CASE: SI-56

DATE: 05/26/04 (REVD 02/13/07)

Lecturer Laura Arrillaga-Andreessen and Victoria Chang prepared this case as the basis for class discussion rather than to illustrate either effective or ineffective handling of an administrative situation. The Stanford Graduate School of Business gratefully acknowledges the assistance of Giving 2.0 (giving2.com) in the development of this case.

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SAND HILL FOUNDATION Susan Ford served as the president and cofounder of the Sand Hill Foundation, a family foundation, which made grants to organizations that benefited people on the San Francisco Peninsula, particularly in San Mateo and Santa Clara Counties. The foundation was established by Tom and Susan Ford in 1995, emerging from the Fords shared passion for giving and community development. The foundation focused on the environment, education, preservation of open space, youth development and job training. The Fords were among the original donors of the Teen Success Program, a support group for teen mothers launched in 1990 by Planned Parenthood Mar Monte (PPMM).1 The program encouraged teens not to have a second child and to stay in school, in exchange for $10 per week and $100 for every 25 weeks of attendance. Teen Success groups met weekly for approximately one-and-a-half hours with up to two group facilitators and up to 12 teen mothers. Childcare was provided during group meetings, and participants could remain in the groups until they turned 18 or completed high school. If a teen became pregnant and had an abortion, she was able to return to the group. If a teen became pregnant, PPMM moved her to another program to receive support for the second child. In 1995, after investing more than $200,000 in the initiative, Susan Ford decided to measure the effectiveness of the Teen Success Program. Her intention was to validate the programs results and identify its strengths and opportunities in an effort to help it grow further. Yet, even though Ford had developed a positive relationship with Linda Williams, the head of PPMM, she worried that Williams might feel threatened by her proposal for an assessment of the programs impact. 1 The Fords had invested in the Teen Success Program prior to formally starting the Sand Hill Foundation.

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The evaluation process resulted in tensions that caused both Ford and Williams to reflect upon the dynamics of the grantor-grantee relationship, as well as the role of evaluation in their future work.

PLANNED PARENTHOOD SAN MATEO: TEEN INCENTIVE PROGRAM

The Teen Success Program evolved from Tom and Susan Fords early experience working with Planned Parenthood San Mateo. It was at their suggestion that Planned Parenthood San Mateo established the Teen Incentive program, a support group that empowered teen mothers to maintain their current family size, finish school, and plan positive futures for themselves and their children. Tom [Ford] heard about a program in Denver, Colorado that paid teenage girls $7 per week not to get pregnant again, recalled Susan Ford.2 Tom contacted the Planned Parenthood in San Mateo County about replicating the Colorado program. They agreed to try the program, and we funded the first program in 1989 in East Palo Alto. We donated $5,000 for the first group of 12 teen moms, and Planned Parenthood raised the additional $21,000 from individual donors to support the group for a year. Susan Ford provided initial consultation and advice on the program design. We were involved initially in terms of where the program should begin, what the focus should be, and whether the stipend should be increased to $10 per week or not. We also decided that there should be more meat to our program versus the one in Colorado. In Colorado, the teens just checked in, showed that they werent pregnant, and received their money, she said. Ford and the Sand Hill Foundation had great success with the Teen Incentive Program in San Mateo and decided to expand their support to other areas in Northern California. Inspired by Tom Ford and the San Mateo program, Morgan Family Foundation President Becky Morgan contacted Linda Williams, the head of Planned Parenthood Mar Monte in Santa Clara, California in 1990 to discuss launching a similar program there.

