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Evaluation of a Community-Based Approach to Strengthen Retention in Early Childhood Home Visiting

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Abstract

Home visiting (HV) is a strategy for delivering services designed to promote positive parenting and prevent exposure to toxic stress during a critical period of child development. Home visiting programs are voluntary and family engagement and retention in service can influence outcomes. Most participants receive less home visits and for a shorter time than prescribed by evidence-based models. The purpose of this study was to evaluate community-based enrichment of HV (CBE-HV), an approach that was developed and implemented to increase engagement and retention in HV. CBE-HV strategies included (1) community engagement, (2) ancillary supports for families in HV, and (3) enhancements to a HV program. A retrospective, quasi-experimental study was conducted to estimate the effect of CBE-HV on the retention of families in a HV program. Comparisons of study participants were made post-implementation of CBE-HV (n = 2191) and over time (n = 3786)—pre- versus post-CBE-HV implementation in the study communities. The CBE-HV effect was statistically significant and protective (hazards ratio [HR] 0.77, 95 % confidence interval [CI]: 0.67, 0.88), indicating that attrition from HV was 23 % less in the CBE-HV group relative to the post-implementation comparison group. In the temporal comparison of study communities, CBE-HV was also associated with a significantly lower risk of HV attrition (HR: 0.71, 95 % CI: 0.56, 0.89). The study demonstrated that CBE-HV is a promising approach to achieve stronger retention and engagement in HV. Further research is needed to identify the components of CBE-HV approaches that are most effective.

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References

  • Adirim, T., & Supplee, L. (2013). Overview of the federal home visiting program. Pediatrics, 132, S59–S64.

    Article  PubMed  Google Scholar 

  • Alonso-Marsden, S., Dodge, K. A., O’Donnell, K. J., Murphy, R. A., Sato, J. M., & Christopoulos, C. (2013). Family risk as a predictor of initial engagement and follow-through in a universal nurse home visiting program to prevent child maltreatment. Child Abuse & Neglect, 37, 555–565.

    Article  Google Scholar 

  • Ammerman, R. T., Stevens, J., Putnam, F. W., Altaye, M., Hulsmann, J. E., Lehmkuhl, H. D., & Van Ginkel, J. B. (2006). Predictors of early engagement in home visitation. Journal of Family Violence, 21, 105–115.

    Article  Google Scholar 

  • Ammerman, R. T., Putnam, F. W., Teeters, A. R., & Van Ginkel, J. B. (2014). Moving Beyond Depression: A collaborative approach to treating depressed mothers in home visiting programs. Zero to Three, 34, 20–27.

    Google Scholar 

  • Astuto, J., & Allen, L. (2009). Home visitation and young children: An approach worth investing in? Society for Research in Child Development, Social Policy Report, 23, 3–22.

    Google Scholar 

  • Bergink, V., Kooistra, L., Lambregtse-van den Berg, M. P., Wijnen, H., Bunevicius, R., van Baar, A., & Pop, V. (2011). Validation of the Edinburgh depression scale during pregnancy. Journal of Psychosomatic Research, 70, 385–389.

    Article  PubMed  Google Scholar 

  • Caldera, D., Burrell, L., Rodriguez, K., Crowne, S. S., Rohde, C., & Duggan, A. (2007). Impact of a statewide home visiting program on parenting and on child health and development. Child Abuse & Neglect, 31, 829–852.

    Article  Google Scholar 

  • Cohen, S., & Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13, 99–125.

    Article  Google Scholar 

  • Constantino, J. N., Hashemi, N., Solis, E., Alon, T., Haley, S., McClure, S., & Carlson, V. K. (2001). Supplementation of urban home visitation with a series of group meetings for parents and infants: Results of a “real-world” randomized, controlled trial. Child Abuse & Neglect, 25, 1571–1581.

    Article  CAS  Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. The British Journal of Psychiatry, 150, 782–786.

    Article  PubMed  CAS  Google Scholar 

  • Damashek, A., Doughty, D., Ware, L., & Silovsky, J. (2011). Predictors of client engagement and attrition in home-based child maltreatment prevention services. Child Maltreatment, 16, 9–20.

    Article  PubMed  Google Scholar 

  • Daro, D., McCurdy, K., Falconnier, L., & Stojanovic, D. (2003). Sustaining new parents in home visitation services: Key participant and program factors. Child Abuse & Neglect, 27, 1101–1125.

    Article  Google Scholar 

  • Dimick, J. B., & Ryan, A. M. (2014). Methods for evaluating changes in health care policy: The difference-in-differences approach. JAMA, 312, 2401–2402.

