Next Generation: Meeting Teens Where They Are

Kate Grossman, M.A; M.S, University of Washington School of Social Work: Seattle, Washington

Introduction

Intervention:

The Next Generation Adolescent Family Life Project aims to increase the health and well being of teen parents and their infant children while also increasing the teens' parenting skills and employment. This home visiting model targets teens in Seattle, Washington who are Latina or homeless.

Rationale:

Next Generation is based on the research from several home visiting programs which demonstrated that parents who read to their children more and had more positive interactions with their children were more engaged in educational activities than comparable families. Children in the Early Headstart Home Based Program showed improved early language and literacy, problem solving, social and basic skills.

Program Description:

The program being evaluated, Children Home Society’s Next Generation Home Visiting Service, coordinates services in areas of healthcare for mom and baby, family planning, family life education, mental health, parenting education, and employment with particular emphasis on assisting teen parents with family life education and employment. A partner agency provides education and employment services for both the mother and father of the baby. Teens are visited weekly or every other week depending on the stage of pregnancy or the age of their child. Teens may stay in the program for two years following the birth of their child or following enrollment if they are parents when enrolled. Teens in school or work training may continue with services for up to five years.

Program Objectives and Purpose of the Evaluation:

The evaluation will identify if Next Generation 1) has been effectively implemented and 2) if it achieves these program outcomes for teens in the program for at least six months:

Teens who have received regular health care will demonstrate healthy pregnancy outcomes and their young children will be current in preventive health care.
Teens will have finished one grade level to complete education or completed job preparation to become self-sufficient.
Teens will show a larger increase in parenting skills than teens who were not in the project as assessed by the home visitor.
Teens will increase social support and access more community resources compared to pre-project use.
Fathers will be more involved in child care compared to initial assessment.
Fathers will show an increase in family responsibility evident in school completion progress or regular employment.

Methods

Evaluation Design

The evaluation is a quasi-experimental study which includes initial and post–program questionnaires as well as follow-up questionnaires to collect data from an intervention group and a comparison group. Follow-up questionnaires are administered 12 months after baseline data collection. The evaluation design includes comparing pre and post service use for the intervention group as well as comparing the intervention group and comparison group on the services received and their related outcomes. The intervention group is recruited by home visitors from hospital referrals, school referrals, clinic referrals and other community based providers. The comparison group is recruited by the evaluator through support groups and alternative schools in the community.

Instruments used and methods of collection

Instruments used for data collection include the AFL Core Questionnaires for Pregnant and Parenting Clients in English and Spanish and the AFL Follow-up Questionnaire in English and Spanish. Additional tools for the evaluation include the Family Assessment Form (FAF), Parenting Pointers Quiz, demographic data, Next Generation Services Checklist, and Next Generation Service Log.

Analysis and statistical methods
The analysis includes (1) the intra-group comparison of means and ranges and other descriptive statistics for the intervention group over time and (2) the inter-group comparison of service data and questionnaire responses for the intervention group and comparison group. The parent's education progress and child’s immunization status as noted on the Service Checklist form is compared at entry into the study and 12 months later to answer these research questions, did participants (1) make progress in finishing one grade level or enrolling in or completing training, and (2) meet preventive care, immunization schedules for infants. These pre and post participation results are analyzed via dependent t tests for mean differences and chi square tests for proportion differences.

The service data is used to describe the duration and intensity of the services received by the participants. The hypotheses are: longer duration services will result in improved education completion outcomes and (2) higher intensity of services will lead to more positive outcomes for teen participants.

Results

For those participants who have been in the program for at least 6 months during the first three years of the project (n=49) 100% reported receiving some type of pre-natal care and care for delivery of their child. At time of entry to the program, 79% had access to public health insurance for mom and baby, 12% had insurance for baby only and 8% had no insurance because their children were over 1 year of age and their DSHS coupons had expired.
92 % percent are delivering healthy birth weight babies and 95% percent are up-do-date on their immunizations.
19% of the teen parents who had been in the program for six months or more during the first three years of the project had a repeat pregnancy within two years of the first pregnancy. This falls within the program objective: 70% of the participants will avoid a repeat pregnancy within two years of the first pregnancy.
Evaluation data from a small number of pre-post test Parenting Pointers quizzes completed show statistically significant improvements over time by the program participants in knowledge about parenting skills as compared to a similar group of teen moms not receiving the home visiting services.
Evaluation data from a small subset of the intervention group who completed pre and post test (12 month interval) Family Assessment Forms indicates that slight overall gains, although not statistically significant, are being made in the areas of caregiver-child interaction and developmental stimulation over time while living conditions and financial conditions slightly declined for this group.
This year, 51% (n=22) of the participants served became employed full or part-time
and 12% (n=5) reported increased income during the year. 35% (n=15) also made significant educational progress by advancing to the next grade, obtaining a GED, high school diploma or college credit
This year three male partners of participants enrolled in the project, enrolled in King County Work Training Services, a partner program, and became employed.
For the first three years of the project 41% (n=20) of the participants who were in the program for at least six months have achieved educational outcomes and 70% of these participants have been receiving services from the King County Work Training Program.
For the first three years of the project, 59 % (n=29) of those who were in the project for at least 6 months have become employed full time or part time and 62% of those of became employed were recipients of King County Work Training Services, a partner program.

Discussion

Due to the fact that most participants are already receiving health care services at program entry, the Home Visitors have been most actively engaged in the delivery of family life education services and referral for education and employment services.

This year an increased number of participants enrolled in school, and a significant number have made progress in the form of moving up a grade or obtaining a diploma or GED. Approximately three fourths of the participants have been referred for school re-entry or employment placement assistance this year through partner agency King County Work Training (KCWT) and 51% of those enrolled in the program this year have become employed. In addition, three fathers have gained employment through KCWT services.

Small gains have been made by participants in parenting skills and knowledge over time compared to a similar group of teen parents not receiving the home visiting service.

The fathering support services have not been successfully implemented at this time.

In year three the evaluators were able to work with staff more closely to collect more complete and consistent program data. The primary challenge remains a very small sample size and an even smaller number of subjects who stay in the program for longer than six months and for whom outcome data can be analyzed.

Contact Information

Name of contact person during abstract review: Kate Grossman
Telephone: (206) 616-7424
E-mail address: kateg3@u.washington.edu