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Randomized Controlled Trial
. 2013 Apr;167(4):333-40.
doi: 10.1001/jamapediatrics.2013.1089.

Prime time: sexual health outcomes at 24 months for a clinic-linked intervention to prevent pregnancy risk behaviors

Renee E Sieving  1 , Annie-Laurie McRee, Barbara J McMorris, Kara J Beckman, Sandra L Pettingell, Linda H Bearinger, Ann W Garwick, Jennifer A Oliphant, Shari Plowman, Michael D Resnick, Molly Secor-Turner
Affiliations
Randomized Controlled Trial

Prime time: sexual health outcomes at 24 months for a clinic-linked intervention to prevent pregnancy risk behaviors

Renee E Sieving et al. JAMA Pediatr. 2013 Apr.

Abstract

Importance: Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy.

Objective: To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention.

Design: Randomized controlled trial.

Setting: Community and school-based primary care clinics.

Participants: Of 253 sexually active 13- to 17-year-old girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey.

Intervention: Offered during an 18-month period, Prime Time includes case management and youth leadership programs.

Main outcome measures: Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months.

Results: At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex. No between-group differences were found in the number of recent male sex partners.

Conclusions and relevance: This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth.

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Figures

Figure
Figure
Flowchart showing randomization of Prime Time study participants. Among patients unavailable for follow-up, “lost” indicates those who could not be located; and “no-show,” those who were contacted and scheduled for a follow-up survey but did not complete the survey.
See this image and copyright information in PMC

Comment in

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