Community-Based Care Management For Teen/Young Adult Mothers and Fathers
Condition: Pregnancy
Study type: Interventional

Summary: 
      Teenagers who become parents often struggle with new challenges as they try to take care of
      their children and themselves. Programs that provide teens with support, education, and
      counseling may help teens to become the best parents they can be and reach their own goals.
      Health care providers who take care of pregnant and parenting teenagers are trying to find
      out what types of programs are most helpful for the physical, emotional, and social health of
      pregnant and parenting teenagers. The purpose of this study is to find out what kinds of
      activities help teens be successful as parents and achieve success in their lives.
    

Detailed description: 
      Pregnant teenagers and teenagers who have children less than 2 weeks old and who attend
      either University Family Medicine, the Maryland Women's Center, Teen Tot Clinic, University
      Care at Edmonson Village, Weinberg Community Health Center, or Maryland General Outpatient
      clinics will be asked to participate in a home visiting and care management program and
      study. Those agreeing to participate are placed into one of two groups. One group receives a
      Home Visiting and Care Management Program along with their usual medical care. The other
      group receives only their usual medical care.

      If placed into the home visiting group, the teen is given a home visitor (also called a Care
      Manager). The Care Manager arranges to meet with the teen every month until the teen's baby
      is 2 years old. The meetings last about 1 hour and usually take place in the teen's home.

      The Care Manager provides 4 Core Services to the teen:

        1. Baseline and ongoing monthly needs assessment for healthcare, mental health, school/job
           attainment, daycare, housing stability;

        2. Computer Assisted Motivational Interviewing (CAMI) sessions with teen mother. In CAMI
           sessions, the teen answers questions on a laptop computer that assess partner
           relationships, sexual behaviors, & risk for repeat pregnancy. Following the assessment,
           the trained Care Manager conducts motivational interviewing, a counseling technique
           aimed at assisting the teen to improve contraceptive and condom use, focus on goals, and
           promote school continuation;

        3. Parenting instruction with a culturally sensitive, developmentally relevant parenting
           curriculum; and

        4. Coordination and linkage with primary care and community partners (e.g. UMB Division of
           Community Psychiatry) with respect to health care, mental health care, and other
           services.

      If the teen grants permission, we will try to contact her baby's father and invite him to
      participate in similar activities.
    

Intervention name(s): Home visiting and care management
Intervention type(s): Behavioral
Intervention description(s): Third trimester teens are assigned a Care Manager (CM) who establishes a continuity relationship and provides monthly visits until the index child is 2 years old. Core services for intervention group include: 1)Baseline and ongoing assessment of health, mental health, housing, daycare, and school needs; 2)Administration of a culturally sensitive, developmentally relevant parenting curriculum; 3)Computer Assisted Motivational Interviewing to promote healthy relationships, improve contraceptive practices, focus on goals, and promote school continuation; 4)Efforts to engage the young father; 5)Linkage and coordination with primary care for teen, child, young father; 6)Support & skills-building for school continuation, higher education, and job readiness.
Allocation: Randomized
Intervention model: Single Group Assignment
Intervention model description: Motivational intervention and support
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Pregnancy in adolescence