Strunk, J. A. (2008).The Journal of School Nursing, 24(1), 13-20.

Nurses are at the forefront of developing interventions to help teen parents. Recently, two meta-analyses have examined what helps teen mothers: the first evaluated the effectiveness of programs that improved educational attainment of teen mothers and concluded that such interventions have had little impact on increasing rates of education in teen mothers (Baytop, 2006). The second was the Strunk study that examined 13 reports of studies relating to school-based clinics and their effects on teenage pregnancy outcomes between 1997 and 2006. Outcomes measured were absenteeism and dropout rates, grade point averages, repeat pregnancy rates, improved parenting skills, immunization rates in infants, social problem solving skills, and responsiveness to infants, although the studies varied in the interventions delivered and the outcomes measured. Results indicated positive effects of school-based clinics on pregnancy/parenting outcomes, with five studies indicating particular educational successes for the mothers. More education is particularly important, as it has been associated with less risk of future pregnancy.

Perhaps most important, the evidence from Strunk's meta-analysis indicated the most important components of a school-based program were counseling, healthcare, health teaching, and child development education. Program effects may be dependent on other needed resources or cumulative over time, and sometimes a program may not have the intended effect of delaying future pregnancies, but may have a secondary, unintended, beneficial effect that is unmeasured, such as improvements in self-sufficiency and coping in the mother. These factors deserve consideration as we build evidence-based practice in teen childbearing programs.

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