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Nurse Visitation for Adolescent Mothers: Two-Year Infant Health and Maternal Outcomes

Koniak-Griffin, Deborah; Verzemnieks, Inese L.; Anderson, Nancy L. R.; Brecht, Mary-Lynn; Lesser, Janna; Kim, Sue; Turner-Pluta, Carmen

Features

Background: Children of adolescent mothers have higher rates of morbidity and unintentional injuries and hospitalizations during the first 5 years of life than do children of adult mothers.

Objective: The purpose of this study was to evaluate the 2-year postbirth infant health and maternal outcomes of an early intervention program (EIP) of home visitation by public health nurses (PHNs).

Methods: In a randomized controlled trial, a sample of predominantly Latina and African American adolescent mothers was followed from pregnancy through 2 years postpartum. The experimental group (EIP, n = 56) received preparation-for-motherhood classes plus intense home visitation by PHNs from pregnancy through 1 year postbirth; the control group (TPHNC, n = 45) received traditional public health nursing care (TPHNC). Health outcomes were determined based on medical record data; other measures evaluated selected maternal behaviors, social competence, and mother-child interactions.

Results: The total days of non-birth-related infant hospitalizations during the first 24 months was significantly lower in the EIP (143 days) than the TPHNC group (211 days) and episodes of hospitalization were fewer; more EIP than THHNC infants were never seen in the emergency room. The EIP mothers had 15% fewer repeat pregnancies in the first 2 years postbirth than TPHNC mothers. The TPHNC mothers significantly increased marijuana use over time, whereas EIP mothers did not.

Conclusions: The EIP improved in selected areas of infant and maternal health, and these improvements were sustained for a period of 1 year following program termination. These findings have important implications for healthcare services.

Deborah Koniak-Griffin, EdD, RN, FAAN, is Professor and Director of the Center for Vulnerable Populations Research at the UCLA School of Nursing, Los Angeles, California.

Inese L. Verzemnieks, PhD, RN, was a Postdoctoral Fellow with the Vulnerable Populations Training Grant at the UCLA School of Nursing, Los Angeles, California.

Nancy L. R. Anderson, PhD, RN, is Professor Emeritus at the UCLA School of Nursing, Los Angeles, California.

Mary-Lynn Brecht, PhD, was Principal Statistician at the UCLA School of Nursing and is Director of the Research Support Core of the Center for Vulnerable Populations Research, UCLA School of Nursing, Los Angeles, California.

Janna Lesser, PhD, RN, CS, was formerly Adjunct Assistant Professor at the UCLA School of Nursing; she is now Assistant Professor at Florida State University, Tallahassee.

Sue Kim, PhD, RN, was a doctoral student at the UCLA School of Nursing; she is now Assistant Professor and Theresa A. Thomas Faculty at the University of Virginia School of Nursing, Charlottesville.

Carmen Turner-Pluta, BMus, is an Administrative Analyst at the UCLA School of Nursing, Los Angeles, California.

Accepted for publication December 3, 2002.

This study was supported by grants from the National Institute of Nursing Research (NINR) (1-R01 NR02325 and NR02325-S1) and the Office of Research on Women’s Health (NR02325-S2). Financial support for the second author was also provided by the NINR (5-T32-NR7077).

The authors thank Anne Ivey, RN, MS, Chief (now retired) and Susan Willis, RN, Supervising Public Health Nurse, of the Division of Community Health Services, San Bernardino County Department of Public Health, for their administrative support in implementation of the project. We also thank Lorraine O. Walker, RN, PhD, FAAN, Luci B. Johnson Professor of Nursing, University of Texas at Austin; and Ramona T. Mercer, RN, PhD, FAAN, Professor Emeritus, University of California, San Francisco School of Nursing for expert research consultation. Finally, we thank the many public health nurses who provided care to the study participants, and the young mothers who welcomed us into their lives.

Correspondence to: Deborah Koniak-Griffin, EdD, RN, FAAN, UCLA School of Nursing, Box 956919, Los Angeles, CA 900095-6919 (e-mail: dkoniak@sonnet.ucla.edu).

© 2003 Lippincott Williams & Wilkins, Inc.