The birth rate for unmarried women aged 15 to 19 increased threefold between 1960 and 1992 (see fig. 1). While the increase in births to unwed teenagers is part of an increasing trend in births to unwed mothers of all childbearing ages, the economic consequences are usually more severe for teenagers because many teenagers who have a child forgo their high school education. Having disrupted her education, the teenage mother may never attain the diploma that the labor market increasingly demands, even for low-wage jobs. Women who begin childbearing during their teenage years are significantly more likely than women who postpone having children to live in poverty, to receive public assistance, and to have long periods of welfare dependency. Nearly half of all unmarried teenage mothers are likely to go onto AFDC within the first 48 months after giving birth. While unwed teenage mothers as a group tend to stay on welfare for a relatively long time, those who have not completed high school are likely to remain on public assistance even longer. We reported last year that AFDC families headed by women who did not have a high school diploma or its equivalent were less likely to leave AFDC than those with at least a high school diploma or equivalent. Estimates of the public costs associated with supporting teenage mothers and their children are high and growing. The Center for Population Options estimates that in 1992 the federal government spent $34 billion in AFDC, Medicaid, and Food Stamp benefits to support families started by teenagers. This was a 17-percent increase from 1991 and a 36-percent rise from 1990. In passing the Family Support Act of 1988 (FSA), the Congress recognized the importance of a high school education to avoiding long-term welfare dependence, especially for young parents. The act created the Job Opportunities and Basic Skills Training program to provide employment training and assistance for recipients of AFDC benefits. JOBS directs states to require custodial parents aged 16 to 19, regardless of the age of their child(ren), who have not completed their secondary education to participate in educational activities directed toward the attainment of a high school diploma or its equivalent, to the extent that these activities are available and that state resources permit. States are afforded substantial discretion in deciding how they will serve AFDC recipients, including teenage mothers in the JOBS program. Although FSA emphasizes the importance of education for teenage mothers on AFDC, it does not require states either to provide all their high school dropout teenage mothers slots in JOBS or to ensure that these teenage mothers actually participate in educational activities by tracking their attendance. As a result, teenage mothers who have dropped out of high school may not be required to participate in JOBS if a state lacks the resources to provide child care, transportation, or JOBS education or training. Moreover, those referred to educational activities through JOBS may not actually attend. In fact, states have moved unevenly to enroll teenage AFDC mothers, including those who have dropped out of school, in JOBS. We reported recently, for example, that one state enrolled as few as 7 percent of AFDC teenage parents, while another enrolled more than half. The number who actually attend high school or GED classes is unknown. The Congress is now considering welfare reform proposals that include provisions that relate directly or indirectly to the AFDC program’s approach to teenage mothers. A provision in the House proposal would deny cash benefits to unmarried mothers under age 18, but permit provision of noncash benefits such as child care or transportation assistance. Both the House and Senate propose to increase the proportion of welfare recipients who must participate in a work program and to reduce states’ funding if they fail to meet participation goals. Most importantly for teenagers, the House proposal would no longer consider enrollment in a high school or equivalency program as work program participation unless the student was also employed an average of 20 hours a week. In contrast, although the Senate’s proposal permits states to deny cash benefits to unwed teenage mothers, they are not required to do so. However, if states do pay benefits to teenage mothers, those teenagers must live under an adult’s supervision and be working toward high school completion. Numerous programs have been established in communities throughout the country to reduce the negative consequences of teenage parenting. Our synthesis of rigorous impact evaluations of five such programs operating in multiple sites identified one feature that distinguished the programs that increased high school or GED completions from those that did not: active monitoring and follow-up of school attendance. All five programs also provided child care and transportation assistance; otherwise, these programs were quite different. Table 1 outlines the programs’ major characteristics (see app. II for descriptions of the programs and their outcomes). While many of the programs we visited shared the common features found in the five evaluated programs, they also provided examples of, but had not yet evaluated, promising approaches to helping teenage mothers overcome obstacles to high school completion. These approaches included providing services in special schools, residential centers, or the teenagers’ homes, as well as offering school-based programs for all at-risk youth. All five program evaluations provided outcome data on secondary education completion. Although all five programs increased school enrollment, only three were successful in helping young mothers complete high school or obtain a GED: Learning, Earning, and Parenting (LEAP), New Chance, and Jobstart. While the ultimate goal is for teenage mothers to be economically self-sufficient, only three of the evaluations included in our synthesis measured economic impacts 2 years or more after teenagers entered the program, and only one had successful results on postprogram employment or AFDC receipt. No feature clearly set this program apart.Consequently, we focused on how to help teenagers complete their secondary education. Although currently there is some debate as to whether the GED provides the same earnings potential as a high school diploma, we combined these measures because the programs we reviewed encouraged either or both as routes to prepare teenagers for employment. One program feature clearly distinguished between programs that increased school completions and those that did not: The three successful programs actively monitored school attendance and followed up either with financial incentives and sanctions or with intensive case management. However, attendance monitoring and follow-up took place in different forms in the three programs that practiced them. The LEAP program, run by the Ohio welfare department, combined active monitoring with financial sanctions and incentives. AFDC offices coordinated closely with school districts to obtain teenage AFDC parents’ attendance records on a monthly basis. When attendance problems arose, LEAP followed up by reducing teenage parents’ monthly AFDC checks by $62 for unexcused absences from school. When attendance was good, LEAP followed up with a comparable bonus in recipients’ AFDC checks. LEAP participants in Cleveland had statistically significant, higher rates of high school graduation or GED completion than those of nonparticipants 1 and 3 years after enrollment. The statewide program also resulted in slightly higher GED completion rates over the short term (18 months after enrollment) but had no information on high school graduations. The community-based New Chance and Jobstart programs combined direct attendance monitoring with either financial rewards or case management. In both, most classes and other activities were held on-site so attendance could be monitored through personal observation. When classes or activities were held off-site, these programs