PURPOSE: This study evaluated the effectiveness of a secondary teen pregnancy prevention intervention that includes school-based social work services coordinated with comprehensive health care for teen mothers and their children. METHODS: A prospective cohort study compared subsequent births to teen mothers followed for at least 24 months or until age 20 years (whichever was longer) compared with matched subjects from state data. Analyses were based on intent to treat and included chi(2), survival, and cost-benefit analysis. RESULTS: Subjects included 63 girls (97% eligible, 99% African-American, mean age 16 years). A propensity-matched comparison group (n = 252) did not differ from subjects. Participation in program components was good: (1) group meetings: 76%; (2) case management: 95%; (3) coordinated medical care: 63%. The majority of subjects used contraception (93%), with greater use of medroxyprogesterone associated with participation in coordinated medical care (80% vs. 50%, p = .0145). Subsequent births were more common in the comparison group (33%) than among subjects (17%) (p = .001), and survival curves were significantly different (p = .007) (hazard ratio = 2.5). There was a trend toward fewer births with increased participation in medical care (p = .08) and case management (p = .08) but not with group meetings. Cost savings were calculated as $19,097 per birth avoided or $5,055 per month. CONCLUSIONS: The intervention was effective in reducing subsequent births to teens; however selection bias of school enrollment cannot be excluded by this study. The cost savings of delayed births outweigh the expenses of this intensive model.
PURPOSE: This study evaluated the effectiveness of a secondary teen pregnancy prevention intervention that includes school-based social work services coordinated with comprehensive health care for teen mothers and their children. METHODS: A prospective cohort study compared subsequent births to teen mothers followed for at least 24 months or until age 20 years (whichever was longer) compared with matched subjects from state data. Analyses were based on intent to treat and included chi(2), survival, and cost-benefit analysis. RESULTS: Subjects included 63 girls (97% eligible, 99% African-American, mean age 16 years). A propensity-matched comparison group (n = 252) did not differ from subjects. Participation in program components was good: (1) group meetings: 76%; (2) case management: 95%; (3) coordinated medical care: 63%. The majority of subjects used contraception (93%), with greater use of medroxyprogesterone associated with participation in coordinated medical care (80% vs. 50%, p = .0145). Subsequent births were more common in the comparison group (33%) than among subjects (17%) (p = .001), and survival curves were significantly different (p = .007) (hazard ratio = 2.5). There was a trend toward fewer births with increased participation in medical care (p = .08) and case management (p = .08) but not with group meetings. Cost savings were calculated as $19,097 per birth avoided or $5,055 per month. CONCLUSIONS: The intervention was effective in reducing subsequent births to teens; however selection bias of school enrollment cannot be excluded by this study. The cost savings of delayed births outweigh the expenses of this intensive model.
Authors: Joanne E Cox; Matthew P Buman; Elizabeth R Woods; Olatokunbo Famakinwa; Sion Kim Harris Journal: Am J Public Health Date: 2012-08-16 Impact factor: 9.308
Authors: John P Elder; Willo Pequegnat; Saifuddin Ahmed; Gretchen Bachman; Merry Bullock; Waldemar A Carlo; Venkatraman Chandra-Mouli; Nathan A Fox; Sara Harkness; Gillian Huebner; Joan Lombardi; Velma McBride Murry; Allisyn Moran; Maureen Norton; Jennifer Mulik; Will Parks; Helen H Raikes; Joseph Smyser; Caroline Sugg; Michael Sweat; Nurper Ulkuer Journal: J Health Commun Date: 2014
Authors: Rehana A Salam; Anadil Faqqah; Nida Sajjad; Zohra S Lassi; Jai K Das; Miriam Kaufman; Zulfiqar A Bhutta Journal: J Adolesc Health Date: 2016-10 Impact factor: 5.012