Generations
The Generations program was designed to be delivered in a primary-care setting. The program was evaluated in community-based primary health care clinics serving a largely urban, low-income, African American population.
Last updated in 2024
The data presented on this page reflect responses from the program’s developer or distributor to a program component checklist that asked them to report on the individual components within their TPP program. The same program component checklist was sent to the developer or distributor of every active TPP program with evidence of effectiveness. The program component table provides information on seven types of program components including content, delivery mechanism, dosage, staffing, format, context, and intended population characteristics; whether the component was present or optional in the program; whether the component is considered to be core to the program; and the lesson number or activity where the component can be found in the program.
In the drop-down menu below, under “Has component,” there are four options that indicate a component as present in the program: (1) “Yes” indicates that the component is present in at least one version of the program (whether that be the program version that was evaluated, the current version, or both versions); (2) “Yes (both versions)” indicates that the component is present in both the evaluated version of the program and the current version of the program; (3) “Yes (current version)” indicates that the component is present in the current, but not the evaluated, version of the program; and (4) “Yes (evaluated version)” indicates that the component is present in the evaluated version of the program, only. Note that for dosage components, the dosage itself is described in the Notes when available.
Some of the components identified are noted as core components of the evidence-based program, but this does not necessarily mean that these components have been rigorously tested and show evidence of effectiveness. Most often developers denoted components as core based on theory or experience in the field. Click here for the list of evidence-based components.
For more details about program components, refer to the FAQ page.
Category | Component | Core Component | Component present | Notes | Lesson number(s) / activities where present |
---|---|---|---|---|---|
Content | School engagement | No | |||
Content | Anatomy/physiology | No | |||
Content | Other | No | |||
Content | Volunteering/civic engagement | No | |||
Content | Spirituality | No | |||
Content | Morals/values | No | |||
Content | Identity development | No | |||
Content | Social support/capital | No | |||
Content | Social influence/actual vs. perceived social norms | No | |||
Content | Social competence | No | |||
Content | Parenting skills | No | |||
Content | Normative beliefs | No | |||
Content | Leadership | No | |||
Content | Gender roles | No | |||
Content | Gender identity | No | |||
Content | Cultural values | No | |||
Content | Connections with trusted adults | No | |||
Content | Conflict resolution/social problem solving | No | |||
Content | Communication skills | No | |||
Content | Child development | No | |||
Content | Boundary setting/refusal skills | No | |||
Content | Substance use cessation | No | |||
Content | Substance use - Other drugs | No | |||
Content | Substance use - Alcohol | No | |||
Content | Substance use - Abstinence | No | |||
Content | Brain development and substance use | No | |||
Content | Vocational/skills training | No | |||
Content | Supplemental academic services | No | |||
Content | Graduating from high school | Yes | Yes (both versions) | ||
Content | College preparation | No | |||
Content | Alternative schooling | No | |||
Content | Self-regulation | No | |||
Content | Self-esteem | No | |||
Content | Self-efficacy/empowerment | No | |||
Content | Resilience | No | |||
Content | Sexual health | No | |||
Content | STIs - Treatment | Yes | Yes (both versions) | ||
Content | STIs - Screening | Yes | Yes (both versions) | ||
Content | STIs - Prevention | No | Yes (both versions) | ||
Content | STIs - Information | No | Yes (both versions) | ||
Content | Sexual risk reduction | Yes | Yes (both versions) | ||
Content | Sexual risk discontinuation | No | |||
Content | Sexual risk avoidance | No | |||
Content | Personal vulnerability | No | |||
Content | Maternal health | Yes | Yes (both versions) | ||
Content | Contraception - Condoms | Yes | Yes (both versions) | ||
Content | Contraception - Long-acting reversible contraceptives | Yes | Yes (both versions) | ||
Content | Contraception - Other | Yes | Yes (both versions) | ||
Content | Contraception - Pills, patches, rings, and shots | Yes | Yes (both versions) | ||
Content | Reproduction | No |
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The Generations program is a multidisciplinary, family-centered, integrated model of health care service delivery for teen parents and children within the primary care setting. There are three primary components of the Generations program:
- Well Woman/Well Child Care: where teen mothers, fathers, and their child(ren) receive medical care from the same provider, in the same setting, and during the same medical visit (e.g., a mother can receive reproductive health services when she brings her child for a well-child visit).
- Intensive Social Work Services: Each teen parent family is assigned a social worker who supports the family, and provides services during medical visits and between visits as needed. The social worker conducts needs assessments and addresses the many social determinants that are often barriers to health among teen parents.
- Mental Health Screening and Treatment: Every teen parent undergoes a battery of mental health screenings to address a range of psychological concerns, including mood, trauma, and interpersonal violence exposure. These screenings, as well as developmental and behavioral health screening of their children, are conducted as a routine part of medical care. Brief and long-term mental health treatment, parent coaching and support, are provided by licensed social workers and psychologists on staff as needed.
Citation | High-Quality Randomized Trial | Moderate-Quality Randomized Trial | Moderate-Quality Quasi-Experiment | Low Study Rating | Did Not Meet Eligibility Criteria |
---|---|---|---|---|---|
Lewin et al. 2015 Lewin et al. 2016 Lewin et al. 2019 |
✓ |
Citation | Setting | Majority Age Group | Majority Racial/Ethnic Group | Gender | Sample Size |
---|---|---|---|---|---|
Lewin et al. 2015 Lewin et al. 2016 Lewin et al. 2019 |
Health clinic or medical facility | 14 to 17 | African American or Black | Young women | 124 |
Evidence by Outcome Domain and Study
Citation | Sexual Activity | Number of Sexual Partners | Contraceptive Use | STIs or HIV | Pregnancy |
---|---|---|---|---|---|
Lewin et al. 2015 Lewin et al. 2016 Lewin et al. 2019 |
n.a. | n.a. |
|
n.a. | n.a. |
Citation | Details |
---|---|
Lewin et al. 2015 Lewin et al. 2016 Lewin et al. 2019 |
The study examined the effectiveness of the program using a quasi-experimental design conducted in six community-based primary health care clinics serving primarily urban, low-income, African-American patients in the Washington, D.C., area. The study compared the outcomes of 74 teen-mothers seeking services in three intervention sites that implemented the Generations program with the outcomes of 50 teen mothers seeking services in three comparison sites that did not offer the program but provided standard community-based pediatric primary care. Outcomes were measured 12 and 24 months after baseline. |