Under contract to the Office of Population Affairs (OPA), Mathematica is conducting an impact study of the Making Proud Choices! (MPC) teen pregnancy prevention program. The impact study is designed to estimate the impact of MPC, compared to the business-as-usual condition, on risk and protective factors, sexual behaviors, and longer term health goals including pregnancy and sexually transmitted infections.
This evaluation used a cluster randomized controlled trial (RCT) design to assess the effectiveness of MPC, with schools within districts randomly assigned to one of two conditions: (1) MPC implemented by health educators, or (2) business as usual. In total, 31 school clusters were randomly assigned to condition, including roughly 2800 students, in four geographic areas across the U.S. The study was implemented over the course of three school years (2016-17, 2017-18 and 2018-19), with youth in each year considered a separate evaluation cohort, and with participating schools (and new cohorts of eligible youth) randomized to condition each year. There are two main sources of data for this study: outcome and implementation data. Youth in the study completed two waves of self-report surveys: (1) a baseline survey administered before programming began, and (2) a follow-up outcome survey administered approximately six months after the end of programming (approximately 9 months after baseline, on average). The surveys measured antecedents to sexual behavior (risk and protective factors), sexual behaviors, and ultimately, MPC's health goals of reducing sexually transmitted infections and teen pregnancies. Program implementation data included fidelity and attendance logs, observations, interviews, study youth focus groups, staff surveys, and technical assistance logs. The benchmark analytic approach for estimating program impacts focuses on individuals with observed (non-missing) outcome data, and will statistically adjust for several baseline and location variables to produce credible and precise estimates of program effectiveness. Several sensitivity analyses will be conducted to understand the robustness of the findings across alternative specifications, and to understand the effect of MPC across a variety of subgroups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
2,810
Knowledge about HIV
Proportion of knowledge items about HIV/STDs answered correctly.
Time frame: Survey administered 6 months post program
Knowledge about pregnancy
Proportion of knowledge items about pregnancy answered correctly.
Time frame: Survey administered 6 months post program
Knowledge about condoms
Proportion of knowledge items about condom use answered correctly.
Time frame: Survey administered 6 months post program
Knowledge about other forms of contraception
Proportion of knowledge items about contraceptive use answered correctly.
Time frame: Survey administered 6 months post program
Belief that sex may adversely affect future goals
Proportion of statements about how sexual activity will interfere with goals and dreams that the respondent agrees or strongly agrees with.
Time frame: Survey administered 6 months post program
Belief that condoms can be pleasurable
Proportion of statements about how condoms can be pleasurable that the respondent agrees or strongly agrees with.
Time frame: Survey administered 6 months post program
Attitudes about condoms
Proportion of statements about condom use that the respondent either agrees or strongly agrees with.
Time frame: Survey administered 6 months post program
Condom self-efficacy
Proportion of statements about self-efficacy using condoms that the respondent agrees or strongly agrees with.
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Time frame: Survey administered 6 months post program
Condom negotiation
Proportion of statements about self-efficacy negotiating condom that the respondent agrees or strongly agrees with.
Time frame: Survey administered 6 months post program
Refusal skills
Proportion of statements about self-efficacy refusing sex with a partner that the respondent agrees or strongly agrees with.
Time frame: Survey administered 6 months post program
Ever any sex (vaginal, oral, or anal)
Binary variable representing if the respondent reported having ever had vaginal, oral, or anal sex.
Time frame: Survey administered 6 months post program
Any sex (in past 3 months)
Binary variable representing if the respondent reported having vaginal, oral, or anal sex in the three month period before completing the follow-up survey.
Time frame: Survey administered 6 months post program
Times having any sex (in past 3 months)
Count variable representing the total number of times respondent had vaginal, oral and/or anal sex in the three month period before completing the follow-up survey.
Time frame: Survey administered 6 months post program
Count of vaginal sex partners (in the past 3 months)
Count variable representing the number of partners for vaginal sex in the three month period before completing the follow-up survey.
Time frame: Survey administered 6 months post program
Any sex without a condom (in past 3 months)
Binary variable representing if respondent reported having any risk for STD/STI sex (sex without a condom) in the three month period before completing the follow-up survey.
Time frame: Survey administered 6 months post program
Times having any sex without a condom in past 3 months
Count variable representing the total number of times respondent had risky sex in the three months before completing follow-up survey.
Time frame: Survey administered 6 months post program
Sex without birth control in past 3 months
Binary variable representing if respondent reported having had unprotected vaginal sex in the three months before completing the follow-up survey.
Time frame: Survey administered 6 months post program
Times having sex without birth control (in past 3 months)
Count variable representing the total number of times the respondent had unprotected vaginal sex in the three month period before completing the follow-up survey.
Time frame: Survey administered 6 months post program
Ever pregnant
Binary variable representing if the respondent reported a pregnancy or has gotten someone pregnant.
Time frame: Survey administered 6 months post program
Any sexually transmitted infection (STI)
Binary variable representing if the respondent indicated having been told they have a sexually transmitted infection.
Time frame: Survey administered 6 months post program