Evaluating teen options for preventing pregnancy: Impacts and mechanisms.

This paper presents findings from an experimental evaluation of the Teen Options to Prevent Pregnancy (TOPP) program, an 18-month intervention that consists of a unique combination of personalized contraceptive counseling, facilitated access to contraceptive services, and referrals to social services. We find that TOPP led to large and statistically significant increases in the use of long-acting reversible contraceptives (LARCs), accompanied by substantial reductions in repeat and unintended pregnancy among adolescent mothers. We provide an exploratory analysis of the channels through which TOPP achieved its impacts on contraceptive behavior and pregnancy outcomes.

A Practical Guide to Cluster Randomized Trials in School Health Research.

Background: When well-designed and implemented, cluster randomized trials can meet the high standards federal agencies and other funders increasingly require for evidence on the effectiveness of school health programs and services. However, designing and implementing these studies can present more challenges than at first appears.

Methods: I reviewed summaries of the methodological literature on cluster randomized trials.

Brief report: Assessing the risk of reporting bias in a RCT for adolescent mothers.

Introduction: Most adolescent sexual and reproductive health studies rely solely upon self-report surveys to assess key variables such as pregnancy and sexually transmitted infections (STIs). The current study investigated the risk of reporting bias that may result from using such surveys to measure outcomes in randomized controlled trials (RCTs).

Methods: As part of an RCT of a multicomponent intervention to delay repeat pregnancy among adolescent mothers, we compared survey data on repeat pregnancy with birth records from a state's vital statistics system.

Impacts of a School-Wide, Peer-Led Approach to Sexuality Education: A Matched Comparison Group Design.

Background: Teen Prevention Education Program (PEP) is a school-wide, peer-led comprehensive sexuality education program currently implemented in more than 50 schools across 2 states. Many teen pregnancy prevention researchers and practitioners view peer-led programs as a promising approach for reducing teen pregnancy and associated sexual risk behaviors. However, prior research on the effectiveness of these programs indicates mixed results.

A randomized trial of motivational interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy among adolescent mothers.

Background: Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low-income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months.

Impacts of an Enhanced Family Health and Sexuality Module of the HealthTeacher Middle School Curriculum: A Cluster Randomized Trial.

Objectives: To evaluate the impacts of an enhanced version of the Family Life and Sexuality Module of the HealthTeacher middle school curriculum.

Methods: We conducted a cluster randomized trial of Chicago, Illinois, middle schools. We randomly assigned schools to a treatment group that received the intervention during the 2010-2011 school year or a control group that did not.

High-Stakes Systematic Reviews: A Case Study From the Field of Teen Pregnancy Prevention.

Background: Systematic reviews help policy makers and practitioners make sense of research findings in a particular program, policy, or practice area by synthesizing evidence across multiple studies. However, the link between review findings and practical decision-making is rarely one-to-one. Policy makers and practitioners may use systematic review findings to help guide their decisions, but they may also rely on other information sources or personal judgment.

Programs to reduce teen pregnancy, sexually transmitted infections, and associated sexual risk behaviors: a systematic review.

Purpose: This systematic review provides a comprehensive, updated assessment of programs with evidence of effectiveness in reducing teen pregnancy, sexually transmitted infections (STIs), or associated sexual risk behaviors.

Methods: The review was conducted in four steps. First, multiple literature search strategies were used to identify relevant studies released from 1989 through January 2011.

The effectiveness of mandatory-random student drug testing: a cluster randomized trial.

Purpose: This article presents findings from the largest experimental evaluation to date of school-based mandatory-random student drug testing (MRSDT). The study tested the effectiveness of MRSDT in reducing substance use among high school students.

Methods: Cluster randomized trial included 36 high schools and more than 4,700 9th through 12th grade students.

Socioeconomic position and health: the differential effects of education versus income on the onset versus progression of health problems.

This article seeks to elucidate the relationship between socioeconomic position and health by showing how different facets of socioeconomic position (education and income) affect different stages (onset vs. progression) of health problems. The biomedical literature has generally treated socioeconomic position as a unitary construct.