coordinated with providers to monitor the teenagers’ attendance. New Chance’s follow-up consisted of intensive case management to help resolve participants’ problems that were identified through monitoring. For example, case managers approached teenagers who had attendance problems to help identify the barriers to good attendance. They then offered assistance, such as counseling, on-site child care, or, for more specialized needs, help in accessing the appropriate resources. Jobstart’s follow-up at a majority of sites involved small financial rewards for maintaining good attendance or for making academic progress; financial sanctions were not used. New Chance participants had significantly higher rates of high school or GED completions than did nonparticipants 1 and 1-1/2 years after enrollment. The Jobstart program participants had higher rates of high school or GED completions than did nonparticipants 4 years after enrollment in the program. Neither Project Redirection nor the Teenage Parent Demonstration was successful in increasing high school or GED completions. The community-based Project Redirection was largely a mentoring program that offered service referrals and sent teenagers to other sites for classes, but did not routinely observe or keep track of their attendance, nor did it follow up on their daily absences. This program, as well as others, experienced attendance problems. In fact, teenagers attended GED classes only about half the time, and those enrolled in regular and alternative school classes failed to attend about a quarter of the time. The Teenage Parent Demonstration staff kept track of participants’ mandated enrollment in educational and other activities, but did not monitor or keep track of daily attendance, nor did the program routinely follow up on an individual’s attendance problems. Project Redirection participants did not have significantly higher rates of high school or GED completions than did nonparticipants at 1, 2, or even 5 years after enrollment in the program. Teenage Parent Demonstration participants’ completions of high school or GED were also not different from those of nonparticipants at 2-1/2 years after enrollment in the program. We observed close monitoring of teenagers’ school attendance in many of the 13 programs we visited. In six of these programs, monitoring and follow-up were carried out formally through intensive case management. The residential centers in Albuquerque and El Paso provided strict supervision of the teenage mothers’ school attendance and performance, as well as their other program activities, along with clear consequences when teenagers failed to comply with rules. In some cases, teenagers who did not obey rules were required to leave the facility; in some centers, they could earn privileges by, for example, making good progress in school or attending counseling sessions. Other innovative programs monitored the activities of the young women on-site in the public or alternative schools that they attended. For example, students in the alternative schools we visited were required to sign in daily. Child care centers in the schools offered additional opportunities for monitoring because child care administrators and teachers were quick to connect the absence of an infant from the center with the possibility that a problem had emerged in the teenage mother’s life. Teenage mothers’ need for child care was viewed as so important that all 5 of the evaluated programs as well as the 13 programs we visited attempted to provide it, either directly or through reimbursement. Some programs provided child care directly in the schools, in the residential facilities, at the job training sites, or in the community. In some instances, the teenage mothers chose to rely on family members rather than the more formal care provided by the programs. Unfortunately, some programs could not meet the needs of all program participants, either because of limitations in the number of available child care slots or because they lacked the resources to reimburse the teenagers for the care. Program directors told us that there were waiting lists for child care at many of the on-site centers, and at one alternative school, teenage mothers who arrived at school with their children after the center was full were sent home for the day. Without child care, these young mothers were unable to attend school. Many programs also recognized lack of transportation as a barrier to teenagers’ ability to complete high school. In addition to having to get to and from school themselves, teenage mothers often have to take their child to and from a child care provider. As a result, many teenage mothers were given transportation assistance, either directly or through reimbursement, which was considered crucial by most program administrators to the success of these programs. The Director of the rural Salem, New Jersey, School-Based Youth Services Program (SBYSP) told us of the complicated provisions she had to make—sometimes arranging special school bus rides—to get teenagers to and from appointments, school, and home. Aside from monitoring and following up on attendance problems and providing child care and transportation assistance, the three programs that demonstrated increased school completions—Jobstart, New Chance, and LEAP—represent quite different program models. Their differences in approach and the nature and extent of services offered demonstrate that a variety of approaches can help young mothers complete their high school education. Many of the programs that we visited resembled the evaluated programs in the types of services they provided. (See fig. 2 for a summary of services provided by the 13 programs visited.) However, because of differences in the populations they served, we cannot directly compare the effectiveness of these programs. The Jobstart program represented a vocational preparation model for disadvantaged high school dropouts—not just teenage mothers, but other young women and men. It provided GED preparation and basic skills instruction as well as training and job placement assistance. Counseling and assistance with child care and work expenses were provided, as needed, to facilitate participation. Many of the programs we visited recognized the importance of employment-related services. For example, the New Jersey School-Based Youth Services Program offered job training and placement services, assistance with career development, and preparation for the world of work. Program directors remarked on these teenagers’ need to develop the good work habits—such as punctuality, self-discipline, and reliability—that are required for school completion as well as for future success on the job. In addition to offering special workshops, the Plainfield, New Jersey, Teenage Parenting Program also engaged volunteer mentors from AT&T and the community to provide moral support and counseling, as well as career development and training services. New Chance represented a comprehensive services model designed to meet the wide range of needs of young AFDC mothers who had dropped out of school and those of their children. It combined education and employment preparation with case management and an array of health and social services. New Chance’s one-stop, drop-in centers offered basic education (or GED preparation) in an initial phase and employment preparation in a later phase; classes in parenting and life skills; and workshops on family planning and substance abuse to most participants on-site. Comprehensive health services for mothers and children and job skills training were often provided off-site. While few of the programs we visited incorporated the diverse components of the New Chance model, many found the need to provide a range of supportive social services. The majority of programs we visited provided personal counseling or support groups to help teenagers deal with a range of personal problems that slowed their progress toward attaining a diploma. A number of programs offered courses in life skills covering a variety of