Indiana University SPEA Edward J. Bloustein School of Planning and Public Policy University of Pennsylvania AIR American University

Panel Paper: Shaping the Evidence Base of Teen Pregnancy Prevention Programs: Updated Evidence on the Effectiveness of a Widely Used Youth Development Program

Thursday, November 12, 2015 : 8:50 AM
Merrick II (Hyatt Regency Miami)

*Names in bold indicate Presenter

Kimberly Francis, Michelle Woodford and Meredith Kelsey, Abt Associates, Inc.
The County of Hennepin, Minnesota, was one of 16 grantees funded by the Office of Adolescent Health (OAH) in 2010 to replicate with fidelity and rigorously evaluate evidence-based teen pregnancy prevention programs. The county chose to replicate the Teen Outreach Program (TOP®), a youth development and service learning program for youth ages 12 to 17 designed to reduce teenage pregnancy and increase school success by helping youth develop a positive self-image, life management skills, and realistic goals. Until now, evidence for the program has been based on one randomized controlled study conducted between 1991 and 1995, which found that TOP®reduced rates of pregnancy, school failure, and academic suspension compared to a control group at the immediate post-test (Allen, Philliber, Herrling, & Kuperminc, 1997). Since that time, the program has expanded its reach and was implemented in more than 350 communities in 31 states in 2012 (Wyman National Network, 2012).

The TOP® model consists of three components implemented over nine consecutive months: (1) weekly curriculum sessions, (2) community service learning, and (3) positive adult guidance and support. In Hennepin County, staff from community agencies along with classroom teachers co-facilitated TOP®during the school day in middle, high, alternative, and public charter schools in the cities with the highest teen birth rates in the county. Abt Associates designed and implemented a cluster-randomized study between 2011 and 2015 to determine the impact of TOP® on reducing sexual risk-taking behaviors among urban teens in Hennepin County. The study sample consists of 61 teachers  randomized within 24 schools to the treatment and control conditions, and 1,644 youth assigned to those teachers. Youth were surveyed three times: at baseline, before the intervention began for the treatment group; 12 months after the baseline survey (short-term impacts) and 24 months after the baseline survey (longer-term impacts). The sample is 55% female, 31% African American, 24% white, 17% Hispanic, with a mean age of 14 years. Approximately 24% were sexually experienced at baseline. Using an intent-to-treat (ITT) analysis, we found no treatment effects on sexual risk-taking behaviors or mediators at either the short-term or long-term follow-ups.

This presentation will include an overview of the intervention as implemented in Hennepin County, present the key impact and implementation findings, and focus on possible explanations for why the original results were not supported. It will be important to interpret the findings in the context of six other rigorous evaluations of TOP®funded by OAH that are in progress. The updated evidence provided by this study is helping to shape the growing evidence base of effective teen pregnancy prevention programs and youth development programs more generally, while posing challenging questions about the scalability of evidence-based programs.


Allen, J. P., Philliber, S., Herrling, S., & Kuperminc, G. P. (1997). Preventing teen pregnancy and academic failure: Experimental evaluation of a developmentally based approach. Child Development, 68(4), 729-742.

Wyman National Network (2014). Community Service Learning Resource Guide. November.