Prime time: Sexual health outcomes at 24 months for a clinic-linked intervention to Prevent pregnancy risk behavior

Renee E. Sieving, Annie Laurie McRee, Barbara J. McMorris, Kara J. Beckman, Sandra L. Pettingell, Linda H. Bearinger, Ann W. Garwick, Jennifer A. Oliphant, Shari Plowman, Michael D. Resnick, Molly Secor-Turner

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Abstract

Importance: Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. Objective: To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention. Design: Randomized controlled trial. Setting: Community and school-based primary care clinics. Participants: Of 253 sexually active 13- to 17-yearold girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey. Intervention: Offered during an 18-month period, Prime Time includes case management and youth leadership programs. Main Outcome Measures: Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months. Results: At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex.Nobetween-group differences were found in the number of recent male sex partners. Conclusions and Relevance: This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth.

Original languageEnglish (US)
Pages (from-to)333-340
Number of pages8
JournalJAMA Pediatrics
Volume167
Issue number4
DOIs
StatePublished - Apr 1 2013

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