Volume 32, No. 5, September/October 2000

TABLES

Using Randomized Designs to Evaluate
Client-Centered Programs to Prevent
Adolescent Pregnancy

Table 1. Characteristics of community-based teenage pregnancy prevention projects funded by the Washington State Department of Health, 1995-1999
Objective Intervention Setting and staff Target clients
Site A
To enhance protective factors in order to increase resiliency in adolescents, thereby preventing early pregnancy.
  • Education and skills-building: School counselors conduct 10-12 group sessions, covering topics related to sexuality, risk behaviors (e.g., substance use), and coping with stress and anger.
  • Mentorship: Youth are matched with adult mentors according to mutual career interests. The intent is for youth and mentors to meet at least monthly and have at least weekly phone contact.
  • Case management: Project staff facilitate clients' relationship with mentors, make referrals to community services (including family planning) as needed and address family issues as needed.
    		•
  • Setting: Project is administered in middle schools by a local health department.
  • Staff: Staff include a social worker and school counselors.
    		•  Youth
    in grades
    7-8
    Site B
    To provide communication and decision-making skills, as well as abstinence and sexuality education, to at-risk youth in order to deter early sexual activity.
  • Education and skills-building: Monthly group sessions are held with school counselors throughout the school year. Topics include pregnancy prevention, HIV and other STD prevention, anger management, suicide, self-esteem, domestic violence and goal-setting. Activities and videos are used to enhance sesssions.
  • Weekly lunch meetings: Project staff meet with youth weekly to discuss and reinforce education topics and provide support.
    Social/recreational activities:     Youth are invited to participate in activities monthly to foster connections among peers and with project staff.
    		•
  • Setting: Project is administered in middle schools by a local family planning clinic.
  • Staff: Staff are health and sexuality educators and school counselors.
    		•  Youth
    aged
    11-14
    Site C
    To provide structured psychological and educational services to assist youth in delaying the onset of sexual activity and avoiding early pregnancy.
  • Education and skills-building: Staff conduct 10 hours of group sessions dealing with issues related to risk for teenage pregnancy. Additionally, youth receive five sessions of the Postponing Sexual Involvement curriculum in school health classes.
  • Advocacy: Advocates work with youth individually and in groups to provide a mentor relationship as well as counseling services, family support, opportunities for recreation and assistance in making contact with other community services (including family planning).
    		•
  • Setting: Project is administered by a mental health agency in local middle schools.
  • Staff: Staff are social workers, social work interns or college students (advocates).
    		•  Youth
    aged
    11-14
    Site D
    To provide education and support to girls at risk for early sexual activity.
  • Education and skills-building: Weekly groups meet throughout the school year. Topics include pregnancy and STD prevention; dating violence; friendship; self-esteem; where to get help in the community; and communication, decision-making and refusal skills.
  • Advocacy: Project staff provide support and advocacy in the group setting linking clients with resources and school and community services (including family planning). In addition, youth are offered individualized support on a regular basis throughout the school year. Individual sessions address issues that arise during groups, build relationships between staff and clients, and explore issues of importance to clients.
  • Social/recreational activities: Several times throughout the year, youth are invited to participate in social/recreational activities, including arts and crafts, cultural activities, outings to the YMCA and family events.
    		•
  • Setting: Project is administered in middle schools by Planned Parenthood.
  • Staff: Staff are health and sexuality educators and counselors.
    		•  Females
    in grades
    7-8
    Site E
    To provide enhanced family planning services to help teenagers avoid pregnancy.
  • Advocacy: Staff provide education and support to teenagers who visit a family planning clinic. Education focuses on ways to avoid STDs and pregnancy, correct contraceptive use and relationship issues. Support may include counseling and helping teenagers make contact with other community services or reenter school.
    		•
  • Setting: Project is administered by a local health in its family planning clinic.department
  • Staff: Staff are nurses, health educators and social workers.
    		•  Females
    aged
    14-17
    Site F
    To provide education, support and referrals to young women at risk for early sexual activity or pregnancy.
  • Education and skills-building: Weekly groups throughout the school year address self-esteem; sexuality; pregnancy and STD prevention; identifying and avoiding risky behavior; life planning; and communication, decision-making, risk reduction, planning and goal-setting skills.
  • Advocacy: Support is provided in the group setting and individually. Individual sessions address issues that arise during groups, build relationships between staff and clients, and explore issues of importance to clients. The intensity of individual support varies according to clients' needs. In addition, staff make referrals and assist clients in accessing other community resources as needed (including family planning).
  • Social/recreational activities: Clients are invited to participate in periodic social/recreational activities.
    		•
  • Setting: Project is administered in middle and high schools by Planned Parenthood.
  • Staff: Staff are health and sexuality educators.
    		•  Females
    aged
    14-17
    Site G
    To empower young women, improve their self-esteem and help them avoid early pregnancy by offering support, care and a safe place.
  • Support groups: Weekly group sessions throughout the school year address consequences of sexual behavior, family and friendship relationships, healthy and unhealthy intimate relationships, decision-making and stress management. Information is provided via worksheets, videos and guest speakers.
  • Advocacy: Staff provide individual support, including counseling and referrals to community services (including family planning).who meet with teenagers at least one hour per week and provide opportunities for recreation and additional support.
    		•
  • Setting: Project is administered in schools and other community-based settings by a local health department.
  • Staff: Staff are health and sexuality educators and social workers.
    		•  Females
    aged
    14-17

