Exploring strengths of an interdisciplinary team in case management of young families in Massachusetts

Background: Though Massachusetts experiences lower birth rates to adolescent mothers than the national average, many young families, especially those from low-income, vulnerable communities, continue to experience poor health and social outcomes. Research suggests that a youth development program model can reduce adolescent pregnancy while also improving outcomes such as educational engagement and resiliency. Few programs have systematically integrated health and educational support for pregnant and parenting youth. Identifying program model strengths and weaknesses is essential for developing robust strategies for working with this special population.

The Massachusetts Department of Public Health has funded five community-based organizations since 2010 to provide young families with team-based wraparound case-management services to pursue three goals: achievement of individualized educational and vocational goals; improving infant health and development; and delay of subsequent pregnancy.

Methods: Six focus groups were held (22 total participants with varied program staffing roles) to assess perceptions of which components of the program had served agencies and participants best, and to flag potential improvements. Groups were facilitated by an independent consultant, and providers were assured confidentiality to encourage openness. Results: Themes that emerged in describing model strengths: flexibility, integration of nursing and education staff, participant-directed outcomes, wraparound model, and whole-family orientation. Themes that emerged in describing programmatic challenges: significant mental health and housing needs, limitations around city/town residency, paperwork burden, lack of data sharing with program, need of staff support systems.

Conclusions: Implications for research and practice include further exploration of outcome-based intervention strategies for young families and refinement of existing models.