The island of Kaua'i has the highest teen pregnancy rate in the state of Hawaii, and the Child and Family Service is trying to change that. The 2012 State of Hawaii primary care needs assessment data indicate that 3.5 percent of total births on the island are to teen mothers. Also, approximately 36.8 percent of Kaua'i high school students report that they have had sex, and 22 percent of those who are sexually active report they drank alcohol or used drugs before the last time they had sex. Of those who are sexually active, only 46 percent reported using condoms. According to the CDC's Youth Risk Behavior Survey, 5 percent of Hawaii youths had sex before age 13; 8 percent have had sex with four or more partners; and 79 percent of sexually active youths did not use birth control the last time they had sex.

The Child and Family Service and its program director Cara Sadira are working to change these statistics while lowering the rate of STDs through its Making Proud Choices programs. However, one of the biggest problems is that sexual discussion is taboo in many homes; therefore, some adolescents are embarrassed to admit they want the information and parents are embarrassed to encourage their youth to participate. The Making Proud Choices programs are designed to help youth realize their dreams and life goals, while increasing awareness of abstinence, contraceptives, and STD prevention. The class teaches them to think ahead about being in an emotionally charged situation, and come up with a plan for responding to the situation.

The town of Waimea, which has the highest teen birth rate on Kaua'i, receives special attention. Several Making Proud Choices programs are available there through Nana's House in collaboration with the Boys and Girls Club. Sadira is hoping to reach even more people during a spring break camp March 18–22, as well as camps during the summer. There are outreach classes currently in session and new classes will begin in April in Kapa'a and Waimea. Sadira also works with island therapists, parents, and other members of the community to include them in programs, and has been collaborating with the nonprofit Hale Opio to provide the program to agencies that work with youths and train other providers.