AIM 4 Teen Moms

Developers
Dr. Leslie Clark, Ph.D.; Irene Lim, LCSW; Frances Cordero, MPH; Mona Desai, MPH; Children’s Hospital of Los Angeles.
Program Summary
AIM 4 Teen Moms seeks to reduce rapid repeat pregnancies by helping teen mothers define specific life aspirations, engage in planning to successfully achieve them, and consider the role of contraception in their lives. The ten-week program consists of six one-hour individual sessions, one ninety-minute group session at the half-way point, and another 90-minute group session at the end of the program. It is delivered in teens' homes and/or community-based locations, by trained facilitators (called Advisors).
Intended Population
The program is designed for new teen mothers who are 14 to 20 years old and have at least one child. It has been evaluated with Hispanic and African American teens who were 15 to 19 years old and had one child, in Los Angeles County, CA.
Program Setting

The program was designed for and evaluated in participant homes (for individual sessions), and in community-based locations (for group sessions).

Contact and Availability Information
AIM Service Center
Children's Hospital Los Angeles
5000 Sunset Blvd., 7th floor
Los Angeles, CA 90027
Phone: 323-361-3126
Email: aim@chla.usc.edu
AIM Service Center
Children's Hospital Los Angeles
5000 Sunset Blvd., 7th floor
Los Angeles, CA 90027
Phone: 323-361-3126
Email: aim@chla.usc.edu
Sample of curriculum available for review prior to purchase
Yes
Adaptation guidelines or kit available
No
Languages available
English and Spanish (pending)
Program Core Components
Category Component Core Component Component present Notes Lesson number(s) / activities where present
Content Graduating from high school Yes Yes (both versions) Higher Education Handout Session 1, Activity E, page 14
Content Substance use - Alcohol No
Content Other No
Content Volunteering/civic engagement No
Content Spirituality No
Content Morals/values No
Content Identity development Yes Yes (both versions) Aspiration Declaration/Imagining My Future Session 2, Activity A, page 38/Group 1, Activity E, page 116-117
Content Social support/capital Yes Yes (both versions) Teen Mom Discussion/My New Positive Influence/Tree of Support Group 1, Activity B, page 108-109 / Group 1, Activity F, page 118/Session 5, Activity C, page 137-138
Content Social influence/actual vs. perceived social norms Yes Yes (both versions) Teen Mom Discussion Group 1, Activity B, page 108-109
Content Social competence Yes Yes (both versions) Communication Styles and Role-Plays/ Choose My Style & Mirror Mirror Group 1, Activity C, page 110 - 114/ Session 5, Activity A, page 133-135
Content Parenting skills No
Content Normative beliefs No
Content Leadership Yes Yes (both versions) Legacy Introduction Session 1, Activity C, page 7-8
Content Gender roles No
Content Gender identity No
Content Cultural values No
Content Connections with trusted adults Yes Yes (both versions) Influences in My Life & Tree of Support Session 5, Activity C, page 137-138
Content Conflict resolution/social problem solving Yes Yes (both versions) Communication Styles and Role-Plays/ Choose My Style & Mirror Mirror Group 1, Activity C, page 110 - 114/ Session 5, Activity A, page 133-135
Content Communication skills Yes Yes (both versions) Communication Styles and Role-Plays/ Choose My Style & Mirror Mirror Group 1, Activity C, page 110 - 114/ Session 5, Activity A, page 133-135
Content Child development Yes Yes (both versions) Child Developmental milestones Session 1, Activity B, page 5-6
Content Boundary setting/refusal skills Yes Yes (both versions) Communication Styles and Role-Plays/ Choose My Style & Mirror Mirror/ Bill of Rights Group 1, Activity C, page 110 - 114/ Session 5, Activity A, page 133-135/Session 5, Activity B, page 136
Content Substance use cessation No
Content Substance use - Other drugs No
Content Substance use - Abstinence No
Content Brain development and substance use No
Content Vocational/skills training Yes Yes (both versions) Higher Education Handout/Personal Experience & Resume Session 1, Activity E, page 14/Session 3, Activity B, page 65-66
Content Supplemental academic services No
Content School engagement No
Content College preparation No
Content Alternative schooling No
Content Self-regulation No
Content Self-esteem Yes Yes (both versions) Inspirational Quotes & Affirmations Poster/Aspiration Declaration Session 1, Activity D, page 11-12/Session 2, Activity A, page 38
Content Self-efficacy/empowerment Yes Yes (both versions) Practices for Self Confidence cards/aspiration declaration Session 1, Activity F, page 16
Content Resilience No
Content Personal vulnerability Yes Yes (both versions) Teen Mom Discussion/Communication Styles and Role-Plays/Mirror Mirror/Tree of Support/Celebration Ceremony Group 1, Activity B, page 108-109/Group 1, Activity C, page 110 - 114/ Session 5, Activity A, page 133-135/Session 5, Activity C, page 137-138/Group 2, Activity C, page 175-176
Content Risk of STIs and Pregnancy Yes Yes (both versions) Introduction to Reproductive Life Plan Session 2, Activity D, page 43-45
Content STIs - Screening No
Content STIs - Prevention Yes Yes (both versions) Birth Control Kit Session 3, Activity A, page 61 - 64; Birth Control Method Handout
Content STIs - Information No
Content Sexual risk reduction Yes Yes (both versions) Birth Control Kit Session 3, Activity A, page 61 - 64; Birth Control Method Handout
Content Sexual risk discontinuation No
Content Sexual risk avoidance No
Content Sexual orientation No
Content Motivational interviewing No
Content Contraception - Pills, patches, rings, and shots Yes Yes (both versions) Birth Control Kit Session 3, Activity A, page 61 - 64; Birth Control Method Handout
Content Anatomy/physiology No
Content Contraception - Condoms Yes Yes (both versions) Birth Control Kit Session 3, Activity A, page 61 - 64; Birth Control Method Handout
Content Contraception - Long-acting reversible contraceptives Yes Yes (both versions) Birth Control Kit Session 3, Activity A, page 61 - 64; Birth Control Method Handout
Content Contraception - Other Yes Yes (both versions) Birth Control Kit Session 3, Activity A, page 61 - 64; Birth Control Method Handout
Content Puberty/development No
Program Objectives
AIM 4 Teen Moms, a positive youth development program, encourages teen mothers to envision positive futures for themselves and to identify the practical steps necessary to achieve their long-term goals. The program’s goal is to reduce rates of unprotected sex. The program aims to achieve these goals through a range of potential mediating factors—for example, encouraging participants to think about their future educational and career aspirations, motivating them to pursue their aspirations, and providing them with the information needed to make informed decisions about effective contraceptive methods.
 
