Browsing by Author "Dodge, Kenneth A"
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Item Open Access A defensive mindset: A pattern of social information processing that develops early and predicts life course outcomes.(Child development, 2022-07) Dodge, Kenneth A; Bai, Yu; Godwin, Jennifer; Lansford, Jennifer E; Bates, John E; Pettit, Gregory S; Jones, DamonThe hypothesis was tested that some children develop a defensive mindset that subsumes individual social information processing (SIP) steps, grows from early experiences, and guides long-term outcomes. In Study 1 (Fast Track [FT]), 463 age-5 children (45% girls; 43% Black) were first assessed in 1991 and followed through age 32 (83% retention). In Study 2 (Child Development Project [CDP]), 585 age-5 children (48% girls, 17% Black) were first assessed in 1987 and followed through age 34 (78% retention). In both studies, measures were collected of early adverse experiences, defensive mindset and SIP, and adult outcomes. Across both studies, a robust latent construct of school-age defensive mindset was validated empirically (comparative fit index = .99 in each study) and found to mediate the impact of early child abuse (38% in FT and 29% in CDP of total effect) and peer social rejection (14% in FT and 7% in CDP of total effect) on adult incarceration.Item Open Access Age Patterns in Risk Taking Across the World.(J Youth Adolesc, 2017-10-19) Duell, Natasha; Steinberg, Laurence; Icenogle, Grace; Chein, Jason; Chaudhary, Nandita; Di Giunta, Laura; Dodge, Kenneth A; Fanti, Kostas A; Lansford, Jennifer E; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Alampay, Liane Peña; Al-Hassan, Suha M; Takash, Hanan MS; Bacchini, Dario; Chang, LeiEpidemiological data indicate that risk behaviors are among the leading causes of adolescent morbidity and mortality worldwide. Consistent with this, laboratory-based studies of age differences in risk behavior allude to a peak in adolescence, suggesting that adolescents demonstrate a heightened propensity, or inherent inclination, to take risks. Unlike epidemiological reports, studies of risk taking propensity have been limited to Western samples, leaving questions about the extent to which heightened risk taking propensity is an inherent or culturally constructed aspect of adolescence. In the present study, age patterns in risk-taking propensity (using two laboratory tasks: the Stoplight and the BART) and real-world risk taking (using self-reports of health and antisocial risk taking) were examined in a sample of 5227 individuals (50.7% female) ages 10-30 (M = 17.05 years, SD = 5.91) from 11 Western and non-Western countries (China, Colombia, Cyprus, India, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the US). Two hypotheses were tested: (1) risk taking follows an inverted-U pattern across age groups, peaking earlier on measures of risk taking propensity than on measures of real-world risk taking, and (2) age patterns in risk taking propensity are more consistent across countries than age patterns in real-world risk taking. Overall, risk taking followed the hypothesized inverted-U pattern across age groups, with health risk taking evincing the latest peak. Age patterns in risk taking propensity were more consistent across countries than age patterns in real-world risk taking. Results suggest that although the association between age and risk taking is sensitive to measurement and culture, around the world, risk taking is generally highest among late adolescents.Item Open Access Around the world, adolescence is a time of heightened sensation seeking and immature self-regulation.(Dev Sci, 2017-02-01) Steinberg, Laurence; Icenogle, Grace; Shulman, Elizabeth P; Breiner, Kaitlyn; Chein, Jason; Bacchini, Dario; Chang, Lei; Chaudhary, Nandita; Giunta, Laura Di; Dodge, Kenneth A; Fanti, Kostas A; Lansford, Jennifer E; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Alampay, Liane Peña; Al-Hassan, Suha M; Takash, Hanan MSThe dual systems model of adolescent risk-taking portrays the period as one characterized by a combination of heightened sensation seeking and still-maturing self-regulation, but most tests of this model have been conducted in the United States or Western Europe. In the present study, these propositions are tested in an international sample of more than 5000 individuals between ages 10 and 30 years from 11 countries in Africa, Asia, Europe and the Americas, using a multi-method test battery that includes both self-report and performance-based measures of both constructs. Consistent with the dual systems model, sensation seeking increased between preadolescence and late adolescence, peaked at age 19, and declined thereafter, whereas self-regulation increased steadily from preadolescence into young adulthood, reaching a plateau between ages 23 and 26. Although there were some variations in the magnitude of the observed age trends, the developmental patterns were largely similar across countries.Item Open Access Associations Between Perceived Material Deprivation, Parents' Discipline Practices, and Children's Behavior Problems: An International Perspective.