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Bright Beginnings initiative helps mothers, infants at the start of life

Yale Medicine Magazine, 2000 - Fall / 2001 - Winter

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It started with a simple statistic. Eight years ago members of the Friends of the Children’s Hospital at Yale-New Haven learned that only 55 percent of the children in New Haven were receiving all their necessary immunizations by age 2. Over the next two years members of the Friends board, pediatric staff and people from the community identified other problems common to young mothers.

The solution was Bright Beginnings, a mentoring program that has matched volunteers one-on-one with 164 young mothers since its inception in 1994. Medical Director John Leventhal, M.D., says it was designed to ensure that the mother and her child had timely prenatal visits and well-baby checkups, to reduce the incidence of childhood injuries and to encourage early intellectual and social stimulation.

None of the young mothers in the program, who range in age from 15 to 24, are in an extremely high-risk group. They were matched with mentors, 40 percent of whom are health care professionals or students in a health field. Most of the mentors are parents who have raised their own children.

“They are people who have extra energy to give support to a young mother,” says program coordinator Lyla Johnson, R.N. After training, the mentors sign on to guide young mothers from the last trimester of their pregnancy through the child’s first birthday.

One of the 164 mentors is Courtney Marsh, a 24-year-old nursing student at Yale who plans to become a nurse-midwife. Since January she has made a weekly visit and several weekly phone calls to Tasha Aaron, who gave birth to her daughter Aurora on March 11. Aaron, 23, has a background in health care—she is certified as a nurse’s aide and an EKG technician—and is well aware of the need for checkups. Aaron credits Marsh with “being there for me when I needed someone to talk to. She was with me when I was admitted to the hospital.”

“Having someone who is just a friend for her is a big part of it,” Marsh says of their relationship. “A lot of it is about plugging her into resources that can help her.” At their weekly meetings they may go out to lunch, visit a midwife, fill out forms or simply talk.

A recent pilot study of the program found that 99 percent of the infants had up-to-date immunizations at 12 months, compared to 80 percent of children in the hospital’s primary care population. Only 4.5 percent of teen mothers were pregnant again within one year, compared to 45 percent of the hospital’s Women’s Center teen population. Successfully matched mothers also missed fewer pediatric appointments and made better use of the health care system.

Although Leventhal has embarked on a more detailed study involving 200 young mothers, half of whom will be assigned prenatally to Bright Beginnings and half of whom will receive standard care, he is encouraged by the pilot findings. “Our ultimate goal would be to see if we could expand this program throughout the state of Connecticut,” Leventhal says.

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