In the long-term, the program aims to reduce rates of unprotected sex leading to fewer repeat pregnancies and teen births.
Program Content

AIM 4 Teen Moms is based on the Theory of Possible Selves, which states that a person’s motivation is determined by a balance of positive and negative ways people see themselves in the future. Individuals who are able to imagine both possible positive and negative futures are more likely to work toward their life goals and achieve future success.

AIM 4 Teen Moms emphasizes control over one’s future, connects present actions and reproductive choices with future achievements, and defines motherhood as an identity strength rather than a stigma. Drawing on the Theory of Possible Selves, Promotion-Prevention Motivational Orientations and youth development principles, AIM 4 Teen Moms identifies and builds on teen mothers’ hopes for their future and elicits their motivations for attaining adulthood goals.

The program consists of five main content core elements:

  1. Thinking about a positive possible future
    Through activities, and discussion, youth envision a positive future and set goals to achieve it.
  2. Present actions to achieve future success.
    Youth learn communication skills, how to identify their own strengths as well as needed resources and experience a sense of success through engagement in personal and group activities.
  3. Safeguarding one’s future.
    Youth are encouraged to safeguard their future through risk reduction.
  4. Creating a reproductive life plan.
    The curriculum incorporates knowledge of different methods of contraception and conceptualizes family planning as part of a larger holistic reproductive health agenda. Youth create a personalized reproductive life plans.
  5. Motherhood as an identity strength.
    The program acknowledges motherhood as a driving force that motivates many young mothers to succeed in life. Youth are encouraged to consider parenting as adding to the strengths and experiences useful to succeed rather than as a limiting factor in their life.

