Dana Rotz1, Menbere Shiferaw2, Robert G Wood3. 1. Wayfair, Inc., 4 Copley Place, Boston, MA, 02116, USA. DRotz@wayfair.com. 2. Mathematica, 1100 First St NE #1200, Washington, DC, 20002, USA. 3. Mathematica, 600 Alexander Park Dr., Princeton, NJ, 08540, USA.
Abstract
INTRODUCTION: A small but growing body of evidence suggests individualized support services and improved access to contraception can promote healthy birth spacing among adolescent mothers. This study examines the effectiveness of Steps to Success, a 2-year home visiting program in San Angelo, Texas, enhanced with content designed to reduce rapid repeat pregnancy among young mothers, increase fathers' involvement, and support mothers' education and career aspirations. METHODS: The study used a randomized controlled trial, with 594 young mothers ages 14-20 randomly assigned to either a program group that received Steps to Success or a control group that received an existing home visiting program focused only on parenting and child development. Women in both research groups completed a baseline survey upon enrolling in the study and 1- and 2-year follow-up surveys. RESULTS: After 2 years, participants in the Steps to Success and existing home visiting groups had similar rates of repeat pregnancy. However, women in the Steps to Success group were more likely to use long-acting reversible contraceptives (effect size = 0.18, p = 0.066), particularly younger adolescent mothers ages 14-18 (effect size = 0.34, p = 0.010). Steps to Success also decreased the incidence of unprotected sex for younger adolescent mothers (effect size = -0.25, p = 0.035). Steps to Success did not improve outcomes in other domains. DISCUSSION: Steps to Success improved some outcomes related to healthy birth spacing among younger adolescent mothers. Communities interested in similar programming may want to consider focusing their services on this age group.
INTRODUCTION: A small but growing body of evidence suggests individualized support services and improved access to contraception can promote healthy birth spacing among adolescent mothers. This study examines the effectiveness of Steps to Success, a 2-year home visiting program in San Angelo, Texas, enhanced with content designed to reduce rapid repeat pregnancy among young mothers, increase fathers' involvement, and support mothers' education and career aspirations. METHODS: The study used a randomized controlled trial, with 594 young mothers ages 14-20 randomly assigned to either a program group that received Steps to Success or a control group that received an existing home visiting program focused only on parenting and child development. Women in both research groups completed a baseline survey upon enrolling in the study and 1- and 2-year follow-up surveys. RESULTS: After 2 years, participants in the Steps to Success and existing home visiting groups had similar rates of repeat pregnancy. However, women in the Steps to Success group were more likely to use long-acting reversible contraceptives (effect size = 0.18, p = 0.066), particularly younger adolescent mothers ages 14-18 (effect size = 0.34, p = 0.010). Steps to Success also decreased the incidence of unprotected sex for younger adolescent mothers (effect size = -0.25, p = 0.035). Steps to Success did not improve outcomes in other domains. DISCUSSION: Steps to Success improved some outcomes related to healthy birth spacing among younger adolescent mothers. Communities interested in similar programming may want to consider focusing their services on this age group.
Authors: Brittni N Frederiksen; Maria I Rivera; Katherine A Ahrens; Nikita M Malcolm; Anna W Brittain; Julia M Rollison; Susan B Moskosky Journal: Am J Prev Med Date: 2018-11 Impact factor: 5.043
Authors: Anne Duggan; Elizabeth McFarlane; Loretta Fuddy; Lori Burrell; Susan M Higman; Amy Windham; Calvin Sia Journal: Child Abuse Negl Date: 2004-06