(54) Exploring the Feasibility of an Integrated Outreach Medical Clinic Within a Community Based Center for Young Mothers and Their Children

Background: Adolescent pregnancy is associated with an increased risk of negative maternal and child health outcomes, correlated with social inequities, especially low income. There is also evidence that adolescent mothers and their children experience barriers to accessing primary healthcare. An outreach clinic founded through a local pediatric hospital was integrated into a community service center for young mothers accessing alternative high school education in Ottawa, Canada. This review aimed to assess data from the pilot project’s first year of service as part of a quality improvement initiative to address the healthcare needs of young mothers and their children.

Methods: Retrospective chart review using the Epic Electronic Medical Record (EMR) for patients who accessed the biweekly outreach clinic from the academic year (10/25/22 to 06/20/23). Charts were reviewed manually to identify patient demographics, chief concern, interventions provided, and if patients had a primary care provider (PCP) registered on the hospital’s EHR.

Results: A total of 49 individual children (ages 3 mos-5 yrs) and youth (mean age = 21.7 yrs) were assessed during the pilot period. Almost two thirds (63.3%) of patients returned for a repeat visit with 132 total clinical encounters noted over a 9-month period (17 clinics total). Just over eighty percent (81.6%) had a PCP. Teen mothers’ chief concerns (n=102 encounters, 66.2%) were broken down equally into: physical/medical concerns (n=36, 35.3%), sexual and reproductive health concerns (n=32, 31.4%), and mental health concerns (n=28, 27.5%) (Fig. 1a). For the infants/children, concerns were primarily infection related and well-child visits (Fig. 1b). The most common interventions provided for both mother and child were supportive, with counselling, conservative management, and anticipatory guidance noted for almost half of encounters (n=112, 48.3%) (Fig. 2). Prescriptions for the mothers (n=38) were primarily mental health-related (n=16, 42.1%) and contraception-related (n=10, 26.3%), with prescriptions for children comprising primarily antibiotics.

Conclusions: Our findings suggest that the integrated health service was feasible and accepted by patients as evidenced by high rates of repeated visits. Most clinical encounters were supportive in nature with the remaining addressing primary health related concerns known to be prevalent and relevant for this population of patients. As a next step, qualitative methodology that explores user satisfaction, opportunities for further growth, and implications relating to health care access should be considered and explored.