In terms of prevention, using a broad perspective to reduce high-risk sexual behavior including the reduction of STIs is one of CDC’s top six priorities and because it is a “winnable battle” such prevention is of paramount importance to health and quality of life for youth (CDC, 2013). Vaccines are currently available for the prevention of hepatitis B and the human papilloma virus and vaccines for other sexually transmitted infections are in development (Mast et al., 2005; Stanberry et al., 2002) and can be used as a primary prevention strategy. Secondary prevention efforts can also be useful in terms of sexually transmitted infections and two means of accomplishing this are via routine screening and partner notification (Auslander, Catallozzi, & Rosenthal, 2012) so that early treatment for infection can be obtained. In terms of the efficacy of vaccinations as a primary prevention strategy, a meta-analysis conducted by Lu, Kumar, Castellsague, and Giuliano (2011) revealed that prophylactic HPV vaccines are safe, well tolerated, and highly efficacious in preventing persistent infections and cervical diseases associated with vaccine-HPV types among young females. The authors did note that research on the long-term efficacy and safety does need to be addressed.

Beyond vaccinations and the secondary prevention strategies mentioned above, a large number of prevention efforts have been made in the sexual risk domain. In the chapter of this text on sexually transmitted infections, Auslander et al. (2012) discuss extensively strategies to reduce adolescent exposure to and acquisition of sexually transmitted infections. They review the literature on routine screening and partner notification, interventions to delay sexual initiation and promote condom use in those choosing to have intercourse, and uptake of other biomedical strategies, including vaccines and microbicides.

Results from an extant review of the literature indicate that the most effective programs address social influences; are grounded within social learning theory (Kirby, 1992); and provide information about STIs, motivational training, and behavior skills for negotiation of abstinence and condoms (Johnson, Scott-Sheldon, Huedo-Medina, & Carey, 2011). Such programs tend to be carried out in community or school settings over multiple sessions in a group-format (Underhill, Operario, & Montgomery, 2007b). Despite that these ingredients appear to be key in achieving higher success, the effect sizes remain small.

Relevant to this discussion is the debate on comprehensive vs. abstinence-only sex education programs. Critics of comprehensive sex education programs have suggested that such programs will increase sexual behavior (Kirby, Laris, & Rolleri, 2007; Underhill et al., 2007b) although research has clearly demonstrated that sex education about abstinence and birth control is associated with healthier sexual behaviors and outcomes. In fact, research on comprehensive sex education programs has indicated that they are successful at delaying sexual initiation, increasing condom use, and reducing unprotected intercourse (Auslander et al., 2012). Conversely, abstinence-only programs (that teach abstinence until marriage) have not been shown to be effective at reducing adolescents’ sexual risk behaviors (Trenholm et al., 2007; Underhill, Operario, & Montgomery, 2007a) as while certainly abstaining from sex certainly reduces exposure and acquisition of sexually transmitted infections, such methods have very high failure rates (Fortenberry, 2005).

In sum, with regard to the prevention of sexually transmitted infections in adolescence there are medical interventions (i.e., vaccinations) that can act well as a primary prevention strategy at least in the short term (longitudinal research examining efficacy is lacking). From a behavioral/medical perspective the use of condoms can also be helpful in preventing the acquisition of sexually transmitted infections. To some extent both of these efforts require prevention strategies that are behavioral in nature and research on sex education programs has indicated relatively small effect sizes for abstinence-only programs (Silva, 2002) with superior outcomes for comprehensive sex education programs (Auslander et al., 2012; DiCenso, Guyatt, Willan, & Griffith, 2002).

Alongside sexual risk for sexually transmitted diseases is unintended pregnancy among adolescents. Aruda and Burke (2012) outline statistics for pregnancy among teenagers noting that the birthrate for teenagers aged 15–17 has fallen since 1991; in 2009 was the lowest it has ever been in nearly 70 years; three in ten girls become pregnant at least once by age 20; one in five pregnancies is to a teen mother; 82 % of pregnancies among 15–19-year-olds are unplanned; and large disparities persist in race and ethnicity. These statistics indicate that even though teenage pregnancy rates have decreased teenage pregnancy remains to be a societal problem.

