Program Increases Teen Contraceptive Use

Prime Time, an 18-month youth development program, was created and tested by researchers from the University of Minnesota Prevention Research Center to prevent pregnancy among vulnerable teens. Prime Time combines

personal case management,
peer health educator training and practice, and
expansion of youth leadership skills through service learning projects.

The aim of Prime Time is to build skills, confidence, motivation, and supportive relationships that every teen needs to succeed, with a focus on responsible sexual health behaviors. Prime Time is different from many youth development programs because it was designed for use by health clinics, which is where many vulnerable teens seek services.

Prime Time Methods

Researchers recruited 253 girls between the ages of 13 to 17, who were sexually active and met at least one risk criteria for teenage pregnancy (such as treatment for a sexually transmitted disease or aggressive and violent behavior). All of the girls received standard care through a clinic, but 126 girls also participated in Prime Time's case management and youth leadership activities. The case managers met with each teen for monthly one-on-one sessions covering topics such as healthy relationships, responsible sexual behaviors, and positive family and school involvement. These sessions included mentorship, counseling, and goal-setting.

Condoms were provided as a part of standard care for all girls

The peer educator groups met once a week for 15 weeks. Sample topics included:

Skills for healthy relationships
Social influences on sexual behaviors
Contraceptive skills

During this 15-week period, girls were asked to reach and teach others in their daily lives with information from their peer educator groups. At the end of the peer educator groups, participants were given opportunities to develop their own lesson plans and teach other groups of teens. Service learning groups also met regularly and followed a curriculum that led participants through the process of identifying their own leadership skills, exploring community needs and assets, and putting on service projects to address community needs.

Prime Time Results

Participation rates were high. Nearly all (93.3%) of the 253 girls completed a survey at 12, 18, and 24 months after the start of the program.

At the 12-month assessment, program participants showed more consistent use of condoms and dual-method contraceptives (such as using both condoms and oral contraceptive pills to prevent pregnancy) than teens receiving standard care. Participants also reported greater stress management skills.
At the 18-month assessment, program participants had significant increases in family connectedness and a significantly higher proportion enrolled in college or technical school at this point of the program. Participants also reported fewer relationally aggressive behaviors including less verbal rejection, rumor spreading, and ostracism of others. This outcome is significant because this type of aggression has been linked to poor health outcomes among youth.
At the 24-month assessment (6 months after the completion of the program), program participants showed more consistent use of condoms and dual-method contraceptives than girls receiving standard care. Participants also reported significantly higher levels of self-confidence to refuse unwanted sex and significant decreases in the perceived importance of having sex for material reasons (for example, in exchange for nice clothes or jewelry).
At every assessment, researchers found more consistent use of hormonal birth control methods (which included oral contraception, injection, contraceptive patch, or vaginal ring) among program participants.

The findings from this study contribute to growing support for youth development approaches to prevent teenage pregnancy. The long-term increases in family connectedness and enrollment in post-secondary education suggest that interventions such as Prime Time may promote positive transitions into early adulthood among adolescent girls most vulnerable to early pregnancy and other negative health outcomes.
"In times of tight budgets, it's especially important to focus on what works," says lead investigator Renee Sieving, associate professor with the University of Minnesota School of Nursing. "Our research shows that when we invest in young people through ongoing one-on-one relationships, opportunities for leadership and effective sexual health services, we support our next generation of citizens."

Prime Time in Your Area

If you are interested in learning more about promoting healthy youth development and preventing teen pregnancy, please visit the University of Minnesota Prevention Research Center website at Division of General Pediatrics and Adolescent Health

, or contact Renee Sieving at sievi001@umn.edu.

Prime Time History

Prime Time began as a pilot study by the University of Minnesota Prevention Research Center through funding from CDC's Prevention Research Centers Program in 1999. Upon completion of the development of this promising strategy, the University of Minnesota Prevention Research Center was able to leverage $3 million in funds in 2006 from the NIH for a more detailed testing of the model. Scientific findings from the study reported here add to the evidence base of the CDC Winnable Battle of Teen Pregnancy.

Prevention Research Centers Program

The Prevention Research Centers Program is a network of academic, community, and public health partners that conducts applied public health research to promote health and prevent disease. Congress authorized the program in 1984. Today, 37 centers, including 5 in a developmental stage, are located in 27 states, and they reach nearly 30 million people in 103 partner communities. PRCs work with vulnerable communities where the average income is one-third lower than the U.S. average. Information about their achievements and work in progress is available on the PRC Program's website.

References

Sieving RE, McMorris BJ, Beckman KJ, et al. Prime Time: 12-month sexual health outcomes of a clinic-based intervention to prevent pregnancy risk behaviors. J Adolescent Health 2011;49(2):172-179. doi:10.1016/j.jadohealth.2010.12.002.
Sieving RE, McMorris BJ, Secor-Turner M, et al. Prime Time: 18-month violence outcomes of a clinic-based intervention. Prev Sci 2013 Apr 2. [Epub ahead of print]. doi:10.1007/s11121-013-0387-5.
Sieving RE, McRee AL, McMorris BJ, et al. Prime Time: sexual health outcomes at 24 months for a clinic-linked intervention to prevent pregnancy risk behaviors. JAMA Pediatr 2013;167(4):333-340. doi:10.1001/jamapediatrics.2013.1089.