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Liang KWH, Liang KWH, Chan QR, Goh WHS. Mitigating adverse social determinants of health in the vulnerable population: Insights from a home visitation programme. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2024; 53:132-141. [PMID: 38920241 DOI: 10.47102/annals-acadmedsg.2023119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Low-income families are exposed to adverse childhood experiences and psychosocial risks that impact child development. At the KK Women's and Children's Hospital in Singapore, Kids Integrated Development Service (KIDS0-3) is a home visitation programme that aims to optimise the development of children from low-income families. Method Data comprising family demographics, maternal psychosocial risks and outcomes of child development were collated through a chart review of 469 mother-child dyads enrolled from June 2014 to October 2022. Results Based on the Family and Adult Support Tool, 312 families (67%) were identified as moderate or high-risk. Children from moderate and high-risk families had poorer Bayley cognitive (mean 95.88 [SD 8.25] versus [vs] 98.44 [SD 8.72], P=0.014) and language scores (mean 87.38 [SD 10.35] vs 90.43 [SD 9.61], P=0.016] at 24 months of age, compared to the low-risk group. Children of teenage mothers had lower Bayley cognitive scores (mean 95.16 [SD 8.42] vs 97.76 [SD 8.55], P=0.037), and children of mothers who experienced sexual abuse had lower Bayley cognitive scores (mean 93.1 [SD 5.68] vs 99.7 [SD 8.17], P=0.013) and language scores (mean 82.3 [SD 12.87] vs 91.3 [SD 10.86], P=0.021]. Antenatal enrolment yielded better child language (mean 90.1 [SD 9.37] vs 87.13 [SD 10.79], P=0.04) and motor outcomes (mean 99.62 [SD 9.45] vs 94.72 [SD 9.51], P=0 .001) than postnatal enrolment. Conclusion Psychosocial risks impact the development of children from low-income families in Singapore. Findings underscore the importance of early, integrated intervention for vulnerable families.
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Affiliation(s)
- Kevin Wei Hao Liang
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- KKH KIDS0-3, Division of Medicine, KK Women's and Children's Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Keith Wei Han Liang
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Qing Rong Chan
- KKH KIDS0-3, Division of Medicine, KK Women's and Children's Hospital, Singapore
| | - Winnie Hwee Suat Goh
- KKH KIDS0-3, Division of Medicine, KK Women's and Children's Hospital, Singapore
- Duke-NUS Medical School, Singapore
- Department of Child Development, KK Women's and Children's Hospital, Singapore
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2
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Huber LT, Molthen F, Cook G, Hughes-Belding K. Facilitating caregiver-child interactions in home visiting: A qualitative observational study. Infant Ment Health J 2023. [PMID: 37256727 DOI: 10.1002/imhj.22063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023]
Abstract
Facilitating parent-child interactions is a key component of evidence-based early childhood home visiting programs. Several observational measures have been created to effectively capture home visiting activities from an operationalized perspective. While the field has a reasonable understanding of what home visitors can do to facilitate developmentally supportive interactions, and why, the how remains elusive for many home visitors. This qualitative study used a modified grounded theory approach to examine the facilitation of caregiver-child interactions during home visits. Home visit video recordings previously coded using the Home Visit Rating Scale (HOVRS) A+ were selected based on facilitation quality. Sixteen home visits (8 lower- and 8 higher-quality facilitation scores) were examined for differences in home visitor behaviors that support parent-child interactions during visits. We identified contextual and specific behaviors that home visitors used to actively engage caregivers and children together in developmentally supportive interactions. Results revealed 11 home visitor behaviors that discriminated higher quality facilitation. These behaviors were categorized into four domains: environmental conditions, executing the activity, strengths-based focus, and caregiver responses. This qualitative study highlights specific behaviors and professional development areas to support more effective home visiting services for a diverse population of families with young children.