The program covers the core elements through six individual sessions and two group sessions:

Session 1 - My Future and My Legacy
Session 2 - My Aspirations and Approach to Family Planning
Session 3 - My Aspirational Resume and Birth Control
Session 4 - Planning and Presenting Myself to the World
Group 1 - Claiming my Future
Session 5 - Relationships in My Life 
Session 6 - Putting it All Together
Group 2 - Celebration

Program Methods
The program sessions involve a sequenced series of activities designed to build on the life experiences of program participants and support positive youth development.

For the home visits, trained program facilitators (‘advisors’) schedule times to meet with participants in their homes or another location and deliver the six sessions over a roughly 10-week period. The sessions involve a mix of interactive discussion, structured activity worksheets, brainstorming, and role-playing. The two group sessions take place in central community-based locations and bring together small groups of program participants near the middle and at the end of the 10-week program. These sessions reinforce the information provided during the home visits, address realities of teen motherhood, and give participants an opportunity to receive feedback and support from a network of peers.  

Participants begin by identifying their future aspirations and choosing a career path to focus on for the purposes of the program. In later sessions, participants write aspirational resumes, draw timelines of their life, and engage in planning for future success. Participants also develop a reproductive life plan that aligns with their present experiences and future goals. Throughout these activities, the participant workbooks require participants to identify current and future achievements, sources of support, and potential “detours” or “roadblocks” to their goals. Near the end of the program, each participant compiles a personal “portfolio” containing the work they accomplished during the program. 
Program Structure and Timeline
AIM 4 Teen Moms is a ten-week program consisting of:
  1. Six 1-hour individual sessions, generally delivered in participants' homes.
  2. Two 90-minute group sessions, delivered in community-based locations.
Staffing
Advisors must be comfortable discussing contraception with teens and interacting with teen mothers on a one-on-one basis. 
Program Materials and Resources
The following materials are provided with the AIM 4 Teen Moms intervention package:
  • Advisor Handbook
  • Implementation Manual and Technical Assistance Guide
  • Monitoring and Evaluation Guide
  • VB Game Kit (Session 2 & 6)
  • Role-Play Scenario Cards & Communication Style Cards (Group 1)
  • Advisor USB Drive, including:
  1. Advisor tools: Continuity Sheet, Directory of Images, & Group Evaluation
  2. Templates: Group 1 Reminder, Group 1 Sign in sheet, Resume, Certificate of Accomplishment, & Certificate of Appreciation
  3. For Youth: Quotes/Affirmations, Birth Control Sheets, & Web Ticket Guide
Additional Needs for Implementation
AIM 4 Teen Moms Licensing Requirements

All agencies who implement AIM 4 Teen Moms must sign a license agreement, granting them the right to implement and/or adapt AIM 4 Teen Moms under the terms outlined by CHLA. All agencies must sign this contract prior to having Advisors (facilitators) trained and implementing AIM 4 Teen Moms. An associated annual license fee for each site must be paid as part of the licensing agreement.

Youth-specific Materials
There are a total of six items that must be purchased for each individual teen participating in AIM 4 Teen Moms.
 
To be purchased from the AIM Service Center:
  • Participant Workbook
  • Key Chains (Session 1)
  • Portfolios (Session 6)
  • Participant USB Drive (Session 6)

The next two items can be ordered from The Career Game website. For more information on how to order the booklets and Web Ticket, go to www.careergame.com to purchase:

  • The Career Game booklet (Session 1)
  • Web Ticket (Session 1)

The following materials are not included in the package and will need to be acquired before implementing AIM 4 Teen Moms.  These should be included within your budget:

  • CDC Developmental Milestones Brochure (available for free) (http://www.cdc.gov/ncbddd/actearly/freematerials.html)
  • Arts/Crafts Kit (e.g.: Markers, stickers, scissors, etc.)
  • Birth Control Kit (e.g.: Sample Implanon, Birth control pills, etc.)
  • Office Supplies (e.g.: Clear Labels, Construction paper, Card stock, etc.)
  • Hand held Mirror (Session 5)

Advisors also need access to a computer and a printer with the ability to access the internet.

