Effects of Home Visitation on Maternal Competencies, Family Environment, and Child Development: a Randomized Controlled Trial

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• 作者：Susan Sierau ; Verena Dähne ; Tilman Brand ; Vivien Kurtz…
• 关键词：Socially disadvantaged families ; Early intervention ; Program implementation ; Nurse ; family partnership
• 刊名：Prevention Science
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：17
• 期：1
• 页码：40-51
• 全文大小：492 KB
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• 作者单位：Susan Sierau (1)
  Verena Dähne (1)
  Tilman Brand (2)
  Vivien Kurtz (3)
  Kai von Klitzing (1)
  Tanja Jungmann (4)
  
  1. Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany
  2. Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology – BIPS, Achterstrasse 30, 28359, Bremen, Germany
  3. Department Youth and Family, Capital City of Hannover, Sutelstrasse 18, 30659, Hannover, Germany
  4. Faculty of Humanities, Institute for Special Educational Intervention and Rehabilitation, University of Rostock, August-Bebel-Strasse 28, 18051, Rostock, Germany
  
• 刊物主题：Public Health; Health Psychology; Child and School Psychology;
• 出版者：Springer US
• ISSN：1573-6695

文摘

Based on the US Nurse-Family Partnership (NFP) program, the German home visiting program “Pro Kind” offered support for socially and financially disadvantaged first-time mothers from pregnancy until the children’s second birthday. A multi-centered, longitudinal randomized controlled trial (RCT) was conducted to assess its effectiveness on mothers and children. A total of 755 women with multiple risk factors were recruited, 394 received regular home visits (treatment group), while 361 only had access to standard community services (control group). Program influences on family environment (e.g., quality of home, social support), maternal competencies (e.g., maternal self-efficacy, empathy, parenting style), and child development (e.g., cognitive and motor development) were assessed from mothers’ program intake in pregnancy to children’s second birthday based on self-reports in regular interviews and developmental tests. Generalized estimating equations (GEE) models showed small, but significant positive treatment effects on parental self-efficacy, and marginally significant effects on social support, and knowledge on child rearing. Maternal stress, self-efficacy, and feelings of attachment in the TG tend to show a more positive development over time. Subgroup effects were found for high-risk mothers in the TG, who reported more social support over time and, generally, had children with higher developmental scores compared to their CG counterparts. Post hoc analyses of implementation variables revealed the quality of the helping relationship as a significant indicator of treatment effects. Results are discussed in terms of implementation and public policy differences between NFP and Pro Kind.