Evaluation of evidence-based practice for adolescent mothers in PHN home visiting care

Background: The U.S. health system is not designed to meet needs of young people, and few health care providers are trained in adolescent health. Adolescent mothers are at high risk of receiving substandard health care due to poverty and lack of age-appropriate health care resources. Public health nurses (PHNs) are ideally suited to provide evidence-based practice (EBP) to pregnant and parenting adolescents through family home visiting programs. Methods: The purpose of this retrospective, descriptive study was to evaluate the services provided to high risk adolescents in local PHN visiting programs in the Midwest. We re-used a convenience sample of Omaha System data for 192 high risk mothers ages 13-17. We used descriptive analysis to evaluate the problems addressed with the adolescent mothers, compared to expected EBP guidelines. Results: Mothers ages 13-17 received services for problems related to poverty (96%), parenting (88%), pregnancy (63%), and postpartum (47%). Serious co-morbidities were addressed with some mothers, including mental health (33%), substance use (23%), and abuse (16%). No services were documented for critical adolescent health issues such as interpersonal relationships, nutrition, or physical activity. Conclusions: PHNs addressed health needs of high risk adolescent mothers; however, some critical EBP interventions were missing. Knowledge of EBP for adolescents may be lacking in the PHN workforce, or there may be missing data due to documentation protocols. Further research is needed to translate EBP into standardized care plans in electronic health records and provide training to PHNs, to guide and support PHN practice with pregnant and parenting adolescents.