Such programs are intended to help adolescent mothers avoid repeat pregnancies and overcome the health, educational, and employment problems often associated with early childbearing. The 1983 study reported here examined programs in 10 localities in 4 States: California, Massachusetts, Michigan, and Tennessee. All 10 sites faced severe obstacles in developing and maintaining programs. The four major constraints identified were inadequate financial support, an insufficient health and social welfare infrastructure, negative public and political attitudes toward a stigmatized population, and an unproven intervention technology. Several pre-existing conditions were associated with the successful development of the more comprehensive programs: a strong, responsive volunteer sector; local and flexible funding to supplement State and Federal aid; resources and mechanisms for coordination; elite support and sanction; and administrative and political leadership. Suggestions for improving the quality and maintenance of such programs are offered. 19 references.