Preventing Subsequent Births for Low-Income Adolescent Mothers: An Exploratory Investigation of Mediating Factors In Intensive Case Management
Methods. Using a quasi-experimental design, comparisons were made for low-income adolescent mothers receiving ICM (n=55) for at least six months (m=2.25 yrs, sd=0.97) versus a similar group of low-income adolescent mothers not in case management (n=32). Using SPSS and MPLUS, chi-square and path analyses were used to test two hypotheses, respectively: 1) ICM will reduce the likelihood of subsequent births to adolescent mothers, and 2) birth control and perceived social support, when controlling for age and head of household, will mediate the relationship between the intervention and subsequent births.
Results. Adolescents in the ICM group (16%) were significantly less likely to have a subsequent birth within three years of the previous birth than the comparison group (32%), but birth control and perceived social support did not appear to be mediators for the intervention. The only significant finding in the path analysis was between birth control and subsequent births. A post hoc analysis found a significant difference in reported birth control between adolescents who had a subsequent birth and adolescents who did not have a subsequent birth (χ2= 4.138, df= 1, p=0.048). Specifically, adolescents who experienced a subsequent birth were less likely to report using birth control.
Implications. This study suggests that ICM may be effective in preventing subsequent births for low-income adolescents. These findings also suggest that enhanced provision of birth control, perhaps in coordination with health care providers, could result in significant reductions in subsequent births to adolescent mothers. However, specific mechanisms of action for decreasing the likelihood of subsequent births within ICM programs require further investigation. Anecdotally, qualitative interviews with adolescents in this project suggested that intentionality of family formation, or the mother’s desire to have another child, may also be a salient factor in the occurrence of subsequent births. Future research should address relationships between intentions, behaviors, and subsequent births for adolescent mothers in order to delineate and inform social support programs.