Scalability of an Evidence-Based Adolescent Pregnancy Prevention Program: New Evidence From 5 Cluster-Randomized Evaluations of the Teen Outreach Program.
OBJECTIVE
To determine if the Teen Outreach Program (TOP), a youth development and service learning program, can reduce sexual risk-taking behaviors compared with a business as usual or benign counterfactual.


METHODS
We synthesized results of 5 independent studies conducted in 5 geographically and ethnically diverse locations between 2011 and 2015 with 17 194 middle and high school students. Each study cluster-randomized classes, teachers, or schools to treatment or control groups and included the students enrolled in those clusters at baseline in an intent-to-treat analysis. Multilevel models tested impacts on recent sexual activity, recent unprotected sexual activity, and sexual initiation among the sexually inexperienced at baseline at approximately 1 and 2 years after baseline.


RESULTS
Precision-weighted average effect sizes showed nonsignificant reductions of 1 percentage point or less in recent sexual activity (5 studies: -0.6; P = .32), recent unprotected sex (5 studies: -0.2; P = .76), and sexual initiation (4 studies: -1.1; P = .10) after 1 year.


CONCLUSIONS
There was little evidence of the effectiveness of TOP in reducing sexual risk-taking behaviors. Results underscored the importance of continually evaluating evidence-based programs that have previously been shown to be effective.
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Kimberly
K
Francis
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Susan
S
Philliber
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Eric R
ER
Walsh-Buhi
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Ashley
A
Philliber
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Roopa
R
Seshadri
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Ellen
E
Daley
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