Randomized controlled trial of ‘teens and toddlers’: A teenage pregnancy prevention intervention combining youth development and voluntary service in a nursery

Abstract

We conducted an independent evaluation of the “Teens and Toddlers” intervention. Our randomized trial examined effects on self‐reported last sex without contraception, >1 episode of sex without contraception in previous 3 months, expectation of teenage parenthood and youth development score, plus secondary outcomes among 449 at‐risk girls age 13/14 in England. The intervention involves 18–20 weekly sessions in pre‐school nurseries. Response rates were 95% post‐intervention and 91% one year later. At follow‐up two, there was no evidence of intervention benefits for primary outcomes and a positive impact for our secondary outcome, low self‐esteem. At follow‐up one, there was no evidence of benefits for our primary outcomes but evidence of benefits for our secondary outcomes: low self‐esteem; low sexual health knowledge; and difficulty discussing the contraceptive pill. The intervention should be refined, with a clearer logic model and more emphasis on sex education, and re‐evaluated.

Young women’s lived experience of participating in a positive youth development programme

“…However, the relevance of our findings to other participants in T&T or other PYD programmes is uncertain. Given that approximately a quarter of participants dropped out of the programme within the first eight weeks (Bonell et al, 2013), our study is liable to selection bias whereby the most satisfied participants remained in the programme.…”

“…The programme providers did not have an explicit theory of change for the intervention though the evaluators developed one as part of a formative evaluation conducted prior to the RCT (Jessiman et al, 2012). The RCT reported that T&T had no impact on its primary outcomes, but intervention participants were less likely to experience a decrease in their self-esteem than the control group (Bonell et al, 2013). The authors concluded that the lack of a prior, explicit theory of change linking intervention components and outcomes might have contributed to its limited impact.…”

“…Confronting such challenges required many young women to reassess their expectations about the work; it was going to require more effort than anticipated. At this point, about a quarter of young women dropped out (Bonell et al, 2013).…”

“…Which of these is most important, and whether all must be present to achieve PYD remains unclear (Roth and Brooks-Gunn, 2003). Given the lack of an over-arching conceptual framework and variability in implementation, it is not surprising that evaluations of PYD interventions report mixed results (Wiggins et al, 2009;Kirby, 2009;Bonell et al, 2013).…”

A Review of the Evidence on the Effects of Community-based Programs on Young People’s Social and Emotional Skills Development

“…These interventions aim to build the skills and wellbeing of young people through the input and/or assistance of an adult or peer, and are usually accompanied by other inputs such as youth development programs and life skills training. The RCT evaluation of the Teens and Toddlers program (Bonell et al 2013), which is aimed at reducing teenage pregnancy through training adolescent girls to become mentors in early childcare, reported significant improvements in participants' self-esteem, although this was based on a non-validated single item survey question. No positive impact was found in relation to use of contraception or expectation of teenage parenthood.…”