topics, including substance abuse prevention and communication skills. Several administrators identified low self-esteem among these young women as a contributor to school failure. Consequently, some programs, like Milwaukee’s Time of Your Life, provided group workshops specifically designed to build self-esteem. Most of the programs we visited offered parenting education in which the young women learned about child development, maternal and child health, and appropriate methods of discipline. Such training was considered especially important because of the relative immaturity of these young women facing the challenges of parenting, as well as the history of abuse that many of these teenagers had experienced. Programs reinforced parenting skills in a variety of ways, such as by pairing communication and parenting skills in a job training program, and by incorporating instruction with modeling and observation in their child care centers. New Chance, as well as many of the programs we visited, explicitly aims to improve the life chances of both the teenager and her child. Routine health care for mother and child was provided on-site in some of the programs we visited, while other programs developed close connections with local community providers to ensure continuity of care. For example, in the New Futures alternative high school, day care center and clinic staff counseled mothers on what to look for and do for their children when they appeared sick. LEAP had the simplest of the program models evaluated, representing no more than the common features described in the previous section: monitoring and following up on attendance in high school (or for some, GED classes) and providing assistance with child care and transportation on an as-needed basis. Teenage parents were enrolled in JOBS (including many still in high school), and program follow-up took the form of tying AFDC benefit levels to their attendance records. AFDC programs in Wisconsin and California, which are experimenting with similar ways of using financial incentives to back up their requirement for teenage parents (in Wisconsin, all teenagers) to attend school, are discussed later in this report. The fact that LEAP successfully increased the rate of school completions without providing extensive services may mean that such services are not required to obtain improvements on average, or it may reflect other differences between the evaluated programs. In particular, the three programs served different populations of teenage mothers: LEAP served both students and dropouts, and was less successful with dropouts; New Chance and Jobstart served only high-school dropouts. It is possible that the less extensive LEAP services may not be successful with young women who have already been out of school for some time. On the other hand, many of the social services offered by programs like New Chance are aimed not so much toward helping these teenagers complete high school as toward improving their parenting behavior and breaking the intergenerational cycle of poverty. We are unable to draw conclusions about the effectiveness of the individual services offered in these programs because there were no independent tests of their contribution to the effects of each program as a whole. Each evaluation provides evidence only on the impact of the services as they were delivered, that is, in a package with monitoring and follow-up. The small number of programs evaluated offered a limited range of variation and thus limits our ability to examine such effects. In addition to the approaches taken in the programs included in our evaluation synthesis, the programs we visited provided examples of innovative approaches to helping teenage mothers complete their high school education that are quite different from those evaluated. These approaches included the use of alternative schools; residential programs; home-based programs; and school-based programs that provided services to all teenagers in the school, not just those who were pregnant or parenting. Alternative schools provide an opportunity for teenage mothers to continue their education in a setting that also actively supports their role as a parent. We visited two such programs: the Teen Parent Academy in El Paso and New Futures in Albuquerque. Both schools provided a wide range of on-site services to support pregnant and parenting teenagers. Although a student could choose to return to a regular high school after the birth of her child, she could also continue at the alternative school, which provided on-site child care and a range of other services to enable teenagers to continue their education while raising a child. Parenting education classes at the Academy taught skills vital to young teenagers in their multiple roles of child, student, parent, and future employee. New Futures had on-site prenatal and perinatal clinics for teenagers, and all students participated in child development classes. Students were required to work in the child care centers as part of their curriculum, and pregnant teenagers were to take a personal and child health care class. The school district provided transportation for students and their children, and counselors were available for individual counseling. In some cases, programs have been developed to deal with the very serious, if not widespread, problem of homelessness among teenage mothers. In Albuquerque, homelessness was identified as a reason that some teenage mothers were unable to continue their high school education. In response, a teenage parent residence was developed. In addition, the El Paso Transitional Living Program aimed to enable homeless young women to remain with their children as well as to strengthen their ability to become self-sufficient. Transitional housing for teenage mothers and their children was one component of the Teenage Services Act (TASA) program in Syracuse, New York: Families could remain there for 2 to 3 years, or until they became self-sufficient. These programs offered more than just shelter. They provided a variety of support services designed to assist the teenager in obtaining a high school diploma or GED; on-site counselors to monitor the residents’ activities; and rules with severe consequences for breaking them, including eviction from the residence. Two programs used home visits to ensure that teenage mothers received the services that they needed to continue their education. The Addison County Parent/Child Center served a rural population. Professional staff visited families in their homes to determine what help might be needed, giving priority to pregnant teenagers, young mothers, extended families of teenage parents, families with handicapped children, and families with abused and neglected children. Home visiting was the centerpiece of Milwaukee’s Time of Your Life Program, an intergenerational program for teenage mothers and their families. The Time of Your Life approach reflected the staff’s belief that since most of their teenage mothers came from multigeneration AFDC families and continued to live at home, the teenage mothers’ problems could not be addressed without educating and supporting the entire family unit. A prenatal community nurse and a family therapist visited clients in their homes, developing a unique program for each client that involved the entire family, then attempted to link the families to the appropriate services. Individual teenagers and their families signed contracts saying that the teenager would complete school and that all concerned would provide a loving and healthy environment for the teenager and her baby. This attempt to directly involve the family is meant to overcome what program staff referred to as welfare families’ frequent “sabotage” of teenage mothers’ efforts to complete school and find work. The statewide New Jersey School-Based Youth Services Program was designed to serve all teenagers, not just teenage parents. It aimed to prevent, and where needed, address the problems facing many of them, including unemployment, the break-up of