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    Table 2. Percentage of clients with selected characteristics or mean values for selected characteristics, by type of site
    Characteristic Youth Teenage
    (N=1,042) (N=690)
    Percentages
    Female 70 90
    Nonwhite 47 26
    Grades mostly Ds/Fs 17 13
    Mother did not finish high school 22 23
    Used in past month:
    Alcohol 22 45
    Tobacco 24 46
    Marijuana 15 32
    Ever had intercourse na 63
    Ever was pregnant na 20
    Means
    Age 13.1 15.4
    Sexual behavior intent† 6.9 8.4
    †Sexual behavior intent is measured on a four-item scale (see Table 5), with possible scores ranging from 4 to 20. Note: na=not applicable because the survey for youth sites does not include items addressing sexual or contraceptive behavior.

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    Table 3. Mean and median number of hours of service that clients receive per program year, and range across sites, by type of site
    Site Treatment Control
    N Mean Median Range N Mean Median Range
    Youth 549 14 11 0-103 493 5 1 0-29
    A 64 18 13 2-103 88 8 8 0-23
    B 121 19 13 0-60 93 7 6 0-29
    C 181 7 6 0-36 170 4 0 0-24
    D 183 15 13 0-41 142 0 0 0-0
    Teenage 371 27 23 0-140 319 2 0 0-29
    E 150 u u u 142 u u u
    F 94 31 25 0-140 72 0 0 0-0
    G 127 22 17 0-63 105 0 0 0-29
    Note: u=unavailable.

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    Table 4. Number of months between pretest and posttest, and follow-up rate, by project site
    Site No. of mos. % followed up
    Total 7 75
    Youth
    A 9 85
    B 6 77
    C 5 63
    D 6 86
    Teenage
    E 8 79
    F 8 80
    G 6 68

