This study examines the causal associations for first time adolescent pregnancy, and evaluates the efficacy of community based interventions targeting adolescent mothers alone, or together with their male partners, and existing kinship support. The primary outcomes include improved health, educational behavioral, and social outcomes in the mother/infant dyad. The final desired outcome is preventing or delaying repeat pregnancies in these first time mothers. Furthermore the investigators will study the specific issue of violence and abuse in pregnant teens and how it relates to mental health status and their pregnancy outcomes. In addition, an intervention is proposed to target health providers caring for pregnant teens. This intervention is intended to heighten their awareness of the health and behavioral risks in pregnant teens and improve their skills in addressing these risks with their patients. The area of repeat adolescent pregnancy was selected because of the rapidly deteriorating patterns of prenatal care utilization and pregnancy outcomes associated with short interval repeated pregnancies in these mothers. The research design for this study is quasi-experimental. First time pregnant mothers will be recruited prospectively and randomized in two groups. Both groups will receive an intervention starting at 24 weeks gestationally and continuing up to 18 months corrected post-natal age. In GRP1 only the mother/infant dyads will receive the intervention, while in GRP2 the male partners and the surrounding kinship structure will also receive the intervention. Outcomes will be compared between the two groups of mother to examine the added efficacy of including the pregnant adolescents' male partners and families in this community based intervention. The impact of the intervention on fathers and kinship and how they relate to the mother/infant dyad will also be analyzed.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Demonstration--Cooperative Agreements (U18)
Project #
1U18HD036104-01
Application #
2623492
Study Section
Special Emphasis Panel (ZHD1-MCHG-B (08))
Project Start
1998-06-01
Project End
2003-04-30
Budget Start
1998-06-01
Budget End
1999-04-30
Support Year
1
Fiscal Year
1998
Total Cost
Indirect Cost
Name
George Washington University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
City
Washington
State
DC
Country
United States
Zip Code
20052
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Kiely, Michele; El-Mohandes, Ayman A E; Gantz, Marie G et al. (2011) Understanding the association of biomedical, psychosocial and behavioral risks with adverse pregnancy outcomes among African-Americans in Washington, DC. Matern Child Health J 15 Suppl 1:S85-95
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Anderson, Karen M; Koo, Helen P; Jenkins, Renée R et al. (2011) Attitudes, experience, and anticipation of sex among 5th graders in an urban setting: does gender matter? Matern Child Health J 15 Suppl 1:S54-64
Koo, Helen P; Rose, Allison; Bhaskar, Brinda et al. (2011) Relationships of Pubertal Development Among Early Adolescents to Sexual and Nonsexual Risk Behaviors and Caregivers' Parenting Behaviors. J Early Adolesc 31:1-26
Molina, Kristine M; Kiely, Michele (2011) Understanding depressive symptoms among high-risk, pregnant, African-American women. Womens Health Issues 21:293-303
Katz, Kathy S; Rodan, Margaret; Milligan, Renee et al. (2011) Efficacy of a randomized cell phone-based counseling intervention in postponing subsequent pregnancy among teen mothers. Matern Child Health J 15 Suppl 1:S42-53

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