Program

Aug 03, 2004

OVERVIEW

The goals of this untitled program for disadvantaged
adolescent mothers are to prevent second pregnancies, maintain attendance at a
clinic so that infants have up to date immunizations, have adolescent mothers
resume schooling, and reduce the use of emergency room for routine infant care.
The program randomly assigned adolescent mothers 17 years of age or younger to
an intervention or control group. The program provides routine care for mothers
as well as additional special care. Mothers in the experimental group were less
likely to have a repeat pregnancy, and their infants were more likely to be
fully immunized. There was no impact on return to school. Clinic drop out was
high, but was lower for those in the treatment than in the control group. Use
of emergency rooms was somewhat lower; but the difference
was not significant.

DESCRIPTION OF PROGRAM

Target population: the program targets
first-time adolescent mothers who had recently given birth.

This
special health care program has four goals. The program tried to prevent second
pregnancies, maintain attendance at clinics so infants could receive up to date
immunizations, have adolescent mothers return to school, and reduce emergency
room use for routine infant care. The program provides regular routine care as
well as additional special care.

The
routine care consists of appointments for appropriate immunizations and
referrals to social services. Special care consists of on site social services.
These services include counseling, referrals to a birth control clinic, and parenting
instruction by a social worker. In addition, mothers were asked their plans for
returning to school and were given instructions on how to manage parenting
issues. Finally, participants receiving special care were given follow up calls
and letters if they missed their appointments.

EVALUATION(S) OF PROGRAM

Evaluated population: 243 first-time
adolescent mothers and their infants were randomly assigned to either a program
or control group.

Approach: All mothers in the sample were
African American, unwed, and Medicaid recipients who had delivered a healthy
baby at a large urban hospital in the eastern US. In total, 120 mothers were
assigned to the experimental group and 123 mothers were assigned to the control
group. Control participants were provided with routine care and experimental
participants were provided with routine care and additional services by a
social worker, pediatrician, and a nurse practitioner. There were no
statistically significant differences between the groups at baseline.

Data
were collected through interviews with mothers, school records, and hospital
records during the mother’s postpartum stay at the
hospital. Data were also collected on demographics, emergency room and
clinic use, repeat pregnancy, immunizations, return to school, and physician
care.

Results: Results of the study indicated that participants in the program attended
significantly more well-baby visits. While both groups had high dropout rates,
members of the experimental group were less likely to drop out of the
clinic. Further, experimental participants had significantly fewer second
pregnancies than control participants. However, based on non-experimental
analyses when breaking up the groups, drop-outs carried the weight of this
difference. In other words, among drop-outs, those in the program group
were less likely than those in the control group to have a second pregnancy. It
appears that even minimal exposure to the program decreases the likelihood of
repeat pregnancies. With regard to immunization, significantly more infants in
the program group were fully immunized than those in the control group. The
researchers did not find a significant difference for mothers returning to
school and found a non-significant difference for the use of emergency room
care for infant care.

SOURCES FOR MORE INFORMATION

References

O’Sullivan, A.L.
and Jacobsen, B.S. (1992). A randomized trial of a
health care program for first-time adolescent mothers and their infants.
Nursing Research, 41(4), 210-215.

KEYWORDS: Early Childhood (0-5), Infants (0-12
months), Adolescence (12-17), High-Risk, Urban, Clinic-based, African American
or Black, Reproductive Health, Teen Pregnancy, Physical Health, Child Care,
Child Maltreatment, Education, High School Completion, Counseling/Therapy,
Parent-management Skills, Life Skills Training, Case Management, Adolescent
Mothers

Program
information last updated 08/03/04.

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