Early Intervention Program for Adolescent Mothers

OVERVIEW

The Early Intervention Program (EIP) for Adolescent Mothers is an intense home visiting program by nurses extending through pregnancy and a year after delivery, designed to improve the health of pregnant adolescents through promoting positive maternal behaviors. EIP is an intense public health nursing program that includes classes on preparing for motherhood, and home visits by specially trained nurses. Classes and home visits cover issues such as health, sexuality, family planning, life skills, maternal role, and social support. A study of EIP found that the program reduced premature births and resulted in fewer days of infant hospitalization in the first six weeks following birth and at the one-year follow-up, while increasing immunizations. However, at one year, there were no significant impacts on number of infants hospitalized, mother-infant interaction, mother's substance use, mother's educational attainment, and mother's repeat pregnancy.

DESCRIPTION OF PROGRAM

Target population: Pregnant adolescent mothers. The program starts in mid-pregnancy and ends when the infant is one year old.

The Early Intervention Program (EIP) for Adolescent Mothers was designed to improve the health of pregnant mothers through the use of classes and home visits by specially trained nurses. The program has four "Preparation for Motherhood" classes that run for a total of six hours of instruction. The classes consist of ten to 15 mothers and are led by a specially trained nurse and focus on topics such as transition to motherhood, parent-child communication, and staying healthy. Group discussion, role-plays, communication games, videos, and written materials are used to teach mothers. The EIP also includes approximately 17 home visits by public health nurses. Each home visit lasts approximately two hours and covers topics in five major areas: health, sexuality and family planning, life skills, maternal role, and social support systems. In the home visits, nurses discuss a variety of topics, including using health care services, complications in pregnancy, and preparing for childbirth. Nurses also provide counseling on topics such as substance use, mental health, and education. EIP nurses also maintain regular phone contact with mothers in between home visits.

EVALUATION(S) OF PROGRAM

Koniak-Griffin, D., Mathenge, C., Anderson, N.L.R., & Verzemnicks, I. (1999). An early intervention program for adolescent mothers: A nursing demonstration project. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 28, 51-59

Evaluated population: Young mothers (N=121and their children were randomly assigned to either the Early Intervention Program for Adolescent Mothers (N=63) or traditional public health nursing care (TPHN) (N=58). Participants were from a large California county with urban and rural communities. Participants ranged in age from 14 to 19 with an average age of 16.7. Most of the mothers came from poor, minority backgrounds and were unmarried. At intake, mothers had an average gestational age of 21 weeks. The participants in the evaluated population were considered at-risk and at baseline, the evaluated population was identified as having experienced childhood physical abuse, sexual abuse, depression, and suicide attempts.

Approach: The researchers collected data using the newborns' and mothers' medical records, nurse interviews, and maternal responses to questionnaires. Data on infant hospitalizations were collected. Mothers were assessed on their level of depression, if any, and on any substance use. The researchers collected data at intake and again at postpartum 4 to 6 weeks after birth.

Results: When examining hospitalization days in the first six weeks of life, a statistically significant difference was found between the treatment EIP and TPHN control groups (23 days for the EIP group and 36 days for the TPHN group). EIP was additionally beneficial in improving infant health as reflected in total numbers of days of hospitalization. The researchers conclude that both EIP and TPHN improved outcomes for mothers and their infants.

Koniak-Griffin, D., Anderson, N. L. R., Brecht, M.-L., Verzemnieks, I., Lesser, J., & Kim, S. (2002). Public health nursing care for adolescent mothers: Impact on infant health and selected maternal outcomes at 1 year postbirth. Journal of Adolescent Health, 30(1), 44-54.

Evaluated Population: Adolescent mothers (N=102) who were ages 14 through 19 years and at 26 weeks or less gestation. Most participants were Latina (64 percent), and 11 percent were African American. Most of the mothers were from low-income families.

Approach: Mothers were randomly assigned to either the Early Intervention Program (EIP) treatment or to a traditional public health approach control group (TPHN) control.Measures were collected when the infant was a year old on the mothers' depression, educational attainment, and repeat-pregnancy status. Also, the infant's health was assessed through the number of children hospitalized (by group), total number of days hospitalized, total number of episodes of hospitalizations, total number of emergency room visits, and percentage of children adequately immunized (by group).

Results: Total number of days of infant hospitalization (excluding birth-related) was significantly lower in the treatment group than in the control group, with 74 and 154 days, respectively. Episodes of hospitalization were higher for the control group children compared with the treatment group, 24 and 14 days, respectively. The percentage of children immunized in the treatment group was 96, compared with 86 percent of the control children. However, number of infants hospitalized and total number of emergency room visits in the treatment group versus the control group did not differ. Also, no differences were found for mother-infant interactions. For mothers, depression symptoms significantly declined from pretest to the one-year follow-up within both groups, but remained nonsignificant between the treatment mothers and control mothers at the one-year follow-up. Similarly, alcohol, tobacco, and marijuana use all had a significantly higher percentage of mothers using at the one-year follow-up compared with their scores at pretest; however, no significant differences between treatment mothers and control mothers existed at the one-year follow-up. No significant impacts were found for mothers' educational attainment or repeat pregnancy.

Limitations of this study were that the data were based on maternal recall and self-report and may be biased as a result.

SOURCES FOR MORE INFORMATION

References

Koniak-Griffin, D., Anderson, N. L. R., Brecht, M.-L., Verzemnieks, I., Lesser, J., & Kim, S. (2002). Public health nursing care for adolescent mothers: Impact on infant health and selected maternal outcomes at 1 year postbirth. Journal of Adolescent Health, 30(1), 44-54.

Koniak-Griffin, D., Mathenge, C., Anderson, N.L.R., & Verzemnicks, I. (1999). An early intervention program for adolescent mothers: A nursing demonstration project. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 28, 51-59

KEYWORDS: Infants (0-12 months), Adolescents (12-17), Home-based, Males and Females (co-ed), Female-only, Black/African American, Hispanic/Latino, Adolescent Mothers, Urban, Rural and/or Small Towns, Home Visitation, Births, Depression/Mood Disorders, Health Status/Conditions, Tobacco Use, Alcohol Use, Marijuana/Illicit/Prescription Drugs, Self-Esteem/Self Concept.

Program information last updated 9/24/10.