families, suicide, drug and alcohol abuse, alienation from school possibly leading to dropping out of school, and unplanned pregnancy. The program emphasized early intervention, family involvement, and the provision of comprehensive services at a single, accessible setting. While the program was school-based, a wide range of community resources supported each local site, and in fact were required in order to receive state funds. In addition, three SBYSP sites we visited created special programs for their teenage parents. In two of the three sites, the teenage parenting program provided on-site child care, in addition to the other services necessary to keep pregnant and parenting teenagers in school. This included life skills and parenting training, mentors who provided moral support, and other community volunteers who were once teenage mothers themselves. Further, Plainfield used its on-site child care center as a tool to provide the teenage parents with the information and support they needed to assist them in their parenting role. To have access to this child care center, teenage mothers had to maintain at least a “C” average, perform community service, participate in case management and support services, and not have another child. Finally, teenagers in SBYSP were encouraged to use the available resources in the community, many of which could be accessed through the program. The city welfare officials we spoke with told us that they required certain teenage AFDC recipients to continue their high school education and referred high-school dropouts to the JOBS program for continuing education. But most AFDC/JOBS offices did not take the additional step of monitoring the attendance of young AFDC mothers who were attending high school or those who were under age 16 (and thus exempted). Programs in three cities stood out, however, because they monitored and followed up on the educational activities of all their teenage mothers on welfare, even if they were still attending high school when they applied for AFDC. All 15 of the city welfare offices we surveyed reported requiring teenage mothers, aged 16 through 19, who were on AFDC and had not completed high school to participate in educational activities aimed at a high school diploma or GED. When teenage mothers who had already dropped out of school applied for AFDC benefits, the welfare offices referred them to the JOBS program to continue their education. (However, not all of these dropouts necessarily participated in educational activities, because localities sometimes lacked resources to serve all those referred to JOBS.) JOBS participants—including those in high school who volunteered for JOBS to obtain child care or transportation assistance—were generally monitored on a monthly basis. If they failed to attend classes, or, in some cases, did not make satisfactory progress, we were told, case managers intervened to find out why. The case managers attempted to identify the problem and to provide the services or link the teenagers with the services necessary to enable them to continue their education. If there was no justifiable explanation for a teenage mother’s failure to attend school, she was threatened with a sanction—a reduction in the amount of her monthly AFDC benefit. However, city AFDC and JOBS officials told us that few teenage mothers actually had their benefits reduced, since most complied with the attendance requirements as a result of the sanctioning process and the case managers’ intervention. On the other hand, when teenage mothers who were enrolled in high school applied for AFDC benefits, they were exempted from participation in JOBS. In most cities, once these teenage mothers were exempted from JOBS, the AFDC office paid no further attention to their education until 6 months had passed and their eligibility for AFDC was being reverified. These teenage mothers could have dropped out of school at any time during those 6 months, and months could have elapsed before AFDC discovered they had dropped out. Once identified as dropouts, these teenage mothers would be referred to JOBS and, depending on resources, might participate in educational activities. Further, teenage mothers under the age of 16, admittedly a small proportion of welfare recipients, are exempted by FSA from requirements that states compel them to attend school as a condition of receiving AFDC benefits. However, 3 cities—Cleveland, Milwaukee, and Los Angeles—of 15 that we surveyed reported routine monitoring of the school attendance of mothers that young. These three cities are part of special waiver programs—LEAP, Learnfare, and Cal-Learn, respectively. Only three of the city welfare offices we interviewed routinely monitored the school attendance of teenage mothers who were still attending high school when they applied for AFDC. These AFDC offices stood out because they monitored and followed up on the educational activities of all their teenage mothers on welfare: Cleveland participated in Ohio’s LEAP program (previously discussed); Milwaukee participated in Wisconsin’s Learnfare program; and Los Angeles became part of the Cal-Learn demonstration project in 1995. Like LEAP, participation in Cal-Learn and Learnfare was mandatory for all teenage mothers on welfare who did not have a high school diploma, whether they were attending school or had dropped out. Dropouts were required either to return to high school or to attend a GED preparation program. Each program monitored attendance routinely, but these programs differed in their use of rewards and sanctions and in whether they offered case management services before applying sanctions. The Cleveland demonstration of the LEAP program operated like the statewide program, but also provided case management and supportive services for teenage parents with recurrent attendance problems. California’s Cal-Learn program used financial incentives and sanctions to reward attendance and academic achievement and also provided case management and supportive services. A welfare family with a teenage parent or parents might receive up to four $100 bonuses in a 12-month period for each teenage parent who maintained a C average or better, or, conversely, up to four $100 reductions in its AFDC benefit for each teenage parent who failed to make adequate progress. Cal-Learn also provided a $500 bonus for high school completion. Wisconsin’s statewide Learnfare program coordinated with the public schools to monitor the attendance of all teenagers on AFDC but used only sanctions, not rewards. When receiving notice of a possible reduction in benefits, a teenage mother on welfare would also be offered case management to help her overcome barriers to school attendance. If her attendance still did not improve, her benefits were reduced. A provision in the House welfare reform proposal regarding teenagers and AFDC could, if passed, affect these three states’ programs for teenage mothers on welfare, by denying cash benefits to mothers under age 18. However, a possible similar approach could be to monitor these younger teenagers’ attendance and use noncash benefits such as child care and transportation assistance to reward satisfactory attendance. Further, it is unclear whether these three AFDC offices would continue to monitor the attendance of teenage mothers 18 years and older if certain provisions to strengthen work program requirements were enacted. These provisions would raise work program participation goals and no longer permit states to count a parent’s high school attendance as participation in a work program unless the parent also was employed. Because a state would not gain credit for teenagers enrolled solely in a secondary school, it might be dissuaded from spending money on programs to monitor and follow up on their attendance. A variety of local programs aim to help teenage mothers avoid welfare dependence through completing their secondary education. Our analysis suggests that close monitoring of teenage mothers’ educational activities with follow-up, when their attendance drops, is effective