Program

Oct 07, 2016

OVERVIEW

Prime Time is an 18-month, clinic-based, youth development intervention for adolescent girls at high risk for pregnancy focused on reproductive health and social-emotional health outcomes. An experimental study assessing program impacts on interim 12-month outcomes found positive impacts on consistency of condom use, hormonal contraceptive use, and dual contraceptive use as well as greater stress management skills but no impacts on the number of sexual partners in the past six months, perceived norms, attitudes and beliefs, or self-efficacy and skills. Data from outcomes at 12 months following the intervention found positive impacts on condom use and dual contraceptive use as well as positive impacts on certain psychosocial outcomes. Similarly, data at the 24 month follow-up indicate more consistent use of condoms, hormonal contraceptives, and dual method strategies and higher levels of family connectedness among the intervention group compared to the control group.

DESCRIPTION OF PROGRAM

Target population: Adolescent girls at high risk for pregnancy

Prime Time is an 18-month clinic-based intervention for sexually active 13-17 year old girls. The program’s goal is to reduce risk factors associated with teen pregnancy including sexual risk behaviors, violence involvement, and low levels of school connectedness. The program has four major components. The case management component includes monthly visits with a case manager covering the topics of emotional skills, healthy relationships, responsible sexual behaviors, and positive family, school, and community involvement. The peer leadership component includes a 15-session peer education training curriculum to build participants’ skills in communication, stress management, conflict resolution, healthy relationships, sexual decision-making, and contraceptive use, as well as understanding social influences on sexual behaviors. There is also a 7-session group teaching practicum. Lastly, the service learning component includes a curriculum that provides real-world experience in civic engagement and leadership.

EVALUATION(S) OF PROGRAM

Study 1:

Sieving, R.E., McMorris, B.J., Beckman, K.J., Pettingell, S.L., Secor-Turner, M., Kugler, K., Garwick, A.W., Resnick, M.D., & Bearinger, L.H. (2011). Prime Time: 12-month sexual health outcomes of a clinic-based intervention to prevent pregnancy risk behaviors. Journal of Adolescent Health, 49, 172-179.

Evaluated population: A total of 253 girls were randomized into the intervention group (n=126) or the control group (n=127). The average age was 15.6 years and the sample included 41 percent black, 21 percent multiracial, 13 percent Hispanic, 12 percent Asian, 11 percent white, and 2 percent Native American youth.

Approach: Research project staff recruited sexually active 13-17 year old girls from four schools and community clinics. Girls were excluded from the study if they were married, pregnant, or had previously given birth. Eligible participants were asked to return for a second visit, where they completed the baseline assessment and were randomized into the treatment or control group.

The typical duration of the program is designed to occur over 18 months, therefore the 12-month outcomes assessed in this study are considered interim rather than post-test. Fourteen girls were lost to follow-up and excluded from the analysis. The final intervention group (n=116) and control group (n=123) did not differ on baseline characteristics. Data on sexual risk behaviors as well as personal, behavioral, and environmental psychosocial factors were collected at baseline and 12 months using self-report surveys. Analyses accounted for the fact that the participants were grouped by schools and community clinics.

Results: Impacts for behavioral outcomes were more promising than for psychosocial outcomes at 12 months. Compared with the control group, girls in the program were significantly more likely to report consistent condom, hormonal contraceptive, and dual method use with their most recent partner. No impacts on the number of male partners in the past 6 months were found. No significant differences were found between the control and intervention group on 12 out of 13 psychosocial outcomes related to teacher connectedness, perceived norms regarding contraception, personal sexual attitudes and beliefs, social-emotional intelligence, partner communication around sexual risk, and self-efficacy around sex refusal and condom use.

One limitation of the evaluation is that the findings may not apply to adolescent girls at high risk for pregnancy who did not seek clinic services.

Study 2:

Sieving, R.E, McRee, A.L., McMorris, B.J., Beckman, K.J., Pettingell, S.L., Bearinger, L.H., Garwick, A.W., Oliphant, J.A., Plowman, S., Resnick, M.D., & Secor-Turner, M. (2013). Prime Time: Sexual Health Outcomes at 24 Months for a Clinic-Linked Intervention to Prevent Pregnancy risk Behaviors. JAMA Pediatrics, 167(4), 333-340.

