Evaluation of the Making Proud Choices! Teen Pregnancy Prevention Program

Study Overview
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Brief Summary
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Under contract to the Office of Population Affairs (OPA), Mathematica is conducting an impact study of the Making Proud Choices! (MPC) teen pregnancy prevention program. The impact study is designed to estimate the impact of MPC, compared to the business-as-usual condition, on risk and protective factors, sexual behaviors, and longer term health goals including pregnancy and sexually transmitted infections.

Detailed Description
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This evaluation used a cluster randomized controlled trial (RCT) design to assess the effectiveness of MPC, with schools within districts randomly assigned to one of two conditions: (1) MPC implemented by health educators, or (2) business as usual. In total, 31 school clusters were randomly assigned to condition, including roughly 2800 students, in four geographic areas across the U.S. The study was implemented over the course of three school years (2016-17, 2017-18 and 2018-19), with youth in each year considered a separate evaluation cohort, and with participating schools (and new cohorts of eligible youth) randomized to condition each year. There are two main sources of data for this study: outcome and implementation data. Youth in the study completed two waves of self-report surveys: (1) a baseline survey administered before programming began, and (2) a follow-up outcome survey administered approximately six months after the end of programming (approximately 9 months after baseline, on average). The surveys measured antecedents to sexual behavior (risk and protective factors), sexual behaviors, and ultimately, MPC's health goals of reducing sexually transmitted infections and teen pregnancies. Program implementation data included fidelity and attendance logs, observations, interviews, study youth focus groups, staff surveys, and technical assistance logs. The benchmark analytic approach for estimating program impacts focuses on individuals with observed (non-missing) outcome data, and will statistically adjust for several baseline and location variables to produce credible and precise estimates of program effectiveness. Several sensitivity analyses will be conducted to understand the robustness of the findings across alternative specifications, and to understand the effect of MPC across a variety of subgroups.

Official Title
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Evaluation of the Making Proud Choices! Teen Pregnancy Prevention Program

Conditions
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Teen Pregnancy Prevention

Intervention / Treatment
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* Behavioral: Making Proud Choices
* Behavioral: Business as usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Enrolled in a study school Attending the targeted class (e.g. health class) for the first time Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The MPC curriculum aims to provide adolescents with the information and tools they need to reduce their risk of sexually transmitted diseases (STDs), HIV, and pregnancy. The curriculum emphasizes abstinence as the safest choice for avoiding pregnancy and STDs, but also encourages youth to use condoms and other methods of birth control if they do have sex. The curriculum includes video clips, student role-playing activities, and group discussions. It also involves skill-building activities for correct condom use, refusal techniques, and safer-sex negotiation, and opportunities for students to practice these skills.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Making Proud Choices<br>This evaluation tests the effect of the MPC School Edition, the version of the MPC 5th Edition designed for implementation in school. This edition includes 9.5 hours of content implemented in 14 40-minute modules. Schools assigned to the MPC condition received MPC in a targeted class. | Behavioral: Making Proud Choices<br> <br> |
| Active Comparator: Business as usual<br>The control group continued with their regular programming in the targeted class, which was often a health or Reserve Officer Training Corps (ROTC) class. | Behavioral: Business as usual<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knowledge about HIV | Proportion of knowledge items about HIV/STDs answered correctly. | Survey administered 6 months post program | 
| Knowledge about pregnancy | Proportion of knowledge items about pregnancy answered correctly. | Survey administered 6 months post program | 
| Knowledge about condoms | Proportion of knowledge items about condom use answered correctly. | Survey administered 6 months post program | 
| Knowledge about other forms of contraception | Proportion of knowledge items about contraceptive use answered correctly. | Survey administered 6 months post program | 
| Belief that sex may adversely affect future goals | Proportion of statements about how sexual activity will interfere with goals and dreams that the respondent agrees or strongly agrees with. | Survey administered 6 months post program | 
| Belief that condoms can be pleasurable | Proportion of statements about how condoms can be pleasurable that the respondent agrees or strongly agrees with. | Survey administered 6 months post program | 
| Attitudes about condoms | Proportion of statements about condom use that the respondent either agrees or strongly agrees with. | Survey administered 6 months post program | 
| Condom self-efficacy | Proportion of statements about self-efficacy using condoms that the respondent agrees or strongly agrees with. | Survey administered 6 months post program | 
| Condom negotiation | Proportion of statements about self-efficacy negotiating condom that the respondent agrees or strongly agrees with. | Survey administered 6 months post program | 
| Refusal skills | Proportion of statements about self-efficacy refusing sex with a partner that the respondent agrees or strongly agrees with. | Survey administered 6 months post program | 
| Ever any sex (vaginal, oral, or anal) | Binary variable representing if the respondent reported having ever had vaginal, oral, or anal sex. | Survey administered 6 months post program | 
| Any sex (in past 3 months) | Binary variable representing if the respondent reported having vaginal, oral, or anal sex in the three month period before completing the follow-up survey. | Survey administered 6 months post program | 
| Times having any sex (in past 3 months) | Count variable representing the total number of times respondent had vaginal, oral and/or anal sex in the three month period before completing the follow-up survey. | Survey administered 6 months post program | 
| Count of vaginal sex partners (in the past 3 months) | Count variable representing the number of partners for vaginal sex in the three month period before completing the follow-up survey. | Survey administered 6 months post program | 
| Any sex without a condom (in past 3 months) | Binary variable representing if respondent reported having any risk for STD/STI sex (sex without a condom) in the three month period before completing the follow-up survey. | Survey administered 6 months post program | 
| Times having any sex without a condom in past 3 months | Count variable representing the total number of times respondent had risky sex in the three months before completing follow-up survey. | Survey administered 6 months post program | 
| Sex without birth control in past 3 months | Binary variable representing if respondent reported having had unprotected vaginal sex in the three months before completing the follow-up survey. | Survey administered 6 months post program | 
| Times having sex without birth control (in past 3 months) | Count variable representing the total number of times the respondent had unprotected vaginal sex in the three month period before completing the follow-up survey. | Survey administered 6 months post program | 
| Ever pregnant | Binary variable representing if the respondent reported a pregnancy or has gotten someone pregnant. | Survey administered 6 months post program | 
| Any sexually transmitted infection (STI) | Binary variable representing if the respondent indicated having been told they have a sexually transmitted infection. | Survey administered 6 months post program |