1. Very Young Adolescent Mothers and Delay of a Second Pregnancy
ISPP ™
Very Young Adolescent Mothers and Delay of a Second Pregnancy
Pat W. Mosena, Ph.D.,
Holly S. Ruch-Ross, Sc.D. and Suzanne G. McLone, M.P.H.

2. The Illinois Subsequent Pregnancy Program
ISPP ™
The Illinois Subsequent Pregnancy Program
A community-based program to delay second pregnancies among adolescent mothers.
Begun as pilot project in Chicago 1990, implemented statewide –2007.
Supported by Illinois Department of Human Services
Program Goals:
Delay a second pregnancy
Use contraception correctly and consistently
Remain in and graduate from high school
There have been 3,000 participants in 30 communities
3% had second pregnancy,
85% graduated/remained in school

3. Subsequent Pregnancy Program Model
Community Area
Chicago
Suburbs
Small Cities
Community-Based Social Service Agency
Public Health Departments
Community Health Center
Agency Type
Home Visitor
On-going, long-term relationship with ISPP trained Home Visitor
Year 1
Advisory Group
Young first-time mothers from diverse communities brought together for training and peer support provided at bimonthly Advisory Group meetings
Peer Education
Intensive Summer Training
Eight week summer Peer Education Training. Eligibility based upon attendance at monthly Advisory Group meetings
Continuing Education Training
Ongoing Peer Education training through bimonthly Peer Education meetings
During the second year, ISPP Peer Educators begin to work in their own communities, talking about the “why” and “how” to delay a second pregnancy
Year 2
Subsequent Pregnancy Program Model

4. Illinois Subsequent Pregnancy Program
ISPP ™

5. ISPP Methods ™ Illinois Subsequent Pregnancy Program Data Collection
Program Years 2001 to 2006 (6 Years)
Data Collected and Reported by ISPP Home Visitor
Participant characteristics at intake
Services received by participant during course of program year (monthly reports)
Early Exit from Program*
Data Self-Reported by Participant:
Questionnaire Completed at Year End – Contraceptive Use
Data Analysis
Data Entered into Microsoft Access
Data Imported into and Analyzed Using SPSS 15.0
* Based upon exit form submitted by Home Visitor and/or date of last Home Visitor contact

6. Participant Characteristics, N=1191
Illinois Subsequent Pregnancy Program
ISPP ™
Participant Characteristics, N=1191 n %
Program Year of First-Year Participation (N=1191)
275
23.1
191
16.0
196
16.5
154
12.9
153
12.8
222
18.6
Participant Ethnicity (n=1088)
African American
639
58.7
Mexican/ Mexican American 71
6.5
Caucasian, Not Hispanic
268
24.6
Puerto Rican 48
4.4
Other (Includes Bi- or Multi-Ethnic) 62
5.7
Participant Status at Intake (n=1135)
Parenting
582
51.3
Pregnant
553
48.7

7. Participant Characteristics, N=1191
Illinois Subsequent Pregnancy Program
ISPP ™
Participant Characteristics, N=1191 n %
Participant Lives with Parent(s) (n=1117)
838
75.0
Participant’s Mother was an Adolescent Parent (n=1086)
515
47.4
Participant’s Sibling(s) was an Adolescent Parent (n=1088)
260
23.9
Participant and/or Participant’s Parent(s) Receives:
TANF/AFDC (n=1055)
302
23.1
Medicaid (n=1096)
421
58.7
Social Security/SSI (n=1055) 56
5.3
Family’s Social/Emotional Support to Participant (n=1100)
Rated “Very Good”/”Consistent” by Home Visitor
815
74.1
Father of Child’s Social/Emotional Support to Participant (n=1099)
535
48.7

8. Participant Characteristics, N=1191
Illinois Subsequent Pregnancy Program
ISPP ™
Participant Characteristics, N=1191 n %
School Status at Intake (n=1102)
In School
892
80.9
Not in School
210
19.1
Was Participant Using Contraception at Intake (Non-Pregnant Only)?* (n=448)
Yes
283
63.2 No
165
36.8
Had Participant EVER used Contraception?* (n=775)
752
97.0 23
3.0
Had Participant EVER used a Condom?* (n=573)
494
86.2 79
13.8
* Program Year not included in analysis

