Poster #61 - Sustained Two-Year Impacts a Universal Short-Term Home Visiting Program: Parenting and Parent Mental Health Outcomes

• In Event: Poster Session 02

Abstract

Importance: Children’s interactions with their parents and caregivers form the immediate microsystem that drives children’s subsequent development (Bronfenbrenner, 1979). Because the parent-infant interaction system is nested within a broader social ecology, these interactions can vary depending on everyday stressors (Campbell et al., 2007; Neppl et al., 2016; Olds, 2008). Without support, home environments can become hectic, unstructured, and unpredictable with parents turning to severe parenting styles that negatively impact children’s development (Duncan et al., 2012; Evans et al., 2005). With over 94% of mothers reporting one or more unmet needs at the time of infant birth, there is an urgency and an opportunity to focus intervention on strengthening the capabilities of parents and caregivers (Dodge, 2022). A universal system of service delivery that helps all parents navigate these inevitable needs may do just that.

Background: Family Connects (FC) is a universal postnatal nurse home visiting program designed to support all families to improve parenting and child and family well-being (Dodge et al., 2013). The goal is to connect with all families in a community at the time of birth, rapidly assess unique family strengths and needs through 1-3 nurse home visits, and then concentrate education and community resources to families with the greatest needs. Previous impact evaluations of FC identified increased family connections to community resources, reduced postpartum mental health depression, a decrease in child emergency medical care costs, and positive parenting through infant age six months (Dodge et al., 2013, 2014; Dodge & Goodman, 2019; Goodman et al., 2019). Longer-term impact evaluation is needed to determine whether these gains are sustained or fade out. Positive parenting through age 24 months has not yet been investigated.

Method: FC implementation was evaluated through a randomized controlled trial consisting of 4,777 families of infants born in Durham County, North Carolina between July 1, 2009–December 31, 2010 (Dodge et al., 2014). All births were randomly assigned to intervention or control conditions. A random, representative subsample of 549 families (n=269 Intervention; n=280 Control) was consented separately for long-term impact evaluation. Five primary dependent variables at age 24 months were average mother self-reported scores for positive parenting behaviors, negative parenting behaviors, father involvement, parent sense of efficacy, and maternal depression. Ordinary least squares (OLS) regressions were used to estimate impact of random assignment to FC on the outcomes of interest, as well as heterogeneity of impact across demographic characteristics.

Results: Mothers assigned to FC engaged in more positive parenting behaviors relative to control mothers (B=0.11; p < 0.05). Hispanic mothers assigned to FC reported greater sense of parenting competence (B= 1.28; p<0.05) and fewer depression symptoms (B= -4.17; p<0.1). FC mothers with children without an identified birth risk reported more positive parenting behaviors (B= 0.14; p<0.01).

Conclusion: This short-term, postnatal home visiting intervention program has improved parenting outcomes through age child two-years, although not all outcomes were improved. This intervention removes any stigma that may be associated with targeted programs. Consequently, children will benefit from positive parenting interactions and experience improving developmental outcomes.

Authors

• Gayane Arturovna Baziyants, Duke University
  Presenting Author

• Kenneth A Dodge, Duke University

• Yu Bai, Duke University

• W. Benjamin Goodman, Duke Univeristy