Effects of intensive case management for pregnant and parenting adolescents on subsequent birth rate, social support, anxiety, and depression

The LifeWorks Care Demonstration Project is an intensive case management (ICM) collaboration among five agencies that utilizes a resiliency-based / developmental assets approach to serve low-income, pregnant and parenting adolescents. Viewing the case manager-client relationship as a developmental asset, this study examined the effects of ICM on anxiety, depression, social support and subsequent births. It was expected that there would be a significantly lower two-year subsequent birth rate for ICM versus a comparison group (CG), a significant decrease in reported depression and anxiety, and a significant increase in social support for adolescents in ICM over a six-month time period. A quasi-experimental, two-group, repeated measures design was implemented. Participant (n=98) were as follows: 16.7 years (sd=1.7), 86% Latina, 80% enrolled or completed school, and 54% pregnant. Dependent t-tests were conducted to assess change over time for both groups. A two-tailed Z-test for proportions was used to assess differences in two-year subsequent birth rates. First and six-month assessments were completed by 46 ICM clients and 19 CG members. ICM clients were younger, more often pregnant, and more often in school or had graduated at first assessment. There was a statistically significant increase for social support for ICM and no significant change for CM on any measure. The Z-test for proportions between ICM (9.4% had a birth within two years of eldest child) and the CG (28.6%) approached significance. Results supported the hypothesis that ICM fosters social support among pregnant and parenting adolescents and suggested positive effects for delaying subsequent births.