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Little research has been done on adolescent pregnancy programming designed to meet the needs of rural youth. To address this research gap, the Administration for Children and Families funded Mathematica Policy Research to conduct a rigorous evaluation of an adapted version of the comprehensive teen pregnancy prevention curriculum Reducing the Risk in collaboration with the Kentucky Department of Public Health. The study focuses on the implementation of Reducing the Risk by two local health departments that delivered the curriculum in high schools in a relatively low-income, mostly rural region in central and southwestern Kentucky. Programming was funded through the state’s Personal Responsibility Education Program (PREP) grant, which provides federal funding for teen pregnancy prevention services.Reducing the Risk identifies abstinence as the most effective way to avoid STDs and unintended pregnancy, but also provides information on contraceptive methods. The two local health departments that participated in the study successfully delivered the curriculum to hundreds of youth in their service regions during the study period. These results suggest that delivering an abstinence and contraceptive education curriculum in rural high schools is feasible and can fill a pressing need.