(Child development, 2018-10) Schenck-Fontaine, Anika; Lansford, Jennifer E; Skinner, Ann T; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A; Oburu, Paul; Pastorelli, Concetta; Sorbring, Emma; Steinberg, Laurence; Malone, Patrick S; Tapanya, Sombat; Uribe Tirado, Liliana M; Alampay, Liane P; Al-Hassan, Suha M; Bacchini, Dario; Bornstein, Marc H; Chang, LeiThis study investigated the association between perceived material deprivation, children's behavior problems, and parents' disciplinary practices. The sample included 1,418 8- to 12-year-old children and their parents in China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Multilevel mixed- and fixed-effects regression models found that, even when income remained stable, perceived material deprivation was associated with children's externalizing behavior problems and parents' psychological aggression. Parents' disciplinary practices mediated a small share of the association between perceived material deprivation and children's behavior problems. There were no differences in these associations between mothers and fathers or between high- and low- and middle-income countries. These results suggest that material deprivation likely influences children's outcomes at any income level.Item Open Access Bidirectional Relations Between Parenting and Behavior Problems From Age 8 to 13 in Nine Countries(Journal of Research on Adolescence, 2018-09-01) Lansford, Jennifer E; Rothenberg, W Andrew; Jensen, Todd M; Lippold, Melissa A; Bacchini, Dario; Bornstein, Marc H; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Steinberg, Laurence; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Alampay, Liane Peña; Al-Hassan, Suha M© 2018 Society for Research on Adolescence This study used data from 12 cultural groups in nine countries (China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, and the United States; N = 1,298) to understand the cross-cultural generalizability of how parental warmth and control are bidirectionally related to externalizing and internalizing behaviors from childhood to early adolescence. Mothers, fathers, and children completed measures when children were ages 8–13. Multiple-group autoregressive, cross-lagged structural equation models revealed that child effects rather than parent effects may better characterize how warmth and control are related to child externalizing and internalizing behaviors over time, and that parent effects may be more characteristic of relations between parental warmth and control and child externalizing and internalizing behavior during childhood than early adolescence.Item Open Access Birth Spacing and Child Maltreatment: Population-Level Estimates for North Carolina.(Child maltreatment, 2023-04) Rybińska, Anna; Bai, Yu; Goodman, W Benjamin; Dodge, Kenneth AWe examine population-level associations between birth spacing and child maltreatment using birth records and child welfare records for 1,099,230 second or higher parity children born in North Carolina between 1997 and 2013. Building upon previous research, administrative data linkages were used to address out-of-state migration and family-level heterogeneity in birth spacing and child maltreatment risk factors. Findings provide the strongest evidence to date that very short birth spacing of zero through 6 months from last birth to the index child's conception is a prenatal predictor of child maltreatment (indexed as child welfare involvement) throughout early childhood. Consequently, information about optimal family planning during the postpartum period should become a standard component of universal and targeted child maltreatment prevention programs. However, challenging previous empirical evidence, this study reports inconsistent results for benefits of additional spacing delay beyond 6 months with regard to child maltreatment risk reduction, especially for children of racial and ethnic minorities. These findings call for further inquiry about the mechanisms driving the connections between birth spacing and Child Protective Services assessments.Item Open Access Can a Broader Education Narrow the Gap? Evidence on Non-Academic Features of Schooling(2016) Sorensen, LucyEmpirical studies of education programs and systems, by nature, rely upon use of student outcomes that are measurable. Often, these come in the form of test scores. However, in light of growing evidence about the long-run importance of other student skills and behaviors, the time has come for a broader approach to evaluating education. This dissertation undertakes experimental, quasi-experimental, and descriptive analyses to examine social, behavioral, and health-related mechanisms of the educational process. My overarching research question is simply, which inside- and outside-the-classroom features of schools and educational interventions are most beneficial to students in the long term? Furthermore, how can we apply this evidence toward informing policy that could effectively reduce stark social, educational, and economic inequalities?
