Skip to main content
SpringerLink
Log in

Adolescent and Adult Clients in Prenatal Case Management: Differences in Problems and Interventions Used

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives

This study sought to characterize differences between pregnant adolescents and adults in the types of problems addressed by case managers, and to assess subsequent differences in the types of interventions used with both groups.

Methods

Data stem from 3947 client encounters, provided by 223 case managers in 92 Medicaid-reimbursed prenatal case management programs; the clients were confirmed to be either adolescents (<20 years of age) or adults. Case managers provided information on each client encounter that occurred during 10 workdays over a 20 workday period using the Case Management Intervention Record , a data collection tool. The Chi square test and the Mann–Whitney U test were used to compare the types and number of problems, the types of intervention received, and the mean number of intervention minutes between adolescents and adults.

Results

Adolescents experienced an average of 3.9 problems whereas adults experienced an average of 3.2 problems (p < 0.001). Compared to adults, adolescents were significantly more likely to experience problems in the areas of pregnancy health, family, education/job, transportation, and housing. With respect to breadth of interventions, adolescent clients were significantly more likely to receive support, clinical acts, and to be given tangible items compared to adult clients. On average, case managers spent significantly more time per encounter with adolescents than with adults overall (mean 56.6 vs. 50.3 min), and on educating, assessing, coaching, and monitoring.

Conclusion

Age related differences have both programmatic and provider implications. The intervention typology can be used to evaluate PCM programs serving high risk population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Issel, L. M., Anderson, R. A., & Kane, D. J. (2003). Administrative characteristics of comprehensive prenatal case management programs. Public Health Nursing, 20(5), 349–360.

    Article  PubMed  Google Scholar 

  2. Lee, E., Mitchell-Herzfeld, S. D., Lowenfels, A. A., et al. (2009). Reducing low birth weight through home visitation: a randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154–160.

    Article  PubMed  Google Scholar 

  3. Slaughter, J. C., & Issel, L. M. (2012). Developing a measure of prenatal case management dosage. Maternal and Child Health Journal, 16(5), 1120–1130.

    Article  PubMed  Google Scholar 

  4. Slaughter, J. C., Issel, L. M., Handler, A. S., et al. (2013). Measuring dosage: a key factor when assessing the relationship between prenatal case management and birth outcomes. Maternal and Child Health Journal, 17(8), 1414–1423.

    Article  PubMed  Google Scholar 

  5. Goyal, N. K., Hall, E. S., Meinzen-Derr, J. K., et al. (2013). Dosage effect of prenatal home visiting on pregnancy outcomes in at-risk, first-time mothers. Pediatrics, 132(Supplement 2), S118–S125.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Van Dijk, J. W., Anderko, L., & Stetzer, F. (2011). The impact of prenatal care coordination on birth outcomes. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 40(1), 98–108.

    Article  PubMed  Google Scholar 

  7. Roman, L., Raffo, J. E., Zhu, Q., et al. (2014). A statewide Medicaid enhanced prenatal care program: impact on birth outcomes. JAMA Pediatrics, 168(3), 220–227.

    Article  PubMed  Google Scholar 

  8. Hamilton, B. E., Ventura, S. J. (2012) Birth rates for US reenagers reach historic lows for all age and ethnic groups. NCHS data brief, no 89. Hyattsville, MD: National Center for Health Statistics.

  9. Issel, L. M., Slaughter, J. C., & Forrestal, S. G. (2011). Prenatal case management of pregnant women: What is the evidence for its contribution to a reduction of disparities in perinatal outcomes? In A. Handler, J. Kennelly, & N. Peacock (Eds.), Reducing racial/ethnic disparities in reproductive and perinatal outcomes: The evidence from population-based interventions (pp. 209–238). New York: Springer.

    Chapter  Google Scholar 

  10. Issel, L. M., Forrestal, S. G., Slaughter, J., et al. (2011). A Review of prenatal home visiting effectiveness for improving birth outcomes. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 40(2), 157–165.

    Article  PubMed  Google Scholar 

  11. Elam-Evans, L. D., Adams, M. M., Delaney, K. M., et al. (1997). Patterns of prenatal care initiation in Georgia, 1980–1992. Obstetrics and Gynecology, 90(1), 71–77.

    Article  CAS  PubMed  Google Scholar 

  12. Melnikow, J., Alemagno, S., Rottman, C., et al. (1991). Characteristics of inner-city women giving birth with little or no prenatal care: a case-control study. Journal of Family Practice, 32(3), 283–288.

    CAS  PubMed  Google Scholar 

  13. Rogers MM, Peoples-Sheps MD, Suchindran C. (1996). Impact of a social support program on teenage prenatal care use and pregnancy outcomes. Journal of Adolescent Health, 19(2), 132–140.

    Article  PubMed  Google Scholar 

  14. Zambrana, R. E., Dunkel-Schetter, C., & Scrimshaw, S. (1991). Factors which influence use of prenatal care in low-income racialethnic women in Los Angeles County. Journal of Community Health, 16(5), 283–295.

    Article  CAS  PubMed  Google Scholar 

  15. Bloom, K. C., Bednarzyk, M. S., Devitt, D. L., Renault, R. A., Teaman, V., & Van Loock, D. M. (2004). Barriers to prenatal care for homeless pregnant women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(4), 428–435.

    Article  PubMed  Google Scholar 

  16. Daniels, P., Noe, G. F., & Mayberry, R. (2006). Barriers to prenatal care among Black women of low socioeconomic status. American Journal of Health Behavior, 30(2), 188–198.

