Effects of a Teen Pregnancy Prevention Intervention, Love Notes, on Teen Pregnancies Among African American, Refugee, Foster and Lgbtq Youth

Background: Teen pregnancy rates in the US have been declining over the past 25 years, yet for several sub-populations, including African American, Refugee and Immigrant, Foster and LGBTQ youth, teen pregnancy remains high and up to three times higher than for youth not from these groups. One reason for the intractability of teen pregnancy among these groups of youth may be the fact that these youth are disenfranchised from family due to high incarceration rates of adults of color, the need to flee economically and politically oppressive countries, leaving many family members behind, being removed from home due to maltreatment and being rejected from homes due to disagreements about sexual orientation or gender identity.  These losses of and conflicts with primary caregivers may drive some youth to attempt to create their own families without thinking about the need for building the relationship skills necessary to maintain them and support a developing child.

Thus, it was hypothesized that a teen pregnancy prevention intervention that embeds the information about sexual health in a larger curriculum on healthy relationship formation and maintenance and preventing dating violence (Love Notes) would lead to fewer pregnancies than a more traditional comprehensive sex education curriculum, Reducing the Risk.  This study examined the efficacy of two different teen pregnancy interventions compared to a control condition, The Power of We (POW), which sought to empower teens to make a difference in their neighborhoods, to see which one had the most impact on reductions in pregnancy among vulnerable youth. 

Methods and Analysis Approach: This study was part of a three-arm, cluster randomized controlled trial.  The larger study recruited 1438 youth between the ages of 14 and 19 who were randomly assigned to Love Notes, Reducing the Risk or the Power of We. 88% were African Americans, 9% were refugees, 21% were foster youth and 16% were LGBTQ youth. The dependent variable examined was number of pregnancies in female participants or pregnancies in partners of male participants at the end of a year following the study.   

Results: Youth in the Love Notes condition (N = 18/501) were less likely than youth in the Power of We (N = 27/416) to experience a pregnancy. The Least Significant Difference (LSD) test produced a difference at the p < .05 level. No other differences between groups were significant. The Love Notes ratio translates to 35 pregnancies per 1,000 youth which is 44% lower than the state ratio of 62 per 1,000 teen pregnancies.  Further analyses of each subgroup will also be shared in the presentation.

Implications: Embedding sexual health information in a larger curriculum on healthy relationships and violence prevention effectively reduces pregnancies. With Kentucky spending $158 Million per year on teenage births, there is significant potential to cut these costs and improve the lives of vulnerable youth. These results have implications for what information youth need to prevent pregnancies and the potential use of Social Impact Bonds or similar mechanisms to reduce unnecessary costs of teen pregnancy.