The first study of three assesses mechanisms by which the Fast Track project, a randomized intervention in the early 1990s for high-risk children in four communities (Durham, NC; Nashville, TN; rural PA; and Seattle, WA), reduced delinquency, arrests, and health and mental health service utilization in adolescence through young adulthood (ages 12-20). A decomposition of treatment effects indicates that about a third of Fast Track’s impact on later crime outcomes can be accounted for by improvements in social and self-regulation skills during childhood (ages 6-11), such as prosocial behavior, emotion regulation and problem solving. These skills proved less valuable for the prevention of mental and physical health problems.
The second study contributes new evidence on how non-instructional investments – such as increased spending on school social workers, guidance counselors, and health services – affect multiple aspects of student performance and well-being. Merging several administrative data sources spanning the 1996-2013 school years in North Carolina, I use an instrumental variables approach to estimate the extent to which local expenditure shifts affect students’ academic and behavioral outcomes. My findings indicate that exogenous increases in spending on non-instructional services not only reduce student absenteeism and disciplinary problems (important predictors of long-term outcomes) but also significantly raise student achievement, in similar magnitude to corresponding increases in instructional spending. Furthermore, subgroup analyses suggest that investments in student support personnel such as social workers, health services, and guidance counselors, in schools with concentrated low-income student populations could go a long way toward closing socioeconomic achievement gaps.
The third study examines individual pathways that lead to high school graduation or dropout. It employs a variety of machine learning techniques, including decision trees, random forests with bagging and boosting, and support vector machines, to predict student dropout using longitudinal administrative data from North Carolina. I consider a large set of predictor measures from grades three through eight including academic achievement, behavioral indicators, and background characteristics. My findings indicate that the most important predictors include eighth grade absences, math scores, and age-for-grade as well as early reading scores. Support vector classification (with a high cost parameter and low gamma parameter) predicts high school dropout with the highest overall validity in the testing dataset at 90.1 percent followed by decision trees with boosting and interaction terms at 89.5 percent.
