Stepping Stones:A home visiting program for pregnant and parenting adolescents and teens

Cabarrus Health Alliance, the public health department in Cabarrus County, North Carolina, is reducing the incidence of child abuse and neglect among families with adolescent and teen mothers through the Stepping Stones Intensive Home Visiting program. Two specially trained registered nurses provide education, support, and counseling regarding pregnancy, child development and community resources. Services are provided to an annual caseload of 60 to 75 pregnant and parenting adolescents and teens through the infants' first two years of life. Stepping Stones has been shown to be successful, in part by having just 1 case of neglect substantiated in 7 years of working with this high-risk population.

Approximately 45% of all reported cases of abuse and neglect in Cabarrus County involve children ages 0 – 6. Adolescent and teen mothers are at higher risk for abuse and neglect of their children. In order to meet the needs of pregnant and parenting teens, the Stepping Stones nurses provide support, education and referrals at home visits, which are tailored to the needs of the individual client. Frequency of visits is determined by the gestation of pregnancy or age of child, and acuity of client's situation.

The Stepping Stones program uses a research-based curriculum developed by the Florida State University Center for Prevention and Early Intervention Policy: Partners for a Healthy Baby. Nurses utilize this curriculum to provide: education on pregnancy, childbirth, and child development; individual goal setting; modeling parent/child interactions; establishing appropriate childhood expectations; and counseling to avoid subsequent pregnancies, to name a few.