Elsevier

Journal of Pediatric Nursing

Volume 29, Issue 1, January–February 2014, Pages 3-13
Journal of Pediatric Nursing

Lasting Effects of an Interdisciplinary Home Visiting Program on Child Behavior: Preliminary Follow-Up Results of a Randomized Trial1

https://doi.org/10.1016/j.pedn.2013.04.006Get rights and content

Child mental health is of great concern requiring effective and appropriate parenting interventions. This pilot study was the first attempt to examine the intermediate effects of an ongoing parenting home visiting program, Minding the Baby (MTB), on parental reflective functioning (RF) and child behavior. Results indicated that the women who participated in the MTB intervention described their children—when assessed post-intervention—as having significantly fewer externalizing child behaviors. However, there was no significant difference between the two groups on parental RF from the end of the intervention to follow-up. The central finding that children who participated with the MTB program were reported to have significantly fewer externalizing behaviors following the intervention has important clinical and public health implications. Recommendations for the design of future follow-up studies and for further exploration of parental RF as it relates to the MTB outcomes are discussed.

Section snippets

Reflective Functioning

Parental reflective functioning (RF) is defined as a parent's capacity to envision the mental states of herself and her child (Slade, 2005) and refers to the awareness that an individual's behavior is a reflection of mental states (thoughts, feelings, intentions, desires) (Ordway et al., in review, Slade, 2002). According to Fonagy and colleagues (2002), one's capacity for RF is central to self-organization and affect regulation. They further suggest that the quality of a person's RF capacity

Design

This pilot study is a prospective longitudinal follow-up study of the MTB home visiting program. In the original design, the MTB primary study used a nested two group experimental design with random assignment of prenatal care groups at a community health center to test the effects of the MTB program with young families (Sadler et al., under review, November 2012). The hypotheses for this follow up study were tested through analyses of data previously collected during the MTB primary study and

Descriptive Findings

The intervention and control group mothers who participated in this follow-up study of the MTB home visiting intervention were similar with regard to most background demographic characteristics (Table 1, Table 2). In this cohort, 25 (11 intervention and 14 control) of the mothers were teenagers (less than 20 years old) at the time of their child's birth, which was not a statistically significant difference between the two groups. Among the children, there was not a significant difference found

Discussion

The purpose of this pilot study was to examine the intermediate effects of the MTB on child behavior and parental RF. This was the first follow-up study of the MTB program and therefore potential challenges to the re-recruitment of the mother–child dyads and selection of outcome measures had not previously been examined. Overall the study was successful in locating the mother–child dyads. The choice of child behavior measures was effective for use with the mothers, but not as effective when we

Acknowledgments

We would like to thank Dr. Kris Fennie and Dr. Tony Ma for their statistical assistance and database development throughout this research project.

This first author was supported by NIH/NINR 1F31NR011263-01; NIH 5T32NR008346-06; Evelyn Anderson Scholarship; Dr. Lorraine G. Spranzo Memorial Scholarship; Sigma Theta Tau-Delta Mu Grant; Nurse Practitioner Health Care Foundation/Community Innovations Award; Jonas Nurse Leaders Scholar Program.

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  • 1

    Data previously presented: Ordway, M.R., Sadler, LS, Slade, A, Dixon, J, Close, N, Mayes, L. (2012). The Effects of a Parenting Intervention on Parental Reflective Functioning and Early Child Behaviors. Oral presentation delivered at the 24th Annual Eastern Nursing Research Society Scientific Sessions, New Haven, CT, March, 2012.

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