Item Unknown Can Genetics Predict Response to Complex Behavioral Interventions? Evidence from a Genetic Analysis of the Fast Track Randomized Control Trial.(J Policy Anal Manage, 2015) Albert, Dustin; Belsky, Daniel W; Crowley, D Max; Latendresse, Shawn J; Aliev, Fazil; Riley, Brien; Group, Conduct Problems Prevention Research; Dick, Danielle M; Dodge, Kenneth AEarly interventions are a preferred method for addressing behavioral problems in high-risk children, but often have only modest effects. Identifying sources of variation in intervention effects can suggest means to improve efficiency. One potential source of such variation is the genome. We conducted a genetic analysis of the Fast Track randomized control trial, a 10-year-long intervention to prevent high-risk kindergarteners from developing adult externalizing problems including substance abuse and antisocial behavior. We tested whether variants of the glucocorticoid receptor gene NR3C1 were associated with differences in response to the Fast Track intervention. We found that in European-American children, a variant of NR3C1 identified by the single-nucleotide polymorphism rs10482672 was associated with increased risk for externalizing psychopathology in control group children and decreased risk for externalizing psychopathology in intervention group children. Variation in NR3C1 measured in this study was not associated with differential intervention response in African-American children. We discuss implications for efforts to prevent externalizing problems in high-risk children and for public policy in the genomic era.Item Open Access Can typical US home visits affect infant attachment? Preliminary findings from a randomized trial of Healthy Families Durham.(Attach Hum Dev, 2017-12) Berlin, Lisa J; Martoccio, Tiffany L; Appleyard Carmody, Karen; Goodman, W Benjamin; O'Donnell, Karen; Williams, Janis; Murphy, Robert A; Dodge, Kenneth AUS government-funded early home visiting services are expanding significantly. The most widely implemented home visiting models target at-risk new mothers and their infants. Such home visiting programs typically aim to support infant-parent relationships; yet, such programs' effects on infant attachment quality per se are as yet untested. Given these programs' aims, and the crucial role of early attachments in human development, it is important to understand attachment processes in home visited families. The current, preliminary study examined 94 high-risk mother-infant dyads participating in a randomized evaluation of the Healthy Families Durham (HFD) home visiting program. We tested (a) infant attachment security and disorganization as predictors of toddler behavior problems and (b) program effects on attachment security and disorganization. We found that (a) infant attachment disorganization (but not security) predicted toddler behavior problems and (b) participation in HFD did not significantly affect infant attachment security or disorganization. Findings are discussed in terms of the potential for attachment-specific interventions to enhance the typical array of home visiting services.Item Open Access Case Studies of Internal Leadership-Training Programs at Successful Charter Management Organizations in California(2014-04-17) Muenchau, MarkThe goal of the following case studies is to examine internal leadership-training programs and successful school leaders who went through the leadership training within charter management organizations (CMOs) in the state of California. Though academics, scholars, and researchers disagree on the structures and mechanisms through which school leaders impact student achievement, they agree that effective school leadership is a precondition for effective schools.Item Open Access Classes of Intimate Partner Violence From Late Adolescence to Young Adulthood.(J Interpers Violence, 2017-06-01) Saint-Eloi Cadely, Hans; Pittman, Joe F; Pettit, Gregory S; Lansford, Jennifer E; Bates, John E; Dodge, Kenneth A; Holtzworth-Munroe, AmyResearchers do not agree on how intimate partner violence (IPV) emerges and changes from adolescence to young adulthood. This may be because change in these behaviors varies across individuals. The present study uses a longitudinal, person-centered approach to examine whether there are multiple classes or patterns of change in the perpetration of IPV during the transitional period from adolescence (age 18) to young adulthood (age 25) using data collected annually from a community sample of 484 participants. Latent class analysis was the analytic approach used. Results revealed three patterns for psychological IPV (Little-to-None, Minor/Increasing, and Extensive/Increasing) and two patterns for physical IPV (Little-to-None and Extensive). Patterns varied greatly in number of representatives, although they were more balanced in size for psychological than physical IPV. Variations in IPV behaviors were also revealed across classes, although as expected in a community sample, minor forms of IPV were more common than severe forms. In addition, classes differed in demographic and relationship status variables. These findings suggest that IPV may occur in multiple distinct patterns as opposed to one average pattern across a population. This suggests that interventions for IPV may need to be geared to differences in patterns to enhance their efficacy.Item Open Access Cumulative Early Childhood Adversity and Later Antisocial Behavior: The Potential Mediating Role of Neurocognitive Functioning(2018-04-09) Yazgan, IdilUnfortunately, early childhood adversity is extremely common in the United States. Twenty-six percent of children will have experienced a traumatic event by the age of 4. It is clear from previous research in the field that negative events during childhood can have deleterious effects later on. Early childhood adversity has been found to be a predictor of later antisocial behavior. However, the mechanisms that play into this relationship are unclear. In this study, we explored neurocognitive functioning as a potential mediator for the pathway between cumulative early childhood adversity and later antisocial behavior using the Child Development Project’s data set consisting of 585 participants. Through our analyses, we concluded that cumulative early childhood adversity increased antisocial behavior in young adulthood and lowered neurocognitive functioning in adolescence. Furthermore, poor neurocognitive functioning predicted later antisocial behavior. Mediation analyses showed that neurocognitive functioning was a significant mediator for the relation between cumulative early childhood adversity and later antisocial behavior. This research has implications on understanding the development of later antisocial behavior and it pinpoints to a potential location for intervention within the pathway from cumulative early childhood adversity to later antisocial behavior.Item Open Access Developmental cascades of peer rejection, social information processing biases, and aggression during middle childhood.(Dev Psychopathol, 2010-08) Lansford, Jennifer E; Malone, Patrick S; Dodge, Kenneth A; Pettit, Gregory S; Bates, John EThis study tested a developmental cascade model of peer rejection, social information processing (SIP), and aggression using data from 585 children assessed at 12 time points from kindergarten through Grade 3. Peer rejection had direct effects on subsequent SIP problems and aggression. SIP had direct effects on subsequent peer rejection and aggression. Aggression had direct effects on subsequent peer rejection. Each construct also had indirect effects on each of the other constructs. These findings advance the literature beyond a simple mediation approach by demonstrating how each construct effects changes in the others in a snowballing cycle over time. The progressions of SIP problems and aggression cascaded through lower liking, and both better SIP skills and lower aggression facilitated the progress of social preference. Findings are discussed in terms of the dynamic, developmental relations among social environments, cognitions, and behavioral adjustment.Item Open Access Dimensions of deprivation and threat, psychopathology, and potential mediators: A multi-year longitudinal analysis.(Journal of abnormal psychology, 2018-02) Miller, Adam Bryant; Sheridan, Margaret A; Hanson, Jamie L; McLaughlin, Katie A; Bates, John E; Lansford, Jennifer E; Pettit, Gregory S; Dodge, Kenneth APrior research demonstrates a link between exposure to childhood adversity and psychopathology later in development. However, work on mechanisms linking adversity to psychopathology fails to account for specificity in these pathways across different types of adversity. Here, we test a conceptual model that distinguishes deprivation and threat as distinct forms of childhood adversity with different pathways to psychopathology. Deprivation involves an absence of inputs from the environment, such as cognitive and social stimulation, that influence psychopathology by altering cognitive development, such as verbal abilities. Threat includes experiences involving harm or threat of harm that increase risk for psychopathology through disruptions in social-emotional processing. We test the prediction that deprivation, but not threat, increases risk for psychopathology through altered verbal abilities. Data were drawn from the Child Development Project (N = 585), which followed children for over a decade. We analyze data from assessment points at age 5, 6, 14, and 17 years. Mothers completed interviews at age 5 and 6 on exposure to threat and deprivation experiences. Youth verbal abilities were assessed at age 14. At age 17, mothers reported on child psychopathology. A path analysis model tested longitudinal paths to internalizing and externalizing problems from experiences of deprivation and threat. Consistent with predictions, deprivation was associated with risk for externalizing problems via effects on verbal abilities at age 14. Threat was associated longitudinally with both internalizing and externalizing problems, but these effects were not mediated by verbal abilities. Results suggest that unique developmental mechanisms link different forms of adversity with psychopathology. (PsycINFO Database RecordItem Open Access Dysregulation in children: Origins and implications from age 5 to age 28.