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YP Mentorship Program Form

About Us

The Center for Community Health and Health Equity (CCHHE) at Brigham and Women’s Hospital serves as the coordinating department for community health programs and acts as the bridge between community-based organizations and the hospital.

Stronger Generations, one of the center’s major initiatives, seeks to promote maternal and child health equity, by providing pregnant and parenting individuals with quality health care and community resources to strengthen their own health, support parenting, and give babies the healthiest start possible

A signature piece of Stronger Generations is our Proud 2 Parent programs, focused on educating, engaging, and empowering expectant and parenting adolescents to enhance their physical, mental and social health outcomes. Our goal is to achieve these outcomes through a focus on peer support and education, patient engagement, and leadership development.

What is the Young Parent Mentoring Program?

The Young Parent Mentoring Program provides young parents with supportive and healthy peer relationships through one-on-on mentoring with young parent leaders in the Greater Boston area. The benefits of the program include free educational and training opportunities, participation in our community-based network of young parent support activities, and tailored 1:1 peer support.

Interested in being matched with a Young Parent Mentor?

Are you a pregnant or parenting young adult under age 25? Do you feel alone in your experience? Do you feel like you could use some help and guidance during pregnancy or while parenting? If so, join the Young Parent Mentoring Program and get paired with a trained mentor who can share similar experiences because they too are a young parent.

Those interested in participating in the Young Parent Mentoring program will be required to identify skills, knowledge, or goals that they would like to achieve with their mentor, and to commit to a regularly scheduled meeting time for structured mentee/mentor activities.

If you are interested in joining the Young Parent Mentoring Program and being matched with a mentor, please complete the application below.

Mentees/Mentors are accepted on a rolling basis.

Name

* must provide value

Zip Code

* must provide value

Phone Number

* must provide value

May we text you for communications?

Yes

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E-mail Address

* must provide value

Social Media (FB, Instagram, Twitter)

Age

Race

Asian

Black/African America

White

Multi-Racial

Other

Please describe:

Are you Hispanic or Latino/a/x?

Yes

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Ethnicity

Cape Verdean

Dominican

Haitian

Jamaican

Other

Please describe

Do you identify as Lesbian, Gay, Bisexual, Queer, or Transgender?

Yes

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Please list the language(s) you speak fluently:

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Please list the names and ages of your children:

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Are you currently co-parenting

Yes

Other

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Please describe:

If co-parenting, what is the nature of your co-parenting relationship?

Co-parenting and single

Co-parenting and in a relationship with the child's biological parent

Co-parenting with someone who is not the child's biological parent

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What birthing and/or parenting support are you looking for?

* must provide value

Health (Vaginal/C-section birth, NICU baby, breastfeeding, nutrition, mental health, etc.)

Parenting

Employment

Education

Multicultural Parenting

Other

Please describe:

Are you currently employed?

* must provide value

Yes

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What do you do for work?

How many hours a week do you work?

What hours do you work?

Mornings

Afternoons

Evenings

What days of the week do you work?

Monday

Tuesday

Wednesday

Thursday

Friday

Weekends

Do you have prior work or volunteer experience?

Yes

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Please describe:

Are you currently enrolled in a school or training program?

* must provide value

Yes

Other

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Please describe:

Name of school or Training Program

Degree

Major/concentration

Graduation Date

How did you hear about the Young Parent Mentorship Program

* must provide value

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What are the top 3 things you would like to get out of your participation in the Young Parent Mentoring Program? (Example: connecting to resources, a listening ear, etc.)

* must provide value

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Have you been involved in or participated in any community programs or resources? Please list below.

* must provide value

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What does being a mentee mean to you?

* must provide value

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Please list any attributes that are important to you when matching you with a mentor. For example: gender, age, sexuality, language, etc.

* must provide value

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What days/times would you be available to participate in the Young Parent Mentorship Program?

* must provide value

Monday-Friday mornings

Monday-Friday afternoons

Monday-Friday evenings

Weekend mornings

Weekend afternoons

Weekend evenings

Is there anything else we should know about your schedule or availability?

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.