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

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.

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.