Intervention Summary

Wyman's Teen Outreach Program

Wyman's Teen Outreach Program (TOP) aims to reduce teens' rates of pregnancy, course failure, and academic suspension by enhancing protective factors. TOP is delivered over 9 months (a full school year) to middle and high school students who voluntarily enroll in the program in school or in an after-school or community-based setting. The program combines supervised volunteer service activities and weekly 1- to 2-hour classroom sessions to empower teens through their help-giving role and to enhance their sense of autonomy while maintaining their sense of relatedness to others in the program. The volunteer service activities selected by the teens vary on the basis of the community needs and resources as well as the capacities and interests of participating students; examples include working as a hospital or nursing home aide, participating in walkathons, and tutoring peers. The teens are supervised and mentored by adult facilitators, and each teen participates in a minimum of 20 hours of community service during the school year.

The classroom sessions are led by trained facilitators (e.g., teachers, guidance personnel) who use the TOP curriculum, Changing Scenes. These sessions include two types of group discussions and experiential activities: those that focus on the teens' service experiences (e.g., developing self-confidence, social skills, assertiveness, and self-discipline) and those that cover a range of issues faced by the students (e.g., managing family relationships, meeting new academic and employment challenges, handling close friendships and romantic relationships). At least one trained facilitator is required for each group of 25 teens or fewer.

In the studies reviewed for this summary, the intervention was provided to students in grades 9-12.

Descriptive Information

Areas of Interest	Mental health promotion
Outcomes	1: Teen pregnancy 2: Academic achievement 3: Academic suspension
Outcome Categories	Education
Ages	13-17 (Adolescent)
Genders	Male Female
Races/Ethnicities	Black or African American Hispanic or Latino White Race/ethnicity unspecified
Settings	School Other community settings
Geographic Locations	Urban Suburban Rural and/or frontier
Implementation History	TOP was developed in the St. Louis Public Schools. Wyman Center, Inc., began delivering TOP to middle and high school students in St. Louis and began national replication of TOP. Wyman Center launched a revised replication system. TOP currently serves nearly 50,000 teens at 1,800 sites in 34 States plus Washington, DC, and is used in rural, urban, and suburban locations.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: No Evaluated in comparative effectiveness research studies: No
Adaptations	No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects	No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories	Universal Selective

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Allen, J. P., & Philliber, S. Who benefits most from a broadly targeted prevention program? Differential efficacy across populations in the Teen Outreach Program. Journal of Community Psychology, 29(6), 637-655.

Study 2

Allen, J. P., Philliber, S., Herrling, S., & Kuperminc, G. P. Preventing teen pregnancy and academic failure: Experimental evaluation of a developmentally based approach. Child Development, 64(4), 729-742.

Outcomes

Outcome 1: Teen pregnancy
Description of Measures	Teen pregnancy was measured with a researcher-developed self-report questionnaire. Facilitators administered the questionnaire to students at the beginning of the school year or upon participants' entry to the program (pretest) and at the end of the school year or upon participants' exit from the program (posttest). The pretest questionnaire assessed pregnancy with a single item, which asked whether the student had ever been pregnant (females) or caused a pregnancy (males). The posttest questionnaire also used one item to assess pregnancy, asking whether the student had been pregnant (females) or caused a pregnancy (males) during the prior school year. Pre- and posttest findings were then statistically analyzed to determine the relative risk of teen pregnancy.
Key Findings	In one study, at posttest, students participating in TOP had a risk of pregnancy that was 53% that of control group participants (odds ratio = 0.53; p < .001), after controlling for significant background factors (i.e., racial/ethnic minority, history of pregnancy). In addition, among study participants who were teen parents at pretest, those participating in TOP had a risk of pregnancy that was 18% that of control group participants (odds ratio = 0.18; p < .01). In another study, at posttest, students participating in TOP had a risk of pregnancy that was 41% that of control group participants (odds ratio = 0.41; p < .05), after controlling for significant background factors (i.e., demographics, prior problem behaviors).
Studies Measuring Outcome	Study 1, Study 2
Study Designs	Experimental, Quasi-experimental
Quality of Research Rating	2.2 (0.0-4.0 scale)

