The Appalachian Adolescent Health and Education Project (AAHEP), in operation for 3 years, is a program designed to reduce adolescent pregnancy rates (prevention component) and provide care for pregnant teenagers (care component) in East Tennessee. Limitations in funding and service delivery prompted the AAHEP to modify its 15-county scope by concentrating its care efforts in 3 counties and its prevention efforts in 2 counties. A review of statistics for the 15-county AAHEP area, the 5-county target area, the 10-county non-target area, and a 3-county control area revealed qualitative and quantitative changes that, although they could not be definitely attributed to the project, seemed strongly associated with project efforts. Target county care services such as counseling, pre-natal care, information on child-care and parenting, introduction to primary care system, determination of sources of payment for medical services, and adoption options, were associated with a reduction of low birth-weight babies born to teenage mothers. Prevention efforts, which included educating high school students about male/female puberty, male/female reproduction, contraception, fetal development, sexually transmitted diseases, decision-making skills, and values education, appear to have reduced the incidence of adolescent births, especially in counties where service has been most intense. (Extensive tables and demographics are included.) (ABB)