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Moon DJ, Nichols CB, Zhang Y, Cruce A, Haran H, Sgourakis A, Lee H, Johnson-Motoyama M. Engagement Measures in Maltreatment Prevention Studies: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1551-1567. [PMID: 37626470 DOI: 10.1177/15248380231188070] [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: 08/27/2023]
Abstract
Prevention services can promote public health by building protective factors and reducing maltreatment risk. Yet, engaging caregivers in prevention services presents a unique set of challenges. Measurement studies are important first steps to increase the knowledge of caregiver engagement in prevention services. The purpose of this scoping review was to investigate how family engagement has been measured and operationalized in the studies of maltreatment prevention/positive parenting programs. The review examined quantitative and mixed methods studies conducted in the U.S., which measured multiple dimensions of client engagement, including behavioral, attitudinal, and relational domains. A total of 88 studies selected from PubMed, CINAHL, ERIC, PsycINFO, Social Work Abstracts, Academic Search Premier, and Web of Science were included in this review. Results indicated that studies examine engagement constructs in all three domains of engagement with a primary focus on behavioral engagement. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys, and a limited number of studies utilized validated measures to assess those constructs. While most studies reported acceptable internal reliabilities, only two studies reported other dimensions of psychometric qualities. Only one validated measure was found, which assessed client perceptions of provider cultural competence. More measurement studies are needed to further incorporate multiple dimensions of engagement into the studies of maltreatment prevention programs, which can inform the effort to develop tailored implementation strategies to fully engage various groups of parents in maltreatment prevention programs.
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Jungmann SM, Grebinyk G, Witthöft M. Parents' views of psychological research with children: Barriers, benefits, personality, and psychopathology. PLoS One 2023; 18:e0287339. [PMID: 37352182 PMCID: PMC10289465 DOI: 10.1371/journal.pone.0287339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/04/2023] [Indexed: 06/25/2023] Open
Abstract
Psychological studies with children have difficulty recruiting participants and samples are more often selective. Given parental consent for children's participation, this study examined parents' perceived barriers and benefits of participating in studies and associated parental personality and psychopathological characteristics. Since there are hardly any instruments available so far, the study also aimed to develop questionnaires for the systematic and standardized assessment of barriers and benefits. One hundred and nine parents with children < 18 years completed questionnaires on willingness to participate, perceived barriers (Parents' Barriers for Participating in Research Questionnaire, P-BARQ) and benefits (Parents' Benefits for Participating in Research Questionnaire, P-BERQ), personality traits, trait anxiety, and psychopathological characteristics. The P-BARQ and P-BERQ showed overall acceptable model fits (TLI/CFI = .90-.94; RMSEA = .08/.14) and internal consistencies (α = .68-.86). Parents' willingness to own participation in psychological studies and their support for children's participation correlated negatively with perceived barriers to participation (r ≥ ǀ-.32ǀ, p < .001). Parental personality traits (such as agreeableness/openness) showed positive associations with one's own participation (r ≥ .19, p < .005) and negative correlations with perceived barriers to participation (r ≥ ǀ-.24ǀ, p < .001), while parental psychopathological characteristics are more closely related to consent to children's participation (r = .24, p < .05). Parental trait anxiety showed both a positive correlation with perceived barriers (uncertainty) and benefits (diagnostics/help) (r ≥ .20, p < .05). For the willingness to participate in studies, barriers seem to play a more crucial role than the benefits of participation. If more information is given about psychological studies, uncertainties and prejudices can be reduced.
