males are considered to have used a  |
|                     | condom at first intercourse if they reported   |
|                     | they were sexually active and used a condom    |
|                     | (rubber) at their first intercourse.           |
+---------------------+------------------------------------------------+
|                     | Sexually experienced refers to males aged 15   |
|                     | to 17 years who had ever had intercourse.      |
+---------------------+------------------------------------------------+
|                     | NSFG will collect comparable data on males     |
|                     | aged 15 to 49 years starting with data         |
|                     | collected in 2001 and will thereby replace the |
|                     | NSAM for tracking of this measure.             |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 5.6, which       |
|                     | tracked the proportion of sexually active,     |
|                     | unmarried people aged 15 to 19 years who used  |
|                     | contraception at most recent intercourse. This |
|                     | measure tracks the proportion of males aged 15 |
|                     | to 17 years who used a condom at first         |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

  -----------------------------------------------------------------------
  9-10c. Condom plus     
  hormonal method at     
  first intercourse:     
  Females.               
  ---------------------- ------------------------------------------------
  **National Data        National Survey of Family Growth (NSFG), CDC,
  Source**               NCHS.

  **State Data Source**  Not identified.

  **Healthy People 2000  Adapted 5.6 (Family Planning).
  Objective**            

  **Measure**            Percent.

  **Baseline**           7 (1995).

  **Numerator**          Number of sexually experienced, unmarried
                         females aged 15 to 17 years who used a condom
                         plus hormonal method at first intercourse.

  **Denominator**        Number of sexually experienced, unmarried
                         females aged 15 to 17 years.

  **Population           U.S. civilian, noninstitutionalized population.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 9-10a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           Unmarried females are considered to have used a
                         condom and hormonal method at first intercourse
                         if they reported they were sexually active;
                         partner used a condom (rubber); and they used
                         either birth control pills, Depo-provera
                         injectables, Norplant implants, or morning-after
                         pills at their first intercourse.

                         Sexually experienced refers to females who had
                         their first premarital voluntary intercourse in
                         the past 5 years.

                         This objective is adapted from a measure in
                         Healthy People 2000 objective 5.6, which tracked
                         the proportion of sexually active, unmarried
                         people aged 15 to 19 years who used both an oral
                         contraceptive and condom at most recent
                         intercourse. This measure tracks the proportion
                         of females aged 15 to 17 years who used a condom
                         plus hormonal method at first intercourse.

                         See Part C for a description of NSFG and
                         Appendix A for focus area contact information.
  -----------------------------------------------------------------------

  -----------------------------------------------------------------------
  9-10d. Condom plus     
  hormonal method at     
  first intercourse:     
  Males.                 
  ---------------------- ------------------------------------------------
  **National Data        National Survey of Adolescent Males (NSAM),
  Source**               Urban Institute.

  **State Data Source**  Not identified.

  **Healthy People 2000  Adapted from 5.6 (Family Planning).
  Objective**            

  **Measure**            Percent.

  **Baseline**           8 (1995).

  **Numerator**          Number of sexually experienced, unmarried males
                         aged 15 to 17 years who used a condom plus
                         hormonal method at first intercourse.

  **Denominator**        Number of sexually experienced, unmarried males
                         aged 15 to 17 years.

  **Population           U.S. civilian, noninstitutionalized population.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 9-10b.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           Unmarried males are considered to have used a
                         condom and hormonal method at first intercourse
                         if they reported they were sexually active; used
                         a condom (rubber); [and]{.underline} their
                         partner used either pills, Norplant, or
                         Depo-provera at their first intercourse.

                         Sexually experienced refers to males aged 15 to
                         17 years who had ever had intercourse.

                         NSFG will collect comparable data on males aged
                         15 to 49 years starting with data collected in
                         2001 and will thereby replace NSAM for tracking
                         of this measure.