    Article  PubMed  CAS  Google Scholar 

  • Dobbie, W., & Fryer, R. G., Jr. (2011). Are high-quality schools enough to increase achievement among the poor? Evidence from the Harlem children's zone. American Economic Journal: Applied Economics, 3, 158–187.

    Google Scholar 

  • Duggan, A., McFarlane, E., Fuddy, L., Burrell, L., Higman, S. M., Windham, A., & Sia, C. (2004). Randomized trial of a statewide home visiting program: Impact in preventing child abuse and neglect. Child Abuse & Neglect, 28, 597–622.

    Article  Google Scholar 

  • Duggan, A., Caldera, D., Rodriguez, K., Burrell, L., Rohde, C., & Crowne, S. S. (2007). Impact of a statewide home visiting program to prevent child abuse. Child Abuse & Neglect, 31, 801–827.

    Article  Google Scholar 

  • DuMont, K., Kirkland, K., Mitchell-Herzfeld, S., Ehrhard-Dietzel, S., Rodriguez, M.L., Lee, E., Layne, C., & Greene, R. (2010). A randomized trial of Healthy Families New York (HFNY): Does home visiting prevent child maltreatment. Retrieved from http://www.ocfs.state.ny.us/main/reports.

  • Enders, C.K. (2010). Applied missing data analysis. Guilford.

  • Fouad, M. N., Johnson, R. E., Nagy, M. C., Person, S. D., & Partridge, E. E. (2014). Adherence and retention in clinical trials: A community‐based approach. Cancer, 120, 1106–1112.

    Article  PubMed  PubMed Central  Google Scholar 

  • Girvin, H., DePanfilis, D., & Daining, C. (2007). Predicting program completion among families enrolled in a child neglect preventive intervention. Research on Social Work Practice, 17, 674–685.

    Article  Google Scholar 

  • Gomby, D. S. (2005). Home visitation in 2005: Outcomes for children and parents. Washington, DC: Committee on Economic Development.

    Google Scholar 

  • Goyal, N. K., Hall, E. S., Meinzen-Derr, J. K., Kahn, R. S., Short, J. A., Van Ginkel, J. B., & Ammerman, R. T. (2013). Dosage effect of prenatal home visiting on pregnancy outcomes in at-risk, first-time mothers. Pediatrics, 132, S118–S125.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goyal, N. K., Hall, E. S., Jones, D. E., Meinzen-Derr, J. K., Short, J. A., Ammerman, R. T., & Van Ginkel, J. B. (2014). Association of maternal and community factors with enrollment in home visiting among at-risk, first-time mothers. American Journal of Public Health, 104, S144–S151.

    Article  PubMed  PubMed Central  Google Scholar 

  • Holland, M. L., Xia, Y., Kitzman, H. J., Dozier, A. M., & Olds, D. L. (2014). Patterns of visit attendance in the nurse–family partnership program. American Journal of Public Health, 104, e58–65.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19, 629–645.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ingoldsby, E. M., Baca, P., McClatchey, M. W., Luckey, D. W., Ramsey, M. O., Loch, J. M., & Smith, B. J. (2013). Quasi-experimental pilot study of intervention to increase participant retention and completed home visits in the nurse–family partnership. Prevention Science, 14, 525–534.

    Article  PubMed  PubMed Central  Google Scholar 

  • Korfmacher, J. (2000). The Kempe family stress inventory: A review. Child Abuse & Neglect, 24, 129–140.

    Article  CAS  Google Scholar 

  • Las Nueces, D., Hacker, K., DiGirolamo, A., & Hicks, L. S. (2012). A systematic review of community‐based participatory research to enhance clinical trials in racial and ethnic minority groups. Health Services Research, 47, 1363–1386.

    Article  PubMed Central  Google Scholar 

  • Lassi, Z.S., Haider, B.A., & Bhutta, Z.A. (2010). Community‐based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. The Cochrane Library.

  • Luby, J., Belden, A., Botteron, K., Marrus, N., Harms, M. P., Babb, C., & Barch, D. (2013). The effects of poverty on childhood brain development: The mediating effect of caregiving and stressful life events. JAMA Pediatrics, 167, 1135–1142.

    Article  PubMed  PubMed Central  Google Scholar 

  • Matthey, S., Henshaw, C., Elliott, S., & Barnett, B. (2006). Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale–implications for clinical and research practice. Archives of Women's Mental Health, 9, 309–315.

