Paine‐Andrews 1999.

Methods	Study design: controlled before‐after study Sampling frame: cross‐sectional design; behavioral change collected by school‐based survey; pregnancy data collected from state health department  Sampling method: convenience Collection method: questionnaire (Adolescent Curriculum Evaluation, Youth Risk Behavior Survey), archival records from state health department Description of the community coalition: Geary County: county school district in affiliation with community mobilizers, student interns from nearby university. Coalition included advisory board, financial sustainability committee. Franklin County: satellite office for regional drug and alcohol prevention center, community mobilizers, advisory board. Wichita: grassroots community organization (Wichita Metropolitan Family Preservation), high schools, community mobilizers, advisory board
Participants	Communities: 3 communities in Kansas: Geary County, Franklin County, and Wichita County: USA Ages included in assessment: questionnaire(s) administered to 7th graders; state health department data for teens age 14 to 17 (n = 1769) Reasons provided for selection of intervention community: communities chosen on the basis of minority populations, SES, and high teen pregnancy rates Intervention community (population size): Franklin County (22,000), Geary County (30,353), Wichita County (304,000) Comparison community (population size): similar Kansas county
Interventions	Name of intervention: School/Community Sexual Risk Reduction Replication Initiative (replication of the School/Community Model for Preventing Adolescent Pregnancy) Theory: Social Learning Theory, Innovation Diffusion Theory Aim: to determine effects of a comprehensive multi‐component school‐ and community‐based intervention on unintended pregnancy among never‐married teens and pre‐teens by promoting abstinence, postponing age of first intercourse, and promoting effective contraceptive use  Description of costs and resources: Kansas Health Foundation; 3‐year grants of $150,000 per year for 3 communities Components of the intervention: enhancing sexuality education (for teachers, community members, parents, clergy), implementing age‐appropriate comprehensive K‐12 sexuality education, increasing access to health services and contraceptives, using mass media to increase awareness and involvement, providing peer support and education, and establishing linkages with communities and religious organizations  Start date: 1993 Duration: 4 years
Outcomes	Outcomes and measures: proportion of adolescents having sex, condom use, pregnancy rate, birth rate Time points: pre‐intervention data: 1991 to 1993; intervention data: 1994 to 1996
Notes	Funding source: Kansas Health Foundation
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Randomization not performed
Allocation concealment (selection bias)	High risk	No allocation concealment
Baseline outcome measurement similar	Unclear risk	Process used to select counties or zip codes with similar pregnancy rates using 5‐year estimated pregnancy rates
Baseline characteristics similar	High risk	Variation between target areas described, but not in detail
Blinding of outcome assessment (detection bias) All outcomes	Low risk	School‐wide surveys and state vital statistical data
Incomplete outcome data (attrition bias) All outcomes	High risk	Response rates to ACE and YRBS surveys between 68% and 73%
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding reported
Protection against contamination	High risk	Intervention and comparison target areas were geographically close. Given community‐level interventions, contamination is possible/likely
Selective reporting (reporting bias)	Unclear risk	Study authors report specific outcomes from large behavioral risk survey