Intensive case management for pregnant & parenting teens

Evidence Rating  
Some Evidence
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  

Case management initiatives for pregnant or parenting teens provide participants with a range of services based upon their needs. Caseworkers may provide support and counseling, assist in creating plans for goals such as finishing high school, work to create support networks among a teen’s family, friends, and partner, or connect teen parents to health care or social services. Case management typically takes place in schools or other community locations, and may be incorporated into dropout prevention programs for teenage mothers.

Expected Beneficial Outcomes (Rated)

  • Reduced teen pregnancy

  • Reduced rapid repeat pregnancies

Other Potential Beneficial Outcomes

  • Increased use of contraception

  • Improved social networks

  • Increased academic achievement

  • Increased high school completion

Evidence of Effectiveness

There is some evidence that intensive case management reduces repeat pregnancies among black and Hispanic adolescent mothers while they participate in the intervention1, 2, 3, 4, 5. Additional evidence is needed to confirm longer term effects and determine which aspects of case management are most effective.

Case management services provided by culturally matched, school-based social workers combined with comprehensive health services and peer education have been shown to reduce repeat pregnancies among black adolescents in urban areas2. A South Carolina-based study indicates that case management programs may also strengthen support networks, improve academic outcomes, and increase high school completion rates among black teenage mothers in rural areas5. Less intensive case management services may not have the same effect on repeat pregnancy rates6.

Research suggests that programs to reduce repeat pregnancy among pregnant and parenting teens are more likely to be effective when easy access to services, contraceptive education7, home visiting7, 8, and tailored messages are included3, and when programs are presented in individual rather than group formats9. For case management programs that include home visits, more frequent visits appear to reduce repeat pregnancy more effectively than usual care2, 3; frequent visits can also increase use of long-acting reversible contraception (LARCs)3.

Impact on Disparities

Likely to decrease disparities

Implementation Examples

Lifeworks’ Teen Parent Services and the Tandem Teen Prenatal and Parenting Program provide comprehensive case management services for teenage parents in Austin, Texas. Lifeworks is a nonprofit offering comprehensive social services for youth and families; their Teen Parent Service offers case management, connections to community resources, parenting groups, and support in school and community settings10. Tandem is an interagency collaboration led by People’s Community Clinic that provides pregnant and parenting teens and their children with medical, mental health, education, vocational, and social support11.

Footnotes

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1 Tolma 2014* - Tolma EL, Stoner JA, McCumber M, et al. Longitudinal evaluation of a teenage pregnancy case management program in Oklahoma. Journal of Family Social Work. 2014;17(5):457-479.

2 Blank 2010* - Blank L, Baxter SK, Payne N, Guillaume LR, Pilgrim H. Systematic review and narrative synthesis of the effectiveness of contraceptive service interventions for young people, delivered in educational settings. Journal of Pediatric and Adolescent Gynecology. 2010;23(6):341-51.

3 Kan 2012* - Kan ML, Ashley OS, LeTourneau KL, et al. The adolescent family life program: A multisite evaluation of federally funded projects serving pregnant and parenting adolescents. American Journal of Public Health. 2012;102(10):1872-8.

4 Lewis 2012* - Lewis CM, Faulkner M, Scarborough M, Berkeley B. Preventing subsequent births for low-income adolescent mothers: An exploratory investigation of mediating factors in intensive case management. American Journal of Public Health. 2012;102(10):1862-5.

5 McDonell 2007* - McDonell JR, Limber SP, Connor-Godbey J. Pathways teen mother support project: Longitudinal findings. Child and Youth Services Review. 2007;29(7):840-55.

6 Finigan-Carr 2015* - Finigan-Carr NM, Murray KW, O’Connor JM, et al. Preventing rapid repeat pregnancy and promoting positive parenting among young mothers in foster care. Social Work in Public Health. 2015;30(1):1-17.

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

8 Cochrane-Lopez 2015* - Lopez LM, Grey TW, Hiller JE, Chen M. Education for contraceptive use by women after childbirth. Cochrane Database of Systematic Reviews. 2015;(7):CD001863.

9 Klerman 2004 - Klerman LV. Another chance: Preventing additional births to teen mothers. Washington, DC: The National Campaign to Prevent Teen Pregnancy. 2004:1-58.

10 Lifeworks-TPS - Lifeworks Youth & Family Alliance. Teen Parent Service (TPS).

11 PCC-Tandem - People's Community Clinic (PCC). Tandem Teen Prenatal and Parenting Program.

Date Last Updated