(Dev Psychopathol, 2017-11-20) McQuillan, Maureen E; Kultur, Ebru C; Bates, John E; O'Reilly, Lauren M; Dodge, Kenneth A; Lansford, Jennifer E; Pettit, Gregory SResearch shows that childhood dysregulation is associated with later psychiatric disorders. It does not yet resolve discrepancies in the operationalization of dysregulation. It is also far from settled on the origins and implications of individual differences in dysregulation. This study tested several operational definitions of dysregulation using Achenbach attention, anxious/depressed, and aggression subscales. Individual growth curves of dysregulation were computed, and predictors of growth differences were considered. The study also compared the predictive utility of the dysregulation indexes to standard externalizing and internalizing indexes. Dysregulation was indexed annually for 24 years in a community sample (n = 585). Hierarchical linear models considered changes in dysregulation in relation to possible influences from parenting, family stress, child temperament, language, and peer relations. In a test of the meaning of dysregulation, it was related to functional and psychiatric outcomes in adulthood. Dysregulation predictions were further compared to those of the more standard internalizing and externalizing indexes. Growth curve analyses showed strong stability of dysregulation. Initial levels of dysregulation were predicted by temperamental resistance to control, and change in dysregulation was predicted by poor language ability and peer relations. Dysregulation and externalizing problems were associated with negative adult outcomes to a similar extent.Item Open Access Effect of a Community Agency-Administered Nurse Home Visitation Program on Program Use and Maternal and Infant Health Outcomes: A Randomized Clinical Trial.(JAMA network open, 2019-11) Dodge, Kenneth A; Goodman, W Benjamin; Bai, Yu; O'Donnell, Karen; Murphy, Robert AImportance:Postnatal home visitation to support parenting and infant healthy development is becoming increasingly common based on university efficacy studies, but effectiveness when disseminated by communities is not clear. Objective:To test implementation and impact of the Family Connects (FC) program when administered by a community agency. Design, Setting, and Participants:In this randomized clinical trial, births were randomly assigned to receive FC or treatment as usual. Independent evaluation was conducted through parent interviews and review of health and child protective services records. Interviewers were blind to the experimental condition of participants, and participants were blind about the purpose of the interview as an intervention evaluation. A total of 936 consecutive residential births at Duke University Hospital from January 1, 2014, through June 30, 2014, were included. Data were analyzed preliminarily for reporting to funders in early 2015 before all birth-record covariates were scored and were analyzed more comprehensively in mid-2019 after administrative birth and child protective service records became available. Interventions:The goals of the FC brief universal program were to assess family-specific needs, complete brief interventions, and connect families with community resources. Community agencies and families were aligned through an electronic data system. Main Outcomes and Measures:Case records documented program penetration and quality. The primary outcome was child protective services investigations for maltreatment. Secondary outcomes were the number of sustained community connections, maternal mental health, parenting behavior, infant well-child care visits and maternal postpartum care compliance, and emergency health care utilization. Results:Of 936 births, 451 infants (48.2%) were female and 433 (46.3%) were from racial/ethnic minority groups. In all, 456 births (46.5%) were randomized to the intervention and 480 (53.5%) were randomized to the control. All analyses were based on intention to treat. The impact analysis included 158 intervention families and 158 control families. Intervention penetration was 76%, adherence to the protocol was 90%, and independent agreement in scoring (κ) was 0.75. Nurses identified and addressed minor problems for 52% of families and connected an additional 42% to community resources. Analysis of the primary outcome of child abuse investigations revealed a mean (SD) of 0.10 (0.30) investigations for the intervention group vs 0.18 (0.56) investigations for the control group (b = -0.09; 90% CI, -0.01 to -0.12; 95% CI, -0.18 to 0.01; P = .07). The intervention group's rate of possible maternal anxiety or depression was 18.2% vs 25.9% for the control group (b = -7.70; 90% CI, -15.2 to -0.1; 95% CI, -16.6 to 1.3; P = .09). Conclusions and Relevance:This study indicates that a nurse home visitation program for families of newborns can be implemented by a community agency with high penetration and quality. Other communities could benefit from wider dissemination of the program provided that quality remains strong and evaluation continues. Trial Registration:ClinicalTrials.gov identifier: NCT01843036.Item Open Access Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age: A Randomized Clinical Trial.(JAMA network open, 2021-07) Goodman, W Benjamin; Dodge, Kenneth A; Bai, Yu; Murphy, Robert A; O'Donnell, KarenImportance
