Mothers’ Engagement in Home visiting as a Function of Fathers’ Formal and Informal Involvement

• In Event: 3-149 - Taking Evidence-Based Home Visiting to Scale: Lessons Learned From MIECHV-Funded Evaluations

Integrative Statement

Although home visiting evaluations have generally reported favorable impacts for mothers and children across a range of domains, effects sizes are typically small (Howard & Brooks-Gunn, 2009). High rates of attrition may partially account for these small effects, with some programs reporting 50% of participants dropping out before their child’s first birthday, and young mothers exhibiting greater attrition than older mothers (O’Brien et al., 2012). Understanding how best to promote retention has the potential to maximize benefits for families (Duggan et al., 2013), and few studies have examined the specific role that fathers play in supporting mothers’ retention.

We examined whether fathers’ involvement in a statewide newborn home visiting program for first time young parents was associated with mothers’ retention, including her length of enrollment, total number of home visits (HV), and total number of joint (mother and father attending) HV. We also examined whether associations differed depending on mothers’ marital status or parenting status (pregnant vs. parenting) at enrollment. Fathers were formally involved, as primary participants (officially enrolled in program) or secondary participants (not eligible and/or interested in full participation but want to remain engaged in program), or informally involved (neither primary nor secondary but attend HV).

Participants were 894 mothers enrolled in the program. At enrollment, the mean age was 18.76 years, three-quarters (72.8%) were cohabitating with partners, and over half (56.8%) were pregnant as opposed to already parenting. A minority (20.9%) of mothers were with a father who was formally involved in the program as a primary or secondary participant.

A series of OLS regression analyses were conducted regressing retention outcome variables on participant status in separate models; follow-up models examined whether marital status or parenting status moderated participant status. Models controlled for maternal race/ethnicity, and robust standard errors were used to account for clustering of mothers within program catchment areas.

Mothers who were primary participants alone stayed in the program 4 months less (B=-3.55, p=.07) and completed 13 fewer total home visits (B=-13.14, p=.01) and 13 fewer joint home visits (B=-12.55, p<.001) than mothers who were primary participants with fathers involved as a primary participant. Among mothers who were never married, mothers with fathers enrolled as primary participants stayed in the program 7-8 months longer than mothers with fathers enrolled as secondary participants (B=-7.96, p=.05) or without formally enrolled fathers (B=-6.93, p=.05). Among mothers who were parenting at enrollment, mothers with fathers enrolled as primary participants stayed in the program 10 months longer (B=-10.01, p=.003) and had 26 more total home visits (B=-25.51, p=.001) than mothers without formal father participation.

Findings suggest that formal father involvement may be one avenue for supporting retention among young mothers participating in home visiting. Home visiting programs must think strategically about how to engage fathers in initial recruitment and continue to engage them over time. Variation in take-up of home visiting based on marital and parenting status points to the need for more targeted outreach, recruitment, and program implementation, particularly for unmarried parents and mothers who enroll after giving birth.

Authors

• Lauren E Stargel, Tufts University
  Presenting Author

• Rebecca Fauth, Tufts University
  Non-Presenting Author

• Jessica Goldberg, Tufts University
  Non-Presenting Author