Study Details

Citation

Smith, Kim, et al. Interim Impacts of the Teen Options to Prevent Pregnancy Program. Mathematica Policy Research, Princeton, NJ: 2015a.

Rotz, Dana, Dara Lee Luca, Brian Goesling, Elizabeth Cook, Kelly Murphy, and Jack Stevens. "Final Impacts of the Teen Options to Prevent Pregnancy Program." Cambridge, MA: Mathematica Policy Research, July 2016a.

Stevens, J., Lutz, R., Osuagwu, N., Rotz, D., Goesling, B. (2017). A randomized trial of motivational interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy among adolescent mothers. American Journal of Obstetrics and Gynecology, 217(4), 423.e1-423.e9. https://doi.org/10.1016/j.ajog.2017.06.010

Program Name

Teen Options to Prevent Pregnancy (T.O.P.P.)

Show Evidence of Effectiveness
Yes
Study Rating and Explanation
High

This study received a high study quality rating because it is a low-attrition randomized controlled trial with no known issues that would suggest the findings cannot be attributed to the program

Program Information

Program Type
Clinic-based
Program Length
10 to 20 sessions

Evaluation Setting

Evaluation Setting
Multiple settings

Study Sample

Average Age Group
18 or 19
Majority Racial/Ethnic Group
White
Gender
Young women

Research Design

Assignment Method
Randomized controlled trial
Sample Size

493

Number of Follow-Ups

2

Length of Last Follow-Up

18 months after enrollment/baseline

Year of Last Data Collection
2015

Study Findings

Result Number Partners
Indeterminate evidence
Result Sexual Activity
Indeterminate evidence
Result Contraceptive
Favorable evidence
Result Pregnancy
Favorable evidence
Reviewed Studies
High-Quality Randomized Trial
Protocol Version
Version 6.0
Effect Sizes
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Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER014023","sid":"277","Rating":"High","OutcomeName":"Use of LARCs in the past 3 months","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"6","FUReference":"Baseline","MeanTreat":"0.38","MeanComp":"0.21","TpperES":"0.499","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"3": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER014023","sid":"277","Rating":"High","OutcomeName":"Use of any birth control method","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"6","FUReference":"Baseline","MeanTreat":"0.84","MeanComp":"0.81","TpperES":"0.156","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"4": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER014023","sid":"277","Rating":"High","OutcomeName":"Use of any hormonal method or IUD","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"6","FUReference":"Baseline","MeanTreat":"0.75","MeanComp":"0.68","TpperES":"0.215","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"5": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER014023","sid":"277","Rating":"High","OutcomeName":"Number of sexual partners in past 3 months","OutcomeDomain":"Number of Sexual Partners","OutcomeDichotomous":"No","SampleType":"Full sample","FUTimingMonths":"6","FUReference":"Baseline","MeanTreat":"0.93","MeanComp":"1.02","TpperES":"NA","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"6": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER014023","sid":"277","Rating":"High","OutcomeName":"Had sexual intercourse in past 3 months","OutcomeDomain":"Sexual Activity","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"6","FUReference":"Baseline","MeanTreat":"0.83","MeanComp":"0.85","TpperES":"-0.097","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"7": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Had sexual intercourse in the past 3 months without a condom","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.54","MeanComp":"0.65","TpperES":"-0.260","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"8": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Had unprotected sex in the past 3 months","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.22","MeanComp":"0.34","TpperES":"-0.351","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"9": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Use of LARCs in the past 3 months","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.41","MeanComp":"0.25","TpperES":"0.443","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"10": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Use of any birth control method","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.83","MeanComp":"0.75","TpperES":"0.307","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"11": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Use of any hormonal method or IUD","OutcomeDomain":"Contraceptive Use","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.71","MeanComp":"0.59","TpperES":"0.308","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"12": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Number of sexual partners in past 3 months","OutcomeDomain":"Number of Sexual Partners","OutcomeDichotomous":"No","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"1.00","MeanComp":"1.00","TpperES":"NA","StatSigRepEffect":"No","RepEffectFavorable":"Not significant","RepEffectMeet":"No"},"13": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Number of lifetime pregnancies","OutcomeDomain":"Pregnancy","OutcomeDichotomous":"No","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"1.60","MeanComp":"1.90","TpperES":"NA","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"14": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Repeat pregnancy","OutcomeDomain":"Pregnancy","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.21","MeanComp":"0.38","TpperES":"-0.519","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"15": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Repeat pregnancy ending in a live birth","OutcomeDomain":"Pregnancy","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.10","MeanComp":"0.20","TpperES":"-0.472","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"16": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Unintended pregnancy","OutcomeDomain":"Pregnancy","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.17","MeanComp":"0.35","TpperES":"-0.585","StatSigRepEffect":"Yes","RepEffectFavorable":"Yes","RepEffectMeet":"Yes"},"17": {"ProgramName":"Teen Options to Prevent Pregnancy (T.O.P.P.)","StudyID":"PPRER014023","ManuscriptID":"PPRER016025","sid":"277","Rating":"High","OutcomeName":"Had sexual intercourse in past 3 months","OutcomeDomain":"Sexual Activity","OutcomeDichotomous":"Yes","SampleType":"Full sample","FUTimingMonths":"18","FUReference":"Baseline","MeanTreat":"0.82","MeanComp":"0.85","TpperES":"-0.143","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.

Details

The program was evaluated using a randomized controlled trial involving pregnant or recently pregnant young women recruited from seven obstetrics-gynecology clinics and five postpartum units of a large hospital system in a Midwestern city. Participants were randomly assigned to either a treatment group that received the 18-month T.O.P.P. program or a control group that received usual care. Surveys were administered at baseline, mid-intervention (6 months after enrollment), and immediately after the end of the intervention (18 months after enrollment).

The study found that adolescents participating in the intervention were significantly less likely to report having had unprotected vaginal intercourse in the past three months at six months after enrollment (effect size = .02) and at 18 months after enrollment (effect size = 0.01). The study also found that 18 months after enrollment, adolescents participating in T.O.P.P. were significantly less likely to report having had a repeat pregnancy (effect size = 0.01), unintended repeat pregnancy (effect size = 0.02), or live birth (effect size = 0.03) since enrollment. At both six and 18 months after study enrollment, the study found no statistically significant program impacts on whether the participant had vaginal sex, whether the participant had vaginal intercourse without a condom, or the number of sexual partners in the past three months.

The study also examined program impacts on measures of use of long-acting reversible contraception, use of effective birth control, trying to avoid pregnancy in the next year, school enrollment, and completion of high school or GED. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.