Outcome 2: Academic achievement
Description of Measures	Academic achievement was measured with a researcher-developed self-report questionnaire that used a single item to assess whether the student had failed any courses during the prior school year. Facilitators administered the questionnaire to students at the beginning of the school year or upon participants' entry to the program (pretest) and at the end of the school year or upon participants' exit from the program (posttest). Pre- and posttest findings were then statistically analyzed to determine the relative risk of course failure.
Key Findings	In one study, at posttest, students participating in TOP had a risk of course failure that was 60% that of control group participants (odds ratio = 0.60; p < .001), after controlling for significant background factors (i.e., racial/ethnic minority, history of pregnancy). In addition, the study found that: Among female study participants, those participating in TOP had a risk of course failure that was 52% that of control group participants (odds ratio = 0.52; p < .001). Among racial/ethnic minority study participants, those participating in TOP had a risk of course failure that was 52% that of control group participants (odds ratio = 0.52; p < .001). Among students with a prior suspension history at pretest, those participating in TOP had a risk of course failure that was 43% that of control group participants (odds ratio = 0.43; p < .001). In another study, at posttest, students participating in TOP had a risk of course failure that was 42% that of control group participants (odds ratio = 0.42; p < .001), after controlling for significant background factors (i.e., demographics, prior problem behaviors).
Studies Measuring Outcome	Study 1, Study 2
Study Designs	Experimental, Quasi-experimental
Quality of Research Rating	2.3 (0.0-4.0 scale)

Outcome 3: Academic suspension
Description of Measures	Academic suspension was measured with a researcher-developed self-report questionnaire that used a single item to ask whether the student had been suspended from school in the prior year. Facilitators administered the questionnaire to students at the beginning of the school year or upon participants' entry to the program (pretest) and at the end of the school year or upon participants' exit from the program (posttest). Pre- and posttest findings were then statistically analyzed to determine the relative risk of academic suspension.
Key Findings	In one study, at posttest, students participating in TOP had a risk of academic suspension that was 52% that of control group participants (odds ratio = 0.52; p < .001), after controlling for significant background factors (i.e., being in younger grades in high school, history of prior course failure and academic suspension, lower levels of parents' education, living in a single-parent family). In another study, at posttest, students participating in TOP had a risk of academic suspension that was 39% that of control group participants (odds ratio = 0.39; p < .001), after controlling for significant background factors (i.e., demographics, prior problem behaviors).
Studies Measuring Outcome	Study 1, Study 2
Study Designs	Experimental, Quasi-experimental
Quality of Research Rating	2.3 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study	Age	Gender	Race/Ethnicity
Study 1	13-17 (Adolescent)	73.2% Male 26.8% Female	45.2% Black or African American 36.8% White 12.8% Hispanic or Latino 5.3% Race/ethnicity unspecified
Study 2	13-17 (Adolescent)	84.6% Female 15.4% Male	67.2% Black or African American 18.7% White 11.2% Hispanic or Latino 2.9% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

Reliability of measures
Validity of measures
Intervention fidelity
Missing data and attrition
Potential confounding variables
Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome	Reliability of Measures	Validity of Measures	Fidelity	Missing Data/Attrition	Confounding Variables	Data Analysis	Overall Rating
1: Teen pregnancy	1.5	2.0	0.8	3.1	2.5	3.5	2.2
2: Academic achievement	1.5	2.1	0.8	3.1	2.5	3.5	2.3
3: Academic suspension	1.5	2.1	0.8	3.1	2.5	3.5	2.3

Study Strengths

The validity of the student self-report measures for course failure and academic suspension was assessed in a sample of students by examining school records. Hours of volunteer service and classroom sessions attended were tracked in both studies, and one study analyzed the dosage effects of these factors. Attrition was low in both studies. Attrition analysis was thorough and revealed no significant differences between intervention and control groups. The analyses were appropriate, thoughtful, and thorough.

Study Weaknesses

All outcomes were assessed using single-item measures, and no test-retest reliability analysis was conducted on these items prior to the studies to determine the items' reliability within the population of students. Although the validity of course failure and suspension measures was assessed in a sample of students by examining school records, it was found that a quarter of these students did not accurately self-report. For the teen pregnancy measure, validity is limited to face validity. Intervention fidelity was difficult to establish because facilitators had considerable latitude in the topics they covered. Evidence of adherence to the curriculum was not provided. In one study, respondents had various points of entry into the study (random assignment, self-selection, and referral); although this concern is mitigated by careful analyses of group differences on available variables, the potential for selection bias remains. The administration of pre- and posttest questionnaires by TOP facilitators may have influenced students' responses.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Philliber Research Associates. The evaluation of Teen Outreach: A guide for program sites. Accord, NY: Author.

Quality assurance materials:

Format and Process for Club and Site Visits
TOP Logic Model.
TOPnet Club and Site Visit Report
Wyman TOPnet Club and Site Visitor's Checklist

Sense Corp. Wyman TOPnet phase II training. Version 1.2. Saint Louis, MO: Author.

Training and support resources:

Facilitator Training Evaluation
Facilitator Training Outline and PowerPoint
Follow the TOP Approach, Wyman's Teen Outreach Program Facilitator Training Guide.
TOP Training Overview
Trainer Kit List and Training of Trainer Guide
Training of Trainers Evaluation
Training of Trainers Outline
Wyman Teen Outreach Program Facilitator Training Logic Model.

Wyman Teen Outreach Program. Changing Scenes curriculum. Eureka, MO: Wyman Center:

Changing Scenes, a curriculum of the Wyman Teen Outreach Program (TOP): Welcome handbook
Changing Scenes, a curriculum of the Wyman TOP: Community service learning guide
Changing Scenes, a curriculum of the Wyman TOP: Level 1
Changing Scenes, a curriculum of the Wyman TOP: Level 2
Changing Scenes, a curriculum of the Wyman TOP: Level 3
Changing Scenes, a curriculum of the Wyman TOP: Level 4
Participant handouts

Other implementation materials:

Chung, S., & Philipps, A. Promoting mental health and well being in adolescence: Recommendations for Wyman's Teen Outreach Program. Eureka, MO: Wyman Center.
Letter of Intent for Partners and Partner Application
Materials Order Form
Reducing and Preventing Teen Violence: Recommendations for Wyman Teen Outreach Program
Sample Materials for Partners
Teen Outreach Program: For the Teens (Potential Partner Presentation)
TOP Budgeting Tool and Club Start Up Kit
TOP Facilitator Sample Job Description
TOP Frequently Asked Questions
Virtual Volunteer Guide

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

Availability of implementation materials
Availability of training and support resources
Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation Materials	Training and Support Resources	Quality Assurance Procedures	Overall Rating
4.0	4.0	3.8	3.9

Dissemination Strengths

Implementation handbooks include concise and practical information that covers a variety of social issues experienced by adolescents, and they offer creative activities associated with the lessons. Program staff are required to attend the implementation training to ensure program stability. A training-of-trainers program certifies experienced facilitators at sites implementing the program to train new facilitators. Fidelity standards and site visit protocols allow opportunities to provide feedback to implementers along with corrective actions that are easy to follow. The evaluation guide includes guidance for collecting outcome data using an assortment of assessment tools.

Dissemination Weaknesses

Program materials lack details to help the facilitator provide quality assurance for day-to-day implementation at the program level.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description	Cost	Required by Developer
Initial start-up package (includes cost of off-site training of trainers for one participant; data collection for the first year of implementation, with report; 8 hours of technical assistance; a site visit during the first year, which includes staff assistance; and 10 sets of the Changing Scenes curriculum)	$26,000 each	Yes
Additional Changing Scenes curriculum (includes a welcome handbook, curriculum manuals for levels 1-4, a community service learning guide, and participant handouts)	$500 per set	No
5-day, off-site training of trainers at the developer site in Missouri (includes the 2.5-day facilitator training, two coaching calls after training, and additional support resources)	$6,000 per participant	Yes
2.5-day, off-site facilitator training	$750 per participant	Yes, for those who do not participate in the training of trainers
Technical assistance (on-site, telephone, or email)	$75 per hour, plus travel expenses if necessary	No
Annual certification fees	$6,000 for 50 clubs or up to 1,000 youth; $1,000 for each additional 10 clubs or 250 youth	Yes

Additional Information

One participant per site is required to attend the training of trainers, although more may attend at the site's discretion. New sites are encouraged to train their own facilitators, but outside facilitator trainings are available through other sites as noted above. The cost per school year to implement TOP averages between $410 and $640 per teen, depending on staff, transportation, food, supplies, and meeting space. Programs held during the school day have the lowest cost structure since most variables are already covered with existing school budgets.