Contraceptive knowledge and use of contraception among adolescent mothers participating in the Illinois Subsequent Pregnancy Program

In ten years, 3,000 adolescent mothers, ages 14-18, have participated in the Illinois Subsequent Pregnancy Program (ISPP), a community-based program designed to delay second pregnancies. Only 3% of these young mothers had a second pregnancy while participating in ISPP, and at year-end, 91% reported having no unprotected intercourse in the last month. ISPP is funded by the Illinois Department of Human Services and provides intense training and individual support to diverse populations of adolescents across the state, African American, Caucasian, Mexican and Puerto Rican. To identify factors associated with low rates of second pregnancy among ISPP participants, the current analysis uses four years of program data (2002-2006) to examine short-term changes in contraceptive knowledge (CK) at one month (pretest ( t1) to posttest) and reported use of contraception at 6 months (t2) of program participation. CK test scores increased from 46% to 73% correct after one month of ISPP curriculum training (n=239, paired t-test, p<0.001). Reported use of a contraceptive method at last intercourse increased from 59% to 81%, t1 to t2 (n=124, McNemar χ², p<0.001). Condom use increased from 57% to 73%, t1 to t2 (n=120, McNemar χ², p<0.01). Using logistic regression, a positive CK score change after one month of training increases the likelihood of using a contraceptive method six months later (Odds Ratio=5.5, p<0.05), controlling for CK, use of contraception, age, ethnicity and pregnancy status at t1. Results support the ISPP model and should help inform other programmatic efforts designed to decrease rapid repeat childbearing among adolescents.