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Affiliation(s)
- Stefanie M. Jungmann
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Galyna Grebinyk
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
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Self-Brown S, Perry EW, Recinos M, Cotner MA, Guastaferro K, Owolabi S, Spears CA, Whitaker DJ, Huang J, Kegler MC. Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure: findings from a pilot study. Pilot Feasibility Stud 2023; 9:81. [PMID: 37173799 PMCID: PMC10175921 DOI: 10.1186/s40814-023-01303-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Exposure to secondhand tobacco smoke (SHS) and child maltreatment are preventable threats to child health. Few evidence-based interventions target both SHS and child maltreatment risk. The purpose of this paper is to describe the systematic braiding process of two evidence-based programs to address child SHS in the home and maltreatment perpetration risk, and present results from the formative work and pilot study. METHODS The first 4 steps of the systematic braiding process were completed, including the following: (1) the identification of core elements of both programs, (2) the development of an initial draft of the braided curriculum (Smoke-Free Home SafeCare - SFH-SC), (3) an acceptability and feasibility pilot of SFH-SC with caregivers of young children who reported a smoker living in the home (N = 8), and (4) feedback collection on the braided curriculum from SafeCare Providers (N = 9). RESULTS Experts identified common pedagogical and theoretical underpinnings for the two programs and braided Smoke-Free Homes: Some Things Are Better Outside into two SafeCare modules. Caregiver feedback from the pilot demonstrated that participants were engaged with SFH-SC and felt supported and comfortable discussing SHS intervention content with the SFH-SC Provider. Caregiver self-reports indicated a slight increase in smoke-free home rules from baseline to follow-up and a notable reduction in parent stress on the Parent Stress Index of 5.9 points (SD = 10.2). SafeCare Provider feedback following intensive review of the curriculum indicated high feasibility for SFH-SC delivery. CONCLUSIONS Parent and Provider findings suggest SFH-SC is a viable intervention that has potential to reduce the public health impact of SHS and child maltreatment for at-risk families. PROTOCOL The protocol for the pilot is not published elsewhere; however, the full protocol for the hybrid trial can be found here: https://clinicaltrials.gov/ct2/show/NCT05000632 . TRIAL REGISTRATION NCT, NCT05000632. Registered 14 July 2021, there is not a separate registration number for the pilot.
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Affiliation(s)
- Shannon Self-Brown
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA.
| | - Elizabeth W Perry
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA
| | - Manderley Recinos
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA
| | - Michaela A Cotner
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA
| | - Kate Guastaferro
- New York University - School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
| | - Shadé Owolabi
- Emory University - Rollins School of Public Health, 1518 Clifton Rd., Atlanta, GA, 30322, USA
| | - Claire A Spears
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA
| | - Daniel J Whitaker
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA
| | - Jidong Huang
- Georgia State University - School of Public Health, 140 Decatur St. SE, Atlanta, GA, 30303, USA
| | - Michelle C Kegler
- Emory University - Rollins School of Public Health, 1518 Clifton Rd., Atlanta, GA, 30322, USA
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Damashek A, Berman A, Belachew B, Kothari C. Pilot test of a measure to assess clients' perceptions of their home visitors. Infant Ment Health J 2023; 44:117-124. [PMID: 36524446 PMCID: PMC10107848 DOI: 10.1002/imhj.22028] [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: 08/04/2021] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
Home visiting services for caregivers of infants and young children have been found to be an effective method for promoting child development. Unfortunately, such services suffer from high rates of attrition, suggesting the need to identify factors related to client retention in services. Research has indicated that the client-provider relationship is an important predictor of client retention in home visiting services; however, measures to assess this relationship are limited. This study reports on a pilot test of the Client Perceptions of Home Visitors Questionnaire, developed to assess home visiting clients' perceptions of their relationship with their home visitor. The measure was completed by 39 diverse home visiting clients during pregnancy in a midwestern town in the United States. The scale was found to have good internal consistency. Validity analyses found that the scale was positively associated with client satisfaction with services and perceived provider cultural sensitivity. The scale was also positively associated with retention in services at an 8-month follow-up. Additional research should examine the measure's psychometrics with larger samples.