in increasing the likelihood that they complete their education. Leveraging the welfare benefit as a sanction or reward for attendance has contributed to high school completion for teenage mothers attending school. Providing supportive services to overcome barriers to continued attendance, with or without financial incentives, also seems to be effective, especially for dropouts. Finally, assistance in meeting their child care and transportation needs may be particularly helpful but did not appear to be sufficient, without attendance monitoring, to enable these young mothers to complete their secondary education. Although current federal AFDC policy emphasizes the importance of teenage mothers’ participation in the JOBS program, it does not require states to serve all teenage mothers in JOBS, nor does it require states to monitor the school attendance of all teenage mothers on AFDC. This was confirmed by local welfare officials who indicated that teenagers’ attendance is not monitored, nor are they referred to JOBS, unless they have already dropped out of school. A preventive strategy of monitoring the attendance of all teenagers, such as that observed in LEAP, was reported in only 3 of the 15 cities we surveyed. These three AFDC offices coordinate with educational providers to ensure that welfare benefits are contingent on teenagers’ continuing their education. The Congress is currently deliberating several reforms to the welfare system, including whether to provide benefits to teenage mothers. Although our work shows that a number of approaches can work to help teenage mothers complete high school, whether states will use these approaches will likely be influenced by the final form of the legislation. The Administration for Children and Families (ACF), within the U.S. Department of Health and Human Services, commented on a draft of this report and generally agreed with our conclusions about promising program approaches, but expressed several concerns. First, ACF claimed that our evaluation synthesis was not a statistically rigorous methodology, given the small number of studies reviewed. Because the evaluated programs were too dissimilar to be aggregated for a statistical analysis, we employed the evaluation synthesis method, which is not intended to yield statistically significant conclusions. Although it may not provide conclusive answers, this analysis did show that certain factors were consistently associated with positive educational outcomes, while others were not. Second, ACF believed that we should more prominently discuss the difference between voluntary and mandatory programs. However, this characteristic did not distinguish between programs that did and did not increase school completions. Third, ACF asked us to clarify that the limitation on work program participation requirements would not apply to teenagers if they were excluded from receiving cash benefits. The text has been changed to clarify this. Fourth, ACF pointed out that the education system also bears responsibility for helping teenage parents complete school. We agree, but examination of this issue was outside the scope of this report. Fifth, ACF believed that we should note that the follow-up periods for these evaluations were too short to see employment and earnings impacts. We do recognize and discuss this issue in explaining the focus of our analysis on school completions (see p. 6). Finally, although ACF believed that we had failed to cite the latest report on the Teenage Parent Demonstration program, the report referred to was included in our evaluation synthesis (see p. 40, Maynard, Nicholson, and Rangarajan, 1993). In addition, ACF provided detailed suggestions, which we have incorporated as appropriate throughout the text. ACF’s comments are reprinted in appendix III. As agreed with your office, unless you publicly announce its contents earlier, we will not distribute this report until 30 days after the date of this letter. At that time, we will send copies to the Secretary of Health and Human Services and other interested parties. We will also make copies available to others on request. Major contributors to this report are listed in appendix IV. If you have any questions concerning this report or need additional information, please call Jane L. Ross on (202) 512-7215. To assist us in identifying promising approaches for helping teenage mothers achieve economic independence, we conducted an evaluation synthesis—a systematic review and analysis of the results of previous evaluation studies of programs sharing this goal. Whereas some evaluation syntheses examine similar studies to learn whether a single program or treatment consistently has the desired effect, this synthesis examined programs that used a range of different approaches toward the same goal to learn which approaches were successful in achieving that goal. The evaluation synthesis consisted of several steps. The first step was locating programs serving teenage mothers, and screening them to identify rigorous impact studies with reliable results on the desired outcomes. In the second step, we identified the commonalities and differences among the programs and assessed whether these were related to whether the programs demonstrated the desired impacts. From this analysis, we drew conclusions from the cumulative picture of existing rigorous research about which approaches have been demonstrated to be successful in assisting these young women. In addition, we asked evaluators of these programs to review our analysis and characterization of the programs and their evaluations. We incorporated their comments where appropriate, including unpublished evaluation findings provided by one of the reviewers. We began our search for relevant studies by identifying as many existing evaluation impact studies as possible of programs serving disadvantaged teenage mothers. We conducted computerized bibliographic searches of the literature on disadvantaged teenage mothers (using keywords such as adolescents and early parenthood) in periodicals on education, psychology, sociology, and program evaluation. Program summaries and bibliographies of research studies were reviewed to identify other studies that might have been missed. We also contacted external experts regarding important studies to consider. From hundreds of citations, we selected over 50 for further review. Our criteria for selecting studies for our synthesis were that: the program served young mothers under the age of 20, or provided separate data on them if it served a broader group; the evaluation measured education, employment, or AFDC receipt as outcomes; and there was some form of comparison with nonparticipants (but not necessarily a control group). These criteria excluded programs that focused exclusively on teenagers’ health outcomes and repeat pregnancies, and many school-based programs without impact evaluations. After applying these criteria, we arrived at a group of eight studies designed either especially for teenage parents or for disadvantaged teenagers in general. We rated the quality of the eight studies to ensure that the research was rigorous and would produce reliable results. We used six specific criteria that together would reflect the rigor, consistency, and reliability of an evaluation study. These criteria are as follows: similarity of the comparison group to the project’s clients, adequacy of the sample size for the analyses performed, standardization of data collection procedures, appropriateness of the measures used to represent the outcome variables, adequacy of the statistical or other methods used to control for threats to presence and appropriateness of the methods used to analyze the statistical significance of observed differences. Each study was rated on a three-point scale from “unacceptable” (because the report provided no information on the dimension or the method was so flawed that the data were probably wrong) to “acceptable,” indicating an appropriate method was used or that attempts were made to minimize problems. In