                         This objective is adapted from a measure in
                         Healthy People 2000 objective 5.6, which tracked
                         the proportion of sexually active students aged
                         15 to 17 years who used condom and birth control
                         pill at most recent intercourse using the Youth
                         Risk Behavior Surveillance System (YRBSS), CDC,
                         NCCDPHP. This measure tracks the proportion of
                         males aged 15 to 17 years who used a condom plus
                         hormonal method at first intercourse.

                         See Appendix A for focus area contact
                         information.
  -----------------------------------------------------------------------

+---------------------+------------------------------------------------+
| 9-10e. Condom at    |                                                |
| last intercourse:   |                                                |
| Females.            |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 19.10a (Sexually Transmitted      |
| 2000 Objective**    | Diseases) (also 18.4a).                        |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 39 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of sexually active, unmarried females   |
|                     | aged 15 to 17 years who used a condom at last  |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of sexually active, unmarried females   |
|                     | aged 15 to 17 years.                           |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   What is your current marital status? Are   |
|                     |     you\...                                    |
|                     |                                                |
|                     |     1\) Married\                               |
|                     |     2) Widowed\                                |
|                     |     3) Divorced\                               |
|                     |     4) Separated, because you and your husband |
|                     |     are not getting along\                     |
|                     |     5) Have you never been married?            |
+---------------------+------------------------------------------------+
|                     | \[Following a series of questions on when      |
|                     | sexual intercourse with a man occurred:\]      |
+---------------------+------------------------------------------------+
|                     | -   The last time you had intercourse, did you |
|                     |     or your partner use any method?            |
+---------------------+------------------------------------------------+
|                     | -   Which methods?                             |
|                     |                                                |
|                     |     1\) Birth control pills\                   |
|                     |     2) Condom\                                 |
|                     |     3) Partner's vasectomy\                    |
|                     |     4) Diaphragm\                              |
|                     |     5) Foam\                                   |
|                     |     6) Jelly or cream\                         |
|                     |     7) Cervical cap\                           |
|                     |     8) Suppository, insert\                    |
|                     |     9) Today sponge\                           |
|                     |     10) Female condom, vaginal pouch\          |
|                     |     11) IUD, Coil, Loop\                       |
|                     |     12) Norplant\                              |
|                     |     13) Depo-provera, Injectables\             |
|                     |     14) Morning after pill\                    |
|                     |     15) Rhythm or safe period by calendar\     |
|                     |     16) Safe period by temperature, or         |
|                     |     cervical mucus test, natural family        |
|                     |     planning\                                  |
|                     |     17) Withdrawal, pulling out\               |
|                     |     18) Respondent sterile\                    |
|                     |     19) Partner sterile\                       |
|                     |     20) Other method (specify)                 |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Unmarried females are considered to have used  |
|                     | a condom at last intercourse if they reported  |
|                     | they were sexually active [and]{.underline}    |
|                     | partner used a condom (rubber) at their last   |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | Sexually active refers to females who have had |
|                     | intercourse in the 3 months prior to           |
|                     | interview.                                     |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 19.10a, which    |
|                     | tracked the proportion of sexually active,     |
|                     | unmarried people aged 15 to 19 years who       |
|                     | report their partner used a condom at last     |
|                     | intercourse. This measure tracks the           |
|                     | proportion of females aged 15 to 17 years who  |
|                     | used a condom (male or female) at last         |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-10f. Condom at    |                                                |
| last intercourse:   |                                                |
| Males.              |                                                |
+=====================+================================================+
| **National Data     | National Survey of Adolescent Males (NSAM),    |
| Source**            | Urban Institute.                               |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 19.10b (Sexually Transmitted      |
| 2000 Objective**    | Diseases) (also 18.4b).                        |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 70 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of sexually active, unmarried males     |
|                     | aged 15 to 17 years who used a condom at last  |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of sexually active, unmarried males     |
|                     | aged 15 to 17 years.                           |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Adolescent    |
| Obtain the National | Males:                                         |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | \[Following a question on marital status:\]    |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had sexual intercourse with  |
|                     |     a female (sometimes this is called "making |
|                     |     love," "having sex" or "going all the      |
|                     |     way")?                                     |
+---------------------+------------------------------------------------+
|                     | -   The last time you had intercourse with     |
|                     |     ([Initials of partner]{.underline}) did    |
|                     |     you, yourself, use any method of           |
|                     |     contraception - that is, something to      |
|                     |     prevent pregnancy or sexually transmitted  |
|                     |     disease?                                   |
+---------------------+------------------------------------------------+
|                     | -   What method did you use?\                  |
|                     |     1) Condom, rubber\                         |
|                     |     2) Withdrawal, pulling out\                |
|                     |     3) Combination of methods, specify\        |
|                     |     4) Other, specify                          |
+---------------------+------------------------------------------------+
|                     | -   The last time you had intercourse with     |
|                     |     ([Initials of partner]{.underline}) did    |
|                     |     she use any contraceptive methods?         |
+---------------------+------------------------------------------------+
|                     | -   What method did she use?                   |
|                     |                                                |
|                     |     1\) Depo-provera\                          |
|                     |     2) Diaphragm or cervical cap\              |
|                     |     3) Douching (washing out) after            |
|                     |     intercourse\                               |
|                     |     4) Female condom\                          |
|                     |     5) Spermicidal foam/jelly/cream or         |
|                     |     suppository\                               |
|                     |     6) IUD, Coil, Loop\                        |
|                     |     7) Norplant\                               |
|                     |     9) Pill\                                   |
|                     |     10) Rhythm, or safe period by calendar\    |
|                     |     11) Sterilization\                         |
|                     |     12) Today sponge\                          |
|                     |     13) Vaginal contraceptive film or insert\  |
|                     |     14) Combination of methods, specify\       |
|                     |     15) Something else, specify                |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Unmarried males are considered to have used a  |
|                     | condom at last intercourse if they reported    |
|                     | they were sexually active [and]{.underline}    |
|                     | used a condom (rubber) at their last           |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | Sexually active refers to males who have had   |
|                     | intercourse in the 3 months prior to           |
|                     | interview.                                     |
+---------------------+------------------------------------------------+
|                     | NSFG will to collect comparable data on males  |
|                     | aged 15 to 49 years starting with data         |
|                     | collected in 2001 and will thereby replace     |
|                     | NSAM for tracking this measure.                |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 19.10b, which    |
|                     | tracked the proportion of sexually active,     |
|                     | unmarried people aged 15 to 19 years who used  |
|                     | a condom at last intercourse. This measure     |
|                     | tracks the proportion of males aged 15 to 17   |
|                     | years who used a condom (rubber) or partner    |
|                     | used a female condom (vaginal pouch) at last   |
|                     | intercourse.                                   |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