In terms of prevention, one of the CDC’s top six priorities is teen pregnancy prevention (CDC, 2013). Aruda and Burke (2012) discuss how in the early to mid twentieth century there was a eugenics movement (based on the belief that the wrong people were having children and being unmarried constituted being a “wrong” person) and sexually active young women were seen as unfit. This prompted the introduction of prevention as it relates to teenage pregnancy with the aim being to ensure that poverty and delinquency were not passed from one generation to another. During the post-World War I era there was a focus on “unwed mothers” and “illegitimate children” (with less emphasis placed on age) and during this time, unmarried teenagers who became pregnant were considered to be delinquents or to have emotional or psychological problems. Despite the above, because prior to the 1960s, most teenage pregnancies led to marriage, teenage pregnancy was a societal nonissue (Aruda & Burke, 2012). In the past four decades we have seen even more historical shifts with the availability of birth control and abortion as an option for teenagers. Nonetheless, the teen parent has been portrayed as a “perpetrator of poverty” (Furstenberg, 2003) and teen pregnancy has been established to be a social problem that does carry stigma despite the media’s attempts to glamorize the pregnant teenager (Aruda & Burke, 2012).

Currently the most commonly employed pregnancy prevention programs are educational in nature and are often referred to as family life education and include components of sexuality, reproduction, decision-making, and sexual relationship issues (Nitz, 1999). Kirby (1992, 1999) has established that prevention approaches can be divided into five groups:

Of importance is the large political debate that has ensued over the use of abstinence-only vs. abstinence-plus (aka comprehensive sex education) curricula. While a discussion on such programs was provided above with regard to sexually transmitted infections there is a separate body of literature that examines the impact of such programs on teenage pregnancy.

Approximately 10 years ago a research article on the outcome of interventions to reduce unintended pregnancies among adolescents (DiCenso et al., 2002) indicated that interventions did not delay initiation of sexual intercourse in women or men, they did not improve birth control use by either women or men, and they did not reduce pregnancy rates in women (although there were significantly fewer pregnancies in women who received multifaceted program). This publication prompted a media heyday and subsequently experts in the field pointed to some of the flaws in the study that may account for the poor findings (McKay, Fisher, Maticka-Tyndale, & Barrett, 2001).

More recently Bennett and Nassim (2005) systematically reviewed school-based teenage prevention programs and found that the majority of abstinence-plus programs increase rates of contraceptive use in teens for up to 30 months. Hoyt and Broom (2002) discuss that programs that share the most improvements in teen pregnancy rates share the following nine characteristics:

While a large number of prevention programs have been created and tested (for a detailed review of school-based programs please see Hoyt and Broom, 2002, and for a detailed review of general interventions and programs see Nitz, 1999) the consensus seems to be that while lowering teenage pregnancy rates has been somewhat successful there is still a lack of well-established prevention programs with good outcome (as is the case with programs aimed at preventing exposure to and acquisition of sexually transmitted diseases). Most recently, the Teen Pregnancy Prevention Initiative (TPPI) funded by the CDC for 2010–2015 has targeted nine communities nationally with high teen pregnancy rates and is looking for a 10 % decrease through four key components: implementation of evidence-based programs, quality community linkages, education, and sustainability (CDC, 2013).

Chu, Sundermann, and DePrince (2012) have covered quite extensively the scientific literature on prevention of sexual and intimate partner violence and readers are encouraged to see the relevant chapter of this text for a more detailed overview. In sum the literature (see Whitaker et al., 2006) has indicated superior efficacy for two programs titled Safe Dates (Foshee et al., 1998, 2004) and Youth Relationships Project (Wolfe et al., 2003, 2009). Safe Dates consists of school and community components and activities are geared at changing norms of dating violence and improving prosocial skills. Alternatively the Youth Relationships Project is designed to be carried out in community agencies and targets high-risk adolescents.

Prevention of adolescent smoking programs is similar to those programs used to prevent other adolescent substance use. Many programs have been developed and tested and meta-analyses have been conducted to compare the efficacy rates of such programs. For example, Rooney and Murray (1996) conducted a meta-analysis in which they examined 90 studies with 131 interventions that used school-based, peer-led, and social influence programs aimed at the prevention of tobacco use. Results from this meta-analysis indicated a small effect size for such programs at posttest (1 year out). Effect sizes were larger for programs targeting sixth graders, programs that were concentrated in a short period or that offered booster sessions, and programs that included a trained teacher and an untrained same-age peer leader.

Readers are encouraged to see the chapter of this text on smoking (Brook, Pahl, Brook, & Brown, 2012) for an elaborate review of the various prevention programs for smoking that exist. Suffice to say, prevention interventions at the individual level should focus on general problem-solving and coping skills, social competence, behavioral self-management, life skills, and specific cigarette refusal skills (Dierker, Merikangas, & Essau, 1997). At the contextual level (1) adolescents should be provided with the opportunity to engage in alternative activities; (2) aims should be made for organizational changes in schools; and (3) community leaders should be trained to organize smoking and drug use prevention task forces (Dierker et al., 1997). A comprehensive approach focusing on different sources of social influence, as well as individual-level factors, seems the most promising (Brook et al., 2012).

