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Effects of Home Visitation on Maternal Competencies, Family Environment, and Child Development: a Randomized Controlled Trial

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Abstract

Based on the US Nurse-Family Partnership (NFP) program, the German home visiting program “Pro Kind” offered support for socially and financially disadvantaged first-time mothers from pregnancy until the children’s second birthday. A multi-centered, longitudinal randomized controlled trial (RCT) was conducted to assess its effectiveness on mothers and children. A total of 755 women with multiple risk factors were recruited, 394 received regular home visits (treatment group), while 361 only had access to standard community services (control group). Program influences on family environment (e.g., quality of home, social support), maternal competencies (e.g., maternal self-efficacy, empathy, parenting style), and child development (e.g., cognitive and motor development) were assessed from mothers’ program intake in pregnancy to children’s second birthday based on self-reports in regular interviews and developmental tests. Generalized estimating equations (GEE) models showed small, but significant positive treatment effects on parental self-efficacy, and marginally significant effects on social support, and knowledge on child rearing. Maternal stress, self-efficacy, and feelings of attachment in the TG tend to show a more positive development over time. Subgroup effects were found for high-risk mothers in the TG, who reported more social support over time and, generally, had children with higher developmental scores compared to their CG counterparts. Post hoc analyses of implementation variables revealed the quality of the helping relationship as a significant indicator of treatment effects. Results are discussed in terms of implementation and public policy differences between NFP and Pro Kind.

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Acknowledgments

The authors thank Dr. Annette M. Klein for her helpful comments. Tilman Brand declared a possible conflict of interest, as he has worked for the Pro Kind foundation from October 2011 to February 2012.

This work was supported by the German Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (grant number IIA6-25080820V6). The State Ministry for Social Affairs and Consumer Protection Saxony, the TUI Foundation, the Dürr Foundation, and the Reimann-Dubbers Foundation gave grants to complete this project.

Conflict of Interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany

    Susan Sierau, Verena Dähne & Kai von Klitzing

  2. Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology – BIPS, Achterstrasse 30, 28359, Bremen, Germany

    Tilman Brand

  3. Department Youth and Family, Capital City of Hannover, Sutelstrasse 18, 30659, Hannover, Germany

    Vivien Kurtz

  4. Faculty of Humanities, Institute for Special Educational Intervention and Rehabilitation, University of Rostock, August-Bebel-Strasse 28, 18051, Rostock, Germany

    Tanja Jungmann

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  1. Susan Sierau
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  2. Verena Dähne
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  5. Kai von Klitzing
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Correspondence to Susan Sierau.

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Sierau, S., Dähne, V., Brand, T. et al. Effects of Home Visitation on Maternal Competencies, Family Environment, and Child Development: a Randomized Controlled Trial. Prev Sci 17, 40–51 (2016). https://doi.org/10.1007/s11121-015-0573-8

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