Home Visiting Program for Adolescent Mothers

*Note: The National Mentoring Resource Center makes these “Insights for Mentoring Practitioners” available for each program or practice reviewed by the National Mentoring Resource Center Research Board. Their purpose is to give mentoring professionals additional information and understanding that can help them apply reviews to their own programs. You can read the full review on the CrimeSolutions.gov website.

In considering the key takeaways from the research on this program that other mentoring programs can apply to their work, it’s useful to reflect on the features and practices that might have influenced its rating as “Promising” (that is, a program that shows some evidence that it achieves justice-related goals when implemented with fidelity).

Getting the most out of a handful of volunteers.

Perhaps the most striking thing about the Home Visiting Program for Adolescent Mothers model is just how much effort this program got from its three volunteer mentors. In the version of the program studied by Barnet and colleagues, three volunteer mentors (all African American women from the community being served) met biweekly with a caseload of 10-15 pregnant and parenting teens in the first year of their children’s lives, as well as meeting monthly with up to 10 mothers whose children were between 1 and 2 years of age. That’s a caseload of as many as 25 “mentees” needing individual meeting times each month! And this was not easy work, either. The study mentions that for several of these parents, meetings needed to be discreetly scheduled outside of the home because of issues around violence and safety in the home. Plus, each meeting needed to use a structured curriculum that offered all participants the same messages and lessons.

It is unclear from the study whether these volunteers received any kind of stipend, or even small things like reimbursement for mileage driving to all these meetings. But whatever the incentives, these volunteers stuck with the program: Only one of the three mentors left during the four year window the program was studied. This allowed for deep relationships to form between these mentors and their mentees, something the authors hypothesize was likely critical to getting these young mothers to change their attitudes and behaviors around parenting and their own access to healthcare. So while it remains a bit of a mystery as to how the program achieved this remarkable volume and duration of work from their volunteers, the program does serve as a nice example of how programs can really lean on motivated volunteers, especially those who have experience and deep commitment to the community being served.

Integration with social workers and other professionals can be critical to achieving certain outcomes.

While these strong volunteer mentors served as the face of the program and the main deliverers of the curriculum and intervention, they did not go into this alone. Each mentor also had access to a social worker who was available to make referrals to other services and monitor issues related to safety and mental health. This “backup” from experienced professionals meant that the mentors could focus more on relationship building and emphasizing the messages in the curriculum, knowing that they had another staff member to lean on if the parent was experiencing a more critical situation in the home.

However, the coordination of services with health care professionals proved more challenging. The evaluation noted that the mentored parents did not connect with primary care physicians any more than the “control” group did and that the lack of communication between mentors and primary care physicians may have meant that some of the participants’ needs around depression, contraception, and other health concerns went unmet. Of course, sharing information with health care professionals is challenging for any community based program due to both logistical and privacy concerns. Mentoring programs should think carefully about how and when their services can interface with doctors and other medical professionals. It may be challenging to achieve program outcomes that are largely dependent on coordination and communication that may prove elusive.

The need to tap into mentee motivations.

One of the minor points in the evaluation write up is worth examining more closely here. The authors note that one of the possible reasons that the program failed to influence contraception use and avoidance of second pregnancies is that the curriculum was great at providing information about contraception options and encouraging access to doctors who could prescribe them (at least the hormonal ones), but was not great at tapping into the motivations of mentees that would get them to be proactive about their birth control. They point out that other studies of effective birth control programs often highlight the importance of helping youth identify motivating factors that would spur their contraceptive use. This might be a goal for the future, a connection to their own sense of self, or even just a desire to not repeat what they consider to be a mistake. But the curriculum in use here emphasized information and health care access over motivations to use those things in practice. This serves as a good reminder to mentoring programs that you can provide your mentors with all kinds of information and tools, but if you are not motivating mentees to take advantage of them, it can often be for naught. Helping youth tap into their sense of purpose and goals likely can go a long ways towards making sure they take full advantage of what the program provides. Evidence of this can be seen in other programs reviewed on this site that emphasize motivation and self-empowerment.

What about the next generation?

While this program, and the evaluation cited in this review, were both focused on outcomes for the teen mothers being served, one also has to wonder about the impact of these services on the infants in their care. Surprisingly, the study did not include any information about whether these moms were more diligent about pediatric check-ups, indicators of better parent skills in practice, or whether their children were healthier or better cared for than those of moms in the control group. While this program was intensely targeted at parents, the reality is that those intended outcomes were in service of their children, hoping to ensure that these infants got the love and support they needed during the critical early years. Hopefully future evaluations of this model—and others intended to support young parents, such as the Office of Juvenile Justice and Delinquency Prevention’s Second Chance Act Strengthening Relationships Between Young Fathers, Young Mothers, and Their Children initiative—will examine whether the outcomes exhibited by the moms (and dads!) in turn translate into improved early childhood outcomes for their children. That next generation is where the community-level impact of a program like this would be truly felt.

For more information on research-informed program practices and tools for implementation, be sure to consult the Elements of Effective Practice for Mentoring™ and the "Resources for Mentoring Programs" section of the National Mentoring Resource Center site.

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