Developing and piloting a peer mentoring intervention to reduce teenage pregnancy in looked-after children and care leavers: an exploratory randomised controlled trial.
BACKGROUND
Looked-after children (LAC) are at greater risk of teenage pregnancy than non-LAC, which is associated with adverse health and social consequences. Existing interventions have failed to reduce rates of teenage pregnancy in LAC. Peer mentoring is proposed as a means of addressing many of the factors associated with the increased risk of teenage pregnancy in this group.


OBJECTIVE
To develop a peer mentoring intervention to reduce teenage pregnancy in LAC.


METHODS
Phase I and II randomised controlled trial of a peer mentoring intervention for LAC; scoping exercise and literature search; national surveys of social care professionals and LAC; and focus groups and interviews with social care professionals, mentors and mentees.


METHODS
Three local authorities (LAs) in England.


METHODS
LAC aged 14-18 years (mentees/care as usual) and 19-25 years (mentors).


METHODS
Recruitment and training of mentors; randomisation and matching of mentors to mentees; and 1-year individual peer mentoring.


METHODS



METHODS
pregnancy in LAC aged 14-18 years.


RESULTS
sexual attitudes, behaviour and knowledge; psychological health; help-seeking behaviour; locus of control; and attachment style. A health economic evaluation was also carried out.


RESULTS
In total, 54% of target recruitment was reached for the exploratory trial and 13 out of 20 mentors (65%) and 19 out of 30 LAC aged 14-18 years (63%) (recruited during Phases I and II) were retained in the research. The training programme was acceptable and could be manualised and replicated. Recruitment and retention difficulties were attributed to systemic problems and LA lack of research infrastructure and lack of additional funding to support and sustain such an intervention. Mentees appeared to value the intervention but had difficulty in meeting weekly as required. Only one in four of the relationships continued for the full year. A future Phase III trial would require the intervention to be modified to include provision of group and individual peer mentoring; internal management of the project, with support from an external agency such as a charity or the voluntary sector; funds to cover LA research costs, including the appointment of a dedicated project co-ordinator; a reduction in the lower age for mentee recruitment and an increase in the mentor recruitment age to 21 years; and the introduction of a more formal recruitment and support structure for mentors.


CONCLUSIONS
Given the problems identified and described in mounting this intervention, a new development phase followed by a small-scale exploratory trial incorporating these changes would be necessary before proceeding to a Phase III trial.


BACKGROUND
This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 85. See the NIHR Journals Library website for further project information.
Division of Population, Health Sciences and Education, St George's, University of London, London, UK.
Gillian
G
Mezey
Division of Population, Health Sciences and Education, St George's, University of London, London, UK.
Deborah
D
Meyer
Division of Population, Health Sciences and Education, St George's, University of London, London, UK.
Fiona
F
Robinson
Social Science Research Unit, Faculty of Children and Learning, Institute of Education, London, UK.
Chris
C
Bonell
School of Social and Community Medicine, University of Bristol, Bristol, UK.
Rona
R
Campbell
Division of Population, Health Sciences and Education, St George's, University of London, London, UK.
Steve
S
Gillard
Peter Jordan Associates, London, UK.
Peter
P
Jordan
Division of Population, Health Sciences and Education, St George's, University of London, London, UK.
Nadia
N
Mantovani
Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Kaye
K
Wellings
Division of Population, Health Sciences and Education, St George's, University of London, London, UK.
Sarah
S
White
D000293:Adolescent; D004739:England; D005260:Female; D005581:Foster Home Care; D006801:Humans; D008603:Mental Health; D008611:Mentors / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010379:Peer Group; D010865:Pilot Projects; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data