Prime Time: 12-Month Sexual Health Outcomes of a Clinic-based Intervention to Prevent Pregnancy Risk Behaviors

Abstract

Purpose-Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. This paper examines sexual risk behaviors and hypothesized psychosocial mediators after 12 months of the Prime Time intervention.Methods-Randomized controlled trial with 253 girls ages 13-17 years meeting specified risk criteria. Intervention participants were involved in Prime Time programming plus usual clinic services for 18 months, control participants received usual clinic services. The intervention employed a combination of case management and peer leadership programs. Participants in this interim outcomes study completed self-report surveys at baseline and 12 months following enrollment. Surveys assessed sexual risk behaviors and psychosocial factors targeted for change by Prime Time.Results-At the 12-month interim, the intervention group reported more consistent use of condoms, hormonal contraception and dual contraceptive methods with their most recent partner than did the control group. The intervention group also reported greater stress management skills with trends towards higher levels of pro-social connectedness at school and with family. No between-group differences were noted in psychosocial measures specific to sex and contraceptive use.Conclusions-Preventing early pregnancy among high-risk adolescents requires multifaceted, sustained approaches. An important research focus involves testing youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful and few efforts have emphasized a dual approach of building protective factors while addressing risk. Findings suggest that youth development interventions through clinic settings hold promise in reducing pregnancy risk among high-risk youth.

Prime Time

“…Together with previous findings demonstrating reductions in sexual risk behaviors, relational aggression, and violence victimization among Prime Time participants, 12-14,26 results from this study suggest that involvement in a youth development intervention that combines individualized case management and youth leadership components holds great promise for preventing multiple risk behaviors among youth most vulnerable to poor health outcomes, including early pregnancy. Furthermore, long-term increases in family connectedness as well as the beliefs and self-efficacy necessary to set healthy sexual boundaries suggest that interventions such as Prime Time may foster social and intrapersonal attributes needed to sustain healthy behaviors.…”

“…Among significant outcomes at 24 months, greater hormonal contraceptive consistency was noted at both prior assessments. Greater consistency in the use of condoms and dual-method contraceptives had been noted at the 12-month assessment, 12 and greater family connectedness at the 18-month assessment. 13 Significant effects on self-efficacy to refuse unwanted sex and the perceived importance of having sex for material reasons were noted only at the 24-month assessment.…”

“…12 At the end of the 18-month intervention, we found higher levels of enrollment in postsecondary education and lower levels of relational aggression among the intervention group, 13 as well as lower levels of violence victimization among intervention participants with strong family connections. 14 In this article, we examine sexual health outcomes of Prime Time—namely, patterns of contraceptive use, number of sex partners, and related psychosocial attributes—6 months after the conclusion of the intervention.…”

“…The 2 groups were similar for multiple indicators. 12 Participants were more likely than eligible nonparticipants to live with only 1 parent (64.5% vs 52.4%) (${\chi }_2^2=19.09$ [n = 545]; P =.02).…”

Comprehensive Adolescent Health Programs That Include Sexual and Reproductive Health Services: A Systematic Review

“…For example, the measure of contraceptive use ranged from ever use in Berhane Hewan 9 to consistency of use in Prime Time 32,34 and ASPPP. 23 Irrespective of their evidence level, most programs assessed short-term outcomes (less than 5 years); 35 those that were able to track the longstanding impact of activities (see for example CAS-Carrera) 28 were generally initiatives working with participants regularly throughout adolescence.…”