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This handbook was written to encourage and assist school districts, schools, and community-based organizations to respond to the growing need for adolescent pregnancy prevention activities in the middle grades. It reflects the experiences of adolescent pregnancy prevention programs across the country, particularly those of the eight Urban Middle Schools Adolescent Pregnancy Prevention Program projects. It describes many of the lessons learned in these projects about appealing to at-risk youth, overcoming the barriers to implementation, working collaboratively, and dealing with controversy. Part 1 looks at why adolescent pregnancy prevention should take place in the middle grades. Implications for risk prevention strategies are discussed. Changes are looked at for meeting developmental needs in middle grades education. Elements of an effective pregnancy prevention program are outlined, and collaboration is discussed as a means to better meet the needs of adolescents. Part 2 contains information about pregnancy prevention strategies, including family life and sexuality education, postponing sexual involvement, counseling, peer education, school-based clinics, service learning, mentoring, and multicomponent programs. Part 3 discusses program implementation and includes information about planning, handling controversy, promoting effective collaborations, staff development, funding, and evaluation. Appendices include a case study, a summary of evaluation of pregnancy prevention strategies, a summary of statistics on teenage sexuality and pregnancy, and a list of resource organizations. (LLL)… (more)