Barnet, B., Rapp, T., DeVoe, M., & Mullins, C. D. (2010). Cost-effectiveness of a motivational intervention to reduce rapid repeated childbearing in high-risk adolescent mothers: A rebirth of economic and policy considerations. Archives of Pediatrics and Adolescent Medicine, 164(4), 370-376.
Model(s) Reviewed:
Computer-Assisted Motivational Intervention plus enhanced home visiting (CAMI+)
,
Computer-Assisted Motivational Intervention (CAMI)
Additional sources:
Barnet, B., Liu, J., DeVoe, M., Duggan, A. K., Gold, M. A., & Pecukonis, E. (2009). Motivational intervention to reduce rapid subsequent births to adolescent mothers: A community-based randomized trial. Annals of Family Medicine, 7(5), 436-445. doi:10.1370/afm.1014
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Not applicable | None | None | Not assessed in manuscripts reviewed before 2021 |
| Study participants | Pregnant teenagers were recruited from urban medical clinics that provided prenatal care to women without insurance or who were insured by Medicaid. The teens were assigned randomly to one of two intervention groups (CAMI and CAMI+) or a control group. Initially 235 pregnant teenagers were randomly assigned, 167 to the treatment groups (87 to CAMI and 80 to CAMI+) and 68 to the comparison group. Most were poor, African American, and unmarried. Mothers ranged in age from 12 to 18 years old at intake (24 weeks or more gestation). Ninety-seven percent of the mothers were African American. Participants were followed for 27 months. |
|---|---|
| Setting | The study was conducted in Baltimore, Maryland. |
| Intervention services | The intervention included two home-based treatment groups: CAMI and CAMI+. The CAMI intervention began after the delivery of the participant’s child and sessions were held every three months until the child turned 2 years old. A participant assigned to the CAMI group met with her counselor to assess her current behaviors and to receive “motivational interview counseling” that encouraged the participant to use contraception and avoid future rapid subsequent pregnancies. The participant and counselor worked together to establish short- and long-term goals. Adolescents assigned to the CAMI+ intervention received all the services given to those in the CAMI group plus more intensive services. These services included additional monthly home visits with a CAMI counselor, which involved case management and education on effective parenting. Participants received a maximum of nine home visits by a CAMI counselor. |
| Comparison conditions | Comparison group members received usual care at their prenatal care sites. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). Subgroups are not listed for manuscripts reviewed before 2021. |
| Funding sources | Department of Health and Human Services, Office of Population Affairs, Office of Adolescent Pregnancy Programs, Grant APRPA006010. |
| Author affiliation | Beth Barnet, a study author, is a developer of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Repeat birth | FavorableUnfavorable or ambiguousNo Effect |
CAMI vs. control | 24 months postpartum | 148 mothers | % = 17.00 | % = 25.00 | = -0.08 | HomVEE calculated = -0.29 | Not statistically significant, p=0.08 | |
| High | Repeat birth | FavorableUnfavorable or ambiguousNo Effect |
CAMI+ vs. control | 24 months postpartum | 148 mothers | % = 14.00 | % = 25.00 | = -0.11 | HomVEE calculated = -0.44 | Statistically significant, p=0.01 |