Adolescent Parenting Program (APP)
About This Program
Target Population: First-time pregnant and parenting youth aged 12 to 19 years old, and who must be enrolled in school or a GED-completion program and their children ages birth to 5 years old.
For children/adolescents ages: 0 – 5
For parents/caregivers of children ages: 0 – 5
Program Overview
APP provides support to first-time pregnant and parenting teens through intensive home visiting and peer group education. Each APP serves a caseload of 15-25 teens that may enter the program at any time during their pregnancy or after their child's birth. Participants in the program receive monthly home visits using either the Partners for a Healthy Baby or Parents as Teachers home-visiting curriculum, along with 24 hours of prescriptive group education with their peers. Supporting adolescent parents to prevent a repeat pregnancy, complete their high school education, acquire job skills, and improve their parenting skills helps them become self-sufficient and better able to support themselves and their families. It also establishes a strong, stable foundation upon which their child will be raised. By investing in teen parents today, APP strives to protect the future of two generations - the young parents themselves and their babies.
Program Goals
The goals of the Adolescent Parenting Program (APP) include:
- Increasing the delay of a subsequent pregnancy
- Increasing graduation from high school with diploma or completion of GED
- Increasing successful transition to adulthood including enrollment in post-secondary education, vocational training, or employment at a livable wage, and living in safe and stable housing after graduation from APP
- Increasing healthy births
- Increasing incidence of appropriate discipline, of nurturing behavior, and of children who are well-cared for
- Increasing age-appropriate physical, emotional, cognitive, and social development, including readiness for school success.
These goals are evaluated using the following outcome objectives:
- Less than 3% of APP participants will experience a subsequent pregnancy while participating in APP.
- Less than 5% of APP participants will drop out of school.
- More than 65% of APP participants will plan to enroll in postsecondary education or training.
Logic Model
The program representative did not provide information about a Logic Model for Adolescent Parenting Program (APP).
Essential Components
The essential components of the Adolescent Parenting Program (APP) consist of:
- Home visiting services, using either the Parents as Teachers or Partners for a Healthy Baby curriculum.
- Minimum of 1 monthly contact for at least one hour
- Four of these twelve contacts must take place in the teen's home
- Case management services to each participant through individualized goal planning
- Peer group education sessions
- Minimum of 24 hours of annual peer group education
- Sessions organized based on a structured logic model
- Sessions with 15-25 teen participants, with smaller sessions on particular issues not affecting all participants (e.g., breastfeeding education and/or support)
- Community Advisory Council (CAC), which serves as a guiding body in the implementation of APP for each local program. Meets quarterly, and consists of representatives from at least five public and private community agencies, such as local health departments, public school systems, departments of social services, mental health services, local corporations, consumers and businesses, media, and other organizations that serve youth.
Program Delivery
Child/Adolescent Services
Adolescent Parenting Program (APP) directly provides services to children/adolescents and addresses the following:
- Risk for delayed school readiness among the children of teen parents and risk for child maltreatment among teen parents
Parent/Caregiver Services
Adolescent Parenting Program (APP) directly provides services to parents/caregivers and addresses the following:
- First-time pregnant teen or teen parent
- Risk of repeat teen pregnancy
- Risk of dropping out of school
- Risk of living in poverty
- Risk of unhealthy relationships
- Incidence of sexual abuse among pregnant/parenting teen girls
- Risk for future IPV or domestic violence
- Risk for reproductive coercion
- Risk for child maltreatment among teen parents
- Inappropriate parental expectations
- Lack of empathy for children's needs
- Reliance on corporal punishment for discipline
- Oppression of children's independence
Services Involve Family/Support Structures:
This program involves the family or other support systems in the individual's treatment: Families and other support systems are involved in the teen's direct services at both home visits and group education sessions. For example, the father or mother of the participant's child may participate in home visits, or attend peer group education sessions. The participant's parents or guardians may also be involved in direct service encounters, as well as with any legal issues the teen may encounter (i.e., child custody).
Recommended Intensity:
At least one 60-minute contact per month. At least four of these twelve sessions must take place in the home.
