ArticleEngagement in Paraprofessional Home Visitation: Families’ Reasons for Enrollment and Program Response to Identified Reasons
Section snippets
The Context for the Present Study: Baltimore’s Comprehensive Family Support Strategy
The Safe and Sound Campaign, created in 1997, is a comprehensive initiative to improve the degree to which children grow up safe, nurtured, and healthy in Baltimore City. One of the Campaign’s 5 strategies—Baltimore’s Comprehensive Family Support Strategy (BCFSS)—aims to improve the health, functioning, and self-reliance of families with children birth to 6. An ad hoc Strategy Team on Family Support selected 6 health and well-being indicators to impact: a) low birth weight, b) preterm birth, c)
Home Visiting Program Models
Two home visiting program models were implemented across the 5 BCFSS neighborhoods implementing home visiting at the time of this study. Three neighborhoods used a Healthy Start home visiting model (Devaney, Howell, McCormick, & Moreno, 2000); Healthy Start is an initiative funded by the Maternal and Child Health Bureau to promote community-based maternal and child health programs, with a particular emphasis on reducing infant mortality. At the onset of BCFSS implementation, the 3 neighborhoods
Baseline Maternal Characteristics
Nearly all study participants were African American, with a mean age just under 23 years (Table 1). About three quarters (77%) enrolled prenatally; for 39% of enrollees, this was their first pregnancy. Although only 40% had graduated from high school or had a GED, 59% had worked either part or full time, in the past year. More than 60% exhibited signs of poor mental health and 13% were experiencing intimate partner violence. In the past year, 44% of enrollees reported drug use and 9% reported
Discussion
Three main findings emerged from this study. First, we found that mothers identified multiple reasons for entering home visitation programs and that their reasons spanned domains. Among all identified reasons for entering, the 2 life course reasons—wanting referrals to job training and/or available jobs and wanting information on how to complete one’s education—were most often given as the first or second most important reason for joining a home visiting program.
Second, we found that maternal
Conclusions
Our findings indicating a high prevalence of employment- and education-related reasons for entering home visiting, juxtaposed with the great need for employment and education services in urban settings, leads us to recommend that home visiting programs in urban settings adopt approaches to maximize their ability to respond to client life course needs. If home visiting programs can provide services and resources that respond to employment- and education-related needs, they might improve their
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Cited by (0)
Supported by the Safe and Sound Campaign of Baltimore, Maryland.
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S. Darius Tandon, PhD, is an Assistant Professor in the Department of Pediatrics at the Johns Hopkins University School of Medicine with a joint appointment in the Bloomberg School of Public Health’s Department of Population, Family, & Reproductive Health. He is a community psychologist who conducts research on perinatal health as well as adolescent and young adult mental health.
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Kathleen Parillo, MA, is a graduate of Towson University’s Masters of Arts program in Experimental Psychology. She is currently employed by NOVA Research Company in Bethesda, Maryland.
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Constance Mercer, BA, has a degree in Early Childhood Education and has worked as a home visitor in Baltimore City and Howard County, Maryland. She is currently a Senior Research Assistant in the Department of Pediatrics at the Johns Hopkins University School of Medicine.
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Maureen Keefer, BA, has a degree in English and Psychology from the University of Virginia. She is currently a Data Analyst in the Department of Pediatrics at the Johns Hopkins University School of Medicine.
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Anne K. Duggan, ScD, is a Professor in the Department of Pediatrics at the Johns Hopkins University School of Medicine with a joint appointment in the Bloomberg School of Public Health’s Department of Health Policy and Management. She has conducted extensive research on the effectiveness of home visiting programs for pregnant women and women with young children in preventing child abuse and neglect.