Young people most at risk of pregnancy live in a milieu of economic and social instability, have limited expectations for educational and employment success, and lack positive influences from family and friends and other adult role models. Adolescents with little guidance and no orientation toward the future do not perceive the risks associated with early sexual activity and unprotected intercourse. Young people can be helped to make the right decisions about pregnancy, abortion, and parenthood if public agencies make a greater commitment to helping high-risk children and youth manage their sexuality responsibly. Starting with a foundation of accurate and age-appropriate information about human sexuality and reproduction, youth-serving agencies can help build tangible decision-making skills and provide accessible resources for postponing sexual activity or preventing unprotected intercourse. In addition to building young people's capacity to prevent pregnancy, public programs should motivate young people to postpone sexual activity and parenthood. Specific initiatives in Kentucky, Texas, South Carolina, Maryland, and Tennessee are described that focus on education, self-esteem, life skills and opportunities, family planning, and youth development. 4 references