Impact of a relationship-based intervention, Love Notes, on teen pregnancy prevention

Objective In this research, a randomized controlled trial (RCT) tested the efficacy of two teen pregnancy prevention (TPP) curricula, Reducing the Risk and Love Notes, compared with a group of adolescents in a control condition, on primary pregnancy prevention among youth at high-risk for teen pregnancy. A secondary purpose was to examine two potential mediators, negative beliefs about teen pregnancy and intentions to follow the sequence of completing education, marrying or establishing a committed relationship, and then having children. Background Teen pregnancy rates for racial/ethnic minority youth in the United States are disproportionately high compared with White youth. Given the positive view of children in these populations and the drive for youth to form peer relationships and explore their sexuality, meeting these cultural and developmental needs within TPP may be critical. Methods The study examined the number of reported pregnancies across the first year after the interventions from a three-arm, cluster RCT engaging 1,448 youth living in poverty between the ages of 14 and 19 years in 23 community-based organizations in a southeastern U.S. city. Results At the 1-year follow-up, youth in Love Notes report significantly fewer pregnancies compared with the control condition (18 pregnancies, 3.51%), F(2, 1,309) = 4.17, p = .02, d = 0.11. There was no significant difference between Reducing the Risk (31 pregnancies, 6.14%) and the control condition (27 pregnancies, 6.49%) in number of pregnancies. Less favorable attitudes about having a child as a teenager and other attitudes were associated with predicted outcomes. Conclusions This study provides additional evidence for the efficacy of Love Notes, which embeds sex education into a larger curriculum on life planning and healthy relationship formation and maintenance. Implications. TPP approaches need to add content on planning and relationships to comprehensive sexual education.