Impact of a Multi-Component Intervention on the Home Environment, and Subsequent effects on Child Outcomes

• In Event: 1-104 - Disentangling the Impact of Home Visiting Programs on Children’s Behaviour, Cognition, and Health

Integrative Statement

Introduction. The quality and quantity of stimulation and support available in the early home environment is a key predictor of heathy cognitive and socio-emotional development. The quality of the home environment is often poorer in low socioeconomic families. Early interventions based on home visiting and parenting training have the potential to significantly improve the quality of the home environment and, in turn, child development. This study aimed to test (1) the impact of a prenatal-to-age-five intervention targeting women from a disadvantaged Irish community on the quality of the home environment, and (2) whether any identified changes in the home environment explain children’s cognitive and emotional development at school entry.
Hypothesis. We hypothesized (1) a positive effect of the intervention program on the home environment, and (2) the observed treatment effects on children’s development to be mediated by the observed improvement of the home environment.
Study population. We used data from the Preparing for life (PFL), a multi-component early intervention program targeting families living in low socioeconomic communities of Dublin, Ireland. PFL aimed to promote children’s development by supporting parents from pregnancy until age 4/5 years, and is based on home visiting, baby massage, and parenting program. Using an experimental design, pregnant women were randomized into a treatment (n=115) or control (n=118) group.
Methods. The home environment was assessed at 6 months, 1½, and 3 years using the Home Observation for Measurement of the Environment (responsiveness, acceptance, organization, learning material, involvement, variety). Cognitive skills were assessed at 5 years using the British Ability Scales. Emotional problems were teacher-reported at 5 years using the Short Early Development Inventory. First, latent growth modeling was used to model changes in the home environment; second, mediation analyses was used to test whether the association between treatment and cognitive and socioemotional outcomes were mediated by the observed changes in the home environment (i.e., intercept and slope parameter of the growth models).
Results. Compared to controls, treatment children were exposed to more stimulating environments in terms of learning material (B=-1.62, p=0.036) and environmental variety (B=-1.58, p=0.009) at 6 months, but these differences faded at 3 years (Figure 1). Treatment families were also more likely to accept suboptimal child behaviors without using punishment (acceptance score, B=1.49, p=0.048) and were more organized at 3 years (B=1.08, p=0.033). None of the changes, however, mediated children’s outcomes (Table 1). These findings suggest that the program positively impacted different home environment dimensions (as hypothesized), but these changes did not account for improvements in children’s outcomes (contrary to our hypotheses). Exploratory moderation analyses aiming to explain these findings, suggested that the impact of improvements in the home environment on child outcomes may be limited to specific groups of children (e.g., children of depressed mothers, children of young mothers).

Authors

• Massimiliano Orri, McGill University
  Presenting Author

• Sylvana Côté, University of Montreal
  Non-Presenting Author

• Richard Ernest Tremblay, University of Montreal
  Non-Presenting Author

• Orla Doyle, University College Dublin
  Non-Presenting Author