PLANNED PARENTHOOD MAR MONTE: TEEN SUCCESS PROGRAM

PPMM was interested in launching a similar program as the one in San Mateo, but they changed the program model to increase the support group focus and gave the program what they perceived to be the more teen-friendly name of Teen Success. Teen Success targeted teen mothers between the ages of 12 to 17, and participants could stay in the program until they reached the age of 18 or when they graduated from high school. Teen mothers could enroll while they were still pregnant or parenting. Teen Success emphasized communication, education, skills development, and problem solving to give teen mothers the guidance and encouragement that they needed. The curriculum included topics such as communication, values, and birth control. Teen Success provided teen mothers with a $10 per week allowance, in exchange for their attendance at a weekly support group led by facilitators. The program also provided bonus rewards of $100 for every 25 weeks that the teens stayed in the program. What appealed to me about Teen Success was that this was an incentive as opposed to a penalty for girls who had become pregnant as teenagers, said Morgan.

2 All quotations from representatives in the case are from interviews by authors unless otherwise cited.

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Ford agreed: Without an intervention, one in five teen mothers would have another child within two years. Most of those who participated in the program initially joined to receive the $10 per week. However, as the teen mothers attended weekly support groups, they began to realize the programs non-monetary benefits. When I first came, I came for the $10, said a participant. But now that I come, I would come without the $10. When you have a baby, you dont really go places anymore, said another participant. Youre usually at home with the baby. You can come here and be with other teen moms and see how its going to be or how it already is. Myrna Oliver, director of Teen Services at PPMM elaborated: They [teen mothers] start to feel ownership of the group. They come out every week, and they feel supported by their peers. They get the guidance from the facilitators, and they start to see the value of setting goals and reaching them.

PROGRAM EXPANSION

Tom and Susan Ford and the Sand Hill Foundation soon expanded their support of Teen Success to PPMM. They offered $5,000 as seed money for each new group and funded a group in the high-need area of East San Jose. PPMM expanded Teen Success geographically into other high-risk areas. According to Oliver, Some alternative schools in Gilroy heard about Teen Success and wanted to start a similar program there. We met with the school principal at Mount Madonna High School and negotiated with the school, and in June 1991, we started our second program in Gilroy. We started the third one in Mountain View, and it just kept on going. By 1995, the Teen Success program had five groups in Santa Clara and San Benito Counties in California, each funded by private or corporate donors. The groups included Eastside (two groups), Mountain View, Sunnyvale, Gilroy, and Hollister. In 1995, there were 46 teens enrolled in the five Teen Success groups. As the program expanded, PPMM worked with local communities to raise money. When we move into a new area such as Watsonville, we really try to find a local donor base and try not to go back to the original donors in Palo Alto or Atherton, noted Oliver. A lot of times, the new donor base is not as affluent as the local one in Silicon Valley, but what weve been able to do is to work with entire counties who agreed to fund a program in a particular area.

PROGRAM MEASUREMENT

By 1995, the Fords had donated over $200,000 to PPMM to fund the Teen Success Program. Up until that point, the Teen Success Program had not yet been formally evaluated. Formal evaluations were very expensive, and it has never been something that donors seemed interested in, said Oliver. Thats not an excuse, but we gradually realized that there was a need to develop some kind of tool through which we would monitor our program participants two, three, and four years out of the program. Even though PPMM had not conducted a formal evaluation of the Teen Success Program, the organization had attempted to track basic statistics. According to PPMM, only 4 percent of Teen Success participants had become pregnant a second time, compared to 33 percent of the general population of teen mothers who had second pregnancies within two years of giving birth. In

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addition, at least 80 percent of Teen Success graduates had completed high school or received a GED, compared to the average of 50 percent of pregnant teens in the general population who had completed high school. More than one in four Teen Success participants had continued her education beyond high school. Oliver commented on the difficulty of tracking repeat pregnancies: We try to keep track of the participants in our program, but many times members move away or dont keep in touch, and therefore our data may be skewed. In 1995, Ford decided to formally evaluate the Teen Success Program:

We wanted to help PPMM grow the program, but we didnt have formal authority over the program. There was nothing in the grant agreements or anything about PPMM needing to consult us on minor or even major changes, but we definitely wanted to help them grow the program. The program was a significant investment for us, so we had opinions about how things should be handled. We wanted to measure the success of the program and determine and verify important statistics such as the pregnancy rate of the teen moms in the program. We also wanted to measure how the teens and the facilitators felt about Teen Success and the impact of the program on the teens who had participated.

