Intensive care reduces teenage pregnancy risk

Researchers in Oregon have discovered that an evidence-based foster care program designed to help young delinquents, also has an effect on teenage pregnancy rates. 

The team from the Oregon Social Learning Center compared the progress of girls in standard state care, with that of others who received Multidimensional Treatment Foster Care (MTFC), a program developed to reduce antisocial behavior. 

Over the course of the study, girls in group care were found to be two and a half times more likely to become pregnant, even after making statistical adjustments to take into account their criminal and sexual history.  

Teenagers receiving MTFC are placed in a “treatment foster family” where a positive, consistent and structured environment is provided to encourage pro-social and age-appropriate behavior. The program includes training, therapy and support for children and family.

Although the girls in group care were regularly separated from boys and spent more time under lock and key, they were still more likely to get pregnant than those receiving MTFC who were fostered in the community, attended public schools and generally led more everyday lives.

Reported in in the Journal of Consulting and Clinical Psychology, the study draws on data from two randomized controlled trials of MTFC that took place between 1997 and 2006.

Numbers were small so the statistical findings are rather fragile, but they indicate that girls receiving group care were more likely to get pregnant if they had a history of antisocial behavior. In the case of those who received MTFC there was no evidence of that link or susceptibility. 

Because these findings suggest that the foster care program influenced both behavior and pregnancy through similar pathways, they may have implications for the design of future prevention programs, say authors David Kerr, Leslie Leve and Particia Chamberlain.

Rather than targeting narrowly defined problems, they advise that “altering general developmental pathways that lead to a host of negative outcomes might be more effective”.

Other attempts to lower teenage pregnancy rates have frequently fallen flat. Sex education curricula, for example, have failed to have much effect. The Oregon work lends support to findings elsewhere that general behavioral approaches may me more useful.

The study looked at 166 girls aged 13-17 already living in state care. When they entered treatment none of them was pregnant, but all had recently been in contact with the criminal justice system.

The research team collected data on the girls before they were allocated to either MTFC or group care, and then at least three times at intervals over the next two years.  

At the outset, information was collected about their criminal histories (based on police records and court data), and the girls were asked about their sexual activity. Reports of pregnancy were recorded over the course of the two years based on interviews with the girls and their caregivers. 

See:
Kerr D, Leve L and Chamberlain P (2009), “Pregnancy Rates Among Juvenile Justice Girls in Two Randomized Controlled Trials of Multidimensional Treatment Foster Care”, Journal of Consulting and Clinical Psychology, 77, 3, pp 588-593