Evidence Rating: No Effects | One study
Date:
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.
Sieving and colleagues (2013) had mixed findings in their evaluation of Prime Time at 6 months following the intervention. Prime Time treatment group participants reported statistically significantly greater consistency of condom use and greater sex refusal self-efficacy, compared with control group participants. However, there were no statistically significant differences between treatment and control groups in number of male sexual partners in the past 6 months, sexual risk communication with partner, family connectedness, school connectedness, stress management skills, or interpersonal skills. Overall, the preponderance of evidence suggests that Prime Time did not have the intended effects on participants.
Study 1
Family Connectedness
There was no statistically significant difference between treatment group participants and control group participants in family connectedness at the 6-month follow-up.
Stress Management Skills
There was no statistically significant difference between treatment group participants and control group participants in stress management skills at the 6-month follow-up.
Interpersonal Skills
There was no statistically significant difference between treatment group participants and control group participants in interpersonal skills at the 6-month follow-up.
Consistency of Condom Use
Treatment group participants reported greater consistency of condom use, compared with control group participants at the 6-month follow-up. This difference was statistically significant.
Sex Refusal Self-efficacy
Treatment group participants reported greater sex refusal self-efficacy, compared with control group participants, at the 6-month follow-up. This difference was statistically significant.
Number of Male Sex Partners in the Past 6 Months
At the 6-month follow-up, there was no statistically significant difference between treatment group participants and control group participants in number of male sexual partners in the past 6 months.
Sexual Risk Communication with Partner
There was no statistically significant difference between treatment group participants and control group participants in sexual risk communication with their partner at the 6-month follow-up.
School Connectedness
There was no statistically significant difference between treatment group participants and control group participants in school connectedness at the 6-month follow-up.
Study 2
Suspensions and Expulsions
At the 18-month follow-up, there was no statistically significant difference between treatment group participants and control group participants in suspensions and expulsions in the past 6 months.
Family Connectedness
Treatment group participants reported higher levels of family connectedness, compared with control group participants, at the 18-month follow-up. This difference was statistically significant.
Stress Management Skills
There was no statistically significant difference between treatment group participants and control group participants in stress management skills at the 18-month follow-up.
Relational Aggression Perpetration
Treatment group participants reported fewer relational aggressive behaviors in the past 30 days, compared with control group participants, at the 18-month follow-up. This difference was statistically significant.
Relational Aggression Victimization
At the 18-month follow-up, there was no statistically significant difference between treatment group participants and control group participants in relational aggression victimization in the past 30 days.
Physical Violence Perpetration
At the 18-month follow-up, there was no statistically significant difference between treatment group participants and control group participants in physical violence perpetration in the past 30 days.
Physical Violence Victimization
At the 6-month follow-up, there was no statistically significant difference between treatment and control group participants in physical violence victimization in the past 30 days.
Fight Avoidance Skills
There was no statistically significant difference between treatment group participants and control group participants in fight avoidance skills at the 18-month follow-up.
School Connectedness
There was no statistically significant difference between treatment group participants and control group participants in school connectedness at the 18-month follow-up.
Study 1
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.
Study 2
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.
These sources were used in the development of the program profile:
Study 1
Sieving, Renee E., Annie-Laurie McRee, Barbara J. McMorris, Kara J. Beckman, Sandra L. Pettingell, Linda Bearinger, Ann W. Garwick, Jennifer A. Oliphant, Shari Plowman, Michael D. Resnick, and Molly Secor-Turner. 2013. "Prime Time: Sexual Health Outcomes at 24 Months for a Clinic-Linked Intervention to Prevent Pregnancy Risk Behaviors." JAMA Pediatric 167(4):333–40.
Study 2
Sieving, Renee E., Barbara J. McMorris, Molly Secor-Turner, Ann W. Garwick, Rebecca Shalfer, Kara J., Beckman, Sandra L. Pettingell, Jennifer A. Oliphant, and Ann M. Seppelt. 2014. "Prime Time: 18-Month Violence Outcomes of a Clinic-Linked Intervention." Journal of Prevention Science 15:460–72.
These sources were used in the development of the program profile:
Sieving, Renee E. , Debra H. Bernat, Michael D. Resnick, Jennifer Oliphant, Sandra Pettingell, Shari Plowman, and Carol Skay. 2012. “A Clinic-Based Youth Development Program to Reduce Sexual Risk Behaviors Among Adolescent Girls: Prime Time Pilot Study.” Health Promotion Practice 13(4): 462–71.
Sieving, Renee E., Barbara J. McMorris, Kara J. Beckman, Sandra L. Pettingell, Molly Secor-Turner, Kari Kugler, Ann W. Garwick, Michael D. Resnick, and Linda H. Bearinger. 2011. “Prime Time: 12-Month Sexual Health Outcomes of a Clinic-Based Intervention to Prevent Pregnancy Risk Behaviors.” Journal of Adolescent Health 49(2):172–79.
Sieving, Renee E., Michael D. Resnick, Ann W. Garwick, Linda H. Bearinger, Kara J. Beckman, Jennifer A. Oliphant, Shari Plowman, and Kayci R. Rush. 2011. “A Clinic-Based, Youth Development Approach to Teen Pregnancy Prevention.” American Journal of Health Behavior 35(3):346–58.
Following are CrimeSolutions-rated programs that are related to this practice:
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 |
Age: 13 - 17
Gender: Female
Race/Ethnicity: White, Black, Hispanic, American Indians/Alaska Native, Asian/Pacific Islander, Other
Geography: Urban
Setting (Delivery): School, Inpatient/Outpatient
Program Type: Conflict Resolution/Interpersonal Skills, Gender-Specific Programming, Leadership and Youth Development, School/Classroom Environment, Wraparound/Case Management
Targeted Population: Females
Current Program Status: Active