Maternal and child health and services utilization outcomes of homeless parenting adolescents: a follow-up study of the out-of-home teen pregnancy project.
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文摘
OBJECTIVE: To examine health and services utilization of young women, and their children, previously served by a comprehensive prenatal care program targeted at pregnant, homeless adolescents. DESIGN: This study, conducted between May and Sept. of 1995, involved the administration of a cross-sectional survey to 43 women who had participated in the Out-of-Home Teen Pregnancy Project between 1986 and 1993. Of 121 participants, a total of 43 of this highly transient population were located and interviewed. Study subjects were located with the assistance of the local public health department, the Dept. of Social and Health Services, the local jail, one State women's prison, the Dept. of Youth Services, a local community hospital, and a number of shelters and drop-in centers. All allowed access to their records. SURVEY INSTRUMENT: The instrument was administered by one of two interviewers in a variety of settings, including the subjects' homes, shelters, parks, community centers, in jail and in prison. Three interviews were conducted by phone. The survey addressed maternal issues, including history of pregnancy, contraceptive use, education, income, employment, current living situation, and substance use, and child issues such as child- and health care, health/behavioral problems, involvement with Child Protection Services and participation in Head Start. The final section included questions regarding social, health and educational services utilized, as well as open-ended questions regarding parenting, mentors and future goals. RESULTS: Subject ages ranged from 16 to 27 years. There was a total of 156 pregnancies between them. Only 13 % of these were planned. 58 % resulted in live births, 42 % in abortions, half of which were elective. Only one subject graduated from high school. 16 % currently worked for money, and 51 % cited public assistance as their primary source of income. Many reported feeling socially isolated. Only 2 % of the children had participated in Head Start, while at least 56 % had been involved with Child Protection Services. CONCLUSIONS: For the very-high risk pregnant adolescent, prenatal services alone are inadequate in ensuring even short-term health and well-being for the mother and child. Many young women express limited future goals, and continue to depend on public assistance. In order to have a significant impact on this population, therefore, early support services must also include continued contraceptive counseling, educational opportunities, job training, and day care services.