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    Table 5. Scales and their components used in project evaluations (and coefficient alpha for each scale), and possible scores for each scale, by type of site
    Type of site and scale Scores
    YOUTH SITES
    Sexual behavior intent (alpha=.87) 4-20
    How likely is it that you will have sexual intercourse in the next year?
    How likely is it that someone might get you to have sexual intercourse in the next year?
    I know some kids my age have had sexual intercourse. (I definitely would...would not do this.)
    How likely is it that you will stay abstinent while you are an unmarried teen?
    Educational aspirations (alpha=.65) 4-20
    Looking ahead, what would you like to do about school? (Quit as soon as possible...finish college.)
    As you look to the future, how important is it to you to get a good education?
    How likely is it that you will get a good education?
    How important is it to your family that you continue your education after high school?
    Hard drug use (alpha=.13) 0-5
    Have you used cocaine in the past month?
    Have you used crack in the past month?
    Have you used crank in the past month?
    Have you used acid in the past month?
    Have you used speed in the past month?
    Other substance use (alpha=.75) 0-3
    Have you used alcohol in the past month?
    Have you used tobacco in the past month?
    Have you used marijuana in the past month?
    Substance use intent (alpha=.77) 3-15
    If someone offered you alcohol and you didn't want to use it, how likely is it that you could say no?
    I know some kids my age have smoked cigarettes. (I definitely would...would not do this.)
    I know some kids my age have used alcohol, marijuana or other drugs. (I definitely would...would not do this.)
    Sexual values (alpha=.76) 4-20
    I think it's OK for kids my age to have sex.
    Having sex is just a normal part of teenage dating.
    My friends think it is OK for kids my age to have sex.
    My beliefs about sex are the same as my parents'.
    TEENAGE SITES
    Sexual behavior intent (alpha=.78) 2-10
    If someone did try to get you to have sexual intercourse, what would you do? (I would definitely say no...definitely say yes.)
    How likely is it that someone might get you to have sexual intercourse in the next year?
    Educational aspirations (alpha=.72) 4-20
    Looking ahead, what would you like to do about school? (Quit as soon as possible...finish college.)
    How important is it to your family that you continue your education after high school?
    How likely is it that you will get a good education?
    As you look to the future, how important is it to you to get a good education?
    Hard drug use (alpha=.61) 0-5
    Have you used cocaine in the past month?
    Have you used crack in the past month?
    Have you used crank in the past month?
    Have you used acid in the past month?
    Have you used speed in the past month?
    Other substance use (alpha=.72) 0-3
    Have you used tobacco in the past month?
    Have you used alcohol in the past month?
    Have you used marijuana in the past month?
    Sexual values (alpha=.91) 3-15
    Having sex is just a normal part of teenage dating.
    Having sex can cause lots of problems for teenagers.
    It is against my values to have sexual intercourse while I am an unmarried teenager.
    Note: Response options for some scaled items are shown in parentheses. For others, responses ranged from "very important" to "not at all important," "very likely" to "not at all likely" or "strongly agree" to "strongly disagree."

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    Table 6. Adjusted mean values for selected measures of youth risk behavior, along with standard errors and statistical power, by site
    Measure Total Site A Site B Site C Site D
    N Adj. mean S.E. Power N Adj. mean S.E. Power N Adj. mean S.E. Power N Adj. mean S.E. Power N Adj. mean S.E. Power
    Sexual behavior intent
    Treatment 395 7.3 .13 .22 54 8.3 .39 .10 81 5.6 .24 .28 110 7.5** .25 .82 150 7.7 .20 .15
    Control 343 7.5 .14 na 73 8.2 .34 na 62 5.2 .27 na 95 8.4 .27 na 113 7.5 .23 na
    Sexual values
    Treatment 195 14.9 .23 .21 13 13.6 .83 .19 32 16.1 .58 .14 52 14.9 .41 .19 98 14.7 .32 .19
    Control 148 15.2 .26 na 19 14.4 .69 na 34 15.7 .54 na 36 15.3 .50 na 59 15.1 .41 na
    Communication with parents
    Treatment 202 0.44 .03 .11 15 0.44 .13 .10 32 0.71 .08 .17 55 0.53 .06 .11 100 0.30 .04 .19
    Control 148 0.46 .04 na 17 0.43 .12 na 32 0.63 .08 na 40 0.52 .08 na 59 0.35 .06 na
    Educational aspirations
    Treatment 237 17.4 .14 .35 20 15.7 .62 .15 32 17.6 .34 .11 51 17.5 .32 .20 134 17.8 .16 .36
    Control 192 17.2 .15 na 32 16.2 .49 na 31 17.7 .34 na 37 17.1 .38 na 92 17.4 .20 na
    Substance use
    Treatment 334 0.80 .05 .24 54 1.1 .14 .18 54 0.19 .06 .18 94 0.97 .10 .25 132 0.79 .07 .37
    Control 302 0.86 .05 na 74 1.3 .12 na 52 0.25 .06 na 82 1.1 .11 na 94 0.66 .08 na
    Substance use intent
    Treatment 194 6.5 .19 .15 14 8.3 .73 .25 30 4.2* .37 .53 52 6.9 .40 .10 98 6.9 .27 .34
    Control 146 6.4 .21 na 16 7.3 .68 na 32 5.1 .35 na 38 7.0 .46 na 60 6.3 .34 na
    *p<.05. **p<.01. Notes: na=not applicable. S.E.=standard error. Power is the ability of a statistical test to reject the null hypothesis (that there is no association) when it is false (i.e., the probability of a correct decision).

