Title: Preventing unplanned repeat pregnancy in teenage mothers: a qualitative study of patients’ and professionals’ experiences of nurse led home based sexual health care.
Funder: Department of Health (England)

Abstract: Background There is a very high risk that one unplanned teenage pregnancy will result in another. Around 30% of babies born to mothers aged 16-19 are second children - this compounds the well know social, economic and health problems caused by unplanned teenage pregnancy. Efforts to prevent this and promote sexual health with teenage mothers is a vital element of sexual health work. There is some evidence that home based inteventions can contribute to this goal but the evidence base for how young mothers experience this type of care and how professionals see their role in providing this care is lacking. A novel home care contraceptive service, P2P, currently helps 200 teenage mothers in Doncaster every year and a detailed understanding of how patients and other stakeholders view and experience this type of care will help improve the benefits of this care to patients. This type of patient care was pioneered in Doncaster and is the longest running NHS service in the UK of its kind. Other, emerging services exist in the NHS, but they are modelled on the P2P approach to patient care. No guidelines for the delivery of this type of patient care exist and, as this type of care is mainly in its infancy in the UK, drawing on the patient experience will contribute significantly to the development of similar services elsewhere in the NHS. Aims of the project The specific aims of the study are to: Explore new young mothers' (16-19 yrs) experiences of nurse led contraceptive home care and how does this affect their future sexual and reproductive health and behaviour. Explore the views and experiences of professional stakeholders who work with this group of women. Develop guidelines for the development of nurse led home based contraceptive care for new teen mothers. Research plan This qualitative study will conduct in-depth interviews with 20-25 teenage mothers who have recently experienced P2P care and also 20-25 interviews with women who have recieved home based sexual health care in the previous 2 years. We will also conduct 3 focus groups with P2P health professionals. Data will be analysed using a 'Framework' approach and findings will be used to gain an in-depth understanding of how teen mothers experience this type of care in order to inform the development of this type of patient care both locally and nationally through the development of care guidelines, reports and publications. Benefits to the NHS The prevention of a repeat teenage pregnancy has numerous benefits. It improves the health and life chances of the child and also the mother. It also reduces the risk of mental and physical health problems in the new mother. It removes the risk associated with a termination of the repeat pregnancy - which has mental health benefits for the woman and also has an economic impact on termination services. Undertaking research to address the current gaps in the knowledge base about home based sexual health care will help improve this type of health care for the 200 new teenage mother seen in Doncaster every year - it will also inform the development of this type of care throughout the NHS. Why we are well placed to do this study The project team is comprised of researchers with experience of qualitative projects related to the sexual health of young people as well as project management expertise. The team contains experienced NHS clinical staff with experience of sexual health work with young people and the delivery and management of NHS sexual and reproductive health services. Inclusion of service users on the project advisory group also adds strength to the team.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH