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Summaries of RCT Grants

Replication RCT of Teen Options to Prevent Pregnancy (T.O.P.P.) in 11 New York City hospitals

This project is a randomized controlled trial (RCT) of the Teen Options to Prevent Pregnancy (T.O.P.P.) program for low-income teenage mothers as implemented in 11 public hospitals in the New York City Health and Hospital (H+H) system.

Grant Recipient: Mathematica

Term: 2019 –2024

Principal Investigators: Brian Goesling, Ph.D., Mathematica Policy Research

Jessica Harding, Ph.D., Mathematica Policy Research

Funding: $1,957,089

Summary: This project is a randomized controlled trial (RCT) of the Teen Options to Prevent Pregnancy (T.O.P.P.) program for low-income teenage mothers as implemented in 11 public hospitals in the New York City Health and Hospital (H+H) system. T.O.P.P. provides teenage mothers with facilitated access to contraceptive services and 18 months of personalized counseling delivered by a nurse educator trained in motivational interviewing. In a prior well-conducted randomized controlled trial (RCT) in Ohio, T.O.P.P. was found to reduce repeat pregnancy at the 18-month follow-up from 39% in the control group to 21% in the treatment group and to reduce repeat births 6 to 30 months after study enrollment from 36% in the control group to 24% in the treatment group.

Researchers from Mathematica will enroll a sample of 1,000 low-income teenage mothers recruited from the 11 H+H hospitals and randomly assign 500 mothers to be offered T.O.P.P. and 500 to a control group with access to existing standard-of-care services. The study’s primary outcome will be repeat pregnancy measured with survey data collected 18 months after random assignment. In addition, the study will (i) measure repeat births over the 18 months using both survey data and administrative records; (ii) measure fidelity of program implementation; and (iii) conduct a detailed cost analysis of the intervention.

The study’s pre-specified pre-analysis plan is linked here. This project is also associated with an expansion and replication grant to PAGNY Health and Research Foundation to support program implementation.

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