Intended for healthcare professionals


Health outcomes of youth development programme in England: prospective matched comparison study

BMJ 2009; 339 doi: (Published 07 July 2009) Cite this as: BMJ 2009;339:b2534
  1. Meg Wiggins, senior research officer1,
  2. Chris Bonell, senior lecturer2,
  3. Mary Sawtell, research officer1,
  4. Helen Austerberry, research officer1,
  5. Helen Burchett, research student2,
  6. Elizabeth Allen, lecturer 2,
  7. Vicki Strange, senior research officer1
  1. 1Social Science Research Unit, Institute of Education, University of London, London WC1H 0NR
  2. 2London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: C Bonell chris.bonell{at}
  • Accepted 16 March 2009


Objective To evaluate the effectiveness of youth development in reducing teenage pregnancy, substance use, and other outcomes.

Design Prospective matched comparison study.

Setting 54 youth service sites in England.

Participants Young people (n=2724) aged 13-15 years at baseline deemed by professionals as at risk of teenage pregnancy, substance misuse, or school exclusion or to be vulnerable.

Intervention Intensive, multicomponent youth development programme including sex and drugs education (Young People’s Development Programme) versus standard youth provision.

Main outcome measures Various, including pregnancy, weekly cannabis use, and monthly drunkenness at 18 months.

Results Young women in the intervention group more commonly reported pregnancy than did those in the comparison group (16% v 6%; adjusted odds ratio 3.55, 95% confidence interval 1.32 to 9.50). Young women in the intervention group also more commonly reported early heterosexual experience (58% v 33%; adjusted odds ratio 2.53, 1.09 to 5.92) and expectation of teenage parenthood (34% v 24%; 1.61, 1.07 to 2.43).

Conclusions No evidence was found that the intervention was effective in delaying heterosexual experience or reducing pregnancies, drunkenness, or cannabis use. Some results suggested an adverse effect. Although methodological limitations may at least partly explain these findings, any further implementation of such interventions in the UK should be only within randomised trials.


  • Contributors: MW co-directed the study and oversaw all data collection and analysis. CB co-directed the study, advised on design and methods, and led the drafting of the paper. MS coordinated the study’s surveys and participated in data collection and analysis. HA coordinated qualitative fieldwork and participated in data collection and analysis. HB coordinated collation of monitoring data and participated in data collection and analysis. EA advised on statistical analysis. VS managed the study and coordinated data collection. All authors contributed to drafting the paper. CB is the guarantor.

  • Funding: The research was funded by England’s Department of Health. The funders required to see a draft of this paper 28 days before submission but in no way influenced the decision to publish or the contents of the paper. The funders were consulted about the design and methods used in the study and commented on drafts of the interim and final project reports. The research team was independent of the funders.

  • Competing interests: None declared.

  • Ethical approval: The Institute of Education research-ethics committee approved the study. Participants gave informed, signed consent to data collection, and data were stored in anonymised form.

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This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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