Background: Teen childbearing is associated with adverse outcomes for both mothers and children, and teens who have a repeat birth are at risk for additional adverse outcomes. Secondary teen pregnancy prevention has become a public health goal, but no specific intervention has emerged as a standard model. We examined the effect of a primary care medical home intervention on rapid repeat pregnancies in teen mothers. Methods: We compared teen mothers enrolled in the intervention with a cohort of demographically similar teen mothers enrolled in standard primary care. Data were collected in-person with 150 African American teen mothers at baseline (child age 2 months) and two follow-ups (child age 12 and 24 months). Results: Intent-to-treat analyses indicated that significantly fewer mothers in the intervention had repeat pregnancies by 24 months (29% vs. 49%; p=0.04). Mothers in the intervention group were more likely to use contraceptives at 12 months (OR=3.18; p=0.02) and at 24 months (OR=2.48; p=0.02) when controlling for baseline use. Bivariate analyses indicated that intervention mothers had steady use of contraception over time, but there was a decline in use among comparison mothers, suggesting that the intervention prevented contraceptive discontinuation. Additional analyses will compare data on program costs to program benefits. Conclusions: This patient-centered medical home intervention is an innovative and effective model for preventing rapid repeat pregnancies among teen mothers. This model of care can easily be integrated into existing primary care settings in order to best support this vulnerable population of mothers and children.