Ford decided to hire an external evaluator to assess the Teen Success Program. I suggested to Linda Williams that we hire an outside evaluator from one of the universities to come in and conduct an analysis, she recalled. Linda wasnt really keen on the idea. She didnt say no, but I knew that she was threatened by the evaluation, so I reassured her that if the results werent what we expected, we wouldnt stop funding the program. Ford ultimately decided to hire Jane Kramer, an academic associated with the Bay Area Foundation for Human Resources and the Center for Reproductive Health Policy Research, 3 to design and conduct the evaluation.

EVALUATION METHODOLOGY AND RESULTS

According to Kramer, the purpose of the evaluation was to determine: (1) what was and was not working well; (2) how the teens and facilitators felt about Teen Success; and (3) how the program impacted teens who had either graduated from Teen Success or left before the time of the evaluation. The evaluation included: (1) observations of all support groups and group interviews with the teens; (2) design of a questionnaire for all teens currently in the program; (3) design of a questionnaire for all teens who left the program (to graduate or for other reasons); (4) analysis of intake data on all teens who joined the program; (5) review of all written material on Teen Success; (6) interviews with all Teen Success facilitators; and (7) review of the literature on repeat adolescent pregnancy. The evaluation also drew upon interviews with 35 (out of a total of 46) teens enrolled in the Teen Success Program (78 percent), and 25 teens who had left the program (21.5 percent). In the Executive Summary of her report, Kramer pointed to both successes and potential areas of improvement:

3 Located at the University of California, San Francisco.

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Teen Success is a solid program that appears to retain teens in the groups and graduates almost half of the teens. Because of poorly maintained records, it is impossible to determine the reason teens left the program before [graduating]. Calculations based on 25 teens that were reached for follow-up interviews indicate that approximately one-third may leave the program because of a pregnancy.4 PPMMs estimates are lower than this (approximately 4 percent or approximately five of 124 teens). The true dropout rate due to pregnancy is likely to be somewhere between 12 percent and 30 percent. The first figure is based on a small (and perhaps unrepresentative) sample, and the second is based on conjecture. Some teens may leave the program without admitting to the group that they are pregnant, and therefore Planned Parenthoods number may under-report pregnancies. The retention of teens appears to be strong, the number of graduates is impressive, and the teens appear to be extremely satisfied with the program.5

Kramer continued by discussing areas of potential improvement:

However, the program itself is in need of updating and strengthening. There are large variations between the quality of facilitators, and there is a lack of guidance about curricula and expectations of what should be accomplished in the groups and how. Moreover, in several of the groups, there appears to be an over-emphasis on checking in and lack of emphasis on more meaningful group activities (such as role play, focused discussions, etc.). PPMM should offer the facilitators additional opportunities for training, through better orientation, more supervision, and continuing education opportunities. Staff should also reassess the vision of Teen Success and explore additional methods of encouraging teens to continue in the program.

Kramer additionally noted opportunities to evolve existing programming:

The presence of five support groups provides fertile ground for testing and implementing new ideas regarding the incentives and bonuses, curriculum, and methods of leading a group. Learning modules should be developed and perhaps be pre-tested in one or two groups to assess their value. PPMM should be encouraged to conduct their own evaluations of the project to improve the quality of services. This includes inviting the teens to provide anonymous feedback on the program. Their feedback may be extremely useful (in one group, the teens told me that they spent very little time discussing birth control, while the facilitator thought that she covered the topic frequently). Facilitators must also maintain better records on both the teens in the program, as well as the graduates. One person should coordinate this effort. It is especially critical to collect data on pregnancy.

Kramer concluded: 4 Of the 14 teens who answered the question, Why did you leave Teen Success? four cited another pregnancy. 5 Quotations in this section are excerpts from the Teen Success Program evaluation.