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Affiliation(s)
- Amy Damashek
- Western Michigan University, Kalamazoo, Michigan, USA
| | - Ariel Berman
- Western Michigan University, Kalamazoo, Michigan, USA
| | | | - Catherine Kothari
- Western Michigan University School of Medicine, Kalamazoo, Michigan, USA
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Peacock-Chambers E, Buckley D, Lowell A, Clark MC, Friedmann PD, Byatt N, Feinberg E. Relationship-Based Home Visiting Services for Families Affected by Substance Use Disorders: A Qualitative Study. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:2121-2133. [PMID: 36909674 PMCID: PMC9997720 DOI: 10.1007/s10826-022-02313-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 06/18/2023]
Abstract
Home visiting programs face many challenges when providing evidence-based services to families affected by substance use disorders (SUDs). We conducted interviews and focus groups with community stakeholders and parents to elucidate important considerations when intentionally attempting to meet the needs of families affected by SUDs through home visiting programs. We identified one primary theme "Who is the client?" that describes how to ensure caregivers perceive themselves as an important focus of the program. Collectively, participants revealed that understanding caregivers' emotional experiences was critical for effectively transforming their subjective experiences of the program. These emotional experiences were related to the quality of their relationships with their children, other family members, and service providers. Three sub-themes illustrate specific examples: 1) responding to the unique emotional needs of mothers in recovery, 2) considering emotional states to inform inclusion in programs, and 3) addressing complex family dynamics related to SUDs in the home. Implications of these findings are discussed.
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Affiliation(s)
- Elizabeth Peacock-Chambers
- Department of Pediatrics, UMass Chan Medical School-Baystate, Springfield, MA, USA
- Department for Healthcare Delivery and Population Science, 3601 Main Street, Third Floor, Springfield, MA 01199, USA
| | - Deirdre Buckley
- UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Amanda Lowell
- Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | - Maria Carolina Clark
- Department of Pediatrics, UMass Chan Medical School-Baystate, Springfield, MA, USA
- Department for Healthcare Delivery and Population Science, 3601 Main Street, Third Floor, Springfield, MA 01199, USA
| | - Peter D. Friedmann
- Department of Medicine, UMass Chan Medical School-Baystate, 3601 Main Street, Third Floor, Springfield, MA 01199, USA
| | - Nancy Byatt
- Department of Psychiatry, UMass Chan Medical School, 222 Maple Ave – Chang Building, Shrewsbury, MA 01655, USA
| | - Emily Feinberg
- Department of Pediatrics, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
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Gonzalez C, Morawska A, Haslam DM. The Impact of Message Content and Format on Initial Parental Engagement in a Parenting Intervention: An Experimental Study. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Background
Engagement strategies are commonly used to enhance parents’ involvement in parenting interventions. However, few strategies have been evaluated to determine their effectiveness at increasing initial engagement. This study tested the effectiveness of message content (benefits vs. costs) and format (video vs. written) of engagement strategies on the initial engagement (i.e., recruitment, enrolment, and first attendance) of parents to parenting interventions.
Methods
Participants were 692 parents of children aged 2 to 12 years old. Parents were randomly allocated to one of four experimental conditions, which tested the combination of message (benefits vs. costs) and format (video vs. written). Recruitment, enrolment, and first attendance were measured as part of parent’s initial engagement to a self-directed parenting intervention.
Results
Neither message content nor format had an effect on recruitment, enrolment, or first attendance. However, parents who saw the costs content were significantly more likely to review the intervention workbook compared to parents who saw the message about the benefits of the intervention.
Conclusions
Brief testimonials have the potential to early engage parents when the message is positive, independently of its format. Future research should further explore the effects of different messages as well as other engagement strategies used to engage parents.
Trial Registration
Australian New Zealand Clinical Trials Registry ACTRN12618001282279, prospectively registered 30/07/2018.