Recommended Duration:
Duration of the program varies by participant. Graduation from high school is the "end point" of the program. Depending on the age of the participant when s/he enters the program, duration could be anywhere from 6 months to five or more years.
Delivery Settings
This program is typically conducted in a(n):
- Birth Family Home
- Foster / Kinship Care
- Community-based Agency / Organization / Provider
- School Setting (Including: Day Care, Day Treatment Programs, etc.)
Homework
This program does not include a homework component.
Resources Needed to Run Program
The typical resources for implementing the program are:
Each APP has at least one full-time coordinator to provide home visiting services and facilitate peer group education sessions. If the coordinator's caseload exceeds 20 participants, it is recommended that an assistant coordinator be hired. For every 5 participants in the program beyond a caseload of 20, 10 additional hours of staff time are recommended to appropriately implement APP. Coordinators need adequate space to conduct peer group education sessions, either at their agency our through in-kind resources. Transportation issues are often reported by coordinators serving rural populations, and coordinators should consider renting passenger vans or subcontracting with a transportation provider to get participants to and from peer group education sessions. Coordinators also need their own means of transportation to conduct monthly home visits with participants.
Manuals and Training
Prerequisite/Minimum Provider Qualifications
Service providers must have a demonstrated history of working with at-risk youth and be trained in either the Partners for a Healthy Baby or Parents as Teachers home visiting curriculum. Staff must also complete at least 18 hours of professional development training annually, aimed at improving program outcomes.
Manual Information
There is a manual that describes how to deliver this program.
Training Information
There is not training available for this program.
Implementation Information
Pre-Implementation Materials
There are no pre-implementation materials to measure organizational or provider readiness for Adolescent Parenting Program (APP).
Formal Support for Implementation
There is no formal support available for implementation of Adolescent Parenting Program (APP).
Fidelity Measures
There are no fidelity measures for Adolescent Parenting Program (APP).
Implementation Guides or Manuals
There are implementation guides or manuals for Adolescent Parenting Program (APP) as listed below:
The APP Manual covers all components of program implementation including: Staffing, fidelity to the home visiting models, process and outcome evaluation, community collaborations, and budget. It is available at http://www.teenpregnancy.ncdhhs.gov/docs/app/APP-PolicyManual-July2012.pdf.
Research on How to Implement the Program
Research has not been conducted on how to implement Adolescent Parenting Program (APP).
Relevant Published, Peer-Reviewed Research
Child Welfare Outcome: Child/Family Well-Being
Sangalang, B. B., & Rounds, K. (2006). Differences in health behaviors and parenting knowledge between pregnant adolescents and parenting adolescents. Social Work in Health Care, 42(2), 1–22. https://doi.org/10.1300/J010v42n02_01
Type of Study:
One-group pretest–posttest study
Number of Participants:
91
Population:
- Age — 12–18 years
- Race/Ethnicity — 65% Black, 26% White, and 9% Native American, Asian American, or Other Racial and Ethnic Groups
- Gender — 100% Female
- Status — Participants were pregnant and parenting adolescent mothers.
Location/Institution: North Carolina
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine substance use, contraceptive behavior, and parenting knowledge among first-time pregnant and parenting adolescents enrolled in the Adolescent Parenting Program (APP). Participants were youth who were pregnant when they entered APP, and the Parenting-Entry group included teenage mothers who were already parenting when they entered APP. Measures utilized include the Adult-Adolescent Parenting Inventory (AAPI-2) and the Knowledge of Infant Development Inventory (KIDI). Results indicate that after one year of program participation, pre- and post-test comparisons indicated improvements in contraception use and parenting knowledge, and increases in reported use of cigarettes, alcohol and other drugs among both groups. Adolescents who entered the program while pregnant experienced greater benefit than adolescents who entered the program already parenting. Limitations include lack of comparison group and possible bias due to self-selection into the program.
Length of controlled postintervention follow-up: None.
