• teenagers
• service delivery
• education and training
• needs assessment

Teenage parenthood typically results in poor outcomes for mother and baby.1 ,2 Children of teenage mothers are more likely to become teenage parents themselves, thus perpetuating the cycle of disadvantage. Evidence from the Family Nurse Partnerships suggests these outcomes could be ameliorated by positive practitioner–mother relationships.2 Practitioners who work with young parents during pregnancy and after birth are in a key position to support them to better manage their lives and health. If healthcare professionals lack the necessary skills to engage young parents effectively, they miss an opportunity to break the cycle.

In this journal issue, Norman, Moffatt and Rankin3 studied young parents' experiences of interactions with health professionals. The young parents reported feeling their concerns about their child's health were not taken seriously, and that they were being judged.3 They wanted to prove themselves as competent caregivers, and poor rapport with health professionals resulted in them feeling defensive and unwilling to engage constructively. As the authors highlight, it is important to improve the quality of these interactions in order to achieve the desired outcomes for young parents and their babies.

One strategy may be to recognise and respect this desire to parent well, and to utilise interactions with health professionals to engage young parents in thinking about how to improve life for themselves and their baby. In order to optimise these interactions, practitioners need to have the requisite skills. One training programme to provide a set of easily acquired, theory-based skills for healthcare professionals designed to do just that is ‘Healthy Conversation Skills’.4 Training is in the use of open discovery questions, listening, reflecting and SMARTER (specific, measurable, action-oriented, realistic, timed, evaluated, reviewed) goal-setting to support lifestyle change through engagement and motivation of patients and clients. The training adopts an empowerment approach that emphasises increasing self-efficacy. The underlying philosophy reflects the belief that just giving information or telling people what to do is unlikely to bring about sustained change. A major strength of such skills is that they can be implemented by practitioners during routine contact with patients.

Poor outcomes can be avoided early if coordinated and sustained support is put in place that builds on the autonomy and self-efficacy of young parents.5 The Family Nurse Partnership, health visitors and midwives are in a perfect position to offer this kind of support for improving the health behaviours and parenting skills of young parents. Training healthcare professionals in skills to support behaviour change in increases their capacity to maximise existing opportunities and engage young parents in improving their lifestyles. Supporting young parents to explore their issues, identify solutions and make plans for the first steps towards change is likely to also increase engagement and satisfaction with service provision.