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Nakanishi M, Yamasaki S, Niimura J, Endo K, Nakajima N, Stanyon D, Baba K, Oikawa N, Hosozawa M, Ando S, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Association between maternal perceived capacity in life and physical punishment of teenage children: a longitudinal analysis of a population-based cohort in Tokyo, Japan. BMJ Open 2022; 12:e058862. [PMID: 35301214 PMCID: PMC8932275 DOI: 10.1136/bmjopen-2021-058862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Perceived capacity denotes a subjective sense of having resources to cope with strains and hardships, and hence maternal perceived capacity may be protective against risk factors for child maltreatment. This study investigated the longitudinal association between maternal perceived capacity in life and child maltreatment. DESIGN This population-based longitudinal study used self-reported questionnaires from the Tokyo Teen Cohort study (TTC), a large community-based cohort study conducted in Japan between 2014 and 2019. SETTING Mother-child pairs were randomly recruited from the resident registries of three municipalities in Tokyo, Japan. METHODS A total of 2515 mothers participated. Mothers' perceived capacity in life was evaluated using the self-reported TTC wave 2 survey when their children were 12 years old. Mothers rated the extent to which they had capacity in terms of time, finance, physical well-being, mental well-being and life in general. Physical punishment, which is linked to more severe childhood maltreatment, was assessed using a question about the use of physical punishment at the wave 3 survey when children were 14 years old. RESULTS After controlling for baseline covariates (including maternal social support, age, marital status, annual household income, educational attainment, child's age, gender, sibling and birth order, and behavioural difficulties), higher perceived capacity in finance (OR 0.95, 95% CI 0.90 to 0.99, p=0.026) and mental well-being (OR 0.93, 95% CI 0.88 to 0.98, p=0.005) were associated with less frequent use of physical punishment with 14-year-old children. CONCLUSIONS Maternal perceived capacity in finance and mental well-being may decrease the risk of frequent use of physical punishment at the 2-year follow-up. Child maltreatment prevention strategies should aim to empower mothers and promote their perceived capacity in financial management and mental health.
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Affiliation(s)
- Miharu Nakanishi
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Junko Niimura
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Kaori Endo
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Naomi Nakajima
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Daniel Stanyon
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Kaori Baba
- Graduate School of Nursing, St Luke's International University, Tokyo, Japan
| | - Nao Oikawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Shinjuku-ku, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (The Graduate University for Advanced Studies), Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
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Kanda K, Blythe S, Grace R, Kemp L. Parent satisfaction with sustained home visiting care for mothers and children: an integrative review. BMC Health Serv Res 2022; 22:295. [PMID: 35241062 PMCID: PMC8895511 DOI: 10.1186/s12913-022-07666-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children. BACKGROUND Sustained home visiting is a service delivery mechanism of both prevention and intervention, in which people receive structured support services within their home environment over an extended period of months or years. For the purposes of this paper, sustained home visiting refers to in-home nursing support to address health inequities for mothers and young children. Sustained home visiting programs have been found to support improved health, wellbeing, and developmental outcomes for children and families. However, there is limited knowledge with regards to the level of parent satisfaction with care provided at home, and the factors and elements of care parents perceive to be critical to their satisfaction. It is important for healthcare practitioners to understand what practices and process parents consider to be a priority in securing their ongoing engagement. DESIGN Integrative review. DATA SOURCES PubMed/Medline, CINAHL, Embase, and PsycINFO. METHODS A multi-step approach was used to search and retrieve peer-reviewed studies from the databases. Study selection, data extraction, data synthesis and critical appraisal were undertaken by two independent researchers. RESULTS A total of 13 studies met the inclusion criteria, including nine quantitative and four qualitative studies. The review found that parents provided with home visiting interventions had higher levels of satisfaction with care than those who received routine or facility-based care. Service dose was a factor associated with parent satisfaction, however, the direction of impact on parent satisfaction was mixed. Other elements of care parents perceived as important to service satisfaction included the nurse-client relationship, being treated with respect, empowerment, and emotional support. CONCLUSION While it is critically important that home visiting practitioners provide evidence-based care and interventions, it is equally important that services are delivered in the context of positive and empowering relationships. Further research is recommended to understand the care process and mechanisms that enhance parent satisfaction and positive experiences, providing optimal quality of care.
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Affiliation(s)
- Kie Kanda
- School of Nursing and Midwifery, Translational Research and Social Innovation Group, Western Sydney University, Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia.
