Program

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.


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