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it decreased from 96 to 93 per 1,000 among whites.3 Minority adolescents are disproportionately represented among teenagers who give birth; of the 38 states that reported rates for 1991–1992, 27 reported an increase in birthrates among Hispanic adolescents, whereas only six of 50 states reported an increase in birthrates among non-Hispanic white teenagers.4 Although no research has been conducted on factors contributing to the risk of pregnancy specifically among the youngest teenagers, some studies have examined the issue among all adolescents. Nonuse or inconsistent use of contraceptives is a major factor: Approximately 35% of unmarried, sexually active teenagers use no form of birth control at first intercourse,5 and a sexually active teenager who does not use birth control has a 90% chance of becoming pregnant within a year’s time.6 One reason for nonuse of contraceptives may be an imbalance of negotiating power resulting from the age discrepancy between many teenage women and their partners; approximately 60% of mothers aged 15–17 report that their partner is at least three years older than they are.7 Young minority adolescents are especially at risk of pregnancy, as nonwhites are likely to engage in sexual intercourse at a younger age than whites.8 Programs aimed at reducing or preventing teenage pregnancies, especially among younger adolescents, must overcome several formidable financial and logistical barriers.9 School-based clinics have long been regarded as an effective means of overcoming some of these barriers by providing convenient, affordable, comLorraine Tiezzi is program director and assistant clinical professor of public health, Judy Lipshutz is health education coordinator, Neysa Wrobleski is a health educator, Roger D. Vaughan is evaluation coordinator and assistant professor of clinical public health and James F. McCarthy is director of the Center for Population and Family Health (CPFH) and the Harriet and Robert Heilbrun Professor, Columbia University School of Public Health, New York. This investigation was a collaborative effort of the Center for Population and Family Health, Presbyterian Hospital, the Ambulatory Care Network Corporation and New York City School District 6. The program received support from the Aaron Diamond Foundation, the Engelberg Foundation, the Carnegie Foundation and the New York State Department of Health. The evaluation of the program was made possible by a grant from the Esther A. and Joseph Klingenstein Fund, Inc., and by general support for the CPFH program evaluation unit from the William and Flora Hewlett Foundation and the Andrew W. Mellon Foundation. Pregnancy Prevention Among Urban Adolescents Younger than 15: Results of the ‘In Your Face’ Program