Public health nursing care for adolescent mothers: impact on infant health and selected maternal outcomes at 1 year postbirth.
OBJECTIVE
To compare effects of an early intervention program (EIP) of intense home visitation by public health nurses (PHNs) with effects of traditional public health nursing care (TPHN) on infant health and selected maternal outcomes of adolescent mothers.


METHODS
EIP adolescents (N = 102) received preparation-for-motherhood classes and individual home visits (from pregnancy through 1 year postpartum) from PHNs employed in a county health department. Participants were predominantly Latina (64%) and African-American (11%) and from impoverished backgrounds. Infant health outcomes were determined based on medical record data; interviews and standardized questionnaires evaluated other program effects (e.g., maternal educational achievement and psychological status). Data were analyzed using Chi-square and repeated measures ANOVA.


RESULTS
Infants of EIP mothers experienced significantly fewer total days (n = 74) and actual episodes (n = 14) of hospitalization during the first year of life than those receiving TPHN (n = 154, n = 24, respectively). Similarly, positive program effects were found for immunization rates. There were no group differences in emergency room visits or repeat pregnancy rates. Alcohol, tobacco, and marijuana use significantly increased from pregnancy through 1 year postpartum in both groups but remained markedly lower than rates prior to pregnancy (lifetime rates).


CONCLUSIONS
These findings demonstrate the positive effects of a PHN home visitation program on health outcomes for children of adolescent mothers. Days of infant hospitalization were substantially reduced and immunization rates increased during the first year of life for children of EIP mothers. Greater efforts need to be directed toward preventing repeat pregnancy and return to substance use following childbirth in at-risk adolescent mothers.
Koniak-Griffin
Deborah
D
UCLA School of Nursing, Box 956919, Los Angeles, CA 90095-6919, USA. dkoniak@sonnet.ucla.edu
Anderson
Nancy L R
NL
Brecht
Mary Lynn
ML
Verzemnieks
Inese
I
Lesser
Janna
J
Kim
Sue
S
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000704:Analysis of Variance; D005260:Female; D006302:Health Services Research; D006630:Hispanic or Latino; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007229:Infant Welfare; D007231:Infant, Newborn; D016389:Maternal-Child Nursing / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000208:ethnology; D011637:Public Health Nursing / Q000458:organization & administration*; D014481:United States