  -----------------------------------------------------------------------
  9-10g. Condom plus     
  hormonal method at     
  last intercourse:      
  Females.               
  ---------------------- ------------------------------------------------
  **National Data        National Survey of Family Growth (NSFG), CDC,
  Source**               NCHS.

  **State Data Source**  Not identified.

  **Healthy People 2000  Adapted from 5.6 (Family Planning).
  Objective**            

  **Measure**            Percent.

  **Baseline**           7 (1995).

  **Numerator**          Number of sexually active, unmarried females
                         aged 15 to 17 years who used a condom plus
                         hormonal method at last intercourse.

  **Denominator**        Number of sexually active, unmarried females
                         aged 15 to 17 years.

  **Population           U.S. civilian, noninstitutionalized population.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 9-10e.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           Unmarried females are considered to have used a
                         condom and hormonal method at last intercourse
                         if they reported they were sexually active;
                         partner used a condom (rubber);
                         [and]{.underline} they used either birth control
                         pills, Depo-provera injectables, Norplant
                         implants, or morning-after pills at their last
                         intercourse.

                         Sexually active refers to females who have had
                         intercourse in the 3 months prior to interview.

                         This objective is adapted from a measure in
                         Healthy People 2000 objective 5.6, which tracked
                         the proportion of sexually active students aged
                         15 to 19 years who used oral contraceptives and
                         condom (by partner) at most recent intercourse.
                         This measure tracks the proportion of females
                         aged 15 to 17 years who used a condom (male or
                         female) plus hormonal method at last
                         intercourse.

                         See Part C for a description of NSFG and
                         Appendix A for focus area contact information.
  -----------------------------------------------------------------------

  -----------------------------------------------------------------------
  9-10h. Condom plus     
  hormonal method at     
  last intercourse:      
  Males.                 
  ---------------------- ------------------------------------------------
  **National Data        National Survey of Adolescent Males (NSAM),
  Source**               Urban Institute.

  **State Data Source**  Not identified.

  **Healthy People 2000  Adapted from 5.6 (Family Planning).
  Objective**            

  **Measure**            Percent.

  **Baseline**           16 (1995).

  **Numerator**          Number of sexually active, unmarried males aged
                         15 to 17 years who used a condom plus hormonal
                         method at last intercourse.

  **Denominator**        Number of sexually active, unmarried males aged
                         15 to 17 years.

  **Population           U.S. civilian, noninstitutionalized population.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 9-10f.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           Unmarried males are considered to have used a
                         condom and hormonal method at last intercourse
                         if they reported they were sexually active; used
                         a condom (rubber); [and]{.underline} their
                         partner used either pills, Norplant, or
                         Depo-provera at last intercourse.

                         Sexually active refers to males who have had
                         intercourse in the 3 months prior to interview.

                         NSFG will collect comparable data on males aged
                         15 to 49 years starting with data collected in
                         2001 and thereby replace NSAM for tracking this
                         measure.

                         This objective is adapted from a measure in
                         Healthy People 2000 objective 5.6, which tracked
                         the proportion of sexually active students aged
                         15 to 17 years who used birth control pills (by
                         partner) and condom at most recent intercourse
                         using the Youth Risk Behavior Surveillance
                         System (YRBSS), CDC, NCCDPHP. This measure
                         tracks the proportion of males aged 15 to 17
                         years who used a condom (rubber) or partner used
                         a female condom (vaginal pouch) plus hormonal
                         method at last intercourse.

                         See Appendix A for focus area contact
                         information.
  -----------------------------------------------------------------------

9-11. Increase the proportion of young adults who have received formal
instruction before turning age 18 years on reproductive health issues,
including all of the following topics: birth control methods, safer sex
to prevent HIV, prevention of sexually transmitted diseases, and
abstinence.

  -----------------------------------------------------------------------
  **National Data        National Survey of Family Growth (NSFG), CDC,
  Source**               NCHS.
  ---------------------- ------------------------------------------------
  **State Data Source**  Not identified.

  **Healthy People 2000  Adapted from 5.8 (Family Planning).
  Objective**            

  **Measure**            Percent.

  **Baseline**           64 (1995).

  **Numerator**          Females aged 18 to 24 years who report having
                         had formal instruction, before turning age 18
                         years, on all 4 reproductive health issues.

  **Denominator**        Number of females aged 18 to 24 years.

  **Population           U.S. civilian, noninstitutionalized population.
  Targeted**             

  **Questions Used To    From the 1995 National Survey of Family Growth:
  Obtain the National    
  Data**                 
  -----------------------------------------------------------------------