Evaluated Population:  The evaluated population was the same as Study 1.

Approach: Study recruitment and randomization was the same as Study 1. Participants in the intervention group were surveyed on sexual behavior and psychosocial attributes at 12 months, 18 months, and 24 months after the baseline survey. This study focuses on outcomes at 24 months post-baseline, or six months after the conclusion of the intervention.

Results:

Outcome survey data at 24 months post-baseline comparing those in the control and intervention groups found tha,t in terms of sexual behavior outcomes, those in the intervention group reported significantly more consistent condom use, hormonal contraceptive use, and dual method use than those in the control group. There was no significant difference between the reported numbers of male sex partners between the groups. In terms of psychosocial attributes, those in the intervention group reported higher levels of family connectedness and significantly greater sex refusal self-efficacy. Compared to those in the intervention group, those in the control group were significantly more likely to report it was important to have sex with their partner in exchange for material things. There were no between-group differences in the rest of the psychosocial attributes.

Study 3:

Sieving, R.E., McRee, A.L., Secor-Turner, M., Garwick, A.W., Bearinger, L.H., Beckman, K.J., McMorris, B.J., & Resnick, M.D. (2014). Prime Time: Long-Term Sexual Health Outcomes of a Clinic-Linked Intervention. Perspectives on Sexual and Reproductive Health, 46(2), 91-100.

Evaluated population: The evaluated population was the same as Study 1.

Approach: Study recruitment and randomization was the same as Study 1. Data on sexual risk behaviors as well as personal, behavioral, and environmental psychosocial factors were collected at baseline and at six, 12, 18, 24 and 30 months using self-report surveys. This study focuses on the trial’s final data collection point, 12 months following the conclusion of the intervention, or 30 months from the start of the intervention.

Results: Data from the 30-month survey found that, compared to the control group, young women in the intervention group reported a significantly greater number of months of consistent condom use and dual method use with their most recent partner. Regarding psychosocial outcomes, among participants who had completed high school or received a GED, the proportion attending college or technical school was higher in the intervention group than in the control group.

SOURCES FOR MORE INFORMATION

References

Sieving, R.E., McMorris, B.J., Beckman, K.J., Pettingell, S.L., Secor-Turner, M., Kugler, K., Garwick, A.W., Resnick, M.D., & Bearinger, L.H. (2011). Prime Time: 12-month sexual health outcomes of a clinic-based intervention to prevent pregnancy risk behaviors. Journal of Adolescent Health, 49, 172-179.

Sieving, R.E., McRee, A.L., Secor-Turner, M., Garwick, A.W., Bearinger, L.H., Beckman, K.J., McMorris, B.J., & Resnick, M.D. (2014). Prime Time: Long-Term Sexual Health Outcomes of a Clinic-Linked Intervention. Perspectives on Sexual and Reproductive Health, 46(2), 91-100.

Sieving, R.E, McRee, A.L., McMorris, B.J., Beckman, K.J., Pettingell, S.L., Bearinger, L.H., Garwick, A.W., Oliphant, J.A., Plowman, S., Resnick, M.D., & Secor-Turner, M. (2013). Prime Time: Sexual Health Outcomes at 24 Months for a Clinic-Linked Intervention to Prevent Pregnancy risk Behaviors. JAMA Pediatrics, 167(4), 333-340.

Contact information

Renee E. Sieving

School of Nursing

University of Minnesota

5-160 Waver Densford Hall

308 Harvard Street South East

Minneapolis, MN 55455

sievi001@umn.edu

612-626-4527

KEYWORDS: Adolescents (12-17), Female only, Clinic/Provider-based, Case Management, Skills Training, Service Learning, Social Skills/Life Skills, Other Relationships, Sexual Activity, Condom Use and Contraception, Other Reproductive Health

Program information last updated on 10/7/16

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