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In sum, Teen Success is a strong program, with a worthwhile goal and appropriate focus. The program needs to take a fresh look at the quality and variations among the support groups and impose a stronger vision regarding what each group should accomplish, both in form as well as substance. The pregnancy rate of between 12 percent and 30 percent is within the range of an expected repeat pregnancy rate for adolescents who are not in a prevention program and is therefore cause for some concern regarding the effectiveness of this program in preventing repeat pregnancies.

Kramers evaluation also showed that Teen Success participants valued the financial incentives but saw many other benefits to the program:

Some have asserted that teens join Teen Success because of the incentives and leave the program when the money is no longer available. Eighty three percent report that incentives are either very or somewhat important. Eighty percent said that they would continue to come to the program if there were no weekly incentives, and 92 percent claim that they would continue to participate even if there were no bonus. Undoubtedly, this issue is more effectively addressed in a controlled trial, where some teens are offered incentives and others receive only support. In lieu of a controlled study, however, teens responses are significant. Teens in Teen Success report that the incentives are meaningful to them but that the program definitely offers other benefits.

EVALUATION RECOMMENDATIONS

Kramer offered both general and specific recommendations to PPMM. General recommendations included improving the program in terms of orientation, organization, format, and content:

Staff should explore alternative ideas for improving the program such as offering additional support (financial or other) to teens who graduate from the program and high school and would like to pursue some form of higher education or training and mentoring programs for teens in Teen Success. A mentoring project can be conceptualized in a variety of ways. Graduates of Teen Success could mentor younger teens; adult mentors could be used to mentor either graduates or current members. Other alternatives that Planned Parenthood may want to consider are to explore whether the teens really would continue to participate if there were no incentives or bonuses (as they say they would). In addition, Planned Parenthood could systematically vary elements of the existing support groups to test ideas regarding curriculum, group structure, and incentives and share this information with program staff. In general, staff should be better trained in internal evaluation methods in order to assure quality and design innovations.6

Specific recommendations included evaluating and improving the content of support groups, as Kramer found that a surprisingly high number of teens could not answer questions about when 6 Ibid.

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during their cycles they were most likely to get pregnant. Kramer recommended re-evaluating the structure of support groups and suggested other techniques to experiment with, such as role plays, focused discussions around a particular topic, and writing exercises. Other specific recommendations included improving the training of facilitators since they did not receive a well thought-out orientation or continuing education, according to Kramer. She recommended on-site observations of facilitators to ensure high-quality support group leadership. Kramer also found that Teen Success did not adequately collect data to measure its own successes:

Extremely poor records are kept, no follow-up has been conducted, and little effort has been made to maintain contact with teens once they leave the program. Facilitators should be required to maintain a minimum of information on each teen. Certainly, when a teen leaves the program, her reason for leaving should be recorded. Ideally, facilitators could keep some process notes with the intake data. Contact information should be updated regularly. At the minimum, the questionnaire should ask: (1) whether the teen had another baby since she left Teen Success; (2) whether she has completed high school and/or further schooling; (3) if she is working (and if so, in what capacity); (4) who she is living with; and (5) use of birth control.

EVALUATION OUTCOME

After Ford learned of the study results, she met with Williams to discuss the results. I first met with the evaluator to discuss the results of the study, she said. Then I met with Linda, and she told me all the reasons why I shouldnt take the results as 100 percent. Linda felt strongly that the evaluator had taken a social scientist and education perspective versus a mental health model. However, I took everything within the right context and did not blow up at anything. I felt that the evaluation was helpful to both PPMM and to the donors. Oliver provided her perspective on the evaluation results, which conflicted with the content of Kramers report: One thing that the evaluator said was that the teen mothers came for the incentive. We completely agreed with that. We knew that the stipend was very important to these young mothers. The evaluator concluded that the girls were only coming for the money, and that she couldnt attest to any known additional valuable outcome. We completely disagreed with that. Oliver continued:

The external evaluator was very kind, but she didnt attend enough group sessions [the evaluator attended three support groups twice and seven support groups only once, according to Oliver and PPMM] that would have afforded her to make a conclusion where there were any changes observed. We thought that the evaluator should have returned and polled the participants at a later point in time to look for a change in attitude from the teens, but she didnt do that. We also disagreed with the question that the evaluator asked about teens knowing when in their cycle they would get pregnant. We didnt feel as if that one question adequately represented

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all the knowledge that we were passing along to the teens in the support groups. We didnt necessarily discount the evaluators study, but it was clear to us that her recommendation wasnt founded on enough facts about the program. She didnt write a negative report, but she had a series of recommendations for us.

Despite an initial difference in opinion within the organization about how to interpret the evaluation, Williams attributed aspects of the organizations subsequent evolution to the reports recommendations:

Our interaction with Susan about the evaluation was positive. I think one thing that is really important with donors is to be honest. With Tom and Susan, there has always been an upside to being very straightforward. I offered my perspective on the evaluation, and I admit that at the time, we probably didnt see the full value of the evaluation. At the time, it didnt seem like we needed to make a lot of changes, but in retrospect, the evaluation recommendations really were forward-looking, and without them, we may not have grown the program as fast or as well without the changes. I dont think Ive communicated that to Susan Ford, though. For example, since our program is expanding so quickly, we are now developing a tool kit or what we call program in a box that we can just hand to new areas that are developing a new Teen Success program. The original concept evolved directly out of the evaluation.

Williams continued:

The evaluator came from an education model and didnt understand the support group mental health model. She thought that the program wasnt nearly structured enough. Although we strongly disagreed that we should have an education model, we did learn from the evaluation that we could build some more structure into our program. We became more focused on making sure that our teens would get all the information that they needed on a variety of topics, rather than just assuming that they received the information.

Williams discussed the origins of her skepticism for evaluations:

Susan definitely caught us at our nadir! Our deep-seated skepticism, approaching cynicism, about the potential value and validity of external evaluations came from our previous negative experiences with evaluations and the political misuse of evaluations as a tool. We did not, of course, suspect Susan of ulterior motives, but we were concerned about a possible conflict of interest with the particular evaluator. In hindsight, Im guessing that if we had approached the evaluation with more positive expectations of the outcome, we would have made better immediate use of the results.

Even though Ford felt the evaluation benefited all parties involved, she commented on potential improvements in the evaluation process. In retrospect, we should have selected the evaluator together and agreed early on about some of the parameters and the process, she said. The

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evaluation would have been even more helpful if PPMM did not feel so threatened at the beginning of the process. Their main objective might not have been to make everything look good.

GRANTOR-GRANTEE RELATIONSHIPS

Williams commented on PPMMs approach to relationships with donors, in terms of engagement and communication:

Relationships with donors, particularly long-time donors, can be very complex and quite varied. Its all about people, and so I believe its important to have a really flexible approach to the relationship, without sacrificing or compromising our values. Weve learned over time that its important to never sell your organizations soul or mission for money. Ive seen organizations whose missions have been hijacked by donors who had completely different agendas. When you have a schizophrenic pull and tug, it can kill an organization.

Williams and Ford did not have regular meetings to discuss the Teen Success Program but rather communicated with each other on an as-needed basis. Williams explained:

Initially, when we set up the program, we certainly communicated with Susan Ford and a few other donors much more frequently. However, now we are so busy in this field. Ideally, it would be more frequent than what we do now, which is about once a year. Susan and I have not really had as much contact very recently as we have had at various times. We definitely use e-mail and talk on the phone from time to time, and we see each other at community events. I also make it a point to send more formal letters to Susan Ford to make note of some of our successes.

