Replication of the Teen Outreach Program in Kansas City
Condition: Teenage Pregnancy
Study type: Interventional

Summary: 
      The Women's Clinic of Kansas City (TWC) replicated the Teen Outreach Program (TOP) across
      Kansas City, Missouri. The purpose of this study is to measure: one year after the end of the
      program year, what is TOP's impact on the treatment group's sexual activity and contraceptive
      use, relative to the control group, at one year following the program?
    

Detailed description: 
      TOP is a youth development and service learning program for youth ages 12 to 17 designed to
      reduce teenage pregnancy and increase school success by helping youth develop a positive
      self-image, life management skills, and realistic goals. The TOP program model consists of
      three components implemented in school, after school, or in community settings over nine
      months: (1) weekly curriculum sessions, (2) community service learning, and (3) positive
      adult guidance and support. The TOP Changing Scenes Curriculum is separated into four
      age-/stage-appropriate levels, Level 1 is typically for youth ages 12 or 13 and Level 4 is
      typically for youth age 17. The curriculum focuses on the presence of a consistent, caring
      adult; a supportive peer group; skill development; sexual health; and sexual behavior
      choices. The intended program dosage for each participant is a minimum of 25 weekly sessions
      (one per week at 40-50 minutes each) and at least 20 hours of community service learning over
      nine months. One or two facilitators, who plan the order of sessions based on the needs and
      interest of youth, implemented TOP in a group of 10 to 25 youth.

      In this cluster randomized controlled trial, twelve of the highest-risk (based on highest
      teen births per zip code ranking in 2008) middle and high schools in the Kansas City
      Metropolitan Area were recruited to participate in the evaluation. After finalizing
      agreements with seven schools that agreed to participate, 7th- and 9th-grade teachers of core
      subjects (such as social studies and English) were recruited to participate. During the two
      years of sample enrollment, 21 teachers participated. At the start of each school year of
      sample enrollment, the study team assessed whether each participating teacher's class
      sections would be eligible for the evaluation based on the number of students enrolled (class
      sections were eligible if they had at least 10 students). Classes were

      This study is a cluster randomized controlled trial across two cohorts. Stratification
      occurred at the teacher level; each teacher's classes were randomized to either TOP or the
      control condition. Random assignment occurred after acquiring parental consent and youth
      assent and administering the baseline survey. A passive consent process was used to notify
      parents that their youth would be participating in a youth development survey unless they
      opted out of the process. In addition, youth were given the option to not assent to any
      specific survey. Overall, youth in completed three surveys: (1) baseline, (2) 9-month
      post-baseline (immediate follow-up), and (3) 21-month post-baseline (1-year post-intervention
      follow-up). Students were surveyed in class using paper-and-pencil surveys; make-up surveys
      occurred during follow-up visits to the school over the final few weeks of school. Those
      chronically absent or no longer enrolled in the study schools were contacted via telephone to
      complete a telephone survey or via email to complete the survey online. Final efforts were
      made to visit youth who dropped out or who had been otherwise unreachable by going directly
      to their homes (if they still lived in the area); these youth were given a paper-and-pencil
      survey to complete. Students received a modest incentive for completing each survey.
    

Intervention name(s): The Teen Outreach Program
Intervention type(s): Behavioral
Intervention description(s): Students received the Teen Outreach Program as described previously.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention