Profile Analysis of Teen Mothers’ Experience with A Home Visiting Program: Association with Parenting Outcomes

• In Event: Engaging Families in Home Visiting Programs – A Relationship Perspective and Approach

Abstract

Background: In home visiting research, variation in participants’ program experience and service uptake has surfaced as central elements in unpacking the “black box” of interventions and understanding the ability of programs to have a measurable impact on child and family outcomes (Berlin, O’Neal, & Brooks-Gunn, 1998; Wen, Korfmacher, & Hans, 2016). In most studies, families’ program experience has been measured by unidimensional constructs, such as family involvement with program (Korfmacher et al., 2008). The current study conceptualizes participants’ program experience with home visiting services as a multi-dimensional construct, influenced in a transactional way by participant and program factors. Specifically, we will examine participant experience with a doula home visiting service from multiple dimensions: (1) amount of program contact (i.e., number of in-person visits), (2) engagement with home visits (i.e., level of involvement with home visitors and understanding of content), (3) relationship quality with home visitors (reported by both doulas and participants), and (4) content focus of the home visits (e.g., healthy pregnancy, parenting, mother’s own development, and support around personal concerns). We explore distinct patterns/profiles of program experience, and understand how the experiences vary by participant and program contextual factors and how it is associated with parenting outcomes.

Method: Data were from a randomized controlled trial of a home visiting program offering prenatal and postpartum support by doulas to young, low-income, African American mothers. We focused on 124 intervention participants who were primarily first-time mothers (89%), with an average age of 18.2 years at enrollment. Program experience data – 14 indicators representing four experience dimensions, were collected through administrative records, doula and mother reports. Mother’s breastfeeding practice, postpartum parenting stress, parent-child interactions, and parenting attitudes were assessed through interview, surveys, and observations. In addition, detailed information on mothers’ psychosocial characteristics was collected at baseline interview. Latent profile analysis was used to identify profiles of program experience and association between these profiles and mothers’ psychosocial characteristics, program factors, and parent outcomes were examined via weighted regression analysis.

Results: The initial latent profile analysis identified three distinctive profiles of program experience: profile #1 (21%) - low contact, low engagement, less positive relationship with doula, and home visits focused more on mother’s own development and parenting postpartum; profile #2 (60%) – high contact, moderate engagement, positive relationship with doula, and home visits focused more on support around mothers’ personal issues and less on parenting postpartum; profile #3 (21%) – high contact, high engagement, positive relationship, and home visits focused more on pregnancy and parenting. Regression analysis suggested that the resultant profiles were associated with participants’ psychosocial characteristics and parenting outcomes. Further refined results will be reported at the conference.

Implications: The study explores program experience by adopting a person-centered approach that identifies varying profiles within which mothers share similar experience with the doula service. It holds important implications for planning and individualizing home visiting services to fit the needs of specific populations and identifying subgroups with differential responses. The findings shed light on how to improve the efficiency of home visiting services.

Authors

• Xiaoli Wen, National Louis University
  Presenting Author

• Jon Korfmacher, Chapin Hall at the University of Chicago
  Non-Presenting Author

• Sydney L Hans, University of Chicago
  Non-Presenting Author

• Yudong Zhang, New York University
  Non-Presenting Author