Methods: Mixed method design was used. The participant consisted of 40 families that were family members and pregnant teenagers aged 10-19 years who taking health services at primary health care settings for 1-2 months before giving birth. Instrument was the family health care intervention package (FHCIP) which be developed based on family resiliency theory, family health care concept, and evidence based practice. It consisted of Family health assessment form, Family health care intervention guideline, Family with Teenage Mom Handbook, and family and adolescent pregnancy adaptation questionnaires with open-end questions. All instruments were validated by five experts. After a trial run for the questionnaires with 10 similar families and pregnant teenagers. The reliability of adolescent pregnancy adaptation; Cronbach’s alpha coefficient was 0.80. And Cronbach’s alpha coefficient for family Adaptation was 0.89. Quantitative data was analyzed by descriptive statistics; frequency, percentage, mean, standard deviation, and analytic statistic for testing difference by dependent t-test. In addition, interviewed data was analyzed by content analysis. The findings were presented by describing with tables, and displaying the categories that emerged from analysis technique.
Results: The findings showed that before implementation; family health assessment was displayed family adaptation score was in low level (Mean = 74.96, Standard deviation = 4.17), and pregnant teenage adaptation score was also in low level (Mean= 112.23, Standard deviation = 6.04). Families had high stress and concern about their teenagers’ health with anger, guilt, and feel loss of their hope about future lives of their teenage girls. All families had kept secret due to negative social value and norm of their community toward teenage pregnancy. They tried to cope by emotional technique and problem solving for overcome their troubles. While, pregnant teenagers were sorry, sad, guilt, and fear about own future lives. They did not function for caring their health as normal pregnant women. They had poor health behaviors such as inappropriate food habit, risk to get accident from motorcycle, some smoking, drinking alcohol, and go around the night. They came to prenatal care clinic with their mothers or boyfriends so late; 2nd or 3rd trimester of pregnancy. They had conflict with their parents and parents of boyfriends. And, some had conflict with their boyfriends. After intervention by using the family health care guideline;(therapeutic communication, family and adolescent counselling, supporting family system, family psycho-education, family conference, family anticipatory guidance, and family education). The project team and 3 professional nurses did continuous monitoring and evaluating by telephone visit and follow up at prenatal clinic. The end of project, the score of family and pregnant teenage adaptation were increased at good level and be statistically significant difference from starting step (P<.05). Many families had planned and done everything for providing care and socializing their pregnant teenagers and their boyfriends to become good parents (adolescent parenting) and allowing to continue study for their good future lives. Some families planned to perform grand-parenting and let their pregnant teenagers continue to study or work for their lives and babies. The pregnant adolescents had coped with the struggle events in daily living by increasing morale, and accepting to their changed situation. They had attempted to adjust their health behaviors and life style for own health and their babies; especially, not smoking and drinking alcohol, not or less driving motorcycle, careful about risks and accidents. However, some adolescent pregnancies had emotional changes and high strain that made conflicts with their boyfriends and parents. Therefore, their families had tried to understand, support, and advise them in positive way. In term of effects and outcomes, the family and adolescent pregnancy showed effective adaptation both body and mind, including, family function. However, some families and pregnant teenagers have several negative or vulnerable factors, especially, poor family relationships and low economic status that made them faced with family health problems such as separation of teenage couple, violence, and being neglected.
Conclusion: As the results, the family health care intervention package could promote health of family with unintended pregnant teenagers in community settings. However, the study design could not approve effectiveness of the intervention package. Therefore, the future study project should design with reliable method and follow up for sustainable health outcomes. In addition, innovation of family health care approach should be created fitting with family and community context that can apply to promote health of family and teenage pregnancy as successfully.