Enhancing a Home Visiting Program to Address Repeat Adolescent Pregnancy: The Longer-Term Impacts of Steps to Success

OPRE Report 2019-96
Publisher: Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research and Evaluation
Sep 30, 2019
Dana Rotz, Menbere Shiferaw, and Robert G. Wood

Key Findings:

  • After two years, mothers in the Steps to Success and traditional home visiting groups had similar rates of repeat pregnancy.
  • However, the evidence suggests that mothers in the Steps to Success group were more likely to use long-acting reversible contraception (LARC) methods than were mothers in the traditional home visiting group.
  • This increase in LARC use was driven by effects on the youngest mothers served by the program, those who were 14 to 18 years old at program enrollment. For this younger group, Steps to Success also decreased the incidence of unprotected sex. There were no effects on LARC use or unprotected sex for adolescent mothers who were 19 or 20 when they entered the program.
  • Compared with traditional home visiting, Steps to Success did not improve outcomes related to father involvement, mothers’ education and career aspirations, or mothers’ parenting behavior.

This report is the last in a series on the implementation and impacts of Steps to Success. It presents evidence on the program’s longer-term impacts relative to Healthy Families San Angelo’s (HFSA) traditional home visiting program focused on parenting and child development. The report discusses outcomes measuring the use of contraception; repeat pregnancy; attitudes toward repeat pregnancy; knowledge of pregnancy prevention; co-parenting; fathers’ engagement with their children; and mothers’ school enrollment, career goals, and engagement with their children. The report also provides information on program costs and documents the study’s methods. Earlier reports presented evidence on the program’s shorter-term impacts and described the design and implementation of Steps to Success.


Personal Responsibility Education Program (PREP)


U.S. Department of Health and Human Services, Administration for Children and Families

Time Frame


Senior Staff

Robert Wood
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Dana Rotz
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