142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

307596
Adolescent and Adult Prenatal Case Management Clients: Differences in Problems and Interventions Received

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

L. Michele Issel, PhD , College of Health and Human Services Dept. of Public Health Sciences, University of North Carolina Charlotte, Charlotte, NC
Kelsey Gilmet , Mid-America Center for Public Health Practice, UIC School of Public Health
Izumi Chihara, MD, MPH , School of Public Health, University of Illinois at Chicago, Chicago, IL
Jaime Acey, PhD , CNHP - Nursing, Drexel University, Philadelphia, PA
Background: Prenatal case management (PCM), also called home visiting, is delivered in the community, as a health-related service for medically or socially high-risk pregnant women to improve birth and early infancy outcomes. This study describes differences between adolescent and adult clients in their health and social problems, and in the types of interventions they received.

Methods: A 2007-2008 national census survey yielded data on a sample of Medicaid reimbursed PCM programs. Case managers provided information on all client encounters that occurred on each of 10 work days over 20 work days, recording the number of minutes spent on each of the eight types of nursing interventions. Clients under 20 years of age were coded as adolescents. The dataset includes 3,947 client encounters, provided by 223 case managers in 92 programs.

Results: The largest category of client problems was pregnancy health concerns (44.3%, n=1749). Chi-square tests revealed differences between the number of client problems for adolescents and adults in pregnancy health (p =.01), family problems (p <0.01), education/job (p <0.01), transportation (p <0.01), and housing (p =.03). Among the 1,025 adolescent clients, the most frequently recorded problem was education/job skills (50.5%, n= 518), and the most time was spent in education (mean of 17.9 minutes, n=847), just slightly more than on assessment (mean of 16.0 minutes, n=840).

Conclusions: Results highlight the need for PCM interventions that are appropriate to the context of adolescence. Prenatal care that is designed to meet the unique needs of adolescent mothers can have substantial benefits.

Learning Areas:

Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related nursing

Learning Objectives:
Describe a standardized approach to measuring the delivery of interventions. Describe the key differences in health problems between adolescent and adult clients receiving prenatal case management. Describe the key differences in interventions received between adolescent and adult clients receiving prenatal case management

Keyword(s): Adolescents, Case Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of federally funded grants focusing on maternal and child health programs, public health nursing, and public health services research. I developed this study and oversaw the data collection and data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.