It is no secret that substance use among adolescents is a continual problem. In fact research has indicated that an astounding near 50 % of teenagers in the United States have used an illicit drug by the 8th grade (Johnston, O’Malley, Bachman, & Schulenberg, 2010). Generally speaking scientific research has indicated that school-based drug prevention programs have the potential to reduce drug use in adolescents (Tobler et al., 2000) although unfortunately most drug prevention programs are not effective (White & Pitts, 1998). These findings have prompted efforts to determine what specifically must be included in such prevention efforts to achieve efficacy.

Results from an extensively well-conducted meta-analysis on school-based prevention programs (Tobler et al., 2000) included 144 studies of 207 school-based drug prevention programs indicated that certain programs did reduce substance use whereas others did not. Programs that reduced substance use employed interactive methods (these programs provide contact and communication opportunities for the exchange of ideas among participants; encourage the learning of drug refusal skills; are focused on social influence approach to drug prevention; and include generic skills training, e.g., assertiveness, coping, communication), while the less effective programs used noninteractive methods (these programs focus only on knowledge of substances, helping the adolescent develop insight into personal feelings and behaviors and on the adolescent’s problem-solving skills regarding personal drug use).

Cuijpers (2002) has attempted to identify “effective ingredients” of school-based drug prevention programs by conducting a systematic review of the literature (he reviewed meta-analyses, studies examining mediating variables of interventions, and studies directly comparing prevention programs with or without specific characteristics). This review resulted in the identification of seven evidence-based quality criteria that programs should incorporate:

More recently Lemstra et al. (2010) conducted a systematic review of the literature to determine if school-based marijuana and alcohol prevention programs were effective in preventing marijuana and alcohol use in adolescents between the ages of 10 and 15 years. Results from this extensive review indicated that the most effective primary prevention programs for reducing marijuana and alcohol use among adolescents in the long term were comprehensive programs that included antidrug information combined with refusal skills, self-management skills, and social skills training.

The World Health Organization (2013) has asserted that obesity is an escalating global epidemic. Because childhood and adolescent obesity are strong predictors of adult obesity and there is a host of problems that develop as a result of obesity (e.g., type 2 diabetes insulin resistance, hypertension: Spruikt-Metz, 2011) prevention efforts are an absolute must. Despite the strong interest and dedication of resources to prevention efforts childhood and adolescent obesity remain high. In fact, the CDC (Ogden & Carroll, 2010) has indicated that in 2007–2008 19.3 % of male adolescents and 16.8 % of female adolescents aged 12–19 were obese.

The Handbook of Pediatric and Adolescent Obesity Treatment (O’Donohue, Moore, & Scott, 2008) offers an extensive overview of etiological, diagnostic, and sociocultural considerations; relevant process variables; treatment approaches (with an emphasis on stepped care); and nutritional approaches with regard to obesity in children and adolescents. Prevention efforts with regard to obesity can come in many forms including the prevention of further weight gain; the prevention of health conditions associated with obesity; or alternatively prevention of obesity in the first place (i.e., preventing normal weight or overweight children and adolescents from becoming obese). Within this handbook a specific discussion on prevention is provided (Story & Kaphinger, 2008) and will be reviewed here, as will be other relevant literature.

Because more than 95 % of children and adolescents (aged 5–17) are enrolled in school, school-based interventions make sense given the magnitude of continuous and intensive contact that academic institutions have with school-aged children and adolescents (Story & Kaphinger, 2008). That being said, school-based interventions have been demonstrated to improve obesity-related behaviors and reduce obesity (Gortmaker et al., 1999) although with limited success (Dobbins, De Corby, Robeson, Husson, & Tirilis, 2009). Recently, Stice, Shaw, and Marti (2006) conducted a meta-analysis to review obesity prevention programs. Their study included 64 prevention programs that aimed to produce weight gain prevention efforts. Of these programs 21 % produced significant prevention effects but these were typically pre-to-post effects (programs that have succeeded at preventing weight gain tend not to have long-term staying power: Spruikt-Metz, 2011). Effects were greatest for programs targeting children and adolescents (as opposed to preadolescents) and females. Programs that were relatively brief, programs solely targeting weight control vs. other health behaviors (e.g., smoking), programs evaluated in pilot trials, and ­programs wherein participants must self-select into the intervention had the greatest effects and factors such as mandated improvements in diet and exercise, sedentary behavior reduction, delivery by trained interventionists, and parental involvement were not associated with significantly larger effects (Stice et al., 2006).