Examining the Efficacy of Prenatal Intervention on Observed Parenting Behaviors in Violence-Exposed Women

• In Event: Engagement and Outcomes of Home Visiting or Small Group Programs in the Transition to Parenthood

Abstract

Intimate partner violence (IPV) affects millions of women annually, and the risk for IPV is heightened during pregnancy (Taillieu & Brownridge, 2010). Prenatal IPV has negative intergenerational effects that extend into the first year of life (McMahon et al., 2011). More specifically, prenatal IPV exposure has been linked to infant dysregulation and disruption to the mother-infant relationship (Kendall-Tackett, 2007; Levendosky et al., 2011). Given that IPV during pregnancy affects not only women’s health but also the health of their children, it is crucial to develop effective interventions for this population (Howell et al., 2017). The Pregnant Moms’ Empowerment Program (PMEP) was developed to address the unique needs of pregnant, IPV-exposed women. PMEP is a 5-session, group intervention that includes content on violence exposure, mental health, perinatal health, infant care, and early parenting. Evidence supports the effectiveness of PMEP in improving maternal mental health and reducing IPV exposure; it is expected that participating in PMEP will also enhance parenting and mother-infant functioning. The current study examined the effects of PMEP on observed maternal sensitivity and intrusiveness at 3-months and 12-months postpartum. Participants were 137 IPV-exposed pregnant women. Half (n=70) received the PMEP intervention and half (n=67) were in a no treatment control condition. Attendance was high for those in the intervention, with women attending approximately 4 of 5 sessions (SD=1.24). Mothers and their infants participated in a 5-minute free play session at each postpartum assessment, during which they were asked to play naturally with their infants. Free play sessions were video-recorded and later double-coded using Braungart-Rieker and colleagues’ (2014) coding scheme by pairs of trained coders with established reliability. Coders rated maternal behaviors on two dimensions in 10 second intervals: maternal sensitivity (e.g., noticing and appropriately responding to infant cues) and maternal intrusiveness (e.g., disregarding infant needs, overriding infant interests, intruding upon infant’s space). Ratings across intervals for each scale were averaged to create two composite scores, as well as a combined score reflecting overall warm-sensitive parenting. No differences in observed parenting behaviors emerged at 3-months postpartum. At 12-months postpartum, however, results of bootstrapped multiple regressions indicated that women who received PMEP showed marginal improvements on maternal sensitivity (β=0.07, p=.100), marginally less intrusiveness (β=0.03, p=.055), and significantly more warm-sensitive parenting overall (β=0.10, p=.037) as compared to women in the control group. The effect size was medium on all dimensions: overall warm-sensitive parenting (d=0.49), intrusiveness (d=0.45), and sensitivity (d=0.39). Results indicated that PMEP improves aspects of positive parenting, including increasing sensitivity and reducing intrusive parenting behaviors. Findings highlight the clinical value of brief interventions as there was evidence of significant and sustained effects in parenting behaviors more than one year after participants received the PMEP intervention. Such positive effects have the potential for intergenerational benefit because enhanced parenting behaviors likely contribute to improved infant outcomes. Given that PMEP is brief and low-cost, it could be incorporated into clinical services at community organizations working with violence-exposed families to improve not only the health of women experiencing violence, but also their children.

Authors

• Kathryn H Howell, University of Memphis
  Presenting Author

• Taylor Napier, University of Memphis

• Caroline R Scheid, University of Notre Dame

• Julie M Braungart-Rieker, Colorado State University

• Laura Miller-Graff, University of Notre Dame