    Article  PubMed  CAS  Google Scholar 

  • McCurdy, K., & Daro, D. (2001). Parent involvement in family support programs: An integrated theory. Family Relations, 50, 113–121.

    Article  Google Scholar 

  • McCurdy, K., Gannon, R. A., & Daro, D. (2003). Participation patterns in home‐based family support programs: Ethnic variations. Family Relations, 52, 3–11.

    Article  Google Scholar 

  • McFarlane, E., Crowne, S. S., Burrell, L., & Duggan, A. (2014). Home visiting service delivery and outcomes for depressed mothers. Zero to Three, 34, 53–60.

    Google Scholar 

  • McGuigan, W. M., Katzev, A. R., & Pratt, C. C. (2003). Multi-level determinants of retention in a home-visiting child abuse prevention program. Child Abuse & Neglect, 27, 363–380.

    Article  Google Scholar 

  • Navaie-Waliser, M., Martin, S. L., Campbell, M. K., Tessaro, I., Kotelchuck, M., & Cross, A. W. (2000). Factors predicting completion of a home visitation program by high-risk pregnant women: The North Carolina maternal outreach worker program. American Journal of Public Health, 90, 121–124.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Nievar, M. A., Van Egeren, L. A., & Pollard, S. (2010). A meta‐analysis of home visiting programs: Moderators of improvements in maternal behavior. Infant Mental Health Journal, 31, 499–520.

    Article  Google Scholar 

  • O’Brien, R. A., Moritz, P., Luckey, D. W., McClatchey, M. W., Ingoldsby, E. M., & Olds, D. L. (2012). Mixed methods analysis of participant attrition in the nurse–family partnership. Prevention Science, 13, 219–228.

    Article  PubMed  PubMed Central  Google Scholar 

  • Olds, D. L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D. W., & Holmberg, J. (2004). Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial. Pediatrics, 114, 1550–1559.

    Article  PubMed  Google Scholar 

  • Olds, D. L., Kitzman, H., Knudtson, M. D., Anson, E., Smith, J. A., & Cole, R. (2014). Effect of home visiting by nurses on maternal and child mortality: Results of a 2-decade follow-up of a randomized clinical trial. JAMA Pediatrics, 168, 800–806.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shonkoff, J. P., Garner, A. S., Siegel, B. S., Dobbins, M. I., Earls, M. F., McGuinn, L., & Wood, D. L. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129, e232–e246.

    Article  PubMed  Google Scholar 

  • Smith, S. A., & Moore, E. J. (2012). Health literacy and depression in the context of home visitation. Maternal and Child Health Journal, 16, 1500–1508.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sweet, M. A., & Appelbaum, M. I. (2004). Is home visiting an effective strategy? A meta‐analytic review of home visiting programs for families with young children. Child Development, 75, 1435–1456.

    Article  PubMed  Google Scholar 

  • Tandon, S. D., Parillo, K., Mercer, C., Keefer, M., & Duggan, A. K. (2008). Engagement in paraprofessional home visitation: Families’ reasons for enrollment and program response to identified reasons. Women's Health Issues, 18, 118–129.

    Article  PubMed  Google Scholar 

  • Wallerstein, N., & Duran, B. (2010). Community-based participatory research contributions to intervention research: The intersection of science and practice to improve health equity. American Journal of Public Health, 100, S40–S46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27, 1–28.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors acknowledge the participation and support of the United Way of Greater Cincinnati and Ohio Help Me Grow.

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Funding

This study was supported in part by Grant R01MH087499 from the National Institute of Mental Health to Ammerman.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

For this type of study (retrospective), formal consent is not required.

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Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA

    Alonzo T. Folger, Anita L. Brentley, Neera K. Goyal, Eric S. Hall, Ting Sa, James L. Peugh, Angelique R. Teeters, Judith B. Van Ginkel & Robert T. Ammerman

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  1. Alonzo T. Folger
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  2. Anita L. Brentley
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  3. Neera K. Goyal
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  4. Eric S. Hall
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  5. Ting Sa
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  6. James L. Peugh
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  7. Angelique R. Teeters
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  8. Judith B. Van Ginkel
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  9. Robert T. Ammerman
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Correspondence to Alonzo T. Folger.

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Folger, A.T., Brentley, A.L., Goyal, N.K. et al. Evaluation of a Community-Based Approach to Strengthen Retention in Early Childhood Home Visiting. Prev Sci 17, 52–61 (2016). https://doi.org/10.1007/s11121-015-0600-9

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  • DOI: https://doi.org/10.1007/s11121-015-0600-9

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