Maternity Group Homes for Young Mothers in Florida: A Mixed Methods Examination

from Annual Report: FY 2021-2022

by fsuchildwelfare

Appendix F: STARS Overview

Maternity Group Homes for Young Mothers in Florida: A Mixed Methods Examination

PRINCIPAL INVESTIGATOR: Melissa Radey, Ph.D., MSSW, MA

Florida State University

CO-PRINCIPAL INVESTIGATOR: Shamra Boel-Studt, Ph.D., MSW

Florida State University

OVERVIEW

Early pregnancy and parenting are related to educational, financial, and social disruptions for young adults and increase the risk of poor developmental outcomes for their children. The FFPSA provides funds for states to mitigate poor maternal and child outcomes among early parents. Maternity homes, one mitigation approach, receive FFPSA funds. However, little is known about the operation and impact of maternity homes in Florida. This project aimed to gain knowledge about

maternity homes for pregnant and parenting young mothers in Florida and their impact on maternal and child well-being, specifically to:

1. describe the program models, services, and target population served in maternity homes in Florida. 2. document the services that maternity home residents receive and how these services contribute to maternal and child well-being after program exit. 3. gain insight into mothers’ and providers’ experiences with maternity homes and perceptions of service impact within the context of young mothers’ lives.

This project is significant because only when we understand how maternity homes operate; the population served, including mothers’ history of CPS involvement; the services provided; and service impact, can decisionmakers develop appropriate, responsive services to meet the needs of young mothers.

Using a multitiered, mixed methods approach, the researchers:

Convened a stakeholder advisory panel to inform

the overall study. The panel included the executive directors of each participating maternity home, at least one additional staff member from each home, and two young mothers currently living in an independent living program who had experience living in a maternity home.

EARLY PREGNANCY DISRUPTIONS:

Conducted program reviews. Four of the nine maternity group homes licensed by the DCF (as of June 2021) provided program documents. Programs were diverse in terms of location (i.e., Broward, Duval, Lee and Marion Counties) and operations (e.g., newly- and well-established homes, and variation in eligibility requirements, staff stability, supervision levels, program services). The researchers obtained documents available publicly (e.g., website) and through maternity home directors (e.g., program manual, handbook) and used a data extraction tool to pull relevant data.

Surveyed mothers with maternity home experience. An online Qualtrics survey, available in both Spanish and English, of maternity home graduates and those no longer receiving services was conducted (N = 36). The surveys provided preliminary evidence of the role of maternity home structure and services on maternal and child outcomes.

Interviewed mothers with maternity home

experience. All mothers who completed a survey were invited to participate in a follow-up interview to gain insight about how and why mothers’ experiences with maternity homes shape their and their children’s development and well-being. Twenty-nine (89%) mothers completed an interview.

Interviewed maternity home providers. Staff from the four participating maternity homes were invited to participate in small group interviews to identify key characteristics of maternity homes and indicators of well-being important to measure when evaluating maternity home effectiveness. Ultimately, between two and six staff participated in an interview, including executive directors and direct care staff (N = 16).

Notably, most mothers had experience in foster care, so the researchers limited the analytic sample to mothers with foster care experience who completed a qualitative interview (n = 25). They included all provider small-group interviews.

KEY FINDINGS

Most mothers were in their late teens or early twenties, and identified as non-Hispanic Black (64%), Hispanic (20%), and non-Hispanic White (16%). Mothers were generally socioeconomically disadvantaged. Nearly half experienced homelessness in their lifetime and 16 percent had exchanged sex for food, money, drugs, or shelter. Nearly one-fourth were currently enrolled in an educational program and one-third were employed, most commonly in the service industry. Mothers averaged approximately 5 years in foster care, with 40 percent experiencing 10 or more placements. Approximately one-half of mothers were currently living in independent living programs. Twenty-two of the 25 respondents learned of the survey from their maternity home director or case manager. A full 52 percent (n = 13) of mothers were receiving extended foster care services compared to the national average of 25 percent of youth with foster care experience.17

FINDINGS:

Participating maternity homes serve pregnant and parenting teens between ages 11 and 21, including mothers in the foster care system. Program goals and missions prioritized 1) helping teen mothers establish safety; 2) developing positive parenting skills; and 3) preparing for independent living.

