Despite the high prevalence of adolescent parenting in the U.S., there is little information on adolescent mother's non-sexual-health behaviors or ways to improve them. This study is a randomized, controlled trail of practice and community-based interventions modeled on Ajzen's Theory of Planned Behaviors aimed at improving health outcomes of African American adolescent mothers aged 15-18 years. The Key outcomes of interest include: complete adolescent immunizations [physical health], not carrying lethal weapons or cigarette smoking [mental health], regular use of condoms and effective hormonal contraception [sexual health]. Adolescents will be enrolled during their post-partum hospitalization into intervention and control groups. All 356 participants will be assessed at baseline. Control group mothers will be asked to seek care at sites of their choice in the community. The 178 intervention mothers will be enrolled in infant health care at a practice site where adolescent family planning, immunization, and dental sealant care are provided within the same building, but in different offices by different providers. Each woman will be assessed for her beliefs, values, attitudes, perceptions of social norms and intentions toward the key outcomes, and a plan will be developed with her to affect these factors in a positive way. A nurse-health educator in the infant practice and the health providers at the infant care, family planning, and dental sites will work to change personal beliefs and values. Perceived social norms will be altered through adolescent peer educators in the practice setting and through home visits to the adolescent and her mother/guardian by the study nurse-health educator. At 18 months post-partum, both intervention and control groups will be visited at home by blinded team of data collectors who will administer questionnaires on the key outcome variables including beliefs, values, attitudes, and perception of social norms related to the outcomes; and on depression, parenting stress, and personality type. Comparison will be made between the two groups regarding key outcomes, and process variables will be modelled to examine their ability to explain outcomes observed.
