A study of social and health outcomes among teenage mothers in North Carolina's adolescent parenting program.

다국어 초록 (Multilingual Abstract)

This dissertation estimates the likely impact of North Carolina's Adolescent Parenting Program (APP), a statewide case management program for first-time pregnant and parenting adolescents. The dissertation presents three distinct studies of two complementary samples of teenage mothers in APP. The first study follows 445 APP participants who entered the program during 2000–2001, and uses APP case management information and birth records to examine the teenage mothers' length of program involvement, birth-related outcomes, and subsequent teen births. Outcomes for APP participants are compared with first-time teenage mothers who did not participate in APP. This first study also explores teenage mothers' changes in health behaviors and parenting knowledge and attitudes after one year of APP participation for a subset of pregnant and parenting adolescents who completed pretest and posttest questionnaires. The second study examines birth outcomes and subsequent births for 1,260 former participants who were involved in APP during 1991–1998. Outcomes are compared between the APP teenage mothers and a comparison group of first-time teenage mothers who did not participate in APP. The third study uses the 1991–1998 APP sample and comparison group from the second study to assess the teenage mothers' involvement with the social services system. Teenage mothers' welfare participation and substantiated reports of child maltreatment for their children are examined. Findings from the three studies provide evidence supporting APP's positive influence on the teenage mothers who participated in the program. Each study in this dissertation contributed an informative piece to the general research aim, and together, the three studies generated credible estimates of the overall impact of the APP program. In general, teenage mothers who received APP case management services did as well as or better than teenage mothers who did not participate in APP, even though APP mothers appeared to have more risk factors for untoward outcomes. Study implications point to the importance of using program dosage and services information for program evaluation. Social work case management and direct services can be instrumental in helping adolescent mothers prepare for the difficult transition to parenting.