Implementing a Home Visiting Program in Texas Designed to Reduce Repeat Pregnancies

Implementing a Home Visiting Program in Texas Designed to Reduce Repeat Pregnancies

New brief summarizes findings from Steps to Success
Jan 29, 2018

Young women who have already had a baby account for one in six teen births. Rapid repeat pregnancies can adversely affect young mothers and their children, building barriers to their future success. A small but growing body of research suggests that programs for adolescent mothers, particularly those that promote long-acting reversible contraceptives (LARCs), can reduce the risk of rapid repeat pregnancy. An evaluation of Steps to Success—a home visiting program for adolescent mothers that offers counseling on contraception, adequate birth spacing, parenting, and child development—aims to build on this growing body of research.

A new brief summarizes the key findings on implementing Steps to Success in San Angelo, Texas. The program is being operated as part of a research study in which young mothers are randomly assigned to receive one of two home visiting interventions: Steps to Success or a traditional program focused on parenting and child development. The brief draws on a previously published report and is part of a multicomponent evaluation of the Personal Responsibility Education Program (PREP), led by Mathematica for the Administration for Children & Families at the U.S. Department of Health and Human Services. PREP provides federal funding to educate youth on abstinence and contraception.

The brief summarizes three key aspects of implementing Steps to Success:

  • Steps to Success in San Angelo, Texas was designed to address repeat pregnancy among adolescent mothers by supplementing a traditional home visiting model with counseling on contraception and adequate birth spacing; instruction on father involvement, coparenting, and relationship skills; and guidance on education and career planning. Steps to Success offers weekly visits with families for a longer period than the traditional program and places a high priority on engaging fathers in home visits as appropriate.
  • The participant population was primarily adolescent mothers who were Hispanic, English-speaking, 18 or older, and in a romantic relationship with the baby’s father at program entry. About 4 in 10 were pregnant when they entered the study; the rest were recruited within a few months of the birth of their baby. Poverty and limited social support networks were common among participants.
  • The Steps to Success differences showed the program provided substantially more support than the traditional home visiting program offered to the control group, 20 versus 12 home visits, on average, during families’ first year in the program. These additional visits gave Steps to Success home visitors time to cover the program’s additional content. Steps to Success also engaged more fathers in home visits than the traditional home visiting program did.

Future reports, scheduled for release in 2018 and 2019, will examine the effects of Steps to Success—relative to the traditional home visiting program offered to the control group—on participating mothers’ contraceptive use, subsequent pregnancies, and other outcomes one and two years after they enrolled in the program.