Evaluating service delivery models for pregnant adolescents

Because programs for pregnant adolescents and teenage parents were developed locally, with little federal or state direction, no standard model of service delivery exists. Programs vary in degree of comprehensiveness and in primary location--hospital, school, social agency, or other. A common assumption, however, has been that multi-service programs providing health, educational, and social services have a greater impact on their participants than programs offering only one of these services. The study reported here tested this assumption by comparing the medical course and subsequent life histories of school-age mothers who participated in a comprehensive program during the prenatal period with those of young mothers who received only health-related services from a hospital in the same city. The relative impact of the two programs was examined controlling for social factors such as age, race, and socioeconomic status. With the exception of post-delivery educational status, the two study groups had similar medical and social outcomes. The educational difference, however, could not be attributed solely to the impact of the comprehensive program because of variations in educational status prior to entering the two programs. This study suggests that the comprehensive and hospital programs, with their unique emphases, served different groups of clients. The "goodness of fit" which existed between the program and clients demonstrates the need for multiple models of delivering services to school-age parents.