Impacts of the Positive Youth Development Program for Expectant and Parenting Teens in California
Condition: Teen Pregnancy Prevention
Study type: Interventional

Summary: 
      Under contract to the U.S. Department of Health and Human Services (DHHS), Mathematica is
      conducting an impact study of California Department of Public Health, Center for Family
      Health, Maternal, Child and Adolescent Health's (MCAH) Adolescent Family Life Program
      Positive Youth Development (PYD) program for a Federal Evaluation of Programs for Expectant
      and Parenting Youth (PEPY). The impact study will be designed to address the impact of PYD,
      compared to the business-as-usual condition, AFLP, in delaying repeat pregnancies, completing
      high school, improving health of the parent and child, and improving linkages and networks of
      support for expectant and parenting teens.
    

Detailed description: 
      The Adolescent Family Life Program (AFLP) has been used by MCAH for more than 3 decades. The
      program was recently enhanced with a positive youth development component, referred to as
      Adolescent Family Life Program Positive Youth Development (PYD) program. The enhanced program
      is a shorter, more intensive program that requires case managers to use motivational
      interviewing to guide participating youth through a prescribed set of activities designed to
      set achievable goals for life planning and building self-sufficiency. A random assignment
      design will be used to assess the program's impact on exposure to program content and short
      term outcomes.

      The evaluation includes two sub-studies, each with a distinct design. In the first sub-study,
      individuals were randomly assigned as part of the enrollment process within two provider
      sites to receive either PYD or AFLP. These two provider sites could support individual random
      assignment because they had enough case managers and clients to support both study conditions
      (PYD and AFLP). In the second sub-study, 13 provider sites, each with a smaller number of
      case managers and clients, were randomly assigned to PYD or AFLP. In this second sub-study,
      participants enrolled after sites were randomly assigned. Potential study participants were
      recruited between December 2014 and January 2017, and were considered eligible for
      participation if they were they (1) were interested in the program, (2) were pregnant or
      parenting, (3) had not been served at the site in the prior six months, (4) spoke either
      English or Spanish, (5) were between ages 14 and 18, and (6) were not enrolled in Nurse
      Family Partnerships.

      For sub-study 1, potential participants who were eligible were randomly assigned to (1) a
      treatment group that was eligible for PYD or (2) a control group that received AFLP. Random
      assignment was conducted within two blocks determined by random assignment site and whether
      study participants were pregnant at the time of random assignment or were parenting at the
      time of random assignment. After random assignment, the study enrollment manager assigned the
      young mother to a case manager delivering the program to which she was assigned. The assigned
      case manager then tried to locate and conduct a first visit with each randomized youth
      mother, but not all could be found. For most who were found and visited, case managers were
      instructed to follow a script that described the program in general terms (without
      differentiating between AFLP and PYD) and the study in detail. The script did not reveal the
      group to which the young mother was assigned. As part of the scripted interaction, case
      managers sought study consent from young mothers to participate in the study data collection.

      For sub-study 2, provider sites were first randomized to either the PYD or AFLP. Young
      mothers were then referred to sites in the same manner as in the first sub-study, went
      through the same initial eligibility screening process. Eligible mothers were assigned a case
      manager. The assigned case manager then tried to locate and conduct a first visit with each
      eligible youth mother, but not all could be found. For most who were found and visited, case
      managers were instructed to follow a script that described the program in general terms
      (without differentiating between AFLP and PYD) and the study in detail. The script did not
      reveal the group to which the young mother was assigned. As part of the scripted interaction,
      case managers sought study consent from young mothers to participate in the study data
      collection.

      The study draws on data from LodeStar, MCAH's administrative records on service receipt, a
      baseline survey administered after enrollment into the study, a follow-up survey administered
      approximately 12 months after enrollment and a follow up survey administered approximately 24
      months after enrollment.
    

Intervention name(s): Adolescent Family Life Program Positive Youth Development (PYD) program; Adolescent Family Life Program (AFLP)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Home visiting program for pregnant and parenting teens with PYD component; Home visiting program for pregnant and parenting teens
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Teen pregnancy prevention; Home visiting; Positive youth development; Adolescent Family Life Program Positive Youth Development