Abstract
As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families’ participation in a home-visitation program offered by a central Kentucky health department on parental risk factors. A family social worker or nurse interviewed parents pre-intervention, completing a Parent Survey which assessed multiple parental risk factors associated with negative health and well-being and to calculate a total risk score. Upon exiting the program, parents are re-interviewed to document improvements, review progress and accomplished goals, plan for transitional services, and calculate a new risk score. As of December 2010, 64 families had completed the home-visitation program and had pre- and post-risk scores available for analysis. Based on paired-sample t tests, there was a statistically significant difference in total mean risk scores among both mothers and fathers from pre to post. The McNemar–Bowker test also revealed statistically different scores for four of the six risk factors for mothers and fathers pre- and post-home-visitation: lifestyle behaviors and mental health, coping skills and support systems, stresses, and anger management skills. Findings suggest that families who were deemed at-risk for adverse pregnancy and child health outcomes benefit from participation in the home-visitation program. Programs designed to promote positive pregnancy outcomes and child development may benefit from providing social support, fostering parental knowledge, skill development and problem solving, insuring proper medical care, and connecting parents with community resources.
Similar content being viewed by others
References
American Academy of Pediatrics. Council on Child and Adolescent Health. (1998). The role of home-visitation programs in improving health outcomes for children and families. Pediatrics, 101(3), 486–489.
Blumenshine, P. M., Egerter, S. A., Libet, M. L., & Braveman, P. A. (2011). Father’s education: An independent marker of risk for preterm birth. Maternal and Child Health Journal, 15(1), 60–67.
Chapman, J., Siegel, E., & Cross, A. (1990). Home visitors and child health: Analysis of selected programs. Pediatrics, 85, 1059–1068.
Dew, P. C., Guillory, V. J., Okah, F. A., Cai, J., & Hoff, G. L. (2006). The effect of health compromising behavior on preterm births. Maternal and Child Health Journal, 11(3), 227–233.
DiLauro, E. (2009, February). Reaching families where they live: Supporting parents and child development through home visiting. Retrieved from http://main.zerotothree.org/site/DocServer/HomeVisitssing_Mar5.pdf?docID=7889.
Duggan, A. K., McFarlane, E. C., Windham, A. M., Rohde, C. A., Salkever, D. S., Fuddy, L., et al. (1999). Evaluation of Hawaii’s healthy start program. The Future of Children, 9(1), 66–90.
Grantmakers In Health. (2010, November 15). Home visiting: Giving parents and children an early boost. Retrieved from http://www.gih.org/files/usrdoc/Issue_Focus_Home_Visiting_11-15-10.pdf.
Illback, R., Sanders, D., Pennington, M., Sanders, D., & Kilmer, A. (2008). Health Access Nurturing Development Services (HANDS) Kentucky’s home visiting program for first time parents program evaluation findings January 2008. Louisville, KY: Reach of Louisville.
Institute of Medicine. (2006, July). Preterm birth: Causes, consequences, and prevention [Report Brief]. Retrieved from http://iom.edu/~/media/Files/Report%20Files/2006/Preterm-Birth-Causes-Consequences-and-Prevention/Preterm%20Birth%202006%20Report%20Brief.pdf.
Kempe, C. (1978). Child abuse: The pediatrician’s role in child advocacy and preventive pediatrics. American Journal of Diseases of Children, 132, 255–260.
Kentucky Cabinet For Health And Family Services. (2007a, December 17). HANDS Program. Retrieved from http://chfs.ky.gov/dph/mch/ecd/hands.htm.
Kentucky Cabinet For Health And Family Services. (2007b, December 17). HANDS mission and vision statement. Retrieved from http://chfs.ky.gov/NR/rdonlyres/D4C90C4B-C35A-44E2-9E38-4871F07427E6/0/Missionstatementpdf.pdf.
Kentucky Cabinet For Health And Family Services. (2007c, July). Kentucky HANDS policies and procedures manual, section 5: Screening and parent visitor process. Kentucky HANDS Technical Assistance Specialists Certification Training.
Kentucky Cabinet For Health and Family Services. (2007, March 27). Prematurity Prevention Partnership Launched [Press release]. Retrieved from http://chfs.ky.gov/news/healthy+babies.htm?wbc_purpose=basic&wbcmode=presentationunpublished.
Korfmacher, J. (2000). The Kempe family stress inventory: A review. Child Abuse and Neglect, 24(1), 129–140.
Lee, E., Mitchell-Herzfeld, S., Lowenfels, A., Greene, R., Dorabawila, V., & DuMont, K. (2009). Reducing low birth weight through home visitation: A randomized controlled trial. American Journal Preventive Medicine, 36(2), 154–160.
Lishner, D. M., Larson, E. H., Rosenblatt, R. A., & Clark, S. J. (1999). Rural maternal and perinatal health. In T. C. Ricketts III (Ed.), Rural health in the United States (pp. 134–149). New York, New York: Oxford University Press.
March of Dimes. (2008, May). Low birthweight. Retrieved from http://www.marchofdimes.com/professionals/medicalresources_lowbirthweight.html.
March of Dimes. (2009/2010, January/April). Premature Birth. Retrieved from http://www.marchofdimes.com/baby/premature_indepth.html.
March of Dimes. (2010a). Prematurity campaign: The economic and societal costs. Retrieved from http://www.marchofdimes.com/mission/prematurity_costs.html.
March of Dimes. (2010b). What we know about prematurity. Retrieved from http://www.marchofdimes.com/mission/prematurity_indepth.html.
McCormick, M. (1985). The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine, 312, 80–90.
Misra, D. (2010). Do fathers matter? Paternal contributions to birth outcomes and racial disparities. American Journal of Obstetrics and Gynecology, 202(2), 99–100.
Murphy, S., Orkow, B., & Nicola, R. M. (1985). Prenatal prediction of child abuse and neglect: A prospective study. Child Abuse and Neglect, 9, 225–235.
National Healthy Start Association. (2010a, Summer). Getting off to a healthy start [Newsletter Issue]. Retrieved from http://www.nationalhealthystart.org/site/assets/docs/Summer_2010_Newsletter.pdf.
National Healthy Start Association. (2010b, July). It takes two to tango: Defining the role of fathers [Issue Brief]. Retrieved from http://www.nationalhealthystart.org/site/assets/docs/NHSA_Fatherhood_Brief.pdf.
National Healthy Start Association, Inc. (n.d.). The healthy start program. Retrieved from http://www.healthystartassoc.org/hswpp6.html.
National Institute of Child Health & Human Development. (2010, August 2). Preterm labor and birth. Retrieved from http://www.nichd.nih.gov/health/topics/Preterm_Labor_and_Birth.cfm.
National Institutes of Health. (2007, September). Specialized community interventions fact sheet. Retrieved from http://www.ninr.nih.gov/NR/rdonlyres/220F2BFB-13E6-449A-8182-8F1321CAC9D0/0/CommunityInterventionsfactsheet.pdf.
Olds, D. (1992). Home visitation for pregnant women and parents of young children. American Journal of Diseases of Children, 146, 704–708.
Olds, D. L., Henderson, C. R., Jr., Chamberlin, R., & Tatelbaum, R. (1986a). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78(1), 65–78.
Olds, D. L., Henderson, C. R., Jr., Tatelbaum, R., & Chamberlin, R. (1986b). Improving the delivery of prenatal care and ouctomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77(1), 16–28.
Pallant, J. (2010). SPSS survival manual: A step by step guide to data analysis using SPSS (4th ed.). New York: McGraw Hill.
Peck, J., & Alexander, K. (2003). Maternal, infant, and child health in rural areas: A literature review. In Rural healthy people 2010: A companion document to healthy people 2010 (Vol. 2, pp. 85–96). College Station, Texas: The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center.
Pew Center on the States. (2010). Pew home visiting campaign fact sheet. Retrieved from http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/Fact_Sheets/Home_Visiting/Home_Visiting_factsheet.pdf?n=1191.
Reichman, N., & Teitler, J. (2006). Paternal age as a risk factor for low birthweight. American Journal of Public Health, 96(5), 862–866.
Shah, P. (2010). Paternal factors and low birthweight, preterm, and small for gestational age births: A systematic review. American Journal of Obstetrics and Gynecology, 202(2), 103–123.
U.S. Department of Health & Human Services. (2010, July 21). HHS Allocated $88 Million for home visiting program to improve the wellbeing of children and families [Press release]. Retrieved October 2010, from U.S. Department of Health & Human Services: http://www.hhs.gov/news/press/2010pres/07/20100721a.html.
Weiss, H. (1993). Home visits: Necessary but not sufficient. Future of Children, 3, 113–128.
Acknowledgments
We gratefully acknowledge the assistance of the Lexington-Fayette County Health Department HANDS staff, the Kentucky Department for Public Health HANDS program, Cheryl Miller with Great Kids, Inc., and the Biostatistics Department, University of Kentucky College of Public Health.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ferguson, J.M., Vanderpool, R.C. Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors. J Child Fam Stud 22, 551–558 (2013). https://doi.org/10.1007/s10826-012-9610-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-012-9610-4