Response-Ability Pregnant and Parenting Program (RAPPP)

Beth Calhoun, Ph.D., University of Illinois, Chicago, IL
Melissa Maguire, MS, The Night Ministry, Chicago, IL

Introduction:

The Response Ability Pregnant & Parenting Program (RAPPP) is a project for youth who are homeless or precariously housed and pregnant and/or parenting in the city of Chicago. The mission of RAPPP is to provide interim shelter services as well as community-based case management to empower youth to meet their basic needs.  This care demonstration project serves pregnant and or parenting adolescents ages 13-18 within Chicago’s city limits with interventions designed to address housing, strengthening support/family systems, and life skills including education, employment, parenting, and subsequent pregnancies. The shelter program is an 8 bed, 8 crib, interim shelter that provides housing and supportive services to runaway and homeless youth. All youth in the program receive case management; participate in counseling, support and recreational groups. The community based program provides homeless prevention services to pregnant and parenting precariously housed youth and their families. Parents in the shelter and community participate in a parenting curriculum that has been designed to meet the unique needs and challenges of runaway and homeless pregnant and parenting teens and their children

The goal of the program is to decrease the number of subsequent pregnancies among pregnant and parenting homeless youth by the following outcomes and objectives:

• Objective 1: Fewer then 15% will have a subsequent pregnancy each year
  • Outcome1: Provide 75 youth with case management services in the shelter and in the community each year.
  • Outcome 2: Provide RAPPP’s the Family Life and Parenting Curriculum to 75 youth in the community and shelter each year.
• Objective 2: At annual follow-up 80% of the infants in the program will be current with their immunization schedules as recorded on the OAPPP Core instrument
  • Outcome 2.1: Provide case management services and resources to maintain and record infant immunization record to mothers in the program
  • Outcome 2.2: Administer the Core instrument to 75 youth annually
• Objective 3: At annual follow-up 80% will show increased educational attainment as show on the OAPP Core Instrument
  • Outcome 3.1 A minimum of 75 youth will set educational goals as part of  case planning.
  • Outcome 3.2: Case Managers will track educational goals quarterly.
• Objective 4: At annual follow-up 70% of the participants will increase safety and stability of housing.
  • Outcome 4.1: Provide a minimum of 32 youth and their children with shelter and services.
  • Outcome 4.2:  Provide employment readiness training to 32 youth in the shelter and 25 fathers annually.

Methods: 

The study will conduct a two-arm, quasi-experimental trial using repeated measures to summatively evaluate the effectiveness of and formatively evaluate the implementation of the program and each of its component activities The Project will comprised of an intervention and control groups of 250 youth each.  The comparison group will be recruited from Simpson Academy, Chicago’s only high school for pregnant and parenting teens. The intervention group is homeless and precariously housed pregnant and parenting youth served in the RAPPP interim shelter and in the community.

This project will continue to actively recruit and follow-up with youth in both comparison and intervention groups through the activities of an evaluation-follow-up worker who is dedicated to tracking and meeting with the youth . The evaluation-follow-up worker has a regular schedule and dedicated space at  Simpson Academy for the comparison group and the Interim Shelter for the intervention group. Follow-up activity will take place either on site or in the community. When enrolling in the study, the follow-up worker will get 3 places of contact for the youth, as a way to track and find the youth.  The worker also gives the youth a card that has their next scheduled date for completing the survey and the follow-up worker’s contact information so the youth can contact the worker. All youth who complete the surveys receive a gift card after completing the surveys.

Results:

As of September 1, 2008 we have enrolled 11 pregnant (n=3) and parenting (n=8) teenagers to the RAPPP intervention, while 53 teenagers were recruited from the comparison group from Simpson Academy (pregnant, n=14; parenting, n=39). Given that our evaluation activity started in March of 2008, all the analyses that can be done at this time are descriptive in nature.  Among those recruited from the intervention site, 2 were 16 years old or younger, 6 were 17 or 18 years old and 1 was 19 years old or older. 5 of respondents were enrolled either in a high school or a GED program, 1 had already graduated from high school and 3 respondents dropped out of high school. When asked how important graduating high school was to them, 2 teenagers stated that it was somewhat important, 3 stated that it was very important and 6 said that it was extremely important. 9 respondents were African American. When asked what methods they used to prevent transmission of a STD, 2 respondents stated that they practiced abstinence and 2 reported using a condom while 3 teenagers said they used no method at all. Asked about medical care received over the past year, 7 respondents reported having a pregnancy test, 3 had an abortion, 7 had a pap smear, 5 had a pelvic exam and 6 received prenatal care. STD counseling had been received by 6 teenagers, 5 of which reported that they had been treated for a STD.

Among the 53 teenagers recruited from the control site, 39% were 16 years old or younger, 45% were 17 or 18 years old and 15% were 19 years old or older. The majority (70%) of respondents were enrolled either in a high school or a GED program, 17% had already graduated from high school and 3 dropped out of high school. All teenagers reported that graduation was extremely or very important to them. The majority (85%) of respondents were African American, 5% were white and 5 respondents did not identify their race. To prevent transmission of a STD, almost half (45%) of teenagers stated that they practiced abstinence and another 45% reported using a condom while 9% said they used no method at all. In regards to medical care received over the past year, 70% of teenagers reported having a pregnancy test, 3 had an abortion, 64% had a pap smear, 51% had a pelvic exam and 49% received prenatal care. Over half (55%) stated that they had received STD counseling and 26% reported that they had been treated for a STD.  

The OAPPP Core Instrument and The Night Ministry Housing and Stability Checklist will be completed, at intake, at the birth of the baby and every 6 months

Discussion

The major activity for this year was to receive IRB approval, develop the relationship with  Simpson Academy in order to  recruit for the comparison group and maintain the services within the RAPPP program in order to recruit youth into the intervention group.  Once the project received IRB approval this spring, recruiting at Simpson Academy included meeting students and parents at report card pick-up day and hosting a career fair in order to get the students excited and involved in completing the surveys for the project. These activities will continue into the 2008-2009 academic. Youth who were residing at the shelter and receiving community based case management were in the intervention group.

Implications

The lessons learned this year was the importance of regular communication between the program staff and the evaluation team.  Once the IRB was approved in February of 2008, the program staff and follow-up worker met weekly to assure that both intervention and control group youth were enrolling.

Contact Information:

Melissa Maguire
Telephone: 773-506-6007
E-Mail Address: melissa@thenightministry.org