Girls Invest: A Mobile-Enabled Economic Empowerment Intervention for Girls
Phase: NA
Conditions: Behavioral Changes
Sponsor: San Diego State University

 
 
 
An intervention to reduce adolescent pregnancy: Girls Invest         
NCT04222959 
March 17, 2022    

Girls Invest Study Procedures 
 
A Two-armed Randomized-Controlled Trial will be be implemented across demographically 
similar communities and ensure adequate numbers recruited. Girls will be recruited from 
community and school-based partnerships. Groups of an average of 10-13 girls from each of 18 
sites will be randomized to: 1) Girls Invest or 2) a wait-list control condition (n= 9 groups per 
arm; total of about 208 girls). Control condition participants will receive Girls Invest after 6 
months follow-up.  
 
Inclusion Criteria. Participants will include girls ages 15-22 years of age who are participating 
in local school-based and community programs primarily serving Latina adolescent girls in the 
San Diego area. Community partners include community-based health centers that have teen-
focused programs. School based partnerships include high schools and community colleges. 
Randomization will be stratified by site type (i.e. we will randomly assign an equal number of 
high schools to be in the treatment group and control group; we will do the same for community 
colleges and community-based partnerships).   
Recruitment and Screening. The project coordinator will be responsible for training and 
oversight of data collection staff. Data collection staff will consist of young females who will be 
trained on research ethics, all data collection activities, and sensitivity when working with this 
population.  
 
Partnerships were developed between Girls Invest and community based programs as well as 
schools predominantly serving the Latinx community such as:  City Heights, San Ysidro, 
Southeast San Diego, El Cajon, Vista, Chula Vista, and National City.   
 
We will work with community based programs as well as local schools, and community colleges 
to conduct recruitment. These partnerships will involve our team going into particular programs 
or classes to recruit a group of adolescent girls. Given that some group-based programs and/or 
classes are still virtually held, we will hold orientation sessions either in-person or via zoom. 
These sessions will include a description of Girls Invest as well as the research study. Among 
girls who are interested, we will support them to download the app, complete consent forms via 
the app, and to take the baseline survey. Girls will also complete the savings account 
application. If parental consent is needed prior to the orientation, we may make arrangements 
for girls to download the app ahead of the orientation or provide the program with hard copies of 
the consent form for girls to have parents sign ahead of the orientation day (if in-person)   
 
At schools, our recruitment may also include in-class presentations. Presentations will involve a 
presentation on financial literacy related topics, including how money and intimate relationships 
intersect, followed by a brief presentation of our Girls Invest program and study for those who 
may be interested. We will stay after class if anyone has questions or wants to enroll. The PI will 
not recruit in any of her own classes at SDSU. We will assure students that participation does 
not affect their grade in the class.   
 
Informed consent and data collection. Informed consent for index participants will occur in-
person during a group orientation or via a phone or online chat. The consent forms can be 
signed with hard copies or via the app. All index participants will be assigned a unique identifier 
to link baseline and follow-up assessments.  
 
Parental consent will be obtained for those participants between the ages of 15-17 years. After 
signing the consent form, each eligible participant (<18 years of age) will be provided with two 
copies of the parental consent form, along with a stamped and addressed envelope, which can 
be used to mail back the signed parental consent form (one copy of the parental consent will be 
kept by the parent/guardian). Participants can also choose to do the signed parental consent via 

the app. After signing their consent forms, all participants will be given access to the app (via a 
username and password); however, initially they will only have access to the resource sheet 
(providing local resources) along with consent forms, including forms for parental consent. 
Parents/guardians will be able to sign the consent via the app. All consent forms will be filed and 
stored separately from other app and survey data. Parental consent forms will be available in 
both English and Spanish.  
 
Baseline and follow-up questionnaires will take approximately 45 minutes and will be self-
administered via an online survey. During an initial orientation, as time permits, participants will 
take the online baseline survey during that time. The online surveys can be taken by 
participants on their own as well.   If participants take the baseline survey on their own, 
participants will be encouraged to complete the questionnaire in a safe and private location. In 
cases where participants do not complete the app-based questionnaire on-time or need 
assistance, staff will provide assistance and offer to meet participants to complete the survey in-
person. The survey requires an ID, which will be provided to participants. Upon completion, 
questionnaire data will not be accessible via the online platform nor the mobile device.   
 
Randomization and Retention. Each group (n=18) will be randomized to study condition. 
Randomization will be stratified by site type (i.e. we will randomly assign an equal number of 
high schools to be in the treatment group and control group; we will do the same for community 
colleges and community-based partnerships). Participants randomized to the Girls Invest 
intervention will be notified with a brief orientation on how to use the app with contact 
information for study staff in case they have questions. App-based data on completion of 
modules and completion time will also be collected. Control group participants will be notified 
that they will be on the wait-list and complete the intervention after 6 months. Regardless of 
study condition, all participants will be linked to the online application for their savings accounts 
(ID can be uploaded online as well) upon completion of the baseline survey. For participants in 
the control group, accounts will become active after the 6 months follow up survey is complete. 
To maximize retention, incentive payments will be escalated: $25 at baseline and $30 at 6 
months follow-up via Amazon e-cards. Participants will also be contacted via the app (or a 
phone call by study staff) every two months to update contact information. Those who do not 
complete follow-up questionnaires via the app will be contacted up to 4 times followed by 
contacting participant’s alternate contacts, using methodology we have used effectively in 
previous studies. If these efforts are not successful, participants will be classified as non-
respondents. Using similar tracking methods, our previous work with a similar sample achieved 
a 92% retention rate at 6 months follow-up.   
 