Fidelity
The developer provides the following guidelines to providers related to implementing AIM 4 Teen Moms with fidelity:
  • Participants should attend at least 5 out of 7 sessions  (*not counting the celebration group session)
  • All participants must complete Session 1 and Session 2.
  • All individual sessions, must be conducted one on one.
  • All facilitator staff must be certified through the AIM Service Center with the 3 day training.
  • AIM 4 Teen Moms facilitator fidelity monitoring sheets may be used for assessing Advisor (facilitator) performance for each individual and group session as appropriate
Regular meetings between the intervention director or program supervisor and facilitators are recommended to ensure consistency and fidelity in implementing the AIM 4 Teen Moms program.
Staff Training
Staff delivering AIM 4 Teen Moms are expected to attend a three day in-person required training before beginning implementation. The training is based on the theory, approach, research findings and core elements underlying AIM 4 Teen Moms and on the content of the Advisor’s Handbook. Training participants have the opportunity for hands-on practice of program activities. In addition, advisors should be knowledgeable in birth control methods and comfortable in talking about methods with teens.
 
Certification to be an AIM 4 Teen Moms advisor (facilitator) requires the successful completion of the 3 day training provided by the AIM Service Center (Email: aim@chla.usc.edu).
Technical Assistance and Ongoing Support
Technical assistance is available by contacting the AIM Service Center (Email: aim@chla.usc.edu).
Allowable Adaptations
Modifications of the legacy worksheet are allowed to increase the suitability to the target population with whom it is being used (e.g. Native American, Asian & Island Pacific teen mothers)
Reviewed Studies
Citation High-Quality Randomized Trial Moderate-Quality Randomized Trial Moderate-Quality Quasi-experiment Low Study Rating Did Not Meet Eligibility Criteria

Covington et al. 2015

Covington et al. 2017

 		✓
Study Characteristics
Citation Setting Majority Age Group Majority Racial/Ethnic Group Gender Sample Size

Covington et al. 2015

Covington et al. 2017

 		Community-based organization, Home-based 14 to 17 Hispanic or Latinx of any race Young women

800
Study Findings

Evidence by Outcome Domain and Study

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Covington et al. 2015

Covington et al. 2017

 		Indeterminate evidence Indeterminate evidence Potentially favorable evidence n.a. Indeterminate evidence
Detailed Findings
Citation Details

Covington et al. 2015

Covington et al. 2017

The program was evaluated in a randomized controlled trial involving low-income adolescent mothers in Los Angeles County. Participants were randomly assigned to either an intervention group receiving AIM 4 Teen Moms or a control group that was not offered the program but that had access to other services for teen mothers in their communities. Outcomes were measured 12 and 24 months after participants enrolled in the study.

The study found that 12 months after enrollment, adolescent mothers in the intervention group were less likely to report having had sex without any effective contraceptive method in the past three months (odds ratio = 0.72, confidence interval = 0.61 to 0.85). This effect was not sustained 24 months after enrollment: adolescent mothers in the intervention group were no less likely than their counterparts in the control group to report having had sex without any effective contraceptive method in the past three months (odds ratio = 1.19).

Twelve and 24 months after enrollment, the study found no statistically significant program impacts on having had sexual intercourse in the past three months, the number of sexual partners in the past 12 months, or on having sex without using a condom or specific forms or birth control methods such as birth control pills, an implant, any LARC method, an IUD, the shot, the patch, or the ring, in the past three months. At the follow-up that occurred 24 months after enrollment, the study also found no evidence of statistically significant program impacts on repeat pregnancy, the number of pregnancies since birth of first child, and repeat pregnancy resulting in a new birth.

Program impacts were also examined on measures of exposure to information about effective contraception, school or work engagement, support for safe sex, and intentions to avoid unprotected sexual activity. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.