    Article  PubMed  Google Scholar 

  17. Johnson, A. A., Wesley, B. D., El-Khorazaty, M. N., Utter, J. M., Bhaskar, B., Hatcher, B. J., et al. (2011). African American and Latino patient versus provider perceptions of determinants of prenatal care initiation. Maternal and Child Health Journal, 15(Suppl 1), S27–S34.

    Article  PubMed  Google Scholar 

  18. Wiemann, C. M., Berenson, A. B., Pino, L G-d, et al. (1997). Factors associated with adolescents’ risk for late entry into prenatal care. Family Planning Perspectives, 29(6), 273–276.

    Article  CAS  PubMed  Google Scholar 

  19. Leland, N. L., Petersen, D. J., Braddock, M., et al. (1995). Variations in pregnancy outcomes by race among 10–14-year-old mothers in the United States. Public Health Reports, 110(1), 53.

    PubMed Central  CAS  PubMed  Google Scholar 

  20. Fraser, A. M., Brockert, J. E., & Ward, R. H. (1995). Association of young maternal age with adverse reproductive outcomes. New England Journal Of Medicine, 332(17), 1113–1118.

    Article  CAS  PubMed  Google Scholar 

  21. Olds, D., Henderson, C. R, Jr, Cole, R., et al. (1998). Long-term effects of nurse home visitation on children’s criminal and antisocial behavior: fifteen-year follow-up of a randomized controlled trial. JAMA, 280(14), 1238–1244.

    Article  CAS  PubMed  Google Scholar 

  22. Olds, D. L., Eckenrode, J., Henderson, C. R., et al. (1997). Long-term effects of home visitation on maternal life course and child abuse and neglect: fifteen-year follow-up of a randomized trial. JAMA, 278(8), 637–643.

    Article  CAS  PubMed  Google Scholar 

  23. Olds, D. L., Henderson, C. R., Chamberlin, R., et al. (1986). Preventing child abuse and neglect: a randomized trial of nurse home visitation. Pediatrics, 78(1), 65–78.

    CAS  PubMed  Google Scholar 

  24. Olds, D. L., Henderson, C. R., Tatelbaum, R., et al. (1986). Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. Pediatrics, 77(1), 16–28.

    CAS  PubMed  Google Scholar 

  25. Hueston, W. J., Geesey, M. E., & Diaz, V. (2008). Prenatal care initiation among pregnant teens in the United States: an analysis over 25 years. Journal of Adolescent Health, 42(3), 243–248.

    Article  PubMed  Google Scholar 

  26. Klein, J. D. (2005). American academy of pediatrics committee on adolescence. adolescent pregnancy: Current trends and issues. Pediatrics, 116(1), 281–286.

    Article  PubMed  Google Scholar 

  27. Issel, L. M. (1997). Comprehensive case management: implications for program managers. Health Care Superv., 15(3), 39–50.

    CAS  PubMed  Google Scholar 

  28. Grobe, S. J., & Hughes, L. C. (1993). The conceptual validity of a taxonomy of nursing interventions. Journal of Advanced Nursing, 18(12), 1942–1961.

    Article  CAS  PubMed  Google Scholar 

  29. Issel, L. M., Forrestal, S. G., Wheatley, R. R., et al. (2011). Surveying hard-to-reach programs: identifying the population of medicaid prenatal case management programs. Maternal and Child Health Journal, 15(7), 883–889.

    Article  PubMed  Google Scholar 

  30. Issel, L. (1996). Measuring comprehensive case management interventions. Development of a tool. Nursing Case Management, 2(4), 132–138.

    Google Scholar 

  31. Issel, L. M. (1997). Doing the work of case management. Health Care Supervisor, 15(3), 39–50.

    CAS  PubMed  Google Scholar 

  32. Teagle, S. E., & Brindis, C. D. (1998). Perceptions of motivators and barriers to public prenatal care among first-time and follow-up adolescent patients and their providers. Maternal and Child Health Journal, 2(1), 15–24.

    Article  CAS  PubMed  Google Scholar 

  33. Issel, L. M. (2000). Women’s perceptions of outcomes of prenatal case management. Birth, 27(2), 120–126.

    Article  CAS  PubMed  Google Scholar 

  34. Monsen, K. A., Banerjee, A., & Das, P. (2010). Discovering client and intervention patterns in home visitng data. Western Journal of Nursing Research, 32(8), 1031–1054.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study was funded in part by the Maternal and Child Health Bureau, HRSA under R40-MC-05472-01. A poster presentation on a related topic was given at the October 2012, APHA Annual Meeting, San Francisco, CA.

Author information

Authors and Affiliations

  1. Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA

    L. Michele Issel

  2. Division of Community Health Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Kelsey Gilmet & Izumi Chihara

  3. Doctoral Nursing Department, and Department of Epidemiology & Biostatistics, Drexel University, Philadelphia, PA, USA

    Jamie Slaughter-Acey

Authors
  1. L. Michele Issel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kelsey Gilmet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Izumi Chihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jamie Slaughter-Acey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Michele Issel.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Issel, L.M., Gilmet, K., Chihara, I. et al. Adolescent and Adult Clients in Prenatal Case Management: Differences in Problems and Interventions Used. Matern Child Health J 19, 2673–2681 (2015). https://doi.org/10.1007/s10995-015-1789-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1789-8

Keywords

Search

Navigation