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Findings from RCT Grants

The Teen Options to Prevent Pregnancy (TOPP) Program: Long-Term Effects on Participants’ Enrollment and Persistence in College

This well-conducted RCT found no statistically significant effects on participants’ rate of college enrollment or persistence within the eight years after study entry.

Grantee: Mathematica Policy Research. The full study report is posted here.

Description of the Intervention: This was a long-term follow-up of an RCT of the Teen Options to Prevent Pregnancy (TOPP) program. TOPP is an 18-month program for low-income adolescent mothers, delivered by nurse educators and a social worker, that aims to reduce rapid repeat pregnancy and promote healthy birth spacing. Previous reports on this RCT found that TOPP is highly effective in preventing rapid repeat pregnancies and births during the 20 to 30 months after study entry. This longer-term follow-up was conducted to determine if the effects on repeat pregnancies and births led to an increase in mothers’ enrollment and persistence in college, in light of evidence from other, non-randomized studies linking repeat births among adolescent mothers to greater difficulties in attending or completing school.

Study Design: The study sample comprised 598 low-income adolescent mothers in Ohio between the ages of 10 and 19 (average age 18) who (i) were over 28 weeks pregnant or less than nine weeks post-partum, (ii) were enrolled in Medicaid, and (iii) spoke English. Approximately half of the mothers were randomly assigned to receive the TOPP program and half were assigned to a control group that did not receive the program. This long-term follow-up used data from the National Student Clearinghouse to estimate TOPP’s effects on participants’ enrollment and persistence in college during the eight years after study entry. 

Impact on the Primary Outcomes: The study found no statistically significant effects on mothers’ rates of enrollment or persistence in college within the eight years after study entry. Specifically, 24% of the TOPP group enrolled in a two- or four-year college within the eight years, versus 29% of the control group – a difference that was not statistically significant. The rates of college persistence (i.e., enrollment for three consecutive semesters without withdrawing) were 6% in each group.

Study Quality: Based on careful review, we believe this is a well-conducted RCT that produced valid findings.1

  1. 1

    For example, the study had successful random assignment (as evidenced by highly similar treatment and control groups), negligible (3%) sample attrition in measuring college outcomes, and valid analyses that were publicly pre-registered.