Ford provided her perspective on grantor-grantee relationships:

Once we decide to grant an organization funding, if we have a prior relationship with the organization, we will usually ask them to submit a report every 6 to 12 months, where the grant period is usually a 12-month period. We are not intimately involved if we know the director and trust them. However, sometimes, we are building a new relationship, and we are helping with starting up a program, and thats when we get more involved in the strategic planning. This is rarer because the organization typically doesnt need or want the assistance of a donor in this wayit can often be very unwelcoming.

Ford noted the complexity of program evaluation:

Measurement is a constant challenge for all kinds of foundations, large or small. How do we determine whether we are really making a difference or not? At the Sand Hill Foundation, funded organizations often tell us what some of the measurements will be. Some of those are hard and fast numbers, while other times, the donations we provide simply help organizations to continue to provide

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services, and we leave it at that. We develop relationships and requirements with donors on a case-by-case basis.

Williams elaborated upon the various measurement and reporting requirements from different donors:

Different donors want different things. Susan Ford has a simple template with basic program statistics. We give her information about new Teen Success groups that have formed and how theyre supported. We also give her information on donor matching so that we can prove that weve actually matched her goal. We also like to give her heartwarming anecdotal information about a success story in each new group. Another donor initially wanted copies of every check written. The challenge of Teen Success is that we have so many donors who all want different things, so theres no standard template and its cumbersome. We probably have one full-time employee working on reporting alone.

TEEN SUCCESS PROGRAM UPDATE

In 1997, Teen Success developed an internal status report that helped teen mothers reflect on and monitor their progress. We developed a tool through which we determined four areas that would be important for youth as they move forward in life, said Oliver. 7 We developed a grid that both participants and facilitators would fill out. We assessed the similarities and differences in those two perspectives. Every 90 days, the participants received the grid again to determine progress. Once a quarter we go through this exercise, and its a great tool for facilitators to determine where their groups are, said Oliver. Ford commented on the expansion of Teen Success: I think what PPMM has done well is to really grow the program. Theyve taken it into Kern County in Bakersfield, which is a really tough community that for a while had the highest teen pregnancy rate in California and in the country. It was difficult for PPMM to find local donors to support the program, so Linda was able to convince her supporters in Silicon Valley to help fund the programs in Bakersfield. Williams cited Susan and Tom Ford as key drivers of program expansion:

What the Fords have done has been to push us. They are true catalysts. Working with them has certainly been a partnership, and I think that our positive relationship has led to better results for both the donor and our organization. One example was the evaluation. It didnt have any negative effects on our relationship with the Fords. They continued to support us in so many ways. Another example was when Susan offered us a $100,000 match for new programs in the Central Valley if we could raise an equal amount from local donors. We ended up raising $125,000.

7 Mental health, physical health, family/friends, and school/job.

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THE FUTURE

By 2002, the Teen Success program had served 625 teen mothers and sponsored 24 support groups of 12 teen mothers per group per year. Over the 12-year period of their relationship with the Fords, the Teen Success Programs service area had grown quickly, and the initiative now operated in more than 20 communities in California and Nevada. Furthermore, in March 2002, PPMM was recognized as the winner of the Planned Parenthood Affiliate Excellence Award for services to teens. As a result, in mid-2002, PPMM was in the process of seeking funding for another comprehensive evaluation of the Teen Success Program (so that the initiative potentially could be replicated by other Planned Parenthood chapters). The rapid expansion of the program and the interest in replication by other Planned Parenthoods fueled our desire for a current evaluation, said Williams. While the previous evaluation experience had initially created some tension between the programs funders and its management team, valuable lessons for grantors and grantees emerged as a result of the process. Williams acknowledged the importance of measurement and commented on the organizations changed perspective toward evaluations: In more recent years, we have had enough positive experiences with evaluations to balance the inevitable political evaluations, which will always be with us. Looking forward, the challenge facing Williams, Ford, and others involved in the Teen Success Program was how to capitalize on their learning to more constructively engage all stakeholders in the evaluation process, effectively monitor the programs impact, and take action on evaluation results. ASSIGNMENT QUESTIONS 1. Assess Fords approach to initiating the Teen Success Programs evaluation. What steps

could Ford and Williams have taken to improve Planned Parenthood Mar Monte and the Sand Hill Foundations mutual learning?

