The effects of a universal short-term home visiting program: Two-year impact on parenting behavior and parent mental health.

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2023-06

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Abstract

Background

At the time of childbirth, families face heightened levels of unmet need. These needs, if left unmet, can lead parents to engage in less positive parenting practices, which in turn, increase the risk of child maltreatment. Family Connects (FC) is a universal postnatal nurse home-visiting program designed to prevent child maltreatment by supporting all families in a community through one to three visits to improve parent mental health and parenting behaviors. A randomized controlled trial of FC demonstrated improving positive parenting and reducing postpartum depression through age 6 months.

Objective

To determine sustained (2-year) impact of random assignment to FC on parenting behavior and parent mental health and identify heterogeneity of effects.

Participants and setting

A representative subsample of 496 families that had been randomized to FC (255 treatment; 241 control) of infants born between July 1, 2009, and December 31, 2010, in Durham County, North Carolina.

Methods

Demographic characteristics were collected through hospital discharge data. Treatment-blinded interviewers collected maternal reports of parenting behavior and mental health at infant age two years. Moderation and subgroup analyses were conducted to estimate heterogeneity in impact of FC.

Results

Mothers assigned to FC engaged in more self-reported positive parenting relative to control mothers (B = 0.21; p < 0.05). Hispanic mothers assigned to FC reported greater sense of parenting competence (B = 1.28; p < 0.05). No significant main effect differences were identified for negative parenting, maternal depression, or father involvement.

Conclusions

Assignment to FC was associated with improvements in population-level self-reported scores of positive parenting 2 years post-intervention.

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Published Version (Please cite this version)

10.1016/j.chiabu.2023.106140

Publication Info

Baziyants, Gayane A, Kenneth A Dodge, Yu Bai, W Benjamin Goodman, Karen O'Donnell and Robert A Murphy (2023). The effects of a universal short-term home visiting program: Two-year impact on parenting behavior and parent mental health. Child abuse & neglect, 140. p. 106140. 10.1016/j.chiabu.2023.106140 Retrieved from https://hdl.handle.net/10161/27405.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Baziyants

Gayane Baziyants

Student

Joint-Degree Ph.D. Candidate at the Sanford School of Public Policy and Psychology & Neuroscience

Gayane is a Joint-Degree Ph.D. Candidate of Public Policy and Psychology & Neuroscience. Her research focuses on identifying evidence-based policies and practices for supporting child development and family well-being. Gayane utilizes diverse research methods, such as randomized control trials, quasi-experimental methods, and implementation science to inform research on supporting families. Her research projects evaluate longitudinal impacts of a universal home visiting program and investigate effects of an unconditional cash transfer on rates of child maltreatment. Gayane is also conducting an implementation evaluation of a developmental monitoring tool across diverse sites that serve children and families. 

Gayane received her Bachelor’s Degree in Education and International Studies from the University of North Carolina Chapel Hill in 2017. Before matriculating at Duke, she worked as a Research Analyst at Child Trends. In this role, she conducted national, state, and community level research analyzing the impact of various early childhood policies and programs. 

Dodge

Kenneth A. Dodge

Professor in the Sanford School of Public Policy

Kenneth A. Dodge is the William McDougall Distinguished Professor of Public Policy and Professor of Psychology and Neuroscience at Duke University. He is also the founding and past director of the Center for Child and Family Policy, as well as the founder of Family Connects International

Dodge is a leading scholar in the development and prevention of aggressive and violent behaviors. His work provides a model for understanding how some young children grow up to engage in aggression and violence and provides a framework for intervening early to prevent the costly consequences of violence for children and their communities.

Dodge joined the faculty of the Sanford School of Public Policy in September 1998. He is trained as a clinical and developmental psychologist, having earned his B.A. in psychology at Northwestern University in 1975 and his Ph.D. in psychology at Duke University in 1978. Prior to joining Duke, Dodge served on the faculty at Indiana University, the University of Colorado, and Vanderbilt University.

Dodge's research has resulted in the Family Connects Program, an evidence-based, population health approach to supporting families of newborn infants. Piloted in Durham, NC, and formerly known as Durham Connects, the program attempts to reach all families giving birth in a community to assess family needs, intervene where needed, and connect families to tailored community resources. Randomized trials indicate the program's success in improving family connections to the community, reducing maternal depression and anxiety, and preventing child abuse. The model is currently expanding to many communities across the U.S.

Dodge has published more than 500 scientific articles which have been cited more than 120,000 times.

Elected into the National Academy of Medicine in 2015, Dodge has received many honors and awards, including the following:

  • President (Elected), Society for Research in Child Development
  • Fellow, Society for Prevention Research
  • Distinguished Scientist, Child Mind Institute
  • Research Scientist Award from the National Institutes of Health
  • Distinguished Scientific Award for Early Career Contribution from the American Psychological Association
  • J.P. Scott Award for Lifetime Contribution to Aggression Research from the International Society for Research on Aggression
  • Science to Practice Award from the Society for Prevention Research
  • Inaugural recipient of the “Public Service Matters” Award from the Network of Schools of Public Policy, Affairs and Administration
  • Inaugural recipient of the Presidential Citation Award for Excellence in Research from the Society for Research on Adolescence
Bai

Yu Bai

Statistician III
Goodman

Ben Goodman

Research Scientist

Ben Goodman is a research scientist at the Center for Child and Family Policy. His research interests focus broadly on the implementation and evaluation of population-based interventions to reduce child maltreatment and improve parent and child health and well-being, including the evidence-based Family Connects postpartum nurse home visiting program. His research also examines how sources of stress and support shape the quality of parent-child relationships, parents’ own well- being, and child development.

Research Interests:
  • Home Visiting
  • Child Maltreatment
  • Parenting
  • Program Evaluation
Education:
  • Ph.D. The Pennsylvania State University - 2009
Murphy

Robert A. Murphy

Associate Professor in Psychiatry and Behavioral Sciences

Dr. Murphy is a licensed clinical psychologist focused on child traumatic stress, including its treatment and prevention and development and dissemination of evidence-based interventions. He is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. Dr. Murphy serves as Executive Director for the Center for Child & Family Health (CCFH), a community and three university partnership (Duke University, the University of North Carolina at Chapel Hill, and North Carolina Central University) dedicated to research, training, and intervention related to child trauma and maltreatment. Interests include treatment and prevention of child maltreatment and traumatic stress, dissemination of evidence based interventions, and improving mental health care for military families. In partnership with the Duke Sanford School of Public Policy Center for Child and Family Policy, he has been active in the development and evaluation, via two randomized controlled trials, of a brief, postnatal, universal nurse home visiting program (Family Connects) that has demonstrated improved parenting and parental distress, as well as reduced emergency medical care costs and lower rates of reported child maltreatment. Since 2003, CCFH has been a community treatment and services center within the National Child Traumatic Stress Network focused on improving access to evidence based mental health care for foster care youth and developing trauma informed child welfare systems.


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