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Intensive case management for pregnant & parenting teens

Health Factors: Sexual Activity
Decision Makers: Educators Local Government State Government Grantmakers Healthcare Professionals & Advocates Nonprofit Leaders Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: <1% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

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

Reduced teenage pregnancy
Reduced rapid repeat pregnancies
Increased use of contraception
Improved social networks
Increased academic achievement
Increased graduation rates

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 intervention (Tolma 2014, Blank 2010, Kan 2012, Lewis 2012, McDonell 2007). 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 areas (Blank 2010). A South Carolina-based study indicates that case management programs may also strengthen support networks, improve academic outcomes, and increase graduation rates among black teenage mothers in rural areas (McDonell 2007). Less intensive case management services may not have the same effect on repeat pregnancy rates (Finigan-Carr 2015).

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 education (Rowlands 2010), home visiting (Cochrane-Lopez 2015, Rowlands 2010), and tailored messages are included (Kan 2012), and when programs are presented in individual rather than group formats (Klerman 2004). For case management programs that include home visits, more frequent visits appear to reduce repeat pregnancy more effectively than usual care (Kan 2012, Blank 2010); frequent visits can also increase use of long-acting reversible contraception (LARCs) (Kan 2012).

Implementation

United States

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 settings (Lifeworks-TPS). 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 support (PCC-Tandem).

Citations - Evidence

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. Accessed on April 19, 2017
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. Accessed on April 27, 2017
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. Accessed on April 27, 2017
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. Accessed on April 19, 2017
Klerman 2004 - Klerman LV. Another chance: Preventing additional births to teen mothers. Washington, DC: The National Campaign to Prevent Teen Pregnancy. 2004:1-58. Accessed on April 19, 2017
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. Accessed on April 19, 2017
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. Accessed on April 19, 2017
Rowlands 2010* - Rowlands S. Social predictors of repeat adolescent pregnancy and focused strategies. Best Practice & Research Clinical Obstetrics Gynecology. 2010;24(5):605–16. Accessed on April 19, 2017
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. Accessed on April 27, 2017

Citations - Implementation

Lifeworks-TPS - Lifeworks Youth & Family Alliance. Teen Parent Service (TPS). Accessed on April 19, 2017
PCC-Tandem - People's Community Clinic (PCC). Tandem Teen Prenatal and Parenting Program. Accessed on April 19, 2017

Page Last Updated

April 27, 2017

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