Comprehensive clinic-based programs for pregnant & parenting teens

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  

Comprehensive clinic-based programs for pregnant or parenting teens address the complex needs of teenage mothers. Programs include health care and family planning services, and help participants with non-clinical needs through case management, counseling, social support, and connections to social services. Services are often provided by both medical teams and social workers. Programs are often geared toward preventing rapid repeat pregnancy, a second pregnancy within 12-24 months. Teenage childbearing poses economic, social, and medical risks to mothers and their infants; risks are magnified by repeat pregnancies during adolescence1.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced teen pregnancy

  • Reduced rapid repeat pregnancies

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased vaccination

  • Increased use of contraception

  • Increased condom use

What does the research say about effectiveness?

There is strong evidence that comprehensive clinic-based programs that support pregnant and parenting teens reduce rapid repeat pregnancies among participants2, 3. Such programs also appear to promote clinic attendance and increase immunization completion for infants3.

Comprehensive programs based in large urban hospital and clinic facilities with multi-disciplinary teams have been shown to reduce repeat pregnancies among minority and low income adolescent mothers through 18 months post-partum2, 3. An assessment of the Philadelphia-based Health Care Program for First-Time Adolescent Mothers and their Infants, for example, indicates that black teenage mothers with Medicaid are less likely to experience a repeat pregnancy within 18 months than non-participating peers4 and an assessment of the Generations program in Washington, D.C. indicates increased contraceptive and condom use for 12 months among black teenage mothers5. An evaluation of the Colorado Adolescent Maternity Program (CAMP) indicates that participants who choose to use long-acting reversible contraception (LARCs) appear least likely to become pregnant again6.

Integrated clinical and social services, combined mother and infant care, contraceptive education, and a multi-disciplinary youth-oriented approach appear to increase program effectiveness. Providing easy access to services and reaching young women at antenatal and postnatal consultations for their first pregnancy may also increase program effectiveness1.

Implementation Resources

SPTW - Social Programs That Work (SPTW). Full list of programs.

Footnotes

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1 Rowlands 2010 - Rowlands S. Social predictors of repeat adolescent pregnancy and focused strategies. Best Practice & Research Clinical Obstetrics Gynecology. 2010;24(5):605-16.

2 Corcoran 2007 - Corcoran J, Pillai VK. Effectiveness of secondary pregnancy prevention programs: A meta-analysis. Research on Social Work Practice. 2007;17(1):5–18.

3 Akinbami 2001 - Akinbami LJ, Cheng TL, Kornfeld D. A review of teen-tot programs: Comprehensive clinical care for young parents and their children. Adolescence. 2001;36(142):381-93.

4 SPTW - Social Programs That Work (SPTW). Full list of programs.

5 Lewin 2016 - Lewin A, Mitchell S, Beers L, Schmitz K, Boudreaux M. Improved contraceptive use among teen mothers in a patient-centered medical home. Journal of Adolescent Health. 2016;59(2):171-176.

6 Stevens-Simon 2001 - Stevens-Simon C, Kelly L, Kulick R. A village would be nice but... It takes a long-acting contraceptive to prevent repeat adolescent pregnancies. American Journal of Preventive Medicine. 2001;21(1):60-65.

Date last updated