Teenage Pregnancy Clinical Trial
Official title:
The Women's Clinic of Kansas City Teen Outreach Program Replication Study
The Women's Clinic of Kansas City (TWC) replicated the Teen Outreach Program (TOP) across Kansas City, Missouri. The purpose of this study is to measure: one year after the end of the program year, what is TOP's impact on the treatment group's sexual activity and contraceptive use, relative to the control group, at one year following the program?
TOP is a youth development and service learning program for youth ages 12 to 17 designed to
reduce teenage pregnancy and increase school success by helping youth develop a positive
self-image, life management skills, and realistic goals. The TOP program model consists of
three components implemented in school, after school, or in community settings over nine
months: (1) weekly curriculum sessions, (2) community service learning, and (3) positive
adult guidance and support. The TOP Changing Scenes Curriculum is separated into four
age-/stage-appropriate levels, Level 1 is typically for youth ages 12 or 13 and Level 4 is
typically for youth age 17. The curriculum focuses on the presence of a consistent, caring
adult; a supportive peer group; skill development; sexual health; and sexual behavior
choices. The intended program dosage for each participant is a minimum of 25 weekly sessions
(one per week at 40-50 minutes each) and at least 20 hours of community service learning over
nine months. One or two facilitators, who plan the order of sessions based on the needs and
interest of youth, implemented TOP in a group of 10 to 25 youth.
In this cluster randomized controlled trial, twelve of the highest-risk (based on highest
teen births per zip code ranking in 2008) middle and high schools in the Kansas City
Metropolitan Area were recruited to participate in the evaluation. After finalizing
agreements with seven schools that agreed to participate, 7th- and 9th-grade teachers of core
subjects (such as social studies and English) were recruited to participate. During the two
years of sample enrollment, 21 teachers participated. At the start of each school year of
sample enrollment, the study team assessed whether each participating teacher's class
sections would be eligible for the evaluation based on the number of students enrolled (class
sections were eligible if they had at least 10 students). Classes were
This study is a cluster randomized controlled trial across two cohorts. Stratification
occurred at the teacher level; each teacher's classes were randomized to either TOP or the
control condition. Random assignment occurred after acquiring parental consent and youth
assent and administering the baseline survey. A passive consent process was used to notify
parents that their youth would be participating in a youth development survey unless they
opted out of the process. In addition, youth were given the option to not assent to any
specific survey. Overall, youth in completed three surveys: (1) baseline, (2) 9-month
post-baseline (immediate follow-up), and (3) 21-month post-baseline (1-year post-intervention
follow-up). Students were surveyed in class using paper-and-pencil surveys; make-up surveys
occurred during follow-up visits to the school over the final few weeks of school. Those
chronically absent or no longer enrolled in the study schools were contacted via telephone to
complete a telephone survey or via email to complete the survey online. Final efforts were
made to visit youth who dropped out or who had been otherwise unreachable by going directly
to their homes (if they still lived in the area); these youth were given a paper-and-pencil
survey to complete. Students received a modest incentive for completing each survey.
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