Queens Hospital Center's Teenage Program

Jill M. Rabin, M.D. & Vicki Seltzer, M.D.

FOCUS

SUMMARY

Based upon the premise that a teen's first pregnancy may stem from underlying, unmet needs, this program provides a comprehensive set of services including medical care, psychosocial support and education to the adolescent, her partner and her family. This approach emphasizes early intervention, beginning during pregnancy. For the duration of the intervention, each patient and her infant remain with a team of providers: an obstetrician-gynecologist, pediatrician, social worker and health educator. The program also has a physician/practitioner "on call" 24 hours a day. Reproductive health and family life education classes are offered to the patient, her partner and her family. In an effort to prevent repeat pregnancy and STDs, the program encourages the teen's partner to participate in education, support, and counseling activities. Access to other services is enhanced by the program's location in a multi-service center which houses many social service agencies. A field study of the intervention was conducted in Queens, New York, with 498 adolescents and their infants. Program participants were more likely to attend clinics regularly, to use contraception more frequently and to attend and graduate high school than were teen mothers in a comparison group. Both the participating teen mothers and their infants experienced better health outcomes than those in the comparison group. The investigators also found a significantly reduced repeat pregnancy rate among participating mothers. Only nine percent of the adolescent mothers in the program had a repeat pregnancy, as compared to seventy percent of the comparison group. Moreover, the teenage mothers' repeat pregnancy rate declined with each successive year of program participation.

SUITABLE FOR USE IN

This program is suitable for use in hospital- or community-based clinics, providing that comprehensive medical and counseling services are available.

ORIGINAL INTERVENTION SAMPLE

Age, Gender
The field study included 498 first time mothers, who were all under age 20 when their child was born (avg. age at delivery = 17 years)

Race/Ethnicity
90% African-American, 6% Latino, 4% other (including Asian, Native American, East Indian and White)

PROGRAM LENGTH

During the field study, participants were eligible to receive services from pregnancy until they reached their 20th birthday. Family life education classes were held on a bi-weekly basis for the duration of the program.

STAFFING REQUIREMENTS/TRAINING

Your team of providers should include physicians, nurses, social workers, health educators and additional staff as needed. In the field study, which served 498 mothers, the staff consisted of a team of physicians (drawn from a rotating pool of 2 pediatricians and 1 or 2 ob-gyns), 3 registered nurses and 6 nurses' aides, 6 social workers, 2 male counselors, 2 health educators, 1 coordinating manager and 6 to 8 clerical assistants. Clergy were also available as needed. In 1984, the program also began recruiting peer counselors to offer presentations in the waiting room. During the field study, the coordinating manager held regular weekly meetings to train the staff. Additionally, each group of service providers (e.g., physicians, social workers, health educators) held their own meetings to discuss training issues particular to their specialty.

   Primary Pregnancy Prevention
   Secondary Pregnancy Prevention
   STD/HIV/AIDS Prevention

ORIGINAL SITE
   School-Based
   Community-Based
   Clinic-Based

APPROACH
   Abstinence
   Behavioral Skills Development
   Community Outreach
   Contraceptive Access
   Contraceptive Education
   Life Option Enhancement
   Self-Efficacy/Self-Esteem
   Sexuality/STD/HIV/AIDS Education

COMPONENTS
   Adult Involvement
   Case Management
   Group Discussion
   Lectures
   Peer Counseling/Instruction
   Public Service Announcements
   Role Play
   Video
   Other
Partner and family involvement
   

PASHA PROGRAM PACKAGE

The PASHA Program Package for this program includes:

  • PASHA User's Guide
  • A Set of Sample Educational pamphlets
  • Handbook for Service Providers
  • Minimum Evaluation Data Set for Care Programs (MEDS)
  • Prevention Minimum Evaluation Data Set (PMEDS)
  • Local Evaluator Consultant Network Directory

  • Telephone technical support on implementation and evaluation for 1 year