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Program increases contraceptive use in at-risk teens

By Andrew M. Seaman

NEW YORK (Reuters Health) - Long after completing an 18-month program designed to teach about contraception and healthy relationships, teenage girls at high risk for unwanted pregnancy were using contraceptives more often and maintaining other safer sexual practices, according to a new study.

Researchers in Minnesota tested an approach to preventing teen pregnancies that is based on providing access to birth control methods and information as well as building girls' sense of connectedness to family and society.

"Our study shows that when we invest in young people through ongoing one-on-one relationships, through opportunities to lead and access to sexual health services, we really support the next generation of citizens," said Renee Sieving, the study's lead author from the University of Minnesota in Minneapolis.

According to the U.S. Centers for Disease Control and Prevention, 31 out of every 1,000 teenage girls between 15 and 19 years old gave birth to a baby in 2011.

That is a record low, but still the highest teen pregnancy rate in the developed world, Sieving and her colleagues point out in the journal JAMA Pediatrics. They add that black and Hispanic teens bear most of the burden of these teen pregnancies.

For the new study, Sieving's team recruited 253 sexually active girls between 13 and 17 years old from clinics in St. Paul and Minneapolis, to be randomly placed in one of two groups.

All would get standard care at the clinic, but half would also be enrolled in the researchers' "Prime Time" youth development program.

At the study's outset, just over half of all the girls in both groups (around 56 percent) were using condoms on more than half of the occasions that they had sex. More than 40 percent said they used condoms less than half of the time.

Girls in each group were also on some other type of birth control for two of the past six months.

One group of 127 girls did not receive any special attention - other than the clinic's standard care and guidance. The other 126 girls were assigned to the new program.

Prime Time assigned each girl participating in that program a case manager who taught about healthy relationships, contraceptive use and how to become more involved with school and family.

The Prime Time teens also went through training to become leaders and teachers who could educate others about what they were learning.

The program took 18 months to complete, and the teens were then asked about their behaviors six months after it the program's end.

The researchers found that the girls who did not go through the program ended up using a condom during sex less consistently than they had two years earlier.

Girls who went through the program, however, ended up doing about 50 percent better at using a condom every time they had sex than at the beginning of the study.

The use of other contraceptives also increased in both groups, but more in the group who went through the Prime Time program.

The girls who went through the program were also more likely to say they were close with their family, and were more confident in turning down unwanted sex. In addition, the Prime Time teens were also more likely to go to college or technical school, according to Sieving.

"The kids we're working with are oftentimes struggling in school - the kid in the back of the room you don't often hear from, and we give them tools," Sieving said.

"You watch them move from 'I don't really have anything that's of any use to anybody,' to 'Wow, I have stuff to contribute!' So it's really cool to see that shift in how they see in themselves," she added.

Amy Bleakley, who studies teen sexual behavior and reproductive health at the University of Pennsylvania in Philadelphia, said the results are promising.

"I think that investment in youth development programs such as this could yield positive results for high-risk adolescent girls," said Bleakley, who was not involved with the new study.

Sieving told Reuters Health that compared to the approximately $10.9 billion teen pregnancy cost U.S. taxpayers in 2008, investing in this type of program also makes financial sense. The Prime Time program costs about $2,800 per teen, she said.

"I just think when you invest in ways that help kids to thrive, it's good for our next generation and there is some cost saving involved," she added.

SOURCE: http://bit.ly/V9WKBO JAMA Pediatrics, online February 26, 2012. (This story corrects paragraph nine to show researchers measured other types of birth control in months - not percents)

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