Predictors of Early Engagement in Home Visitation
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Predictors of engagement in mothers receiving home visitation in the first year of service was examined. Early engagement was studied in three ways: (1) length of time active in the program during the first year of service (duration), (2) number of visits received (quantity), and (3) gaps in service between visits (consistency). Examined visits received in 515 first-time mothers in a Healthy Families America (HFA) program. Parameters of engagement were investigated, and predictors of engagement were identified using demographics and the Kempe Family Stress Inventory. Inclusive of the Assessment Visit, 31.8% of mothers disengaged prior to the first month of service. Remaining active in the program was associated with being Caucasian, and increased parenting risk (mental health/substance abuse history, low social support, increased stress). Most mothers had fewer home visits than prescribed. Gaps in prescribed service were common, with 89.4% of mothers experiencing gaps between visits of 1 month, and dropping to 16.4% having gaps of 2 months. In contrast to findings from clinic-based interventions, early engagement in home visitation is associated with lower levels of functioning and acute needs. These findings add to a growing body of literature suggesting that increased adversity promotes engagement in prevention programs in general, and home visitation programs in particular. To the extent that mothers who are actively engaged in home visitation are likely to have increased psychosocial needs, curricula may require modification and augmentation to address these needs and optimize program effectiveness.
KEY WORDS:home visitation engagement retention prevention
We acknowledge the contributions of participating mothers, home visitors, and agencies that are part of Every Child Succeeds, and the funders who support its efforts.
- Eckenrode, J., Ganzel, B., Henderson, C. R., Smith, E., Olds, D. L., Powers, J., Cole, R., Kitzman, H., and Sidora, K. (2000). Preventing child abuse and neglect with a program of nurse home visitation: The limiting effects of domestic violence. J. Am. Med. Assoc. 284: 1385–1391.CrossRefGoogle Scholar
- Gomby, D. S., Culross, P. L., and Behrman, R. E. (1999). Home visiting: Recent program evaluations—analysis and recommendations. Future Child. 9: 5–25.Google Scholar
- Guterman, N. B. (2001). Stopping Child Maltreatment Before It Starts: Emerging Horizons in Early Home Visitation Services, Sage Publications, Thousand Oaks, CA.Google Scholar
- Karoly, L. A., Greenwood, P. W., Everingham, S. S., Hoube, J., Kilburn, M. R., Rydell, C. P., Sanders, M., and Chiesa, J. (1998). Investing In Our Children: What We Know And Don't Know About The Costs And Benefits Of Early Childhood Intervention, RAND, Santa Monica, CA.Google Scholar
- Kreft, I., and de Leeuw, J. (1998). Introducing Multilevel Modeling, Sage, London.Google Scholar
- Margie, N. G., and Phillips, D. A. (eds.). (1999). Revisiting Home Visiting: Summary of a Workshop, National Academy Press, Washington, DC.Google Scholar
- National Committee to Prevent Child Abuse. (1998). Healthy Families America Training Manual, Author, Chicago.Google Scholar
- Osofsky, J. D., Culp, A. M., and Ware, L. M. (1988). Intervention challenges with adolescent mothers and their infants. Psychiat J. Stud. Interper. Proc. 51: 236–241.Google Scholar
- Spiker, D., and Wagner, M. (2001). Dimensions of engagement in home visiting programs: The Parents as Teachers (PAT) experience. Paper presented at the Biennial Meeting of the Society for Research in Child Development, Minneapolis.Google Scholar