Study Details

Citation

Abt Associates. Reducing the Risk: Interim Impact Report, Teen Pregnancy Prevention Replication Study, Report prepared for the Office of Adolescent Health and the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, September 2015a.

Kelsey, M., Blocklin, M., Layzer, J., Price, C., Juras, R., Freiman, L. (201c). Replicating reducing the risk: 12-month impacts of a cluster randomized controlled trial. American Journal of Public Health, 106, S45-S52. doi:10.2105/AJPH.2016.303409

Kelsey, M., Layzer, J., Blocklin, M., Price, C., and Juras, R. "Reducing the Risk: Longer-Term Impact Report." Draft Teen Pregnancy Prevention Replication Study, Abt Associates: Cambridge, MA, November 2016d.

Program or Component Study?
Program
Program or Component Name

Reducing the Risk

Show Evidence of Effectiveness
No
Study Rating and Explanation
High

Random assignment study that met all criteria for a high rating; findings show no positive, statistically significant impact on a relevant behavioral outcome measure for either the full sample or key subgroups.

Program Information

Program Type
Sexual health education
Program Length
10 to 20 sessions

Evaluation Setting

Evaluation Setting
In school: High school

Study Sample

Average Age Group
14 to 17
Majority Racial/Ethnic Group
Hispanic or Latino
Gender
Youth of any gender

Research Design

Assignment Method
Cluster randomized controlled trial
Sample Size

2689

Number of Follow-Ups

2

Length of Last Follow-Up

24 from BL

Year of Last Data Collection
2014 (Imputed to year of publication minus one year)

Study Findings

Result Sexual Activity
Indeterminate evidence
Result Contraceptive Use
Indeterminate evidence
Result STI or HIV
Indeterminate evidence
Result Pregnancy
Indeterminate evidence
Reviewed Studies
High-Quality Randomized Trial
Protocol Version
Version 5.0
Details

A recent study conducted by a separate group of researchers evaluated the standard version of the program when implemented on a broader scale and among a more broadly-defined target population. The study used a cluster randomized trial involving eighth to tenth grade students in 17 public schools across three states (California, Missouri, and Texas). Students were randomly assigned by classroom to either a treatment group that received the program or to a control group that received either a standardized health class (one site) or the regular school instruction. Surveys were administered before random assignment (baseline) and again 12 and 24 months after baseline.

The study findings failed to replicate the favorable impacts on sexual initiation found in prior studies of the program. In particular, 12-months after the baseline, the study found that students in the control group were no more likely than those in the treatment group to report having ever had sex (odds ratio = 0.95). At the 24-month follow-up, the study found no statistically significant program impacts on sexual initiation among the study participants who were not sexually active at baseline.

The study also found, for the full study sample and at each of the two follow-ups, no evidence of statistically significant program impacts on other measures of sexual risk behavior such as rates of sexual activity and unprotected sexual activity in the past 90 days. In addition, at the 24-month follow-up, the study found no evidence of statistically significant program impacts on being diagnosed with a STI in the last 12 months or on becoming pregnant (females) or getting someone pregnant (males).

The study also examined program impacts on measures of knowledge of pregnancy risk, knowledge of STI risk, attitudes toward protection, attitudes toward risky behavior, motivation to delay childbearing, condom negotiation and refusal skills, and intentions to become sexually active and use protection when sexually active. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.

Effect Sizes
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Sample","FUTimingMonths":"24","FUReference":"Baseline","MeanTreat":"0.02","MeanComp":"0.02","TpperES":"-0.053","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"15": {"ProgramName":"Reducing the Risk","StudyID":"PPRER014019","ManuscriptID":"PPRER016030","sid":"182","Rating":"High","OutcomeName":"Currently sexually active (in last 90 days)","OutcomeDomain":"Sexual Activity","OutcomeDichotomous":"Yes","SampleType":"Full Sample","FUTimingMonths":"24","FUReference":"Baseline","MeanTreat":"0.36","MeanComp":"0.34","TpperES":"0.043","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"16": {"ProgramName":"Reducing the Risk","StudyID":"PPRER014019","ManuscriptID":"PPRER016030","sid":"182","Rating":"High","OutcomeName":"Ever sexually active","OutcomeDomain":"Sexual Activity","OutcomeDichotomous":"Yes","SampleType":"Subgroup-BL sexual exp.","FUTimingMonths":"24","FUReference":"Baseline","MeanTreat":"0.38","MeanComp":"0.34","TpperES":"0.099","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"17": {"ProgramName":"Reducing the Risk","StudyID":"PPRER014019","ManuscriptID":"PPRER016030","sid":"182","Rating":"High","OutcomeName":"Oral sex in last 90 days","OutcomeDomain":"Sexual Activity","OutcomeDichotomous":"Yes","SampleType":"Full Sample","FUTimingMonths":"24","FUReference":"Baseline","MeanTreat":"0.26","MeanComp":"0.25","TpperES":"0.023","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"18": {"ProgramName":"Reducing the Risk","StudyID":"PPRER014019","ManuscriptID":"PPRER016030","sid":"182","Rating":"High","OutcomeName":"Sexual intercourse in the last 90 days","OutcomeDomain":"Sexual Activity","OutcomeDichotomous":"Yes","SampleType":"Full Sample","FUTimingMonths":"24","FUReference":"Baseline","MeanTreat":"0.31","MeanComp":"0.30","TpperES":"0.048","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"}}

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.