514754
research-article2013
JPCXXX10.1177/2150131913514754Journal of Primary Care & Community HealthHarris et al
Pilot Study
Young Mothers Lack Plans to Receive Preventive Health Care
Journal of Primary Care & Community Health 2014, Vol. 5(2) 144–147 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/2150131913514754 jpc.sagepub.com
Kari R. Harris1, Carolyn R. Ahlers-Schmidt1, and Kerri L. Weeks1
Abstract Background: Despite their health vulnerability, multiple barriers to health care exist for adolescent mothers. This pilot study aimed to gain information regarding preventive health care intentions of young mothers following pregnancy. Methods: We administered institutional review board–approved surveys to mothers aged 15 to 21 years at a local hospital where 75% of infants are born. Participants were questioned regarding current and intended use of health care. Results: Results showed that only half of the young mothers identified a primary care provider (PCP) but more had seen some type of doctor in the 3 years preceding their pregnancy. White mothers were significantly more likely than Hispanic to have seen a physician prior to pregnancy; family physicians (FPs) were referenced most. Additionally, white and black mothers were significantly more likely than Hispanic mothers or mothers of other ethnicity to have received minor emergency care during pregnancy. While FPs were referenced most frequently, few mothers planned to see one for preventive care. Nearly half of participants planned to see their obstetrician/gynecologist (OBGYN) for routine yearly checkups. Conclusions: This research indicates a gap in health care for young mothers. Only half enter parenthood with a PCP, and once mothers, few plan to see a physician for preventive care. In this study, OBGYNs were identified most often for preventive health care. Therefore OBGYNs should provide comprehensive care to this population, or connect them with other PCPs. Furthermore, young mothers do plan on seeing FPs for acute health care, supporting previous recommendations that physicians use all visits to provide comprehensive care to adolescents. Keywords adolescent, pregnancy in adolescence, health knowledge, primary prevention
Introduction The negative health impacts following teen pregnancy and the benefits of routine preventive health care are well known to health care providers. What remains unclear is whether young mothers are receiving preventive health care following their pregnancy, and if so, who is providing this care. Previous research has shown young mothers want to be seen by a consistent provider, to be counseled on birth control, and to be screened for sexually transmitted infections and depression.1-3 However, because of barriers, this population has a difficult time accessing and continuing with comprehensive medical care. Barriers to care included living in poverty, lower education level than adult mothers, frequent phone service interruptions, higher likelihood of depression, decreased access to medical care, lack of health insurance, feelings of lower self-esteem, and poor parenting skills.1(p448),2(275),4-6 With regard to health care for their infants, young mothers are more likely to seek regular care in emergent/urgent care settings and less likely to utilize preventive care visits.7 Sedgwick County is a mid-sized, urban area and compared with state-wide data, adolescent rates of pregnancy in this county are high. In 2009, the county had 35 pregnancies
per 1000 10- to 19-year-olds as compared with 26 per 1000 in all of Kansas. Unfortunately, while the state-wide rate has decreased over recent years, the rate of teen pregnancy overall in Sedgwick County has increased.8 This increased rate of teen pregnancies leads to a growing population of vulnerable young mothers in need of comprehensive medical care; however, no studies to our knowledge have addressed whether local young mothers are receiving health care. Although there are many providers who are capable of providing comprehensive medical care to young mothers, it is unclear who, if anyone, is providing regular routine health care to this population and whether demographic factors influence this care.
Methods We developed a 24-question, paper survey that was approved by a local institutional review board. Postpartum 1
University of Kansas School of Medicine–Wichita, Wichita, KS, USA
Corresponding Author: Kari R. Harris, 620 N. Carriage Parkway, Wichita, KS 67208, USA. Email: [email protected]
Downloaded from jpc.sagepub.com at CALIF STATE POLY UNIV LIBRARY on March 14, 2015
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Harris et al Table 1. Demographics of Participants. Demographic Race White Hispanic/Latino Black Other Missing Age (years) 15 16 17 18 19 20 21
Frequency
Percentage
82 27 12 23 2
56.2 18.5 8.2 15.8 1.4
2 3 7 16 38 30 47
1.4 2.1 4.8 11.0 26.0 20.5 32.2
mothers aged 12 to 21 years were eligible to participate. Surveys were administered prior to discharge at a single hospital where 75% of local infants are born. Providers with delivering privileges at the hospital were asked permission to include their patients in the study and none excluded their patients from the study. Surveys were reviewed by a panel of experts in the fields of obstetrics and gynecology (OBGYN), pediatrics, and family medicine. Nondemographic questions focused on the health care that the young mother received prior to getting pregnant and her intentions for future health care now that she was a mother. No incentives were offered to the participant for completing the survey. If a young mother was not available to immediately participate in the survey, the researcher offered to leave the survey in her room or reapproach her at another time. Survey frequencies and percentages were calculated for all responses. Chi-square analysis was used to compare age (