The Family Connects (FC) program, a community-wide nurse home visiting program for newborns, has been shown to provide benefits for children and families through the first 2 years of life. Potential longer-term outcomes for child well-being remain unknown.Objective
To determine the effect of randomization to FC on child maltreatment investigations and emergency medical care through 5 years of age.Design, setting, and participants
In this randomized clinical trial, families of all 4777 resident births in Durham County, North Carolina, from July 1, 2009, to December 31, 2010, were randomly assigned to receive the FC program or treatment as usual. Impact evaluation was on an intent-to-treat basis and focused on a subsample of 549 families randomly selected from the full population and included review of hospital and Child Protective Services (CPS) administrative records. Statistical analysis was conducted from November 6, 2020, to April 25, 2021.Interventions
The FC programs includes 1 to 3 nurse home visits beginning at the infant age of 3 weeks designed to identify family-specific needs, deliver education and intervention, and connect families with community resources matched to their needs. Ongoing program engagement with service professionals and an electronic resource directory facilitate effective family connections to the community.Main outcomes and measures
Two primary trial outcomes were CPS-recorded child maltreatment investigations and emergency medical care use based on hospital records.Results
Of the 4777 randomized families, 2327 were allocated to the intervention, and 2440 were allocated to services as usual. Among the children in the full study population, 2380 (49.8%) were female, 2397 (50.2%) were male, and 3359 (70.3%) were from racial/ethnic minority groups; of the 531 children included in the impact evaluation follow-up, 284 (53.5%) were female, 247 (46.5%) were male, and 390 (73.4%) were from racial/ethnic minority groups. Negative binomial models indicated that families assigned to FC had 39% fewer CPS investigations for suspected child maltreatment through 5 years of age (95% CI, -0.80 to 0.06; 90% CI, -0.73 to -0.01; control = 44 total investigations per 100 children and intervention = 27 total investigations per 100 children); intervention effects did not differ across subgroups. Families assigned to FC also had 33% less total child emergency medical care use (95% CI, -0.59 to -0.14; 90% CI, -0.55 to -0.18; control = 338 visits and overnight hospital stays per 100 children and intervention = 227 visits and overnight hospital stays per 100 children). Positive effects held across birth risk, child health insurance, child sex, single-parent status, and racial/ethnic groups. Effects were larger for nonminority families compared with minority families.Conclusions and relevance
The findings of this randomized clinical trial suggest that, when implemented with high quality and broad reach, a brief postpartum nurse home visiting program can reduce population rates of child maltreatment and emergency medical care use in early childhood.Trial registration
ClinicalTrials.gov Identifier: NCT01406184.Item Open Access Evaluation of a Family Connects Dissemination to Four High-Poverty Rural Counties.(Maternal and child health journal, 2022-05) Goodman, W Benjamin; Dodge, Kenneth A; Bai, Yu; Murphy, Robert A; O'Donnell, KarenObjectives
Home visiting is a popular approach to improving the health and well-being of families with infants and young children in the United States; but, to date, no home visiting program has achieved population impact for families in rural communities. The current report includes evaluation results from the dissemination of a brief, universal postpartum home visiting program to four high-poverty rural counties.Methods
The study utilized a quasi-experimental design. From Sept. 1, 2014-Dec. 31, 2015, families of all 994 resident births in four rural eastern North Carolina counties were assigned to receive Family Connects (FC; intervention group). A representative subsample of families participated in impact evaluation when the infants were 6 months old: 392 intervention group families and 126 families with infants born between Feb. 1, 2014-July 31, 2014 (natural comparison group). Data were analyzed preliminarily for reporting to funders in 2016 and, more comprehensively, using propensity score matching in 2020.Results