2. As Williams looks to the future, how could Planned Parenthood Mar Monte improve its capacity to monitor the Teen Success Programs impact? How could the Sand Hill Foundation support the programs ability to measure and communicate results?

3. How could Ford use the lessons learned from the Teen Success Program evaluation to inform

her future grantmaking related to teen pregnancy prevention?

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Exhibit 1 PPMM Teen Success Group FY 1996 Budget

Salaries $11,918 Payroll Taxes and Benefits 1,943 Occupancy 1,271 Snacks for Group Meetings 1,118 Stipends and Bonuses 6,090 Staff Mileage 840 Overhead 3,045 Other 184 Total $26,408

Note: Salary costs are composed of one teen services coordinator at two hours per week; two group leaders at five hours per week; and two babysitters at four hours each per week.

Source: Information provided by PPMM.

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Exhibit 2 Evaluation Questionnaires

Teen Success Questionnaire (targeted to teens within the program) 1. When did you join the Teen Success Program? 2. How did you hear about the Teen Success Program

a. Referred by other program (which one?) b. Referred by teacher c. Friend d. Clinic e. Flier/notice f. Other

3. Were you pregnant when you joined the Teen Success Program? 4. Are you going to school now? 5. If yes, what type of school:

a. Regular b. Alternative school c. Continuation school d. Independent studies e. Other

6. Are you currently receiving or are you participating in any of these programs? a. AFDC b. TAPP c. Independent studies d. Continuation school e. Connection f. Counseling g. WIC h. Other

7. Have any of the family members below been teen parents? a. Mother b. Father c. Sister/brother d. Other

8. Who do you live with now? 9. Are you pregnant now? 10. How many children do you have now? 11. Do you want to have other children? 12. If yes, when would you like to have other children? 13. How many children do you think you want? 14. Did you plan your first child? 15. If yes, why did you want a child at that time? 16. If no, why do you think that you got pregnant? 17. When during a womans cycle is she most likely to get pregnant?

a. During her period b. A week before her period c. A week after her period d. Two weeks before her period e. I dont know

18. Some teen moms say that at the time they got pregnant there was some crisis or difficulty in their life. What was going on in your life at the time that you got pregnant?

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a. Involved with drugs and or alcohol b. Involved with gangs c. Trouble with parents d. Not going to school e. Problems with friends f. Parents involved with drugs/alcohol g. Feeling neglected by parents h. Other problems

19. How old was the father of your baby at the time that the baby was born? 20. At that time was the father of your baby

a. Going to school b. Working c. In trouble with the law d. Involved with gangs e. Involved with drugs/alcohol

21. Does the father of your baby have other children? 22. Why did you join the Teen Success Program? 23. What is the most important thing about the Teen Success Program to you? 24. What would you like to see differently in the Teen Success Program? 25. How important would you say that the weekly money that you receive from the program is?

a. Very important b. Somewhat important c. Not very important

26. Would you still come to the meetings if there were no weekly incentive? a. Yes b. No c. Im not sure

27. Have you received a bonus in the Teen Success Program? 28. Do you think that you would continue to come even if there were no bonuses? 29. Did the money make a difference in your deciding to join the Teen Success Program?

a. Yes, definitely b. A little c. Not at all

30. How do you spend the money that you receive from this program? a. Daily expenses b. Mostly the babys expenses c. Mostly save the money d. Gifts e. Other

31. What is the hardest thing about having a baby? 32. What is the best thing about having a baby? 33. Why do you think that many teen moms have another baby within about 2 years of having the first

one?

Source: Information provided by the Sand Hill Foundation.