Sangalang, B. B. (2006). Teenage mothers in parenting programs: Exploring welfare outcomes during early transition to parenthood. Families in Society: The Journal of Contemporary Social Services, 87(1), 105–111. https://doi.org/10.1606/1044-3894.3489
Type of Study:
Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants:
1549
Population:
- Age — 12–19 years
- Race/Ethnicity — Control Group: 18% White, 77% Black, and 5% Hispanic; Comparison Group: 31% White, 63% Black, and 6% Hispanic
- Gender — 100% Female
- Status — Participants were pregnant and parenting adolescent mothers.
Location/Institution: North Carolina
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare welfare participation and economic well-being among teenage mothers who received case management services from the North Carolina Adolescent Parenting Program (APP). Participants were allocated to APP or a comparison sample of teenage mothers. Measures utilized include administrative data on receipt of welfare cash assistance obtained from state databases. Results indicate that there was no significant association between APP participation and the likelihood of longer welfare dependence of more than 36 months. Limitations include non-randomization of subjects and possible selection bias.
Length of controlled postintervention follow-up: None.
Sangalang, B. B., Barth, R., & Painter, J. S. (2006). First-birth outcomes and timing of second births: A statewide case management program for adolescent mothers. Health & Social Work, 31(1), 1–22. https://doi.org/10.1093/hsw/31.1.54
Type of Study:
Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants:
2,520
Population:
- Age — 12–19 years
- Race/Ethnicity — APP Group: 70% Black, 24% White, and 6% Hispanic/Other; Comparison Group: 48% Black, 43% White, and 9% Hispanic/Other
- Gender — 100% Female
- Status — Participants were pregnant and parenting adolescent mothers.
Location/Institution: North Carolina
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the impact of the Adolescent Parenting Program (APP) on prenatal care utilization, birthweight, gestational age, and time until second birth. Participants were a sample of first-time pregnant and parenting adolescents, compared to a sample of pregnant and parenting adolescents not enrolled in the APP program. Measures utilized include the Adequacy of Prenatal Care Utilization (APNCU) Index. Results indicate that the groups had similar rates of prenatal care use. Participation in APP however, was associated with an increased likelihood of normal birth weight and full-term birth. Adolescents ages 12 to 16 in the APP group also delayed second births significantly longer than the non-APP group. Limitations include lack of randomization and possible bias due to self-selection.
Length of controlled postintervention follow-up: Not specified.
Gruber, K. J. (2012). A comparative assessment of early adult life status of graduates of the North Carolina adolescent parenting program. Journal of Child and Adolescent Psychiatric Nursing, 25(2), 75–83. https://doi.org/10.1111/j.1744-6171.2012.00324.x
Type of Study:
Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants:
35
Population:
- Age — 18–24 years
- Race/Ethnicity — 27 African American, 4 Biracial, 2 Hispanic, and 2 White
- Gender — 100% Female
- Status — Participants were pregnant and parenting adolescent mothers.
Location/Institution: Greensboro, North Carolina
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the effectiveness of the North Carolina Adolescent Pregnancy Prevention (NCAPP) program [now known as Adolescent Parenting Program]. Participants were compared to a sample of adolescent parent peers identified by the graduates. Measures utilized include Parenting Sense of Competence Scale, the Parenting Opinions Questionnaire, the Student Life Satisfaction Scale, a subset of the Multidimensional Students’ Life Satisfaction Scale, the 10-item Rosenberg Self-Esteem Scale, and the Young Female Parent Life Status Assessment Form. Results indicate that NCAAP graduates were on a more positive life course: greater primary responsibility for housing and utilities, greater higher education enrollment, more job stability, and greater focus on career goals. Limitations include small sample size, non-randomization of participants, and comparison group not from the same population pool.
Length of controlled postintervention follow-up: None.
Additional References
No reference materials are currently available for Adolescent Parenting Program (APP).
Contact Information
- Audrey Loper, MPH, MS
- Agency/Affiliation: North Carolina Department of Health & Human Services
- Website: www.teenpregnancy.ncdhhs.gov
- Email: audrey.loper@dhhs.nc.gov
- Phone: (919) 707-5688
- Fax: (919) 870-4827
Date Research Evidence Last Reviewed by CEBC: June 2023
Date Program Content Last Reviewed by Program Staff: April 2014
Date Program Originally Loaded onto CEBC: March 2013