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    Table 7. Adjusted mean values for selected measures of teenage risk behavior, along with standard errors and statistical power, by site
    Measure Total Site E Site F Site G
    N Adj. mean S.E. Power N Adj. mean S.E. Power N Adj. mean S.E. Power N Adj. mean S.E. Power
    Sexual behavior intent
    Treatment 208 6.2* .13 .58 116 6.5* .18 .63 na na na na 92 5.9 .18 .10
    Control 170 6.6 .15 na 110 7.0 .19 na na na na na 60 5.8 .23 na
    Intercourse in past month
    Treatment 191 0.62** .03 .76 98 0.69 .05 .39 32 0.50** .08 .81 61 0.57 .06 .11
    Control 166 0.74 .04 na 102 0.78 .04 na 23 0.83 .10 na 41 0.59 .08 na
    Ever had intercourse
    Treatment 275 0.79 .02 .12 114 0.98 .01 .17 69 0.56 .05 .14 92 0.71 .03 .11
    Control 232 0.80 .02 na 112 0.96 .01 na 59 0.60 .05 na 61 0.72 .03 na
    Contraceptive intent
    Treatment 181 3.7 .11 .43 88 4.1** .15 .75 65 3.4 .17 .15 28 3.2 .28 .27
    Control 174 3.5 .11 na 84 3.6 .15 na 53 3.2 .19 na 37 3.6 .24 na
    Contraceptive use in last month
    Treatment 99 0.80 .04 .15 63 0.85 .05 .12 12 0.73 .14 .46 24 0.73 .08 .24
    Control 90 0.77 .04 na 64 0.82 .05 na 15 0.42 .13 na 11 0.87 .12 na
    Contraceptive use at last sex
    Treatment 72 0.82 .06 .10 22 0.88 .07 .10 18 0.77** .10 .94 32 0.80 .09 .46
    Control 72 0.82 .06 na 30 0.89 .06 na 13 0.24 .12 na 29 1.00 .10 na
    Contraceptive use always
    Treatment 70 0.45 .06 .39 21 0.49 .11 .30 18 0.47* .10 .72 31 0.39** .09 (.77)
    Control 72 0.56 .06 na 30 0.66 .09 na 13 0.11 .12 na 29 0.69 .09 na
    Educational aspirations
    Treatment 195 4.2 .06 .11 73 4.1 .10 .22 51 4.3 .12 .11 71 4.3 .10 .16
    Control 169 4.2 .07 na 86 4.0 .09 na 43 4.3 .13 na 40 4.4 .13 na
    Hard drug use
    Treatment 205 0.06 .02 .14 73 0.0* .02 .66 52 0.06* .02 (.52) 80 0.13* .03 (.67)
    Control 180 0.05 .02 na 87 0.06 .02 na 43 0.0 .03 na 50 0.03 .03 na
    Other substance use
    Treatment 207 1.3 .06 .21 75 1.2 .11 .16 52 1.5 .12 .28 80 1.4 .10 .10
    Control 180 1.2 .07 na 87 1.1 .11 na 43 1.3 .13 na 50 1.4 .13 na
    Sexual values
    Treatment 109 7.7 .21 .12 22 8.6 .46 .28 40 7.6 .32 .12 47 7.3 .32 .11
    Control 106 7.6 .21 na 31 8.0 .39 na 36 7.5 .34 na 39 7.5 .35 na
    *p<.05. **p<.01. Notes: na=not applicable. S.E.=standard error. Power is the ability of a statistical test to reject the null hypothesis (that there is no association) when it is false (i.e., the probability of a correct decision). Power measures in parentheses indicate associations that are significant in the opposite direction than was hypothesized.

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