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Exhibit 2 Evaluation Questionnaires (continued)

Teen Success Questionnaire Follow-Up (targeted to teens who had left the program) 1. How many children do you have? 2. How old is (are) your child(ren)? 3. How old were you when you joined the Teen Success group? 4. How old was your child(ren) when you joined the Teen Success group? 5. Were you pregnant when you joined? 6. Have you graduated from high school (or received your GED)? 7. Are you in high school now or working towards your GED? 8. Are you in college now? 9. Are you working now? 10. Are you mostly home with your child(ren) now? 11. Are you married now? 12. Have you had another child since you left the program? (If yes, how many?) 13. Did you graduate from the Teen Success Program? 14. Did you leave the Teen Success Program before you graduated from the program? 15. Why did you leave the program when you did?

a. Moved out of the area b. No longer interested c. Dissatisfaction with the program d. Busy with other activities e. Became pregnant again f. Difficulty getting to meetings g. Other

16. Whom do you live with now? 17. What do you usually use to prevent pregnancy? 18. Do you use a birth control method when you have sex?

a. Every time b. Some of the time c. Hardly ever d. Never

19. How important would you say the following were to you when you were in the program? a. Friendship b. Adults to confide in c. Weekly incentives d. Bonuses e. Being with teens with similar experiences f. Other

20. Of the above, which would you say was the most important? 21. Would you have joined the program if you hadnt received the weekly incentives? 22. Do you think that you would have continued if you hadnt received weekly incentives? 23. If you had to choose between weekly incentives or 6-month bonuses, which would you prefer? 24. If you were to design a program to help teen moms delay a second pregnancy, what would be the

most important element you would make sure to have in it? 25. If you could improve the Teen Success Program, what would you like to include or change? 26. What ethnic group best describes you? 27. We would like to stay in touch with you once a year. Would it be okay if we contact you again? Source: Information provided by the Sand Hill Foundation.

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Exhibit 3 Sample Letter From PPMM to the Sand Hill Foundation

June 2, 1995 Dear Tom and Susan, Were so pleased Jane Kramer has begun her evaluation of Teen Success and look forward to learning her perceptions of the essential elements of the program. Meanwhile, we want to assure you that the program does remain a success. Once again, every teen motherall 72 in six groupshas remained pregnancy free. They are all in some form of educational program. Interestingly, regular high school is their preferred choice. Many of the young moms resent the dumbing down and lowered expectations of some teen parent programs. The key to their ability to attend more challenging options, of course, is available childcare. In your East San Jose group, eight members are Latina, two are Asian American, and two are white. One is 15, five are 16, five are 17, and one is 18. Half live at home, half elsewhere. They have the most difficulty of all groups in finding safe, stable housing. One young mom, now 16 with a 17-month-old child, was one of our two Teen Talk members to become pregnant in the first, least successful year of that program. She has become significantly more responsible, giving up some of the extremely high-risk behavior of her middle school years in her attempt to be a good mother. Her career goal, which has remained constant, is to become a probation officer. Another ambitious teen became dissatisfied with the lack of challenge in her teen mothers school program. She took and passed sufficient proficiency exams to be admitted to San Jose City College which she finds more fulfilling. A Cambodian teen recently left the group to return to regular high school. She credits Teen Success with motivating her to establish her goal of graduating from high school and attending junior college and with supporting her to resist family pressure to give her partner more babies. We hope you will renew your support for the Eastside II group. Currently, the annual budget for a single group is $26,000, a modest 5.6% increase over the $25,000 a group cost when the program was founded five years ago. In addition, the sixth group in Hollister has been established at last, and we hope we can still count on your $5,000 seed match. Your generosity continues to transform the aspirations, the lives, and the futures of these young mothers and their children. It is extraordinarily powerful to watch them develop the skills and confidence to become productive, contributing members of society. Not only the teens and their babies but also our community owes you an enormous debt and heartfelt appreciation. Gratefully, Linda Williams Source: Sand Hill Foundation.