The Impact of Brief Interventions With Condom Demonstrations on Youth: A Systematic Review.

PURPOSE: This review examined whether there is evidence that brief interventions with condom demonstration lessons have impacts on behavioral and nonbehavioral outcomes for youth and young adults. METHODS: We conducted a systematic review using a prespecified search strategy and processes consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified a pool of 11 eligible studies that tested the effectiveness of a single-session intervention that was no longer than 60 minutes and included a condom demonstration. We included all outcomes at all time points and organized them into eight domains. RESULTS: Single-session interventions with condom demonstrations showed favorable short-term and long-term impacts for samples of largely sexually active youth. Studies found statistically significant impacts in 29%-50% of the tests for effects on attitudes toward condoms, knowledge of sexual health and condom use, perceptions of condom use and sexuality, and condoms use intentions. DISCUSSION: Our review found evidence that brief interventions with condom demonstrations have potential effects on behavioral and nonbehavioral outcomes for vulnerable and transient sexually active youth warranting future studies to assess condom demonstrations in isolation.

Teen Pregnancy Prevention Evaluation Technical Assistance: A Case Study.

PURPOSE: This case study discusses Mathematica's experience providing large-scale evaluation technical assistance (ETA) to 65 grantees across two cohorts of Teen Pregnancy Prevention (TPP) Program grants. The grantees were required to conduct rigorous evaluations with specific evaluation benchmarks. This case study provides an overview of the TPP grant program, the evaluation requirements, the ETA provider, and other key stakeholders and the ETA provided to the grantees. Finally, it discusses the successes, challenges, and lessons learned from the effort. CONCLUSION: One important lesson learned is that there are two related evaluation features, strong counterfactuals and insufficient target sample sizes, that funders should attend to prior to selecting awardees because they are not easy to change through ETA. In addition, if focused on particular outcomes (for TPP, the goal was to improve sexual behavior outcomes), the funder should prioritize studies with an opportunity to observe differences in these outcomes across conditions; several TPP grantees served young populations, and sexual behavior outcomes were not observed or were rare, limiting the opportunity to observe impacts. Unless funders are attentive to weaning out evaluations with critical limitations during the funding process, requiring grantees to conduct impact evaluations supported by ETA might unintentionally foster internally valid, yet underpowered studies that show nonsignificant program impacts. The TPP funder was able to overcome some of the limitations of the grantee evaluations by funding additional evidence-building activities, including federally led evaluations and a large meta-analysis of the effort, as part of a broader learning agenda.

Sustaining Programs: Lessons Learned from Former Federal Grantees.

INTRODUCTION: A common concern of federal funders and grant recipients is how to sustain program activities once their federal funding period ends. Federal funding can be intended to develop or seed a program but not necessarily to continue its activities indefinitely. Understanding the importance of programmatic sustainability, the Office of Population Affairs (OPA) conducted research in 2015 on the elements that contribute to sustainability. As part of the Sustainability Study, OPA collected information from former Pregnancy Assistance Fund (PAF) program grantees. METHODS: Grantees that were awarded cohort 1 PAF program funding (2010-2014) but not awarded cohort 2 funding (2014-2017) were eligible for study inclusion because their OPA funding ended more than 1 year prior to the Sustainability Study, allowing for an assessment of sustainability after federal funding. Seven former PAF grantees were identified as eligible. Interviews were conducted with six of these grantees; grant applications and interim final reports from all seven were reviewed. RESULTS: Five lessons emerged from interviews and review of grant documentation. Programs successfully continuing beyond the federal grant period tended to (1) diversify funding sources, (2) communicate regularly with key stakeholders, (3) form partnerships with like-minded programs, (4) consider implementing evidence-based interventions, and (5) begin planning for sustainability early. DISCUSSION: By considering these lessons learned from the research, grantees can be well positioned to continue beyond a federal grant period. The lessons garnered from the Sustainability Study have informed, expanded, and affirmed OPA's sustainability toolkit, sustainability framework, and technical assistance.

