Further Research, Evidence-Based Interventions Needed to Aid Pregnant and Parenting Teens

RESEARCH TRIANGLE PARK, N.C. – Support programs for teen parents and their children can help facilitate education, behavior change and access to resources, but more work is needed to meet the needs of this population, according to a series of new articles, two of which were coauthored by researchers at RTI International.

Teen parents and their children are at increased risk for a variety of negative social, economic and health outcomes, including lower rates of educational attainment, a higher likelihood of dependence on public assistance, and short- and long-term health problems.

The series, published in the October issue of the American Journal of Public Health, focuses on ways to address these and other issues related to pregnant and parenting adolescents. Researchers from RTI helped coordinate the series and led two of the studies that were included.

One of the RTI-led papers evaluated the effectiveness of the federally funded Adolescent Family Life program, which offered support care demonstration projects to develop, implement and evaluate interventions for pregnant and parenting teens, their infants, young fathers and/or male partners, and extended families.

According to the study, the program helped lower repeat teen pregnancies, increased contraceptive use among teen mothers and facilitated routine child care.

Researchers surveyed more than 1,000 pregnant and parenting teens enrolled in 12 Adolescent Family Life demonstration projects in 10 states. About half of the teens were enrolled in the projects’ standard core services; the others received the projects’ enhanced care services.

As part of standard core services, teens were provided education about problems associated with teen premarital sex, counseling and referral for family planning services, prenatal and postnatal care, nutrition information and counseling, and screening and treatment of sexually transmitted infections.

The enhanced care services included home visits, case management, school-based activities, mentoring and child care services during project activities. These activities were primarily delivered in participants’ homes, schools and health clinics.
Teens who received enhanced care were about 1½ times more likely to use long-acting contraception (including intra-uterine devices, contraceptive implants or injectable contraception) and were less than half as likely to have a repeat pregnancy within 12 months of when they entered the program than teens who received standard care. 

“Federally funded efforts like the Adolescent Family Life demonstration projects can improve outcomes for teen mothers,” said Olivia Silber Ashley, Dr.P.H., a senior public health scientist at RTI and the project’s principal investigator. “Our results demonstrate that the program made a difference for these young people.”

Another paper in the series, written by researchers from RTI and the U.S. Department of Health and Human Services, called for additional rigorous evaluations of intervention programs for teen parents and their families. Such evaluations, they said, could help inform program planners about what components are effective under what conditions and guide related policy decisions.

The researchers conducted an assessment of peer-reviewed articles that evaluated intervention programs aimed at teen parents. After analyzing 15 years’ worth of articles, they found only 14 with sufficient study quality to be included in the review.

“Focused efforts are still needed to provide pregnant and parenting adolescents with appropriate, high-quality services,” said Barri Burrus, Ph.D., director of RTI’s Primary Prevention Research and Evaluation program and one of the paper’s authors. “Unfortunately, the evidence needed to inform such interventions is limited because relatively few rigorous program evaluations and replications have been conducted.”

According to the paper, logistical difficulties, program delivery challenges and lack of funding are contributing factors to the absence of scientific evaluations of such programs.

The authors also note that the usefulness of the studies included in their review was further limited because of inconsistencies in how results are reported, making it difficult to compare the effects from one study to another.