general, most of these programs had well-designed and rigorously implemented evaluations with experimental or quasiexperimental designs. Five of the eight evaluations met our criteria. We identified problems in three evaluations (Learnfare, the Teenage Services Act program (TASA), and Young Families Can Programs) that were serious enough to question the reliability of their results, and thus we did not include these evaluations in our synthesis. The five evaluations selected for our synthesis were Project New Chance; Jobstart; the Learning, Earning, and Parenting (LEAP) program; Project Redirection; and the Teenage Parent Demonstration (TPD). A confounding factor found in two of the programs was the similarity in services received by the program participants and the comparison group (as a result of their availability elsewhere in the community). This type of confounding factor means that the standard measure of program impact—the difference between outcomes for the two groups—will most likely underestimate the program’s true impact relative to receiving no services. All five of the selected programs served teenage mothers, most of whom were receiving AFDC benefits, and encouraged them to complete their education before seeking employment. These programs operated in the 1980s in multiple sites, although LEAP operated in only one state. All programs provided child care and transportation or reimbursed their costs. Each program offered basic education, but most also offered vocational preparation or training. Some programs required mandatory participation; others were voluntary. Some served primarily young, first-time mothers (aged 14 to 17), whereas others served older teenage mothers (19 to 22 years old), and one served other young men and women as well. The programs delivered services in different ways—sequentially or concurrently, on-site and off-site, and brokered services (linked services to participants) or provided services directly to participants. To develop a cumulative picture about which approaches were successful in increasing the economic self-sufficiency of teenage mothers, we first identified the impacts each program had achieved and then compared the programs’ characteristics and results with each other. The impacts we focused on for the evaluation synthesis were directly related to economic self-sufficiency: employment, public assistance receipt, and school completion measured as receipt of a high school diploma or GED. For each outcome in each study, we compared the results of the participants receiving program services (treatment group) with those of the control (or comparison) group, and any differences were deemed to be program impacts. The evaluation reports estimated the likelihood that these differences were due to random chance using standard tests of statistical significance. For our interpretation, we used a common significance level of 5 percent (.05) or less, which was stricter than that used by some of the evaluations. We used a structured approach to look for program features or characteristics that might explain why some programs had positive impacts and others did not, on each of the desired outcomes. For example, we looked for features that were common, yet unique, to the three programs with positive outcomes on educational attainment. First, we compared the programs’ results by the general program approach they represented: education, training, and comprehensive services. We then compared them along more detailed single features that were discussed in the literature as being important for serving this population. These features included the set of services provided; whether the program created services specially tailored to the needs of teens, such as an alternative school; whether participation was mandatory or voluntary; the age group served; and service delivery method used. We also examined features of the studies themselves that might influence the likelihood of demonstrating statistically significant results, such as whether the comparison group received services similar to those provided by the program. The synthesis entailed comparing program features of the programs with positive outcomes, and contrasting them with the features of the other programs without positive outcomes, excluding those studies with no data on that particular outcome. Thus, for example, we also looked for similarities and differences in features within the set of comprehensive service programs. After we found no single unique program feature, we looked beyond individual program features to combinations that might explain the results. We reviewed the comments of the evaluators about any problems encountered in program or study implementation. We considered not only which services were delivered and how, but how they might influence the participants and their behavior. All of the programs monitored program participation, but we noted that one of the programs with no school completion gains, Project Redirection, had problems with school absenteeism. This led us to discover that the other three programs with positive impacts on school completion monitored attendance instead of just enrollment or participation, and that all three also followed up on the results of that monitoring. Looking across the studies gave us the opportunity to uncover information not readily seen by looking at only one of them. Including several program approaches in our review allowed us to see that while a particular approach can be successful, it is not the only successful approach. Nor do single studies ordinarily allow one to make inferences about which of the variety of program components were probably responsible for its observed effects, while examining patterns across a group of studies may. However, a sample of five studies cannot provide conclusive answers, since many potential differences between them might be related to why one program had significant results and another did not. Because only three of the studies had longer-term data on employment and AFDC receipt, we had insufficient data to identify features distinguishing success on these longer-term outcomes. This voluntary, multisite (16 sites in 10 states) demonstration focused on the well-being of school dropout teenage mothers (aged 16 to 22) as well as their children. New Chance provided 20 to 30 hours per week of basic skills, high school diploma, or GED preparation in an initial phase and job skills training afterward. Local community organizations offered a one-stop, drop-in center where participants also received life skills and parenting classes; workshops on family planning and substance abuse; counseling, child care (often free and on-site), and transportation; and intense case management monitoring and assistance. Skill training, work internships, job placement assistance (offered later), and health services were often provided off-site. Participants could remain in the program for up to 18 months, but the average length of stay was about 8 months. The New Chance evaluation used an experimental design with a randomly assigned control group, but many members of the control group received similar services from other providers in the community. The evaluation also reported problems with participants leaving the program (dropping out) after the educational component (even when program providers worked to keep them involved) and thus not getting employment-related services in the later phase of the program. The New Chance evaluation reported educational enrollment and school completion gains after 1 and 1-1/2 years, but had no statistically significant employment gains or AFDC reductions in this short term. It also measured many other outcomes in areas such as parenting, family planning, life skills, and health status. Positive effects on the mother’s democratic style of disciplining and raising a child were reported. But the evaluation reported negative effects on reducing subsequent pregnancies; participants were actually more likely to become pregnant again. This voluntary job training program