This study characterized the patterns and predictors of pre-post changes in knowledge, attitudes, beliefs, behaviors, and intentions (KABBIs) among 641 youth who completed evidence-based teen pregnancy prevention programs. At follow-up, 64.0% of youth showed changes knowledge, communication, and attitudes; 22.5% showed changes in knowledge, attitudes, beliefs, communication, and increased sexual intentions; and 13.6% showed changes in attitudes and decreased sexual intentions. The strongest predictors of changes were youth baseline KABBI scores, mode of delivery, and number and type of adaptations made to the curricula. Results underscore the importance of examining the role of youth and program characteristics in predicting KABBI change patterns.