Pregnancy-free club: a strategy to prevent repeat adolescent pregnancy.

Public health nurses (PHNs) implement interventions from the Public Health Intervention Wheel in a school-based program to prevent repeat adolescent pregnancy. The local health department, the school district, and a community hospital collaborated to develop the Pregnancy-Free Club (PFC) for adolescent mothers attending the school. Their goal was to prevent repeat adolescent pregnancy through a multifaceted approach. Strategies include the daily presence of PHNs in the school, monthly pregnancy tests and surveys, health counseling and referral, and group health education classes. The school also provides day care for participants' children. Following program initiation, the repeat adolescent pregnancy rate declined from 25% [corrected] to a mean of 7.2% [corrected] over 9 years of the program. Data from focus groups conducted with program participants suggested modifications that would increase participant satisfaction with the PFC. The daily presence of a PHN who was open and nonjudgmental paired with a supportive school environment, the availability of birth control counseling and referral, and affirmation of healthy choices to remain pregnancy free, were essential program components.