Longer-Term Educational Impacts of a Program to Promote Healthy Birth Spacing Among Adolescent Mothers

Among programs designed to reduce teen pregnancy, few evidence-based interventions specifically aim to reduce repeat pregnancies. Repeat pregnancies among adolescent mothers, however, are both prevalent and consequential. About one-sixth of births to adolescent mothers are repeat births. Compared to adolescent mothers with only one child, those with more than one face increased health risks and greater long-term difficulties related to educational and economic outcomes.

Teen Options to Prevent Pregnancy (TOPP) is an 18-month multicomponent program to delay repeat teen pregnancy among adolescent mothers. Developed by staff from the OhioHealth hospital system and Nationwide Children’s Hospital in Columbus, Ohio, TOPP features personalized contraceptive counseling by nurses trained in motivational interviewing (MI), along with access to a contraceptive clinic and transportation and social worker assistance. Beginning in 2011, Mathematica collaborated with staff from OhioHealth and the Nationwide Children’s Hospital to conduct a randomized controlled trial (RCT) of TOPP with 598 adolescent mothers with low incomes. Based on follow-up surveys conducted 6 and 18 months after study enrollment, as well as state birth records collected for up to 30 months after enrollment, this initial RCT found that TOPP significantly reduced the chances of study participants having a repeat pregnancy or subsequent birth, and increased their chances of using long-acting reversible contraception.

This present study builds on these results by examining the longer-term impacts of TOPP on participants’ educational outcomes. As mentioned above, repeat births among adolescent mothers are linked to greater difficulties in attending or completing school, which might hinder their ability to achieve economic self-sufficiency later in life. This study examines whether TOPP impacted mothers’ enrollment and persistence in postsecondary education over a period of up to eight years after starting the program, using college enrollment data from the National Student Clearinghouse.