Grant Recipient: Mathematica
Principal Investigators: Brian Goesling, Ph.D., Mathematica
Term: 2019 –2021
Summary: This project is a long-term follow-up of a randomized controlled trial (RCT) of Teen Options to Prevent Pregnancy (T.O.P.P.) — a program for low-income adolescent mothers, delivered by nurse educators and a social worker, which aims to reduce rapid repeat pregnancy and promote healthy birth spacing.
The T.O.P.P. program was evaluated in a well-conducted RCT with a sample of 598 low-income adolescent mothers (ages 10 to 19) who were randomly assigned to either receive the T.O.P.P. program or to a control group that did not receive the program. The study found that T.O.P.P. produced large, statistically significant reductions in the likelihood of rapid repeat pregnancies and births in the 18 to 30 months after random assignment. For the full sample, the program reduced the rate of repeat pregnancy during the 18 months after random assignment by about half (21% for the T.O.P.P. group vs. 39% for the control group). For the subsample of mothers ages 18 or 19 at the start of the program for whom the study obtained state birth records, the program reduced the rate of new births during the 30 months after random assignment by about one-third (24% for the T.O.P.P. group vs. 36% for the control group). Both effects were statistically significant.
Under this project, the researchers will extend follow-up using administrative records to determine whether T.O.P.P. produces impacts on the primary outcome of repeat births over a longer period (four years after random assignment). The researchers will also determine whether T.O.P.P. produces downstream impacts on mothers’ education, employment, earnings, and public assistance benefit receipt (Medicaid, SNAP, WIC, and TANF) four years after random assignment.