This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations.

Introduction A common concern of federal funders and grant recipients is how to sustain program activities once their federal funding period ends. Federal funding can be intended to develop or seed a program but not necessarily to continue its activities indefinitely. Understanding the importance of programmatic sustainability, the Office of Population Affairs (OPA) conducted research in 2015 on the elements that contribute to sustainability. As part of the Sustainability Study, OPA collected information from former Pregnancy Assistance Fund (PAF) program grantees. Methods Grantees that were awarded cohort 1 PAF program funding (2010–2014) but not awarded cohort 2 funding (2014–2017) were eligible for study inclusion because their OPA funding ended more than 1 year prior to the Sustainability Study, allowing for an assessment of sustainability after federal funding. Seven former PAF grantees were identified as eligible. Interviews were conducted with six of these grantees; grant applications and interim final reports from all seven were reviewed. Results Five lessons emerged from interviews and review of grant documentation. Programs successfully continuing beyond the federal grant period tended to (1) diversify funding sources, (2) communicate regularly with key stakeholders, (3) form partnerships with like-minded programs, (4) consider implementing evidence-based interventions, and (5) begin planning for sustainability early. Discussion By considering these lessons learned from the research, grantees can be well positioned to continue beyond a federal grant period. The lessons garnered from the Sustainability Study have informed, expanded, and affirmed OPA’s sustainability toolkit, sustainability framework, and technical assistance.

Purpose The New Mexico Graduation Reality and Dual-role Skills (GRADS) program provides services for expectant and parenting students at high schools. The GRADS program has operated since 1989, serving more than 17,000 youth. This study summarizes the GRADS program model and program administrators’ lessons learned from implementing this comprehensive, large-scale program. Description The GRADS program is a multicomponent intervention that can include a classroom intervention, case management, linkages to child care and health care, and support for young fathers. The program aims to support expectant and parenting youth in finishing high school, delaying a repeat pregnancy, promoting health outcomes for their children, and preparing for college and career. This study presents program administrators’ lessons learned to increase understanding of how to implement a statewide program to support expectant and parenting students. Assessment During the 2010–2017 school years, the GRADS program operated in 26–31 sites each year, serving a total of 2691 parenting youth. Program administrators identified lessons learned from implementing the GRADS program during that period of expansion, including allowing variation across sites based on resources and needs, providing centralized implementation support, fostering buy-in from school and district leaders, and collecting consistent data to better understand participant outcomes. Conclusions Although not based on a rigorous impact or implementation study, this article provides lessons learned from a statewide, school-based program that may be a promising way to serve a large number of expectant and parenting youth and help them overcome challenges for completing high school.

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Objectives With funding from the Pregnancy Assistance Fund, the Maternal, Child, and Adolescent Health Division (MCAH) of California redesigned its existing Adolescent Family Life Program (AFLP) for expectant and parenting young women into a more intensive and structured intervention, AFLP with positive youth development (PYD). This paper presents key findings from a federally funded, rigorous implementation study of the two programs. Methods This implementation study collected data from 13 agencies from January 2016 through December 2017, including interviews with 69 case managers and 18 supervisors; focus groups with 130 program participants; surveys of 66 case managers and 1330 young women; and observations of 42 visits with program participants. The study combined qualitative and quantitative analysis methods. Results As designed, PYD was a much more structured and intensive program than AFLP. Case managers and supervisors saw value in the PYD model and new approach but needed more support and guidance than expected in order to deliver it with fidelity. MCAH provided additional trainings and technical assistance to address challenges. In practice, although staff noted differences in approach and content, the youth experience with the two programs was similar. Conclusions for Practice Integrating the PYD framework into case management systems may foster youth self-sufficiency and resiliency. However, the rigid structure of the program was often challenging to implement in practice. Organizations interested in implementing prescribed case management approaches should consider allowing opportunities for flexibility in implementation and providing more detailed preservice training to prepare staff for real-world implementation.