at 13 sites, run by local community colleges or employment-oriented organizations, served disadvantaged teenagers aged 17 to 21 who had dropped out of school, including substantial numbers of teenage mothers. It linked teenagers to occupational training and to training-related employment, as well as provided training in-house. Sites often provided support services to facilitate participation (such as lunch or clothing money), and directly provided individualized self-paced GED instruction. The average stay in the program was 7 months (even though the program could last 1-1/2 years), so some participants might not have been in the program long enough to get much beyond their GED certificate. This evaluation used an experimental design with control groups and reported no major problems with control group comparability or participation rates. It reported data separately on teenage mother participants, thus allowing comparison with our other programs. The program reported educational enrollment and school completion gains at 4 years after program entry, but no employment gains or AFDC benefit reductions. The program did not provide family planning services, and participants experienced more subsequent pregnancies than the control group over the 4 years following the start of the program. Concerning the other participants, the program also reported school completion gains programwide, earnings increases for young men who had been arrested, and lower rates of AFDC receipt among young women who had not been mothers or who were not living with their children at program entry. This ongoing mandatory program enforces school attendance for all pregnant or parenting teens (under 20 years old) who do not have a high school diploma or GED and are receiving AFDC in the state of Ohio. It provides incentives and sanctions to attend school (increases and decreases in their AFDC benefits) and reimbursement for child care and transportation. Welfare offices obtain information from the public schools to monitor school attendance, note absences (excused and unexcused), and apply sanctions or incentives as appropriate. When needed, a case manager reimburses teenagers for child care or transportation costs, and in some locales has regular personal contact with a subset of teenagers. Program participation ends when the participant reaches age 19 or receives a high school diploma. There have been two evaluations of this program. The evaluation of the statewide program used an experimental design with a randomly assigned control group and was based on a subset of randomly selected counties in Ohio. A second evaluation provided long-term follow-up on a subset of the statewide program (Cleveland only) and an evaluation of a special demonstration offering additional services. A recently published evaluation reported the long-term results for both the Cleveland subset and the special demonstration. The statewide evaluation reported improved educational enrollment and attendance as well as increased GED completions after 1-1/2 years. But it had no information on high school graduations, nor did it separately note the GED results for those who were in school and for those who had already dropped out by the time they entered LEAP. The evaluation of the long-term Cleveland data showed increases over 3 years in GED or high school completions (but not for GED completions alone) for those who were in school on program entry, but not for school dropouts. The program did help dropouts return to school or an educational program. It did not, however, result in getting even a majority of teenage mothers into school, and only a small portion received their diploma or GED. Neither employment nor AFDC benefits were measured by these evaluations. In addition, the second evaluation assessed the addition of dropout prevention and truancy reduction services for selected participants in Cleveland. The study resulted in school completion gains over 3 years, but the comparison of the basic LEAP program with the LEAP-plus-additional-services program was inconclusive since many participants never received the extra services. This voluntary program, with sites in Boston; New York City; Phoenix; and Riverside, California, served young teens (aged 14 to 17) receiving AFDC, about half of whom were not attending school. While its approach was comprehensive, it mainly linked participants to existing services. It offered employment and basic skills training (mostly off-site), while a drop-in center provided individual counseling, pregnancy prevention, and parenting and life skills workshops after classes. Its unique characteristic was the use of community women who provided mentoring and friendship. Participants could remain in the program for up to 18 months, or until the participant reached 19 years old or received a GED, whichever came first; the average stay was 12 months. The quasiexperimental evaluation used comparison groups of teenagers from different cities, raising the possibility that existing differences between these groups (and not program participation) could account for some of the differences in their outcomes. In addition, the program also had difficulties carrying out the research as planned: the comparison group members received similar services in their communities, and program participation as well as school absenteeism was a problem. The program did not routinely monitor program or school attendance. The program realized school enrollment gains after 1 year, but no school completion gains after 1, 2, and 5 years. It was one of the few programs that measured long-term impacts, but it had no statistically significant employment gains or reduction in AFDC benefits. The results of parenting education were measured in more positive home environment and positive child development scores. After 5 years, it reported increased subsequent pregnancies. The Teenage Parent Demonstration (TPD) program is a mandatory program with 3 sites (in Chicago and Newark and Camden, New Jersey). It required first-time parents (under age 19) receiving AFDC to enroll in education, training, or employment activities. The program, which was run by the local welfare office, sanctioned those who did not enroll in activities by reducing their AFDC benefits. Case management, some educational services, and workshops on parenting, survival skills, and family planning were provided on-site. The program offered services for the length of the evaluation (almost 4 years) until age 20, and reimbursed child care and transportation expenses, with all participants receiving services for at least 1-1/2 years. The evaluation used an experimental design with control groups. The program reported good enrollment rates but periods of inactivity (failure to attend activities) of up to 6 months for some individuals, which suggests that some participants did not receive the intended treatment. The program aimed to change enrollment or participation rates (in school, training or a job) and was successful in doing so (participation rates were over 90 percent), but it had no significant school completion gains. It was the only program to have significant impacts on employment and AFDC receipt. Although participants experienced increased earnings and reductions in average AFDC benefits after 2 years, there was no significant change in their poverty status. Further, the incidence of subsequent births did not change significantly. The following team members made important contributions to this report: Margaret Boeckmann, Senior Social Science Analyst, was the team leader; Elaine Vaurio, Social Science Analyst, was the project manager for the evaluation synthesis; Rathi Bose, Vernette Shaw, and Lois Shoemaker, Evaluators, conducted site visits and prepared work papers; Gale Harris, Senior Evaluator, provided advice throughout the development of the report; and Nancy Crothers, Senior Evaluator, provided writing assistance. Bloom, Dan, Veronica Fellerath, David Long, and Robert G. Wood. LEAP: Interim Findings on a Welfare Initiative to Improve School