Study Details

Citation

Lewin, Amy, Stephanie Mitchell, and Michel Boudreaux. "Improved Contraceptive Use Among Teen Mothers in a Family-Centered Medical Home." Unpublished manuscript, University of Maryland, 2015.

Lewin, A., Mitchell, S., Beers, L., Schmitz, K., Boudreaux, M. (2016). Improved contraceptive use among teen mothers in a patient-centered medical home. Journal of Adolescent Health, 59(2), 171-176.

Lewin, A., Mitchell, S.J., Quinn, D.A., Street, T.M., Schmitz, K., Beers, L.S. (2019). A primary care intervention to prevent repeat pregnancy among teen mothers. American Journal of Preventive Medicine, 56(3), 404-410. https://doi.org/10.1016/j.amepre.2018.10.015

Program Name

Generations

Show Evidence of Effectiveness
Yes
Study Rating and Explanation
Moderate

Quasi-experimental study that that met all criteria for a moderate rating; findings show a positive, statistically significant impact for at least one behavioral outcome

Program Information

Program Type
Clinic-based
Program Length
Fewer than 10 sessions

Evaluation Setting

Evaluation Setting
Health clinic or medical facility

Study Sample

Average Age Group
14 to 17
Majority Racial/Ethnic Group
African American or Black
Gender
Young women

Research Design

Assignment Method
Quasi-Experimental Design
Sample Size

124

Number of Follow-Ups

2

Length of Last Follow-Up

24 from BL

Year of Last Data Collection
2019

Study Findings

Result Contraceptive
Favorable evidence
Reviewed Studies
Moderate-Quality Quasi-Experiment
Protocol Version
Version 5.0
Effect Sizes
{"0":{"ProgramName":"Generations","StudyID":"PPRER014009","ManuscriptID":"PPRER014009","sid":"278","Rating":"Moderate","OutcomeName":"Effective contraceptive use","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"12","FUReference":"Baseline","MeanTreat":"0.88","MeanComp":"0.70","TpperES":"0.694","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"1":{"ProgramName":"Generations","StudyID":"PPRER014009","ManuscriptID":"PPRER014009","sid":"278","Rating":"Moderate","OutcomeName":"Condom use","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"12","FUReference":"Baseline","MeanTreat":"0.72","MeanComp":"0.53","TpperES":"0.500","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"}}

NA = Not available. This means the authors did not report the information in the manuscripts associated with the studies we reviewed.

a This information was not available whenever authors did not report information for the treatment and comparison groups separately on outcome means, standard deviations, and/or sample sizes.

b Authors reported that the program effect (impact) estimate is statistically significant with a p-value of less than 0.05 based on a two-tailed test.

c For some outcomes, having less of that outcome is favorable. In those cases, an effect with a negative sign is favorable to the treatment group (that is, the treatment group had a more favorable outcome than the comparison group, on average).

d An effect shows credibly estimated, statistically significant evidence whenever it has a p-value of less than 0.05 based on a two-tailed test, includes the appropriate adjustment for clustering (if applicable), and it is not based on an endogenous subgroup.

Details

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.

The study found that 12 months after study enrollment, mothers in the intervention group were more likely to report using effective contraception the last time they had sex (effect size = 0.694). Mothers in the intervention group were also more likely to report using a condom the last time they had sex (effect size = 0.500). Findings at the 24-month follow-up received a low rating because the study did not demonstrate that the treatment and control groups in the sample at this follow-up were sufficiently similar before the introduction of the program.