Assessing the feasibility, fidelity, acceptability, and scalability of Girls Invest (Aim 1). 
Data logs will serve to monitor study progress in recruitment (e.g. proportion eligible, interested, 
refused, and ability to recruit at least 1 friend), participant retention (e.g., differential dropouts by 
condition), adherence (e.g., savings account enrollment), and adverse events. Information on 
recruitment and retention (as well as intra-cluster correlation of endpoints within social 
networks) will help inform sample size determination for a subsequent full-scale trial. 
Contamination will be assessed via items on the follow-up survey (e.g. control participants’ 
knowledge of Girls Invest or any participants in the Girls Invest intervention). App-generated 
data will assess engagement with and completion of Girls Invest (e.g. # modules completed, 
time spent on each) and used to identify completers (80% of the Girls Invest modules) versus 
non-completers.  
 
Evaluation of acceptability and receptivity will include in-depth interviews (up to n=30; similar 
proportions index participants and peers, 5 with non-completers) to evaluate participants’ 
experiences with Girls Invest (e.g. content, app dynamics, savings account features), and 
identify mechanisms underlying any intervention effects (e.g. did the intervention affect 

economic vulnerability? how did these effects influence girls’ sexual and contraceptive decision-
making? Were certain components most impactful?) These will take place via a phone or online 
call or in private space at La Maestra. Based on our previous work, we expect 20 interviews to 
be sufficient for saturation of themes; however, we will conduct additional interviews (up to an 
additional 10) if needed. Participants will be paid $30 for in-depth interviews. For those 
participants who are <18 years of age, we will obtain parental consent using the main study 
consent form, rather than using a separate form for in-depth interviews. Details of the in-depth 
interviews will be provided in these main study parental consent forms.  While details are 
included in the main study consent form for participants, we will also review all of the in-depth 
interview procedures and details in a separate consent form provided immediately prior to the 
in-depth interview.  
 
Statistical Power and Analyses on Economic, Social, and Health Behavior Risks. (Aim 
2) Sample size calculation is based on intermediate outcomes (Figure 1) with at least 25% 
prevalence at baseline. To achieve 80% power, we will require 208 participants (approximately 
13 in each of 16 groups) to be able to determine a moderate effect size of 0.52 (26% difference 
between the two arms on intermediate factors in Figure 1), using an intra-class correlation 
coefficient (ICC) of 0.03 given the group structure, type I error of 0.025, and 20% attrition 
(conservatively estimating 80% retention over 6 months). Note the sample size has taken 
multiple comparisons (using Bonferroni adjustment) into account. In addition, we may likely 
have a lower ICC, which would afford greater statistical power.  
 
To assess clustering within groups (n=18), random effects models will calculate ICCs. We will 
conduct intent-to-treat analyses using crude and adjusted mixed effects logistic and linear 
regression models with a focus on intermediate variables (Figure 1) to assess group-by-time 
effects, with adjustments for clustering and intervention engagement and completion. To assess 
random imbalances (at baseline) and differences in attrition by condition, we will perform chi-
square analyses and t-tests. We will adjust for relevant covariates to address imbalances 
between conditions. Differences in attrition between study conditions will be noted as potential 
threats to validity. We will also explore variations in observed intervention effects by savings 
behaviors, module completion, as well as relevant factors identified via in-depth interview 
findings. 

Figure 1. Girls Invest Components and Expected Outcomes 
 
Gender and 
Financial skills 
training via app: 
Focused on skills 
and knowledge 
needed within the 
financial lives of 
adolescent girls
Savings Account: 
Creation of savings 
account with 
subsidies deposited 
based on 
completion of app 
trainings
Girls Invest 
Components
Intermediate Outcomes
Social Risk Factors for Adolescent Pregnancy
- Increased attitudes supportive of 
contraceptive use
- Increased intentions and prioritization for 
using contraception and delaying pregnancy
- Increased self-efficacy to make 
sexual/reproductive decisions in 
relationships
- Increased knowledge of healthy versus 
unhealthy relationships
Sexual Health Behaviors
- Increased use of effective 
contraception
- Increased condom use
- Decreased frequency of sexual 
activity
Impact
Decreased
Risk for 
Adolescent 
Pregnancy
Economic-Related Outcomes 
• Decreased perceived economic vulnerability
• Improved financial literacy 
• Improved self-efficacy to navigate financial 
systems
• Increased savings intentions 
• Improved expectations related to a) future 
career and educational goals, and b) economic 
autonomy
• Decreased perceived need for financial 
reliance on male partners
Economic-Related Outcomes
- Improved financial situation 
and economic self-sufficiency 
(e.g. greater income 
generation, savings)
- Decreased financial reliance on 
male partners
Outcomes
Social Risk Factors for 
Adolescent pregnancy
- Decreased intimate partner 
violence
- Decreased male partner 
control over 
reproductive/sexual decisions