Evaluation suggests youth scheme pilot did not reduce teenage pregnancies
08 July 2009
An evaluation of a government-funded pilot scheme aimed at reducing teenage pregnancy, drug use and school exclusion suggests it did not reduce – and perhaps might have increased – pregnancies among participants, according to an article just published in the British Medical Journal.
The study found that young teenage girls who took part in the Young Person's Development Programme (YPDP) were more likely to become pregnant than girls in a matched comparison group who did not participate and instead were receiving other forms of youth support.
Eighteen months after enrolment, 16 per cent of young women in YPDP became pregnant compared with 6 per cent of those in the comparison group. Fifty-eight per cent of YPDP young women said they had had a sexual experience versus 33 per cent of comparisons. In addition, 34 per cent YPDP young women said they were likely to become teenage mothers against 24 per cent of comparisons. The researchers found no evidence for such effects among young men, or of effects on other health outcomes such as substance use.
The independent evaluation was commissioned by the Department of Health and carried out by researchers from the Institute of Education and the London School of Hygiene & Tropical Medicine. Over 2,300 young people took part in the programme, which ran from 2004 to 2007 and was aimed at young men and women aged 13–15 deemed by teachers and other professionals as at risk of teenage pregnancy, substance use and school exclusion.
The programme, partly informed by a successful New York initiative, involved work in 27 pilot areas and offered education, training and employment opportunities, life-skills, mentoring, volunteering, sexual health and substance misuse education, arts, sports and advice on accessing services. Participants were to be involved for one year.
While much of the work was of high quality and some young people showed significant personal progress during their time as participants, many received fewer than the intended 6–10 hours per week of services, and provision varied greatly between sites. The work was intended to be in addition to normal schooling but in some sites, young people participated in the scheme instead of school.
Researcher Meg Wiggins (Institute of Education) says "Our evaluation findings suggest that programmes aimed exclusively at young people at risk may bring them into contact with others more disposed to engage in risky behaviours – and therefore make them more likely to engage in these behaviours themselves."
Researcher Chris Bonell (London School of Hygiene & Tropical Medicine) adds: "We recommend that if policymakers do aim to develop other youth schemes targeting vulnerable young people, they take on board the lessons from our research, and test the schemes using randomised controlled trials."
Notes for editors
To interview Meg Wiggins please contact the Institute of Education Press Office on +44 (0)20 7612 6459, h.green@ioe.ac.uk.
To interview Chris Bonell, please contact the London School of Hygiene and Tropical Medicine Press Office on +44 (0)20 7927 2073/2802 or email gemma.howe@lshtm.ac.uk.
The Department of Health's pilot programme was partly informed by the Children's AID Society-Carrera programme in New York, an intensive after-school intervention combining youth development, sexuality education and regular sexual health clinic checkups. This was reported as delaying young women's sexual experience, increasing use of contraception and reducing pregnancies but with no such benefits for young men.
The findings of the evaluation might, at least in part, reflect research limitations. In practice, young people were sometimes recruited to the comparison group using a slightly more general criterion ("vulnerable young people") than those used in YPDP recruitment ("deemed by teachers and other professionals as at risk of teenage pregnancy, substance use and school exclusion"). However, the comparison group was recruited from areas matched on deprivation and teenage pregnancy rates, and was not generally at lower risk at baseline. The researchers also adjusted statistically for these pre-existing differences, which did not change the results.
Drop-out from the research was a major challenge in this study and the findings might reflect participants at higher baseline risk being followed up more completely in the YPDP than the comparison group. However, the results suggest this was true for only some baseline measures of risk, with the pattern being reversed for others. Weighting the data to compensate for this did not change the findings.
It might also be that these findings occurred because the intervention "labelled" some participants as risky and therefore reinforced this; or brought them into contact with peers more engaged in risk behaviours.
Meg Wiggins is a senior research officer in the Social Science Research Unit at the Institute of Education. Chris Bonell is a senior lecturer in the London School of Hygiene & Tropical Medicine. Both specialise in sexual and reproductive health and substance abuse.
The Institute of Education is a college of the University of London, specialising in teaching, research and consultancy in education and related areas of social science and professional practice. The Institute conducts over one-third of the educational research in the UK and last year's Research Assessment Exercise judged that 35 per cent of the work it had submitted was "world leading", while much of the remainder was of international significance.
The London School of Hygiene & Tropical Medicine is Britain's national school of public health and a leading postgraduate institution worldwide for research and postgraduate education in global health. Part of the University of London, the London School is the largest institution of its kind in Europe with a remarkable depth and breadth of expertise encompassing many disciplines. It is one of the highest-rated research institutions in the UK.