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Affiliation(s)
| | | | - Gina Cook
- California State University, Stanislaus, Turlock, California, USA
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3
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Burkhardt T, Huang LA, Herriott A, Pacheco-Applegate A, Spielberger J. Strengthening Home Visitor Practice Through an Embedded Model of Infant and Early Childhood Mental Health Consultation. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:105-114. [PMID: 36322271 DOI: 10.1007/s11121-022-01461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 01/29/2023]
Abstract
Home visitors face the difficult task of engaging and supporting families who experience economic, social, and mental health challenges. Infant and Early Childhood Mental Health Consultation (IECMHC) is one strategy to improve early childhood professionals' abilities to promote maternal and children's mental health through relationship building and collaboration. To date, most of the evidence showing positive effects of IECMHC comes from evaluations conducted in center-based early childhood programs. Only a few have examined the implementation and outcomes of IECMHC in home visiting programs. Using a longitudinal, matched-comparison group design, a three-year pilot study of a cross-system, embedded model of IECMHC assessed implementation and outcomes for teachers and home visitors. Here, we focus on intervention effects on home visitor-family relationships based on an analysis of 42 recordings of home visits. We used the Home Visit Rating Scales Adapted & Extended to Excellence (HOVRS-A+ v.2.1; Roggman et al., in 2010) and created another scale, the IECMHC scale, of items aligned with the expected outcomes of the model. Home visitors in the intervention group scored significantly higher on the HOVRS-A+ home visitor responsiveness to family scale over time than those in the comparison group. Additionally, scores of home visitors in the intervention group increased at a greater rate, on average, on the newly developed IECMHC scale than scores of home visitors in the comparison group. We conclude that the Illinois model of IECMHC successfully improved home visitors' responsiveness to families and improved the quality of home visits. Due to the small sample, we recommend further study of the model in home visiting and further development of the IECMHC scale as part of the HOVRS-A+ .
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Affiliation(s)
- Tiffany Burkhardt
- Chapin Hall at the University of Chicago, 1313 E. 60Th St, Chicago, IL, 60637, USA.
| | - Lee Ann Huang
- Chapin Hall at the University of Chicago, 1313 E. 60Th St, Chicago, IL, 60637, USA
| | - Anna Herriott
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, IL, USA
| | | | - Julie Spielberger
- Chapin Hall at the University of Chicago, 1313 E. 60Th St, Chicago, IL, 60637, USA
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4
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Walsh BA, Innocenti MS, Early S, Hughes-Belding K. Coaching home visitors: A thematic review with an emphasis on research and practice needs. Infant Ment Health J 2022; 43:959-974. [PMID: 36219872 DOI: 10.1002/imhj.22016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 08/03/2022] [Indexed: 11/07/2022]
Abstract
There is wide recognition in early childhood fields that coaching is important to a professional's development and growth in general, but little is known about coaching home visiting professionals in particular. An early childhood home visiting professional works with families to encourage positive parent-child interactions, family goal setting, and family well-being and health. Determining the essential components of coaching home visitors will help advance this field. Because coaching in the home visiting field is emergent, this article draws on literature from the early childhood field with an emphasis on applications for home visiting. We gleaned six themes that may represent common features of coaching. This article presents a compilation of common themes identified in literature reviews on coaching professionals across the early childhood field that warrant further development and evaluation by home visiting practitioners and researchers regardless of the home visiting model. The discussion concludes with recommendations to stimulate research and practice on coaching home visitors.
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Affiliation(s)
- Bridget A Walsh
- Human Development and Family Science, University of Nevada, Reno, Nevada, USA
| | - Mark S Innocenti
- Institute for Disability Research, Policy, and Practice, Utah State University, Logan, Utah, USA
| | | | - Kere Hughes-Belding
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
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5
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Walsh BA, Edwards AL, Cook GA, Hughes-Belding K, Rahn E. Exploring Changes in Home Visitors' Perspectives in the Context of a Professional Development Activity. EARLY CHILDHOOD EDUCATION JOURNAL 2021; 50:1143-1155. [PMID: 34404972 PMCID: PMC8360760 DOI: 10.1007/s10643-021-01249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED Research-based professional development opportunities for early childhood home visitors are valuable to the Early Head Start-Home-Based Option (EHS-HBO) and to the home visiting field broadly to strengthen effective practice. We explored EHS-HBO home visitors' (N = 5) perspectives on effective practice through a professional development activity that included viewing videos of their own practice, analyzing the video and assessment data of their practice and parent-child interactions, and reflection. A convergent mixed methods multiple-case study was used. A variety of skills were noted within each case as indicators of effective practice, suggesting that a plethora of complex skills are needed to work with families. Across-case analytic strategies were used to compare subthemes, codes, and substantial statements across cases to generate themes. Two major themes emerged from our data analysis across cases: practicing self-reflective consciousness and building foundations for parent-child interactions. The findings have implications for professional development activities. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10643-021-01249-3.
