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AIM for Teen Moms is an adaptation of an evidence-based teen pregnancy prevention program designed to increase contraception use and reduce rapid repeat pregnancy by helping adolescents define goals for themselves as adults and identify steps for how to achieve those goals. It is unique in its basis in the Theory of Possible Selves and engages parenting teen mothers in planning for the future around a desired career goal. We tested whether key theory-based mediators directly targeted by the intervention were measured well in this population, and whether they mediated intervention effects on one of the primary outcomes, sex without effective birth control, at short-term (12 month) follow up.
First, we examined the performance of measures of identity development status of participants. Factor analyses showed that, for this population of teen mothers, items in the Ego-Identity measure, which were originally designed to divide identity status into 4 stages, clustered into just 2 stages, renamed “Questioning” and “Answered.” Both had response options of 1=strongly agree, 2-5= unlabeled scale points, 6=strongly disagree. Cronbach’s alphas were .63, .70, .73 and .75 for Questioning and Answered at baseline and 12 month follow up, respectively. Second, we examined measures of “Promotion” and “Prevention” regulatory focus orientation to problem solving. Promotion measures a person’s focus on pursuing positive outcomes, while Prevention measures a focus on avoiding negative outcomes. Both had response options as above. Factor analyses showed that, for this population, items clustered into the original subscale definitions, with Cronbach’s alpha of .77, .89, .79 and .73 for the Promotion and Prevention scales at baseline and 12-month follow up, respectively.
Finally, we assessed whether each of these four theoretically-derived scales actually mediated the effect of the intervention on reducing incidents of sex without effective birth control at the 12 month follow up. To assess this we used the product of coefficients Sobel test based on a series of logistic regression analyses. Results showed that Questioning status was a statistically significant (p=.04) mediator, accounting for 13.3% of the total intervention effect. The other three constructs were not statistically significant mediators, although Prevention orientation to problem solving was significantly impacted by the intervention, but not related to the outcome. These results suggest the identity development portion of the intervention should be an area of focus with this population of teen moms.