Collaborative approaches to prenatal care: strategies of successful adolescent programs

Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review

About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.

Translation and adaptation of a questionnaire on the needs of postpartum adolescents

OBJECTIVE

Describe the processes of translation to the Portuguese language and cultural adaptation of the Postpartum Learning Needs (PLN) to the Portuguese context.

METHOD

Methodological study of an instrument that was constructed and validated in Jordan. Here are presented the procedures referring to linguistic, semantic and cultural validation, involving the stages of translation from English to European Portuguese, synthesis of translations, back-translation to the original language, expert committee, and pre-testing.

RESULTS

In the translation process, some vocabulary variations were solved through consensus among translators. The expert committee found that the version translated to Portuguese presented semantic, idiomatic, cultural and conceptual equivalence, while needing some adjustments. Pre-testing was applied to 45 adolescent mothers, of whom 86.6% considered the items comprehensible.

CONCLUSION

Semantic, idiomatic, cultural and conceptual equivalences were conceptually satisfactory among questionnaire versions, which is relevant for the Portuguese culture and easily understandable. It is crucial to assess the psychometric properties of the questionnaire so its adapted version can be made available.

Which Pregnant Adolescents Would be Interested in Group-Based Care, and Why?

STUDY OBJECTIVE

To determine if pregnant adolescents interested in group-based prenatal care have different demographic and psychosocial characteristics than those interested in individual prenatal care. Factors that influence the preferred model of prenatal care patients were assessed.

DESIGN, SETTING, AND PARTICIPANTS

Prospective comparison of demographic and psychosocial characteristics of 153 pregnant adolescents enrolled in an adolescent-oriented prenatal and pediatric program at Children's Hospital Colorado.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Pregnant study participants were queried and their preferred mode of prenatal care and reasons for that preference were examined.

RESULTS

Younger (16 years and younger) and primiparous adolescents were more likely to be interested in group care. Those not interested in group-based care were more likely to smoke and wanted to be pregnant. Most participants were interested in group-based prenatal care to belong to a peer group, receive additional education and support, and to have fun. Reasons participants were not interested in group-based care included concerns about belonging to a group, preferring individual care, and experiencing logistical concerns such as scheduling conflicts, limited transportation, and childcare resources.

CONCLUSIONS

Identifying which patients are interested in group prenatal care influences development of the program model and recruiting procedures, maximizing the effectiveness of the program by offering services based on patient needs. Identifying factors that influence patients' prenatal care choices enables providers to offer support to reduce barriers to participation and structure care that is best suited to patients willing to commit to and engage in the program.