Project MAS, An Adolescent Pregnancy Care Program

Kimberly McWilliams LMSW and Gina Miller, MA, LBSW: Project MAS at The Children’s Shelter, San Antonio, TX
Margaret Brackley and Ph.D. Gail Williams, Ph.D.: Department of Nursing, University of Texas Health and Science Center at San Antonio, TX

Introduction

Project MAS (Mothers and Schools) is a teen parenting program aimed at helping adolescent parents acquire the necessary support to complete high school, become nurturing parents and ultimately become successful members of our community.  As a center and community based Care Program, Project MAS offers both Core and Wraparound Services. Core Services include: six weeks of homebound education beginning within days of deliver; on site child-care while students are in class; in-home case management provided to teen mothers and fathers for one year following delivery; and a 26 session culturally relevant curriculum focused on enhancing parenting skills and developing a nurturing routine.  Curriculum is delivered by a predominantly Mexican American staff.  In addition to these Core Services Project MAS also offers Wraparound services which include:  peer mentoring; gender specific support groups focused on parenting education; and life skills groups developing goal setting and career advancement.  The question addressed in this program evaluation is if statistically significant differences in program objectives occur between young mothers who participate in Project MAS Core Services and those who participate in Project MAS Core plus Wraparound Services.  Program objective are to: (1) increase adherence to parental responsibilities; (2) increase achievement of developmental milestones of infants; (3) increase adherence to infant immunizations; (4) reduces incidence of subsequent births; (5) increase rate of teen parents graduating from high school.

Methods

A randomized control trail is being used for this research design.  The program is offered to 11 high schools within San Antonio Independent School District.  San Antonio’s rate of school-age pregnancy and birth (ages 15-17) is extraordinarily high.  San Antonio Metropolitan Health District showed a 2005 birth rate for this age group of 39 per 1,000, as compared to 21.4 per 1,000 for the national average.  The school district refers students to Project MAS.  Following the child’s delivery students are being informed of the study, which will offer additional services to the students and their male partners.  Students are then offered bi-weekly case management if there are in the Project MAS Core services group or bi-weekly case management plus peer mentoring; parenting education groups; and life skills groups if they are in the Project MAS Core plus Wraparound services group.  Case managers administer all study surveys in the subject’s home at baseline, 12 month, and 18 month follow-up points.  Laptop software is used to administer self-report measures, including the Adult Adolescent Parenting Inventory (AAPI), Ages and Stage, Development Assist Profile (DAP), and the AFL Core.  Questionnaires are used to assess knowledge of childrearing practices as measured by the AAPI, variables associated with academic success as measured by the DAP, and data on program objectives such as developmental milestones as measure by the developmental screener Ages and Stages. 

Results

At the end of year 2 of the project, 20 students have provided baseline data for Project MAS.  Data collection began at the end of August, 2008.  This number reflects equal enrollment in Project MAS Core and Project MAS Core plus Wraparound Service.  At this time no statistical analysis of the differences between the two groups on outcome objectives has been completed. 

Currently, Project MAS is working on enrolment of clients for baseline data collection.  It is estimated that Project MAS will enroll 190 females and 30 males by the end of the 2008/2009 school year.  Students are being referred to Project MAS by the school district for mandatory six week maternity leave. 

Process evaluation will examine how services are delivered and what impact dosage of participation has on outcomes.  It is hypothesized that students receiving Project MAS Core plus Wraparound Services will: (1) attain greater academic achievement; (2) demonstrate increased adherence to parental responsibilities; (3) demonstrate increased achievement of developmental milestones (4) increased adherence to infant immunizations (5) demonstrate reduced repeat pregnancies then those students receiving Project MAS Core services alone. 

Discussion

After one month of implementation of the project, no conclusions can be drawn at this point about the effectiveness of the program.  However, a similar evaluation of Project MAS in 2001-2005 demonstrated significant results including: 91% of parenting seniors graduating high school; 70% enrolling in higher education or vocational training; 3% having a subsequent birth; and 100% of those attending parenting workshops showing enhanced parenting skills.  Project MAS is hoping to provided similar outcomes for the current project. 

The program has encountered a couple of challenges in the first two year of the project including, delays in gaining IRB oversight and turnover of staff.  This turnover includes both direct care staff and evaluation staff.

Implications

One lesson learned in the first two years of this study would be the importance of hiring and training top quality staff.  The high amount of turnover in both direct care and evaluation staff has cost the program valuable time and resources.    

If program practices prove statistically significant, Project MAS can be used as a model prevention program for working with young teen parents.  Additionally, Project MAS utilizes culturally relevant curricula delivered by a predominantly Mexican American staff.  Adhering to the cultural values can also designate Project MAS as a model for working with Hispanic youth. 

Contact Information:

Kimberly McWilliams
Telephone: 210-212-2597
E-Mail Address: kmcwilliams@chshel.org