Young Parents Program, Project Connect
Condition: Adolescents; 18 and Under When Child Was Born for Mothers; 25 and Under When Child Was Born for Fathers
Study type: Interventional

Summary: 
      1. Specific Aims

        1. To evaluate the effects of life skills/parenting groups that are embedded within a
           comprehensive multidisciplinary clinic for adolescent parents (the Young Parents
           Program), using a randomized control design. Specifically, the effect of group
           participation on the following adolescent parent outcomes will be investigated:

             -  Parenting attitudes and skills including empathy, non-violent discipline, role
                appropriateness and developmentally appropriate expectations.

             -  Skills of daily living, social relationships, and work/study at follow-up, as
                measured by the Ansell-Casey Life Skills Assessment Scale.

             -  Depression and perceived social support using the CESD-C and Duke Social Support
                scale.

             -  Repeat pregnancy rates at 12 and 24 months after first delivery.

        2. To evaluate the overall Young Parents Program service delivery as required by the Office
           of Adolescent Pregnancy Programs (project funder) using a cross cutting evaluation of
           health services utilization, social needs and work/educational outcomes.
    

Detailed description: 
      The Young Parents Program (YPP), a specialty clinic within Children's Hospital Primary Care
      Center, provides comprehensive medical care, mental health services, and advocacy to high
      risk, urban teen parents and their young children through a teen-tot model. YPP serves 152
      teenage mothers and their babies annually with a multi-disciplinary team knowledgeable in the
      medical, social, and developmental issues of adolescence and early childhood. Project Connect
      is an evaluation of both the medical and social services provided by YPP and a randomized
      controlled trial of an intensive educational arm of YPP.

      YPP serves the population that economically, ethnically, and geographically represents the
      highest rates of subsequent pregnancies and the greatest risk for poor birth outcomes. The
      staff of physicians, nurse practitioners, social workers, and nurse consists of experienced
      professionals work with parents, adolescents, and children. YPP has cooperative relationships
      with Boston area education and job training sites, Early Intervention Programs, the
      Massachusetts Department of Revenue, community agencies, mental health services, and teen
      living programs.

      By providing an integrated family based comprehensive medical home and a randomized
      controlled trial of intensive parenting/life skills training, Project Connect enhances teen
      parents' connections to child, family, peers, partners, medical care, and mental health.
      Medical care, home visiting, child/adolescent health services, mental health, and fathers'
      programming are all linked into a continuous program. Goals of the intensive intervention are
      to enhance parenting and life skills, help participants optimize family interactions, and
      build self-efficacy.

      Project Connect brings together YPP at Boston Children's Hospital (BCH), Healthy Baby/Healthy
      Child (HB/HC) nurse home visiting program and Families First, a parenting education agency,
      to provide a state-of-the art model of care for parenting teens in Boston. The model builds
      on lessons learned and strengths of each program, adding critical new elements of randomized
      control trial of parenting/life skills modules, and home visiting. Prenatal services will
      encourage breast-feeding, and support infant care and parenting. YPP provides a medical home
      with coordinated, continuous health care services, psychosocial support, parenting/life
      skills modules and individual services for teen mothers and fathers. Integrated fathers'
      services emphasize male parenting roles, communication, life skills training, violence
      prevention and positive youth development.
    

Intervention name(s): Parenting/Life Skills Intervention; Teen-tot medical home
Intervention type(s): Behavioral; Other
Intervention description(s): Modules adapted from the Ansell-Casey Life Skills Assessment Curriculum, the Women's Negotiation Project Curriculum for Teen Mothers and the Nurturing Curriculum. Goal is to help teen mothers develop positive parenting skills, decrease repeat pregnancy and acquire skills of daily living. The series of five, one-hour long, structured, one-on-one interactive modules aims to help teens build positive, empathetic relationships with their children, while enhancing self-efficacy and increasing the sense of self- worth for parents and children. Domains addressed include child development/discipline, safety, house/money management, social relationships, career planning, substance abuse and community and interpersonal violence.; Medical, mental health, and social services provided to teen parents and their children
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research