+---------------------+------------------------------------------------+
|                     | \[Question asked for each health topic:\]      |
|                     |                                                |
|                     | -   Now I'm interested in knowing about        |
|                     |     [formal]{.underline} sex education you may |
|                     |     have had. Before you were 18, did you have |
|                     |     any formal instruction at school, church,  |
|                     |     a community center, or some other place    |
|                     |     about\...                                  |
|                     |                                                |
|                     |     1\) Method of birth control?\              |
|                     |     2) Sexually transmitted diseases?\         |
|                     |     3) How to prevent AIDS using safe sex      |
|                     |     practices?\                                |
|                     |     4) Abstinence or how to say NO to sex?     |
+=====================+================================================+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Females are considered as having received      |
|                     | formal instruction if they report they         |
|                     | received formal sex education before age 18    |
|                     | years on [all]{.underline} four topics: birth  |
|                     | control, sexually transmitted diseases, safe   |
|                     | sex practices, and abstinence.                 |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 5.8, which       |
|                     | tracked the proportion of people aged 10 to 18 |
|                     | years who have discussed human sexuality,      |
|                     | sexual abuse, and values surrounding           |
|                     | sexuality, with their parents and/or have      |
|                     | received information through another           |
|                     | parentally endorsed source, such as youth,     |
|                     | school or religious programs. This measure     |
|                     | tracks the proportion of females aged 18 to 24 |
|                     | years who have received formal, before turning |
|                     | age 18 years, on reproductive health issues,   |
|                     | such as birth control methods, safer sex to    |
|                     | prevent HIV, prevention of STDs, and           |
|                     | abstinence.                                    |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

+---------------------+------------------------------------------------+
| 9-12. Reduce the    |                                                |
| proportion of       |                                                |
| married couples     |                                                |
| whose ability to    |                                                |
| conceive or         |                                                |
| maintain a          |                                                |
| pregnancy is        |                                                |
| impaired.           |                                                |
+=====================+================================================+
| **National Data     | National Survey of Family Growth (NSFG), CDC,  |
| Source**            | NCHS.                                          |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 5.3 (Family Planning).            |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 13 (1995).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of married females with impaired        |
|                     | fecundity.                                     |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of married females aged 15 to 44 years. |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National Survey of Family        |
| Obtain the National | Growth:                                        |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   What is your current marital status? Are   |
|                     |     you\...                                    |
|                     |                                                |
|                     |     1\) Married,\                              |
|                     |     2) Widowed,\                               |
|                     |     3) Divorced,\                              |
|                     |     4) Separated, because you and your husband |
|                     |     are not getting along,\                    |
|                     |     5) Have you never been married?            |
+---------------------+------------------------------------------------+
|                     | \[Following a series of questions to ALL       |
|                     | respondents that address pregnancy,            |
|                     | contraceptive use and periods of no sexual     |
|                     | activity:\]                                    |
|                     |                                                |
|                     | -   Have you ever had [both]{.underline} your  |
|                     |     tubes tied, cut, or removed? This          |
|                     |     procedure is often called a tubal          |
|                     |     ligation.                                  |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had a hysterectomy, that is, |
|                     |     surgery to [remove]{.underline} your       |
|                     |     uterus?                                    |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had [both]{.underline} your  |
|                     |     ovaries removed?                           |
+---------------------+------------------------------------------------+
