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Formative Evaluation of Home Visitors' Role in Addressing Poor Mental Health, Domestic Violence, and Substance Abuse Among Low-Income Pregnant and Parenting Women

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Abstract

Objectives: This research assessed home visitor effectiveness in communicating about and responding to poor mental health, domestic violence, and substance abuse among pregnant and parenting women home visited as part of a comprehensive family support strategy in seven urban communities. Methods: Cross-sectional studies were conducted with mothers (n = 189) actively engaged in home visitation programs and home visitors (n = 45). Maternal interviews assessed need for and receipt of mental health, domestic violence, and substance abuse services, and home visitor discussion of these risk areas. Home visitor surveys assessed perceived adequacy of training and personal effectiveness in addressing these risk areas. Results: Over half of mothers needed mental health, domestic violence, or substance abuse services; however, only 27% of mothers in need of service received services. Most mothers reported having communicated with their home visitor about the three risk areas, but there were no differences in communication frequency based on whether services were needed. Most home visitors perceived themselves as effective in communicating about and responding to these risk factors but rated the training they had received in these areas as less than adequate. Conclusions: Home visitors could benefit from more intensive training in the formal assessment of risks and the protocols for communication about those risks with their clients. Home visitors could also receive support from and work in collaboration with professionals in addressing client risks. Further research on home visit content is needed to determine which strategies facilitate home visitors' ability to effectively communicate about and address client risks.

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ACKNOWLEDGMENTS

This work was funded by the Safe and Sound Initiative of Baltimore. The Johns Hopkins University Institutional Review Board as well as the hospital where families from one neighborhood were recruited approved the study. The authors thank the leadership and staff of the Safe and Sound Campaign, The Family League of Baltimore City, and The United Way of Central Maryland for their commitment to this evaluation. We would like to thank Michael Cenci, Martha Holleman, Constance Mercer, Elizabeth Saylor, and Barbara Squires for their review of this manuscript. We would also like to thank Ethel Robinson, Kimberly Staton, and Cleo Stewart for their work as family interviewers. Finally, we thank all BCFSS families and home visitors who participated in this study.

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Authors and Affiliations

  1. Research Associate, Department of Pediatrics, Johns Hopkins University School of Medicine, 1620 McElderry Street, Baltimore, MD, 21205-1903, Maryland

    S. Darius Tandon PhD (Research Associate), Kathleen M. Parillo MA, Carrie Jenkins MA & Anne K. Duggan ScD

  2. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, Maryland

    S. Darius Tandon PhD (Research Associate)

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  1. S. Darius Tandon PhD
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  2. Kathleen M. Parillo MA
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  3. Carrie Jenkins MA
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  4. Anne K. Duggan ScD
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Correspondence to S. Darius Tandon PhD.

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Tandon, S.D., Parillo, K.M., Jenkins, C. et al. Formative Evaluation of Home Visitors' Role in Addressing Poor Mental Health, Domestic Violence, and Substance Abuse Among Low-Income Pregnant and Parenting Women. Matern Child Health J 9, 273–283 (2005). https://doi.org/10.1007/s10995-005-0012-8

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  • DOI: https://doi.org/10.1007/s10995-005-0012-8

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