Program Profile: Prime Time

The program aims to reduce precursors of teen pregnancy, including sexual risk behaviors, involvement in violence, and disconnection from school. The program is rated No Effects. There was a statistically significant impact on consistency of condom use and relational aggression perpetration, but there was no statistically significant impact on physical violence victimization, relational violence victimization, stress management, interpersonal skills, or fight avoidance skills.

A No Effects rating implies that implementing the program is unlikely to result in the intended outcome(s) and may result in a negative outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

Prime Time is a youth development program intervention designed for adolescent girls at high risk for pregnancy. The multicomponent, 18-month program is intended for use in primary care clinics. The program is targeted at reducing precursors of teen pregnancy, including sexual risk behaviors, involvement in violence, and disconnection from school. Additionally, the program aims to build skills, confidence, motivation, and supportive relationships.

Program Components

The Prime Time program consists of two major program components: case management and peer leadership.

Case management involves one-on-one visits between case managers and the girls in the program. During the first month after enrollment, the case managers hold their initial visit with each program participant and then hold monthly visits with the girls throughout the 18 months of the intervention. Visits are held in community locations that are convenient for the teens. The visits focus on a core set of topics, including emotional and social skills and positive family, school, and community involvement. Case management is a client-centered approach; the topics and strategies focused on during the visits are determined by the capacities, interests, and needs of the participants. However, all core topics are addressed, including healthy relationships, responsible sexual behaviors (i.e., contraceptive use), and positive family and school involvement.

Prime Time also includes two peer-leadership components: peer-educator training and employment (Just In Time curriculum) and service-learning groups (It’s Our Time curriculum).  All sessions are led by two case managers, held in the community locations that are convenient for the girls, and involve between 4 and 12 participants.

• Just In Time involves a standard 15-session curriculum addressing communication skills, stress-management skills, conflict-management skills, expectations and skills for healthy relationships, social influences on sexual behaviors, sexual decision-making skills, and contraception. During the sessions, the girls practice group decision-making, problem-solving, and conflict-management skills. They are also given homework activities to discuss the topics with adult family members. After completing the training curriculum, the girls complete a seven-session practicum with an existing group of students, which involves selecting a topic, developing a lesson plan, teaching a group session, adjusting the lesson plan as needed, and teaching a second group session.
• It’s Our Time entails three core units in a standard curriculum, focused on core elements of service learning: preparation, action, reflection, and celebration. The service-learning activities expand on social skills for prosocial group involvement acquired during Just In Time.

Key Personnel

The Prime Time program components are implemented by case managers who are experienced in working with urban teenagers from diverse cultural backgrounds. The case managers complete a 4-week training focused on intervention principles, practicing feedback in implementing court intervention strategies prior to implementation. Throughout the intervention, case managers receive weekly clinical supervision.

Study

Sieving and colleagues (2014) evaluated Prime Time using the same sample and methods described in Study 1 (Sieving et al. 2013). Out of the 253 girls who completed the pretest surveys, 239 (94.5 percent) completed the survey again 18 months later.

The primary outcomes of interest included aggressive and violent behaviors (measured as relational aggression perpetration and victimization, and physical violence perpetration and victimization); and related psychosocial and behavioral outcomes (including measures of family connectedness, school connectedness, fight avoidance skills, stress- management skills, and rates of suspensions and expulsions). Each 18-month outcome was regressed on participation in Prime Time (intervention versus control), controlling for the baseline measure of the outcome. No subgroup analyses were conducted. 

Study

Sieving and colleagues (2013) used a randomized controlled trial to evaluate outcomes 6 months after completion of the Prime Time intervention. The sample consisted of sexually active girls between the ages of 13 and 17 who met at least one of the following criteria: a clinic visit showing they were not pregnant; a visit requiring treatment for sexually transmitted infection; young age (13 or 14 years); aggressive and violent behaviors; sexual risk behaviors; and behaviors indicating disconnection from school. Girls who were unable to understand the consent materials, were married or pregnant, or who had already given birth were not eligible for the study.

For 6 months, between April 2007 and October 2008, trained study staff at four community and school-based primary care clinics screened 1,434 girls, of whom 571 were sexually active girls who met at least one of the risk criteria. These girls were invited to participate in the study. Invited girls then had to complete two visits at the clinic in order to enroll, in an effort to minimize study attrition. Following randomization, 126 girls were assigned to the intervention condition and 127 girls were assigned to the control condition. Out of the 253 girls who completed the pretest survey, 236 (93.3 percent) completed the follow-up survey 24 months later. At baseline and again 24 months later (following 18 months of the intervention), all participants completed an audio computer-assisted self-interview. The average age of the intervention and control groups was 15 years. In terms of race/ethnicity, the largest percentages of both groups were Black/African/African American (44 percent of the intervention group versus 38 percent of the control group), and mixed/multiple race/ethnicity (19 percent of the intervention group versus 23 percent of the control group); followed by Hispanic/Latina (16.7 percent versus 7.9 percent), white/European American (6.3 percent versus 15.7 percent), and American Indian/Native American (3.2 percent versus 2.4 percent). At baseline, the groups were not significantly different on demographic characteristics.

The outcomes of interest included consistency of contraceptive use (with a most recent sexual partner) and the number of male sex partners in the past 6 months. The study also looked at a number of psychosocial outcomes, such as social–emotional skills (stress management and interpersonal skills), social connectedness (to school and family), and sexual efficacy and skills (sexual refusal self-efficacy and sexual risk communication with partner). The authors used an intent-to-treat approach in which participants' data was analyzed based on the group in which they were randomized, regardless of their level of participation, and generalized estimating equations to evaluate the effects of the intervention. Each 24-month outcome (6 months following completion of the intervention) was regressed on participation in Prime Time (intervention versus control), controlling for the baseline measure of the outcome. No subgroup analyses were conducted. 

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

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School-Based Interventions to Reduce Exclusion

School exclusion (more commonly known as suspension and expulsion) is broadly defined as a disciplinary measure imposed in reaction to students’ misbehavior. This practice comprises school-based programs that seek to decrease the prevalence of exclusion and thereby reduce the detrimental effects that suspensions or expulsion from schools may have on students’ learning outcomes and future training or employment opportunities. This practice is rated Effective for reducing school exclusion.

Evidence Ratings for Outcomes

Education - Expulsion/Suspension

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?