Community-Based Care Management For Teen/Young Adult Mothers and Fathers

Study Overview
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Brief Summary
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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
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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: Baseline and ongoing monthly needs assessment for healthcare, mental health, school/job attainment, daycare, housing stability; 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; Parenting instruction with a culturally sensitive, developmentally relevant parenting curriculum; and 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.

Official Title
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BRIDGES: A Randomized Trial of Community-Based Care Management For Teen/Young Adult Mothers and Fathers

Conditions
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Pregnancy

Intervention / Treatment
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* Behavioral: Home visiting and care management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant teenagers Ages 12-18 years old >= 24 weeks gestation Attending any of 5 West Baltimore prenatal care sites. Male partner (baby's father) if the pregnant teenager agrees to let the program contact him to invite participation. Exclusion Criteria: Age < 18 years and no parent/guardian able to grant consent. Male partner of a pregnant teen/teen mother if she does not grant consent to let us contact him and invite participation.

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Single Group Assignment
Interventional Model Description: Motivational intervention and support
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: HV<br>Intervention arm. | Behavioral: Home visiting and care management<br>* 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.<br>|
| No Intervention: Cntr<br>Usual care control | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Repeat pregnancy |  | Within 2 years of the index birth | 
| Parenting attitudes and behaviors |  | at 1 year and 2 years postpartum | 
| School continuation or graduation |  | at 2 years postpartum | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Remission of depression |  | at 1 year and 2 years postpartum | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pregnancy in adolescence