|                     | -   Have you ever had any [other]{.underline}  |
|                     |     operation that makes it impossible for you |
|                     |     to have another baby?                      |
+---------------------+------------------------------------------------+
|                     | -   As far as you know, are you completely     |
|                     |     sterile from this operation, that is, does |
|                     |     it make it impossible for you to have a    |
|                     |     baby in the future?                        |
+---------------------+------------------------------------------------+
|                     | -   Has (name of husband/partner) ever had a   |
|                     |     vasectomy or any other operation that      |
|                     |     would make it impossible to father a baby  |
|                     |     in the future?                             |
+---------------------+------------------------------------------------+
|                     | \[Nonsurgically sterile respondents are those  |
|                     | who have not reported any operations for       |
|                     | themselves, or if they are married or          |
|                     | cohabiting, for their husbands/partners.\]     |
|                     |                                                |
|                     | \[For respondents who are nonsurgically        |
|                     | sterile:\]                                     |
|                     |                                                |
|                     | -   Some women are not                         |
|                     |     [physically]{.underline} able to have      |
|                     |     children. As far as you know, is it        |
|                     |     physically possible for you, yourself, to  |
|                     |     have a baby?                               |
+---------------------+------------------------------------------------+
|                     | -   What about (name of husband/partner)? As   |
|                     |     far as you know, is it                     |
|                     |     [physically]{.underline} impossible for    |
|                     |     him to father a baby in the future?        |
+---------------------+------------------------------------------------+
|                     | \[If it is physically possible:\]              |
|                     |                                                |
|                     | -   Some women are [physically]{.underline}    |
|                     |     able to have a baby, but have              |
|                     |     [difficulty]{.underline} getting pregnant  |
|                     |     or carrying a baby to term. As far as you  |
|                     |     know, would you, yourself, have any        |
|                     |     difficulty getting pregnant or carrying a  |
|                     |     baby to term?                              |
+---------------------+------------------------------------------------+
|                     | -   As far as you know, does (name of male     |
|                     |     partner) have any difficulty fathering a   |
|                     |     baby?                                      |
+---------------------+------------------------------------------------+
|                     | -   At any time has a medical doctor ever      |
|                     |     advised you to [never]{.underline} become  |
|                     |     pregnant (again)?                          |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Females are considered to have impaired        |
|                     | fecundity if they reported they are married;   |
|                     | [and]{.underline} neither they or their        |
|                     | husband has had a sterilizing operation;       |
|                     | [or]{.underline} any [one]{.underline} of the  |
|                     | following:                                     |
+---------------------+------------------------------------------------+
|                     | \(a\) she and her husband are nonsurgically    |
|                     | sterile and it is physically impossible for    |
|                     | her to get pregnant or carry a baby to term,   |
|                     | or for her husband to father a baby;           |
+---------------------+------------------------------------------------+
|                     | \(b\) it is physically difficult for her to    |
|                     | get pregnant or carry a baby to term, or for   |
|                     | her husband to father a baby;                  |
+---------------------+------------------------------------------------+
|                     | \(c\) she has been advised by a doctor (for    |
|                     | health reasons) [not]{.underline} to become    |
|                     | pregnant;                                      |
+---------------------+------------------------------------------------+
|                     | \(d\) she and her husband have been married    |
|                     | for at least 36 consecutive months and have    |
|                     | reported sexual activity without contraception |
|                     | for at least 36 consecutive months, and have   |
|                     | had no pregnancies in that time period.        |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 5.3, which       |
|                     | tracked the prevalence of infertility. This    |
|                     | measure tracks the proportion of married       |
|                     | couples who are unable to conceive or maintain |
|                     | a pregnancy due to impaired fecundity.         |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of NSFG and       |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

  -----------------------------------------------------------------------
  9-13. (Developmental)  
  Increase the           
  proportion of health   
  insurance policies     
  that cover             
  contraceptive supplies 
  and services.          
  ---------------------- ------------------------------------------------
  **Comments**           An operational definition could not be specified
                         at the time of publication.

                         A proposed data source is The Alan Guttmacher
                         Institute (AGI).**^5^**

                         See Appendix A for focus area contact
                         information.
  -----------------------------------------------------------------------

## References

1\. Henshaw, S.K. Unintended pregnancy in the United States. *Family
Planning Perspectives* 30 (1):24-29, 46, 1998.

2\. Abortion surveillance---United States, 1993 and 1994, Special focus:
Surveillance for reproductive health. *Morbidity and Mortality Weekly
Report* 46(SS‑4), 1997.

3\. Henshaw, S.K., and Kost, K. Abortion patients in 1994‑1995:
Characteristics and contraceptive use. *Family Planning Perspectives*
28(4):140-147, 158, 1996.

4\. Fu, H.; Darroch, J.E.; Haas, T.; et al. Contraceptive Failure Rates:
New Estimates from the 1995 NSFG. *Family Planning Perspectives*
31(2):56-63, 1999. \<http://www.agi-usa.org/pubs/journals/3105699.html\>

5\. The Alan Guttmacher Institute. *Uneven and Unequal: Insurance
Coverage and Reproductive Health Services.* New York, NY: the Institute,
1994, 1-38.