Of FC-eligible families, 78% initiated participation; 83% of participating families completed the program (net completion = 65%). At age 6 months, intervention parents reported more community connections, more frequent use of community services, greater social support, and greater success with infants sleeping on their backs. Intervention infants had fewer total emergency department and urgent care visits. Intervention parents had more total emergency department and urgent care visits and (marginally) fewer overnights in the hospital.Conclusions for practice
FC can be implemented successfully in high-poverty rural communities with broad reach and positive benefits for infants and families.Item Open Access Financing a Pre-K Expansion in Durham: Lessons from Other Communities(2017-06-19) Quarton, KatherineA growing body of evidence suggests that public investment in high-quality preschool programs improves school readiness, and produces significant and lasting impacts on children across a wide variety of outcomes. Research suggests that the impact of high quality preschool services is especially robust among children from disadvantaged backgrounds, including low-income children and English Language Learners. Analysis of Census data suggests that there is an unmet need for preschool services in Durham County, North Carolina. Of the approximately 2,000 4-year-olds in Durham living below 200% of the Federal Poverty level, only about 800 received preschool services during the 2015-2016 school year. This suggests that there is an unmet need of approximately 1,200 low-income 4-year-olds in Durham each year. Durham elected officials charged the Finance Subcommittee of the Durham Community Preschool Task Force with providing information about financial models that can support preschool expansion and eventually universal preschool in Durham. This Masters Project supports the Subcommittee’s efforts by presenting case studies and analysis of how communities around the country funded preschool expansions at the local level. The goal of this effort is to develop insights for the Task Force drawn from the real experiences of communities that are leading the effort to expand access to high-quality preschool ahead of state and federal efforts. This paper is broken down into several sections. Chapters one through three introduce the challenge facing Durham, address contextual factors affecting preschool access in Durham and North Carolina more broadly, and overview preschool financing strategies available to local governments. Chapters four through eight provide analysis of five case studies of communities that increased access to preschool with local funds. Findings are based on in-person and phone interviews and analysis of primary and secondary reports. Each case focuses on a unique financing strategy and identifies barriers and keys to success. Two communities studied (Denver and Boston) have pursued universal programs, while the other three (Forsyth, Wake and Salt Lake County) have expanded programs in a targeted manner. These include: 1. Salt Lake County, UT – Pay for Success 2. Denver, CO – Sales Tax and Sliding Scale Tuition Payments 3. Forsyth County, NC – Philanthropy 4. Wake County, NC – County Budget 5. Boston, MA: Mixed formula (with emphasis on district funds) The paper concludes with implications for successful funding strategies in Durham.Item Open Access Framing Debate to Lift Children Out of the Political Divide(2017) Mandel, Adam MandelMany cost-effective, evidence-based developmental programs (EBPs) remain inaccessible to children in need. To improve access to care, this dissertation theoretically and then empirically examines different approaches to advocating for dissemination funding in a polarized political context. Section 1 describes recent advances in the use of morally framed messaging to change attitudes. Section 2 reviews research on political polarization with an emphasis on how polarization affects online message processing. Section 3 describes a theoretically informed EBP advocacy strategy that seeks to tailor and target advocacy messages to promote bipartisan support for EBP dissemination.
Sections 4, 5, and 6 describe three studies designed to test whether motivated social cognition (Jost, Glaser, Kruglanski, & Sulloway, 2003) or moral foundations theory (Graham, Haidt, & Nosek, 2009) may be used to tailor message frames to speak to the distinct needs of Liberals and Conservatives. In Section 7, results and limitations are discussed. Although the three studies provide limited support for the hypothesis that theory can be used to design persuasive, tailored messages, message frames were consistently overwhelmed by competition from partisan cues and ideological arguments. The dissertation concludes by arguing that, in order to generate bipartisan support for EBP dissemination, implementation funding and structures that are already highly prioritized by Liberals need to be designed to appeal to Conservatives’ substantive policy preferences.
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