9. Participant Characteristics, N=1191
Illinois Subsequent Pregnancy Program
ISPP ™
Participant Characteristics, N=1191
Mean Age of Mother at Program Intake, Years (n=1054)
16.3 (Range: 12 to 22)
Mean Age of Child at Program Intake, Months (n=479)
6.2 (Range: <1 to 49)

10. Services Received by Participant , N=1191
Illinois Subsequent Pregnancy Program
ISPP ™
Services Received by Participant , N=1191 n %
Participant Received Home Visiting Services (N=1191)
Yes
1153
96.8 No 38
3.2
Participant Attended Group Meetings (N=1191)
704
59.1
487
40.9
Mean Number of Home Visitor Contacts (n=1153)
26.4 (Range: 1 to 234)
Mean Number of Group Meetings Attended (n=704)
11.5 (Range: 1 to 75)
Did Participant Complete the Program Year? (n=1133)
760
67.1
373
32.9

11. Participant Outcomes at Year End, n=692*
Illinois Subsequent Pregnancy Program
ISPP ™
Participant Outcomes at Year End, n=692* n %
Participant Either In School or Graduated/Received GED (n=647)
553
85.5
Participant Was Sexually Active in Previous Month (n=664)
475
71.5
Of those sexually active in past month:
Use of Condom at Last Intercourse (n=458)
372
81.2
No Unprotected Intercourse in Last Month (n=445)
409
91.9
Used Contraception Correctly (n=428)
408
95.3
* Number of participants who completed the program year (May 1st or later) and had year-end data on file

12. Very Young Participants: How they Differ from Their Older Counterparts
Illinois Subsequent Pregnancy Program
ISPP ™
Very Young Participants: How they Differ from Their Older Counterparts
Significance levels: *** p<0.001; **p<0.01; * p<0.05; all two-tailed tests.
Fisher’s Exact 2 test statistic used

13. Very Young Participants: How they Differ from Their Older Counterparts
Illinois Subsequent Pregnancy Program
ISPP ™
Very Young Participants: How they Differ from Their Older Counterparts
Significance levels: *** p<0.001; **p<0.01; * p<0.05; all two-tailed tests.
Independent sample t-test statistic used

14. Illinois Subsequent Pregnancy Program
ISPP ™
Bivariate Analyses: School Status and Contraceptive Behavior at Year End by Maternal Age
χ2 statistic used; No significant differences by maternal age

15. Illinois Subsequent Pregnancy Program
ISPP ™
Bivariate Analyses: School Status and Contraceptive Behavior at Year End by Number of Individual Contacts
Individual Contacts
Significance levels: *** p<0.001; **p<0.01; * p<0.05; all two-tailed tests.
Independent sample t-test statistic used

16. Illinois Subsequent Pregnancy Program
ISPP ™
Bivariate Analyses: School Status and Contraceptive Behavior at Year End by Number of Group Meetings Attended
Group Meetings Attended
Significance levels: *** p<0.001; **p<0.01; * p<0.05; all two-tailed tests.
Independent sample t-test statistic used

17. ISPP Key Findings ™ Illinois Subsequent Pregnancy Program
ISPP participants who are very young (age 14 or less) DO NOT differ from older participants (age 15 or older):
On perceived risk variables at program intake
On test scores (pre or post)
At Year–End, ISPP participants who are very young (age 14 or less) DO NOT differ from older participants (age 15 or older) on selected outcomes:
School status
No unprotected sex in last month (sexually active participants)
Use of a condom at last sexual intercourse
Participants who are very young DO differ from older ISPP participants in the amount of services received during program year:
They have MORE individual contacts from their Home Visitor
They attend MORE group meetings

18. Illinois Subsequent Pregnancy Program
ISPP ™
Conclusions
ISPP Home Visitors report that younger participants, those age 14 or less when they enter the program, are more “needy”, and require more of their time and effort than older participants, those age 15 and older at program intake.
Results of the current analysis demonstrate that younger ISPP participants do require more intense service delivery; they have more individual contacts with their Home Visitor and they attend more Group Meetings.
However, with intense service delivery, younger ISPP participants have year-end outcomes consistent with older participants.
These findings support the efficacy of the Subsequent Pregnancy Program Model in meeting the individualized needs and achieving desired outcomes among young mothers participating in ISPP.