Attendance Among Teenage Parents. New York: Manpower Demonstration Research Corporation, May 1993. Cave, George, Hans Bos, Fred Doolittle, and Cyril Toussaint. JOBSTART: Final Report on a Program for School Dropouts. New York: Manpower Demonstration Research Corporation, Oct. 1993. Hershey, Alan. Enrolling Teenaged AFDC Parents in Mandatory Education and Training Programs: Lessons From the Teenage Parent Demonstration. Princeton, N.J.: Mathematica Policy Research, Inc., Dec. 1991. Long, David, Robert G. Wood, and Hilary Kopp. LEAP: The Educational Effects of LEAP and Enhanced Services in Cleveland. New York: Manpower Demonstration Research Corporation, Oct. 1994. Maynard, Rebecca, ed. Building Self-Sufficiency Among Welfare- Dependent Teenaged Parents: Lessons From the Teenage Parent Demonstration. Princeton, N.J.: Mathematica Policy Research, Inc., June 1993. Maynard, Rebecca, Walter Nicholson, and Anu Rangarajan. Breaking the Cycle of Poverty: The Effectiveness of Mandatory Services for Welfare-Dependent Teenage Parents. Prepared for the U.S. Department of Health and Human Services, Contract # HHS-100-86-0045. Princeton, N.J.: Mathematica Policy Research, Inc., Dec. 1993. Maynard, Rebecca, Denise Polit, Alan Hershey, John Homrighausen, Ellen Kisker, Myles Maxfield, Charles Nagatoshi, Walter Nicholson, and Shari Dunstan. The Evaluation Design for the Teenaged Parent Demonstration. Prepared for the U.S. Department of Health and Human Services, Contract # HHS-100-86-0045. Princeton, N.J.: Mathematica Policy Research, Inc., Sept. 1988. Polit, Denise, and Janet R. Kahn. “Project Redirection: Evaluation of a Comprehensive Program for Disadvantaged Teenage Mothers,” Family Planning Perspectives (July/Aug. 1985), pp. 150-55. Polit, Denise, Janet R. Kahn, and David Stevens. Final Impacts From Project Redirection: A Program for Pregnant and Parenting Teens. New York: Manpower Demonstration Research Corporation, Apr. 1985. Polit, Denise, Janet C. Quint, and James A. Riccio. The Challenge of Serving Teenage Mothers: Lessons from Project Redirection. New York: Manpower Demonstration Research Corporation, Oct. 1988. Polit, Denise, and Cozette Morrow White. The Lives of Young Disadvantaged Mothers. Saratoga Springs, N.Y.: Humanalysis, Inc., May 1988. Quint, Janet C. “Project Redirection: Making and Measuring a Difference.” Evaluation and Program Planning, 14 (1991), pp. 75-86. Quint, Janet C., Barbara L. Fink, and Sharon L. Rowser. New Chance: Implementing a Comprehensive Program for Disadvantaged Young Mothers and Their Children. New York: Manpower Demonstration Research Corporation, Dec. 1991. Quint, Janet C., Denise F. Polit, Hans Bos, and George Cave. New Chance: Interim Findings on a Comprehensive Program for Disadvantaged Young Mothers and Their Children. New York: Manpower Demonstration Research Corporation, Sept. 1994. _____. New Chance: Interim Findings on a Comprehensive Program for Disadvantaged Young Mothers and Their Children. Executive Summary. New York: Manpower Demonstration Research Corporation, June 1994. Bogenschneider, Karen, and Thomas Corbett, eds. Welfare Reform: Can Government Promote Parental Self-Sufficiency While Ensuring the Well-Being of Children? 2nd ed. Wisconsin Family Impact Seminars Briefing Report. Madison, Wis: University of Wisconsin, Jan. 1995. Burke, Vee. Job Opportunities and Basic Skills (JOBS) Program: Basic Facts. Congressional Research Service Report for Congress. 94-282 EPW, Mar. 30, 1994. Corbett, Thomas. “Changing the Culture of Welfare.” Focus, 16:2 (Winter 1995), pp. 12-21. Granger, Robert C. “The Policy Implications of Recent Findings From the New Chance Demonstration, Ohio’s Learning, Earning, and Parenting (LEAP) in Cleveland, and the Teenage Parent Demonstration (TPD).” Manpower Demonstration Research Corporation. Paper presented at the annual meeting of the Association for Public Policy and Management, Chicago, Oct. 27-29, 1994. Gueron, Judith, and Edward Pauly. From Welfare to Work. New York: Russell Sage, 1991. Gwat-Yong Lie and Robert Moroney. “A Controlled Evaluation of Comprehensive Services Provided to Teenaged Mothers Receiving AFDC.” Research on Social Work Practice, 2:4 (Oct. 1992), pp. 429-46. Harris, Kathleen Mullan. “Teenage Mothers and Welfare Dependency.” Journal of Family Issues, 12:4 (Dec. 1991), pp. 492-518. Kisker, Ellen, and Marsha Silverberg. “Child Care Utilization by Disadvantaged Teenage Mothers. Journal of Social Issues, 47:2 (1991), pp. 159-77. Marsh, Jeanne C., ed. “Special Issue: Services to Teenage Parents.” Evaluation and Program Planning, 14:1/2 (1991). Maynard, Rebecca. “The Effectiveness of Interventions Aimed at Reducing the Incidence of Teenage Pregnancy and Mitigating the Consequence of Early Childbearing.” Paper presented at Annual Meeting of Association for Public Policy and Management, Chicago, Oct. 27-29, 1994. New York State Department of Social Services, Office of Program Planning, Analysis & Development and Division of Family & Children Services. Evaluation of the Teenage Services Act Program (TASA). Albany: Feb. 1990. Nickel, Phyliss S., and Holly Delany. Working With Teen Parents: A Survey of Promising Approaches. Family Focus, Inc., Chicago: Family Resource Coalition, 1985. Rudd, Nancy, Patrick McHenry, and Myungkyun Nah. “Welfare Receipt Among Black and White Adolescent Mothers.” Journal of Family Issues, 11:3 (Sept. 1990), pp. 334-52. The Center for Population Options. Teenage Pregnancy and Too-Early Childbearing: Public Costs, Personal Consequences. 6th edition, Washington, D.C.: 1992. University of Southern California School of Social Work. California’s Adolescent Family Life Program: Evaluating the Impact of Case Management Services for Pregnant and Parenting Adolescents. Final report, Aug. 1990. Welfare to Work: State Programs Have Tested Some of the Proposed Reforms (GAO/PEMD-95-26, July 14, 1995). Welfare to Work: Current AFDC Program Not Sufficiently Focused on Employment (GAO/HEHS-95-28, Dec. 19, 1994). Families on Welfare: Teenage Mothers Least Likely to Become Self-Sufficient (GAO/HEHS-94-115, May 31, 1994). Families on Welfare: Focus on Teenage Mothers Could Enhance Welfare Reform Efforts (GAO/HEHS-94-112, May 31, 1994). Welfare to Work: States Move Unevenly to Serve Teen Parents in JOBS (GAO/HRD-93-74, July 7, 1993). The Evaluation Synthesis (GAO/PEMD-10.1.2, Mar. 1992). Teenage Pregnancy: 500,000 Births a Year but Few Tested Programs (GAO/PEMD-86-16BR, July 21, 1986). The first copy of each GAO report and testimony is free. Additional copies are $2 each. Orders should be sent to the following address, accompanied by a check or money order made out to the Superintendent of Documents, when necessary. Orders for 100 or more copies to be mailed to a single address are discounted 25 percent. U.S. General Accounting Office P.O. Box 6015 Gaithersburg, MD 20884-6015 Room 1100 700 4th St. NW (corner of 4th and G Sts. 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Summary: Pursuant to a congressional request, GAO provided information on local programs that help teenage mothers complete their secondary education as a step toward self-sufficiency. GAO found that: (1) communities have responded to the growth of unwed teenage mothers by creating programs to help them achieve economic self-sufficiency by completing their secondary education; (2) three of the five programs studied increased secondary education completion by actively monitoring school attendance and providing access to child care and transportation; (3) innovative approaches to help teenage mothers complete high school included alternative public schools for pregnant and parenting students, residential facilities for homeless teenage mothers on welfare, and home visiting; (4) all of the 15 cities surveyed required teenage mothers on welfare to continue their secondary education, but 12 of the cities did not monitor the teenage mothers' attendance; and (5) states use of these successful approaches will depend on Congress' decision on whether welfare benefits should be provided to teenage mothers.