Evaluation of the Oklahoma City Promise Place Program for pregnant and parenting teens: A school-based intervention with a focus on case management

Background: The NorthCare Promise Place Program (PPP), funded by the Office of Adolescence Pregnancy Programs (OAPP), provided case management services to pregnant and parenting teens in an Oklahoma City high school. Program goals were to decrease repeat teen-pregnancy rates, improve graduation rates, and improve health outcomes for participants and their babies. Methods: A quasi-experimental design was employed to assess intervention effectiveness. A total of 203 students in grades 7-12 from the intervention and comparison schools participated in the study (140 intervention, 63 comparison). Enrollment was continuous with a follow-up period up to 2 years and an overall retention rate of 53%. Annual focus groups were conducted with intervention participants. Rigorous process evaluation was employed throughout the intervention. Effectiveness measures included the “AFL” (Adolescent Family Life) Questionnaire, as required by OAPP. Data analysis included Chi-square or Fisher's exact tests for categorical measures, and a log-rank test for time-to-event distributions. Results: Both qualitative and qualitative research indicated that the PPP had a positive impact upon students in the intervention group. First, the time to repeat pregnancy was delayed among participants in the intervention school compared to the comparison school (p<0.0001). Second, there were reduced drop-out rates among parenting teens (15% vs. 55%, p=0.0064) and finally, pregnant intervention teens were also less likely to deliver before 36 weeks (10% vs. 27%, p=0.049). Conclusion: PPP is effective in delaying repeat pregnancies, facilitating graduation and promoting healthy outcomes. Case management through Family Advocates is a promising approach to decrease repeat teen-pregnancy rates.