Developing and Evaluating Pregnancy Prevention Programs for Teen Moms: Recruitment, Implementation, and Retention

Introduction: Recruitment and retention offer some of the greatest challenges to evaluating and implementing prevention programs, particularly in ongitudinal evaluations with vulnerable populations. In recruitment, evaluators must not only convince intended participants to agree to participate in a study, but they also must locate them and obtain access to them. Furthermore, retention in evaluation activities becomes more challenging the longer they go on. Tracking study participants for one or more years often takes a tremendous amount of resources. Parenting teens represent a vulnerable but important population to study. Often these teens live in extreme poverty, are transient, lack consistent phone numbers, are overwhelmed with their responsibilities, and can face additional challenges like substance use, mental illness, or gang affiliation.  They also may have parents or partners in their lives who do not support (and may even hinder) their participation in a study.  Often these issues also must be addressed to keep the teens in programs and ensure their effectiveness. This presentation will describe the challenges faced in recruiting, tracking, and retaining new teen moms in a program in some of the highest poverty areas in Los Angeles County, and how we were successful in overcoming challenges to recruit 950 teens. Strategies presented will include partnering with key agencies, developing clear protocols, training and monitoring field staff, preventing tracker burn out, and maintaining safety in field work.

Methods: The program was an individualized intervention delivered in the teen’s home. Teen names and contact information were provided by agencies working with teen mothers and passed on to field staff who were responsible for locating the teen, securing study consent, and collecting baseline survey data, tracking teens, and collecting follow-up survey data. Data were collected via ACASI software at baseline and 12-months after baseline, are currently being collected at 24- and 36-months post baseline and are planned for 48-months post baseline. Teens randomized into the prevention program received 7 individual and 2 group sessions that were developed to specifically address characteristics of teen moms.

Results: We successfully recruited 950 teens, and attained approximately an 85% follow-up rate at the 12-month follow-up, with nearly 80% retention as we near the end of our 24-month follow up. Our process for recruitment and retention has included the use of trained field staff, monthly contact with the teen moms, a database system that allows for real-time monitoring of tracking, and a partnership with several local case management programs that serve some of the teens. We will present our insight and lessons on what types of tracking activities worked and didn’t work.  The presentation will be relevant to and provide information to enhance the practice of anyone conducting a longitudinal evaluation, especially with hard to track populations.