A Systematic Review of Programs to Promote Aspects of Teen Parents' Self-sufficiency: Supporting Educational Outcomes and Healthy Birth Spacing.

INTRODUCTION: Expectant and parenting teens experience many challenges to achieving self-sufficiency and promoting their children's healthy development. Teen parents need support to help them address these challenges, and many different types of programs aim to support them. In this systematic review, we examine the research about programs that aim to support aspects of teen parents' self-sufficiency by promoting their educational outcomes and healthy birth spacing. METHODS: We conducted a comprehensive literature search of published and unpublished literature to identify studies of programs to support teen parents that met this review's eligibility criteria. The quality and execution of the eligible study research designs were assessed to determine whether studies' findings were at risk of bias. We then extracted information about study characteristics, outcomes, and program characteristics for studies considered to provide rigorous evidence. RESULTS: We identified 58 eligible studies. Twenty-three studies were considered to provide rigorous evidence about either education, contraceptive use, or repeat pregnancy or birth. Seventeen of these studies showed at least one favorable effect on an outcome in one of these domains, whereas the other six did not show any significant or substantial effects in these domains. These 17 studies represent 14 effective programs. DISCUSSION: Effective programs to support expectant and parenting teens have diverse characteristics, indicating there is no single approach for promoting teens' education and healthy birth spacing. More rigorous studies of programs to support teen parents are needed to understand more about how to support teen fathers and the program characteristics associated with effectiveness.

Family Economic Well-Being Following the 1996 Welfare Reform: Trend Data from Five Non-Experimental Panel Studies.

This analysis summarizes trends in family economic well-being from five non-experimental, longitudinal welfare-to-work studies launched following the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). The studies include a sizable group of parents and other caregivers who received TANF at the point of sample selection or shortly thereafter, and share a wide range of similar measures of economic well-being. This analysis provides descriptive information on how these families are faring over time. Our results confirm what has been found by previous studies. Many families remain dependent on public benefits, and are either poor or near-poor, despite gains in some indicators of economic well-being. We caution that these aggregate statistics may mask important heterogeneity among families.

The mental health of married, cohabiting, and non-coresident parents with infants.

OBJECTIVES: We compared recent parents (married, cohabiting, not cohabiting but romantically involved, and not romantically involved) to examine the association between mental health problems and relationship status. METHODS: We analyzed data from the Fragile Families and Child Wellbeing Study that followed a cohort of approximately 4900 births in large US cities. Our study included a large oversample of nonmarital births (n=3700) and interviews with both mothers and fathers. We used the Composite International Diagnostic Interview Short Form to assess depression and generalized anxiety 1 year after the birth. Self reports were used to measure heavy drinking, illicit drug use, incarceration, and partner violence. RESULTS: Unmarried parents reported more mental health and behavioral problems than did married parents, and unmarried parents whose relationships ended before the birth reported more impairment compared with other groups of unmarried parents. CONCLUSIONS: A substantial number of children are born to unmarried parents and are at risk for poor parenting and poor developmental outcomes. Government initiatives aimed at increasing marriage rates among low-income couples need to consider the mental health status of unmarried parents.

Does remarriage expand perceptions of kinship support among the elderly?

This study addresses the debate over whether higher-order marriages will help offset the expected loss of social support from kin due to divorce for future generations of the elderly. We use data from the first wave of the National Survey of Families and Households (NSFH1, 1987-1988) to examine the effects of marriage, marital disruption, and remarriage on perceptions of overall support and support from kin. To measure perceptions of overall support, we look at whether respondents say that they have someone to: (1) turn to in an emergency, (2) borrow money from, and (3) talk to when they are depressed. To measure perceived support from kin, we look at whether respondents name kin as a source of support. We find that marriage and remarriage increase perceptions of support from kin, whereas divorce reduces perceptions of support. We also find that men benefit more from marriage and lose more from divorce than women. Taken together our findings suggest growing inequality in social support among the future elderly population.