Louisville Teen Pregnancy Prevention Project
Condition: Pregnancy; Sexually Transmitted Diseases
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional

Summary: 
      This study is comparing the impact of two teen pregnancy prevention interventions, Reducing
      the Risk and Love Note with a non-related training on community building to determine which
      is most effective for which participants in delaying sexual initiation, enhancing use of
      condoms and other forms of birth control, decreasing sexually transmitted diseases and
      decreasing the number of pregnancies. The participants were 1450 youth between the ages of 14
      and 19 including those from poor urban settings, those from immigrant and refugee families
      and those from the foster care system. Both girls and boys were be in the study. The
      investigators predict that girls, immigrants and refugees and foster youth will have better
      outcomes when participating in Love Notes, a program focused on healthy relationship
      formation and maintenance as a frame for how to manage the sexual aspect of relationships
      while boys and urban youth will have better outcomes when participating in Reducing the Risk.
      Both groups will have better outcomes than those in the control condition.
    

Detailed description: 
      The purpose of this research is to conduct a randomized controlled trial with three groups to
      test the effectiveness of various interventions aimed at reducing risky behavior by
      teenagers. Two intervention groups will each receive a training intervention to reduce the
      chances of teen pregnancy, contraction of STIs, and abusive relationships among high risk
      youth in the Louisville community. The wait-list control group will receive training on the
      unrelated topic of community building at the same time. According to the Centers for Disease
      Control (CDC) Youth Risk Behavior Surveillance System (YRBSS), 50% of Kentucky high school
      students have participated in sexual intercourse, 37% report currently being sexually active,
      and 14% have reported having sexual intercourse with four or more sexual partners.
      Furthermore, only 41% of sexually active students reported using a condom the last time they
      had sex. These are risky sexual practices that may lead to HIV/STI infection, as well as
      unintended pregnancy, within the adolescent population. Understanding the pregnancy
      intentions of these adolescents is not only important with regards to adolescent pregnancy,
      but it is also important in light of HIV and STI infection when 6% of adolescents and young
      adults (<20 years of age) in Kentucky have been reported as HIV positive since 2009. As of
      January 2009, Kentucky ranked 42nd for teenage births (where 1 is best) with a teenage birth
      rate of 56 per 1,000 girls ages 15-19 years of age. Kentucky was only slightly above
      Mississippi, which ranked 50th with a teenage birth rate of 68.4 per 1,000. Kentucky's
      teenage birth rate is higher than the national rate which is currently 41.9 per 1,000 girls
      ages 15-19 years of age. The most recent Kentucky teen birth rates in 2007 show that
      Jefferson County (52.34 per 1,000 ages 15-19) exceeds the birth rate of the nation. To
      address these issues, 1450 Louisville youth were given the opportunity to participate in one
      of two intervention curricula: called Reducing the Risk and Love Notes, or a waiting list
      control condition.
    

Intervention name(s): Reducing the Risk; Love Notes
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Reducing the Risk: Building Skills to Prevent Pregnancy, STD and HIV (RtR) was developed by Richard Barth, MSW, Ph.D. in California. The training manual is in its 5th Edition and was last published in 2011. This curriculum is one of the first that was evaluated using an experimental design, with a longitudinal follow up (6 months and 18 months) and tested on a large group of high school students (N = 758). It is also one of the first programs to show an impact on beliefs of adolescent sexual behavior prevalence and actual behavior as well as increasing parent-child communication about abstinence and contraception (Kirby, Barth, Leland, and Fetro, 1991).; The second healthy relationships program for high-risk youth, Love Notes, was developed to educate participants about healthy relationships, including issues of decision-making, communication and conflict resolution, and overall safety, including the prevention of pregnancy and sexually transmitted disease (Pearson, 2009). Love Notes is a derivative of the Prevention and Relationship Enhancement Program (PREP; Stanley, Markman, & Jenkins, 2009), which is relationship marriage education program listed as an evidence-based practice (EBP) by SAMSHA (www.samhsa.gov). This curriculum builds on social exchange theory and meets the needs of youth who are alienated and in need of loving personal relationships.
Other intervention name(s): Comprehensive Sex Ed; Relationship Ed
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Teen Pregnancy Prevention