Maynard 1994.

Methods	DESIGN: Multi‐centre RCT LENGTH OF FOLLOW‐UP: Minimum 25 months after enrolment; mean 29 months (range of means 28 to 30 months depending upon location); 3% of participants had follow up at or beyond 42 months DATA ANALYSIS: Only participants who completed follow‐up were analysed. In addition, mentioned in Table 3 that sample sizes for some items were smaller due to further missing values. ATTRITION RATE: Overall 35.6% did not complete follow up surveys UNIT OF DATA ANALYSIS: Individuals SAMPLE SIZE CALCULATION: No information provided EQUIVALENT STUDY GROUPS AT BASELINE: Difficult to judge because baseline characteristics are reported only for selected outcomes and do not distinguish between the interventions.  PROCESS EVALUATION: Attendance at workshops was recorded: Completed at least 1 workshop: Chicago 90%; Newark 39%; Camden 58%. Attended all workshops: Chicago 79%; Newark 10%; Camden 24%. Participation in family planning workshop ranged from 21% in Newark to 85% in Chicago. Authors noted that case managers were trained in parenting skills but in reality had few opportunities to offer individual counselling in this area.
Participants	NUMBER RANDOMISED: 5297 randomised but the study focuses on 3412 who completed follow up (1691 from Group 1 and 1721 from Group 2). Stated that these were representative of the full sample (no data provided). AGE: mean 18.4 years GENDER: All women SOCIO‐ECONOMIC STATUS: Received welfare as child occasionally or always: 63% Grew up in single‐parent household: 42% Living with employed mother: 15.8% Living with unemployed mother: 31.6% Not living with mother: 52.7% Completed high school or GED: 33.3% In high school or GED: 34.7% Dropped out: 32.0% ETHINCITY/RACE (data for 3412 participants): black 2580 (76%); Hispanic 562 (17%); white 236 (7%). LOCATION: USA; Chicago, Camden, Newark; assumed urban PREVIOUS STI: Not reported SEXUAL RISK BEHAVIOUR: Had never used contraception: 27.2% Did not use contraception at last intercourse: 54.3% Average age at first contraception use: 15.9 years (sexually active on average for 3 years at enrolment) OTHER: Participants (in Group 1) were required to participate or be subject to a substantial reduction in benefits ($160 per month).
Interventions	NAME OF STUDY: Not stated GROUP 1: Education and parenting skills programme for teenage mothers (n = 1721) YEAR STARTED: 1987 to 1990 PROVIDER(S): Trained case managers (50 to 60 cases each) SETTING(S): Stated only that conducted in 3 cities, each of which had high rates of unemployment, poverty and crime TYPE: Information/Education; practical skill development (personal skills; parenting skills; awareness of contraception methods and STIs); increased self‐sufficiency. DURATION (note inter‐site variability): Overall duration: 3 days to 12 weeks Chicago: 6 workshops; total 9 hours over 3 consecutive days Camden, Newark: total number of workshops not stated; total 80 to 100 hours over 5 to 12 weeks Illustration of variability of duration for specific workshops: Family planning: ranged from 1.5 hours (Chicago) to 54 hours (Newark) Parenting: ranged from 1.5 hours (Chicago) to ˜20 hours (Newark) Life skills: only offered as needed in Chicago; ˜20 hours in Newark THEORETICAL BASIS: Not stated STIs COVERED: None specified: primarily a pregnancy management programme but did mention STIs in workshops GROUP 2: Usual local welfare services provision for teenage mothers (n = 1691) Standard welfare provision: participants received Aid to Families with Dependent Children (AFDC) benefits and the limited support and services normally available under that programme OTHER: Benefits penalties (see participants section above) appear to be relevant only to Group 1, although this was not stated explicitly.
Outcomes	PRIMARY/SECONDARY: Not stated which outcomes were primary or secondary.  Behaviour (contraceptive use; choice of contraception)  Health state (repeat pregnancy; pregnancy outcome)
Notes	COST DATA: none reported. Note that the outcomes were reported only as relative effects in the enhanced services intervention compared to regular services; they were only reported for location and ethnicity groups, with no overall intervention effect given.
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Unclear risk	No information provided
Allocation concealment?	Unclear risk	No information provided
Blinding? All outcomes	Unclear risk	No information provided
Incomplete outcome data addressed? All outcomes	Unclear risk	The study only analysed data for 3412 participants who completed follow up (of the 5297 randomised). Attrition rates were not reported separately by trial group. No reasons were given for attrition and it is therefore not clear whether reasons for attrition differed between trial groups
Free of selective reporting?	Unclear risk	Difficult to judge because several outcomes were stated in the methods but it was not explained whether these would be included in a predictive model and/or reported separately. Probably more outcome data would have been available than were reported as the results given are only an overall summary. All 4 outcomes were reported but only according to ethnicity and site (not overall).
Free of other bias?	Unclear risk	Unclear whether trial groups were equivalent at baseline, due to limited information.