research-article2013
JPCXXX10.1177/2150131913514754Journal of Primary Care & Community HealthHarris et al
Pilot Study
Young Mothers Lack Plans to Receive Preventive Health Care
Journal of Primary Care & Community Health 2014, Vol. 5(2) 144–147 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/2150131913514754 jpc.sagepub.com
Kari R. Harris1, Carolyn R. Ahlers-Schmidt1, and Kerri L. Weeks1
Abstract Background: Despite their health vulnerability, multiple barriers to health care exist for adolescent mothers. This pilot study aimed to gain information regarding preventive health care intentions of young mothers following pregnancy. Methods: We administered institutional review board–approved surveys to mothers aged 15 to 21 years at a local hospital where 75% of infants are born. Participants were questioned regarding current and intended use of health care. Results: Results showed that only half of the young mothers identified a primary care provider (PCP) but more had seen some type of doctor in the 3 years preceding their pregnancy. White mothers were significantly more likely than Hispanic to have seen a physician prior to pregnancy; family physicians (FPs) were referenced most. Additionally, white and black mothers were significantly more likely than Hispanic mothers or mothers of other ethnicity to have received minor emergency care during pregnancy. While FPs were referenced most frequently, few mothers planned to see one for preventive care. Nearly half of participants planned to see their obstetrician/gynecologist (OBGYN) for routine yearly checkups. Conclusions: This research indicates a gap in health care for young mothers. Only half enter parenthood with a PCP, and once mothers, few plan to see a physician for preventive care. In this study, OBGYNs were identified most often for preventive health care. Therefore OBGYNs should provide comprehensive care to this population, or connect them with other PCPs. Furthermore, young mothers do plan on seeing FPs for acute health care, supporting previous recommendations that physicians use all visits to provide comprehensive care to adolescents. Keywords adolescent, pregnancy in adolescence, health knowledge, primary prevention
Introduction The negative health impacts following teen pregnancy and the benefits of routine preventive health care are well known to health care providers. What remains unclear is whether young mothers are receiving preventive health care following their pregnancy, and if so, who is providing this care. Previous research has shown young mothers want to be seen by a consistent provider, to be counseled on birth control, and to be screened for sexually transmitted infections and depression.1-3 However, because of barriers, this population has a difficult time accessing and continuing with comprehensive medical care. Barriers to care included living in poverty, lower education level than adult mothers, frequent phone service interruptions, higher likelihood of depression, decreased access to medical care, lack of health insurance, feelings of lower self-esteem, and poor parenting skills.1(p448),2(275),4-6 With regard to health care for their infants, young mothers are more likely to seek regular care in emergent/urgent care settings and less likely to utilize preventive care visits.7 Sedgwick County is a mid-sized, urban area and compared with state-wide data, adolescent rates of pregnancy in this county are high. In 2009, the county had 35 pregnancies
per 1000 10- to 19-year-olds as compared with 26 per 1000 in all of Kansas. Unfortunately, while the state-wide rate has decreased over recent years, the rate of teen pregnancy overall in Sedgwick County has increased.8 This increased rate of teen pregnancies leads to a growing population of vulnerable young mothers in need of comprehensive medical care; however, no studies to our knowledge have addressed whether local young mothers are receiving health care. Although there are many providers who are capable of providing comprehensive medical care to young mothers, it is unclear who, if anyone, is providing regular routine health care to this population and whether demographic factors influence this care.
Methods We developed a 24-question, paper survey that was approved by a local institutional review board. Postpartum 1
University of Kansas School of Medicine–Wichita, Wichita, KS, USA
Corresponding Author: Kari R. Harris, 620 N. Carriage Parkway, Wichita, KS 67208, USA. Email: [email protected]
Downloaded from jpc.sagepub.com at CALIF STATE POLY UNIV LIBRARY on March 14, 2015
145
Harris et al Table 1. Demographics of Participants. Demographic Race White Hispanic/Latino Black Other Missing Age (years) 15 16 17 18 19 20 21
Frequency
Percentage
82 27 12 23 2
56.2 18.5 8.2 15.8 1.4
2 3 7 16 38 30 47
1.4 2.1 4.8 11.0 26.0 20.5 32.2
mothers aged 12 to 21 years were eligible to participate. Surveys were administered prior to discharge at a single hospital where 75% of local infants are born. Providers with delivering privileges at the hospital were asked permission to include their patients in the study and none excluded their patients from the study. Surveys were reviewed by a panel of experts in the fields of obstetrics and gynecology (OBGYN), pediatrics, and family medicine. Nondemographic questions focused on the health care that the young mother received prior to getting pregnant and her intentions for future health care now that she was a mother. No incentives were offered to the participant for completing the survey. If a young mother was not available to immediately participate in the survey, the researcher offered to leave the survey in her room or reapproach her at another time. Survey frequencies and percentages were calculated for all responses. Chi-square analysis was used to compare age (
