Pathways Teen Mother Support Project: Longitudinal findings

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Abstract

This article reports the outcomes for the Pathways Teen Mother Support Project, a randomized field trial of an intensive intervention for low income pregnant and parenting teens in a four-county area of rural South Carolina. 107 treatment group and 90 control group teens were recruited from a variety of sources and randomly assigned to treatment and control conditions, with the treatment group receiving services including case management, support groups, family group decision making, life skills education and training, leadership development, and related services over 24 months. The project's goals were to a) reduce repeat pregnancies; b) increase school retention and graduation; c) reduce substance use; and d) improve well-being. Data were collected at baseline and 6-month intervals over the course of the intervention and were analyzed through mixed effects analysis of variance. The results showed that, compared to the control group, treatment group teens had fewer pregnancies; performed better academically and graduated at higher rates; reduced their marijuana use; were less impulsive; improved their problem solving beliefs; and had more social support, especially from family members. These findings hold promise for designing and implementing community interventions to support pregnant and parenting teens, particularly in rural communities.

Introduction

The Pathways Teen Mother Support Project was a randomized field trial of a comprehensive, community intervention for pregnant and parenting teens in economically distressed communities in several rural South Carolina counties. The project's goals were to a) reduce substance use; b) improve academic achievement; c) reduce repeat pregnancies; and d) improve well-being. The approach taken was to strengthen teens' personal and social competencies; increase support from the teens' immediate and extended family; and increase the role of community social institutions in supporting the teens' success.

The premise underlying the intervention held that the most effective way to support pregnant and parenting teens is by building local capacity, drawing on the inherent strengths of family and community in collaborative problem solving. Young people have tremendous potential to help create a safe and nurturing community and the social, economic, and personal circumstances interfering with that potential are an appropriate target for change. Helping pregnant and parenting teens build capacity to secure their and their family's social and economic well-being, while simultaneously strengthening the capacity of the broader community to support teens and their families, is an important step to a healthy community for everyone.

Pathways helped pregnant and parenting teens by 1) brokering and coordinating supportive services for teens and their children; 2) strengthening family support for the teens' goals through supportive home visits and family group decision making; 3) strengthening peer to peer support through mutual assistance groups and other activities that fostered reciprocal helping; 4) strengthening personal and social competencies through parenting, problem solving, self-management, and interpersonal skills training; and 5) creating opportunities for teens to develop leadership by participating in planning and implementing project activities.

Section snippets

Review of the literature

Although having declined in recent years, the U.S. still has one of the highest teen pregnancy rates among industrialized nations. Each year, nearly a million teens become pregnant, with just over half of these resulting in a live birth. This is a pregnancy rate of 83 out of every 1000 teens ages 15 to 19 (Alan Guttmacher Institute, 2004, Boonstra, 2002, Coley and Chase-Lansdale, 1998).

The social and economic costs of early childbearing are tremendous. Teen mothers often do poorly in school and

The Pathways intervention model

There were five core components to the Pathways model: 1) case management was used as a social support strategy and a means for linking teens and their families with community resources; 2) family group decision making was a means of involving family members in planning for and supporting the teens' goals; 3) mutual assistance groups were a means of building social support and reciprocal helping for teens, and as a vehicle for developing the teens' leadership capacity; 4) life skills education

Attrition analysis

Of the 197 survey participants at baseline, 150 completed the survey at 6-month follow-up, 138 at 12-month follow-up, 137 at 18-month follow-up, and 114 at 24-month follow-up. This is a 42% attrition rate across all data collection points. For each data collection point, a random sample of teens having completed the survey at both baseline and the data point in question was compared to teens not having completed the survey. These results revealed that teens having completed the survey and not

Discussion

The results support the efficacy of the intervention model in reducing substance use and improving educational, family planning, and social well-being outcomes for pregnant and parenting teens living in distressed communities. Especially noteworthy is the reduction in subsequent pregnancies for teens taking part in the intervention. Two previous large-scale initiatives to support teen mothers, the New Chance and Teenage Parent Welfare demonstrations did not show any significant reduction in

Limitations

These findings need to be interpreted with caution on several counts. Teens were not drawn randomly from the population of pregnant and parenting teens in the project's service area, introducing bias to the sample. Another source of bias is found in the racial composition of the sample. Available data show that about half of the pregnant and parenting teens in the project's target area were White and half African–American (South Carolina State Budget and Control Board, 2000), yet just over 90%

Conclusions

The outcome findings from the Pathways Project are fairly robust, even in light of the limitations noted, supporting the efficacy of the intervention model in helping pregnant and parenting teens from distressed rural communities meet their social and educational goals. Teens taking part in the intervention continued in school and caught up on education missed as a result of early parenting. They also reduced some risk behaviors, allowing the teens to become more focused on their goals. These

Acknowledgements

This research was supported by grant number # SPO8239 from the Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, U. S. Department of Health and Human Services.

The authors wish to acknowledge Sylvia Barr; Nekeisha Bennett; Labonta Fulton; Lisa Phelan, M.S.W.; and Cecilia Wragg, project staff members; the teens and their families who participated in the project; and the community partners who supported the work.

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