The 130th Annual Meeting of APHA

Abstract #35019

Lee SmithBattle, RN, DNSc, School of Nursing, Saint Louis University, 3525 Caroline St., St. Louis, MO 63104, 314-577-8980, smithli@slu.edu

Teen mothers often appear in professional discourse as voiceless subjects who are to conform to scientific norms. Objectively-defined norms and predetermined agendas are evident in the critical pathways, agency protocols, and efforts to standardize home visiting interventions. This highly prescriptive approach does not map well onto the world of particular teen mothers and does not validate or strengthen the clinical reasoning and responsiveness of PHNs; it is also inconsistent with the PHN maxim "to begin with people as they are and the situation as it is." In lieu of protocols which dictate visit-to-visit activities, an intervention study, designed to promote individualized care, is underway in the Midwest. Because the study is in progress and results are not yet available, this paper will describe how the clinical tools and the training of the PHNs have been developed to promote the PHNs' clinical reasoning and responsiveness to teen mothers and their families. The clinical tools include a baby book journal (written from the baby's perspective) and PHN training in "interventive interviewing" and in the "speaking for the baby technique." In addition, PHNs participate in guided discussion of longitudinal case studies to help the PHNs imaginatively enter the life-world of diverse teens and to understand the case from the multiple perspectives of the teen, her parents and partner, and the baby. Finally, semi-structured clinical interviews are designed to strengthen the nurse's understanding and to gain the family's trust and engagement in this home visiting intervention.

Learning Objectives:

• Describe the advantages and disadvantages in using protocols, critical pathways, and predefined outcomes in caring for teen mothers.
• Describe how the components of this intervention promote individualized care of teenage mothers.
• Analyze study approaches to promoting the clinical reasoning of PHNs.

Keywords: Home Visiting, Maternal and Child Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.