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Affiliation(s)
| | | | - Gina A. Cook
- California State University, Stanislaus, Turlock, USA
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6
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Peterson CA, Zhang D, Flittner A, Shelley MC, Doudna K, Cohen RC, Aaron L, Fan L. Estimating Home Visit Activities: How Much Observation is Enough? CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-021-09618-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rubio‐Codina M, Dormal M, Araujo MC. Observing home‐visiting quality at scale with the home visit rating scales and a supervisor checklist in Peru. Infant Ment Health J 2019; 40:343-362. [DOI: 10.1002/imhj.21775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Marta Rubio‐Codina
- Social Protection and Health DivisionInter‐American Development Bank Washington District of Columbia
| | - Marta Dormal
- Social Protection and Health DivisionInter‐American Development Bank Washington District of Columbia
| | - M. Caridad Araujo
- Social Protection and Health DivisionInter‐American Development Bank Washington District of Columbia
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8
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Manz PH, Ventresco NE. Observing home‐visiting quality across time: A longitudinal reliability study of the Home Visit Rating Scales. Infant Ment Health J 2019; 40:363-379. [DOI: 10.1002/imhj.21780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Harden BJ. A step forward to quality: The home visit rating scales and the measurement of process quality in home-visiting programs. Infant Ment Health J 2019; 40:401-404. [PMID: 30969441 DOI: 10.1002/imhj.21782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Brenda Jones Harden
- Department of Human Devleopment, University of Maryland, College Park, Maryland
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10
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Hughes‐Belding K, Peterson CA, Clucas Walter M, Rowe N, Fan L, Dooley LJ, Steffensmeier C, Wang W, Bao J, Goodman K. Quality home visits: Activities to promote meaningful interactions. Infant Ment Health J 2019; 40:331-342. [DOI: 10.1002/imhj.21779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kere Hughes‐Belding
- Department of Human Development and Family StudiesIowa State University Ames Iowa
| | - Carla A. Peterson
- Department of Human Development and Family StudiesIowa State University Ames Iowa
| | - Melissa Clucas Walter
- Human Development and Family SciencesCollege of Health and Human SciencesNorthern Illinois University DeKalb Illinois
| | - Neil Rowe
- Center for Public Partnerships and ResearchUniversity of Kansas Lawrence Kansas
| | - Liuran Fan
- School of Educational ScienceYangzhou University Yangzhou China
| | - Leslie J. Dooley
- Department of Human Development and Family StudiesIowa State University Ames Iowa
| | - Chloe Steffensmeier
- Department of Human Development and Family StudiesIowa State University Ames Iowa
| | - Wen Wang
- Department of Human Development and Family StudiesIowa State University Ames Iowa
| | - Juan Bao
- Department of Human Development and Family StudiesIowa State University Ames Iowa
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11
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Korfmacher J, Frese M, Gowani S. Examining program quality in early childhood home visiting: From infrastructure to relationships. Infant Ment Health J 2019; 40:380-394. [PMID: 30925209 DOI: 10.1002/imhj.21773] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although there are many examples of evidence-based early childhood home-visiting programming, the field itself struggles with modest outcomes and variable levels of program effectiveness. This article documents the experience of creating a statewide monitoring system to assess home-visiting program quality and compliance to identified standards, integrating multiple sources of information across different domains of functioning. Monitoring results from 57 programs are summarized, with variable but promising levels of quality. Programs generally report satisfaction and benefit from the process. In addition, the relationship between direct observations of home visits and home-visitor report of their approach to working with families is analyzed. Results suggest significant, albeit small, associations. Although there are trade-offs between comprehensiveness of information gathering and practical application, the use of monitoring findings to support home-visiting programs holds potential for quality improvement.
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12
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Green BL. Understanding quality in home visiting-How Far Have We Come and Where Do We Need to Go? Infant Ment Health J 2019; 40:395-400. [PMID: 30921493 DOI: 10.1002/imhj.21778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Beth L Green
- Center for Improvement of Child and Family Services, Portland State University, Portland, Oregon
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13
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Peterson CA, Roggman LA. Observing home-visit quality with the home visit rating scales: Introduction to the special section. Infant Ment Health J 2019; 40:309-314. [PMID: 30893486 DOI: 10.1002/imhj.21777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Evidence-based home-visiting programs aim to address one of the most important challenges facing our species-setting the next generation on a healthy path of development that prepares them for a future that is simultaneously uncertain and promising. Diverse research literatures have pointed to practices to effectively meet this challenge and better achieve the unfulfilled promise of home visiting by more effectively engaging parents in supporting their children's early development and well-being. Measures of home-visit quality practices drawn from social work, pediatric nursing, early childhood, and early intervention research literatures have identified building relationships with families and focusing on their strengths as effective, practices that are particularly important for vulnerable families. The articles in this special section used the Home Visit Rating Scales to examine stability in home-visit quality over time, study specific home-visiting processes linked with quality, validate a supervisor checklist of home-visiting implementation, and consider the home visit in relation to an array of indicators reflecting overall home-visiting program strength and stability. These articles exemplify progress in home-visiting research over recent decades, including advances in direct observational methods and measurement as well as examinations of home visiting as an observable process across various home-visiting program models and populations.
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Affiliation(s)
- Carla A Peterson
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa
| | - Lori A Roggman
- Department of Family, Consumer and Human Development, Family Life 129, Utah State University, Logan, Utah
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