Clinical trial evaluates intervention to reduce pregnancy risk among adolescent girls

More consistent use of condoms, oral contraception or both was reported by a group of teenage girls who took part in a youth development intervention aimed at reducing pregnancy risk in high-risk adolescents, according to a report of a randomized controlled trial published Online First by JAMA Pediatrics.

The United States continues to have the highest rates of teen pregnancy and childbearing among the industrialized nations and each year more than 750,000 young women ages of 15 and 19 years become pregnant, resulting in more than 400,000 births, according to the study background.

Renee E. Sieving, R.N., Ph.D., F.S.A.H.M., of the University of Minnesota, Minneapolis, and colleagues examined sexual risk behaviors and outcomes with a 24-month follow-up survey, six months after the conclusion of the Prime Time youth development intervention.

Prime Time is an intervention for girls at high risk for pregnancy and designed for primary care clinics. The primary focus was on promoting change in selected psychosocial attributes linked to sexual risk behaviors and other behavioral outcomes, working with case managers and intervention components such as youth leadership.

Of 253 sexually active 13- to 17-year-old girls, who met specified risk criteria, 236 (93.3 percent) completed the 24-month survey. The trial included 126 girls assigned to the intervention and 127 assigned to the control group.

"Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth," the study notes.

At the 24 months follow-up, the intervention group reported "significantly more consistent" use of condoms, hormonal contraception and dual-method contraception (hormonal contraception plus condoms) than the control group, according to the results of data collected using self-report surveys. The girls in the intervention also reported improvements in family connectedness and self-confidence to refuse unwanted sex, and they also reported reductions in the perceived importance of having sex, the results indicate.

"Together with previous findings demonstrating reductions in sexual risk behaviors, relational aggression and violence victimization among Prime Time participants, results from this study suggest that involvement in a youth development intervention that combines individualized case management and youth leadership components holds great promise for preventing multiple risk behaviors among youth most vulnerable to poor health outcomes, including early pregnancy," the study concludes.