Core services include:

• Needs assistance for mothers and their children • Access to health care • Case management (e.g., individual service plans and goals) • Parenting classes • Life skills training • Counseling or therapy • Nutrition classes • Vocational training • Childcare • Transportation

From the mothers’ perspective, most reported receiving independent living skills, educational assistance, counseling or therapy, medical coordination, childcare assistance, and friendship within the home. Still, only one mother shared that she was prepared for selfsufficiency upon maternity home exit. Interviews with mothers and providers illuminated the context around mothers’ experiences with maternity homes.

INTERVIEW FINDINGS:

Theme

Adversity, crisis, and rejection

Tension between useful programs and structured delivery

Unfulfilled aspirations for connections

Summary

Mothers faced high levels of adversity, stress, and rejection. Unplanned pregnancies often exacerbated mothers’ delicate balance of resources and support. Providers recognized mothers’ difficult pasts and current situations. They viewed maternity homes as key opportunities to support mothers at critical times in their lives; they also recognized the difficulties in serving mothers with such complex, difficult histories.

Together, the narratives of maternity home services and operation reveal the vital and intricate role that maternity homes serve for residents. Generally, mothers desired services and structure. At the same time, they wanted structure that was individual- and circumstance-specific. They also simultaneously wanted freedom and guidance to navigate early motherhood. Providers identified the difficulty of introducing structure given mothers’ histories of adversity, stress, and rejection. Providers identified mothers’ struggle between structure and independence and viewed structure as central to successful parenthood.

Mothers and providers both wanted mothers to develop connections within and outside of the maternity home. However, the circumstances that led mothers to the maternity home placement (e.g., unplanned pregnancy, rejection from family) commonly led to mothers’ hesitancy to trust others. Moreover, their lack of trust, coupled with unhealthy ways of handling conflict (e.g., fights), contributed to high “drama” in the homes and early departures for mothers and staff members alike.

Theme

Slow progress toward independence

Summary

Mothers and providers voiced similar goals for mothers, primarily, to live independently through acquiring necessary education and skills. Both also recognized inevitable “hiccups” in meeting goals. Yet, mothers had lower standards of success (e.g., staying alive and maintaining custody of child) while providers defined success through continued, measurable progress towards goals. Both groups also recognized the need for additional services (e.g., driver’s license preparation) to promote independent-living success.

Limitations to the study include the use of convenience sampling and a small sample size impeding the generalizability of the findings. The researchers surmise the sample overrepresents maternity home providers with more experience and with more established programs as well as a more advantaged sample of mothers than the broader population of mothers with maternity home experience.

RECOMMENDATIONS

Due to the limited sample size and limited generalizability, the following implications are suggestive only and subject to additional study.

1. Policymakers interested in meeting the needs of young mothers in maternity homes may want to consider establishing a statewide network to oversee maternity homes and allow providers to connect with one another.

2. Providers can emphasize the application of program content to help mothers recognize that program engagement will contribute to smoother transitions after they leave the homes. 3. Additional training of frontline providers might

increase skills to work with mothers successfully thereby increasing job satisfaction and decreasing turnover. 4. Providers should anticipate and prepare for untimely departures and could discuss the realities that mothers will face outside of the home while working with mothers to put the necessary supports in place. Celebrating and rewarding progress (however small) and helping mothers develop future-oriented thinking may lengthen stays and contribute to more successful transitions after exit.

5. Our finding that mothers struggle to overcome their adverse backgrounds and transition to independence after exiting maternity homes suggests the importance of extended foster care particularly for this vulnerable, two-generation population. Encouraging participation can facilitate healthier mother and child outcomes.

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