| | - Stacy Blythe
- School of Nursing and Midwifery, Translational Research and Social Innovation Group, Western Sydney University, Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia
| | - Rebekah Grace
- Transforming Early Education and Child Health, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Lynn Kemp
- School of Nursing and Midwifery, Translational Research and Social Innovation Group, Western Sydney University, Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia
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Taylor EK, Dopp AR, Lounsbury K, Thompson Y, Miller M, Jorgensen A, Silovsky JF. Enhancing Early Engagement (E3) in mental health services training for children's advocacy center's victim advocates: feasibility protocol for a randomized controlled trial. Pilot Feasibility Stud 2021; 7:212. [PMID: 34872619 PMCID: PMC8645678 DOI: 10.1186/s40814-021-00949-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative. Methods The feasibility study protocol is to develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training embeds key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs were randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program and differential impact and costs by level of training will be examined. Discussion The overarching goal of this project is to test the feasibility of training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child, and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods hybrid type II effectiveness-implementation and cost-effectiveness trial of family navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols. Trial registration NCT04221633 Date and version identifier March 25, 2021; Vers. 1.0 (original); September 11, 2021; Vers 2.0 (revision); October 29, 2021; Vers. 3.0 (revision)
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Affiliation(s)
- Erin K Taylor
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th St #4900, Oklahoma City, OK, 73104, USA.
| | - Alex R Dopp
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA
| | - Kaitlin Lounsbury
- National Children's Alliance, 516 C St NE #100, Washington, DC, 20002, USA
| | - Yutian Thompson
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th St #4900, Oklahoma City, OK, 73104, USA
| | - Michelle Miller
- National Children's Alliance, 516 C St NE #100, Washington, DC, 20002, USA
| | - Ashley Jorgensen
- HumRRO, 700 North Hurstbourne Parkway, Suite 100, Louisville, KY, 40222, USA
| | - Jane F Silovsky
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th St #4900, Oklahoma City, OK, 73104, USA
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Guastaferro K, Strayhorn JC, Collins LM. The multiphase optimization strategy (MOST) in child maltreatment prevention research. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:2481-2491. [PMID: 34887652 PMCID: PMC8654128 DOI: 10.1007/s10826-021-02062-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 05/27/2023]
Abstract
Each year hundreds of thousands of children and families receive behavioral interventions designed to prevent child maltreatment; yet rates of maltreatment have not declined in over a decade. To reduce the prevalence and prevent the life-long negative consequences of child maltreatment, behavioral interventions must not only be effective, but also affordable, scalable, and efficient to meet the demand for these services. An innovative approach to intervention science is needed. The purpose of this article is to introduce the multiphase optimization strategy (MOST) to the field of child maltreatment prevention. MOST is an engineering-inspired framework for developing, optimizing, and evaluating multicomponent behavioral interventions. MOST enables intervention scientists to empirically examine the performance of each intervention component, independently and in combination. Using a hypothetical example of a home visiting intervention and artificial data, this article demonstrates how MOST may be used to optimize the content of a parent-focused in-home intervention and the engagement strategies of an intervention to increase completion rate to identify an intervention that is effective, efficient, economical, and scalable. We suggest that MOST will ultimately improve prevention science and hasten the progress of translational science to prevent child maltreatment.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Jillian C. Strayhorn
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Linda M. Collins
- Departments of Social & Behavioral Sciences and Biostatistics, School of Global Public Health, New York University
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11
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Garstang J, Watson D, Pease A, Ellis C, Blair PS, Fleming P. Improving engagement with services to prevent Sudden Unexpected Death in Infancy (SUDI) in families with children at risk of significant harm: A systematic review of evidence. Child Care Health Dev 2021; 47:713-731. [PMID: 33929753 DOI: 10.1111/cch.12875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/25/2021] [Indexed: 11/29/2022]
Abstract
This paper reports part of a wider systematic review commissioned by the English National Safeguarding Panel on Sudden Unexpected Death in Infancy (SUDI). The wider review covered three areas: interventions to improve safer sleep practices in high-risk families, interventions to improve engagement with services and decision making by parents at high risk of SUDI about infant sleep environments. Here, we report the qualitative and quantitative studies reviewed under the engagement strand. Parental engagement is understood to be a multidimensional task for health and social care professionals comprising attitudinal, relational and behavioural components. Following a PROSPERO registered systematic review synthesizing the three strands outlined, 28 papers were found to be relevant in the review of interventions to improve engagement with services in families with children at risk of significant harm through abuse or neglect. No studies were found that specifically focused on engagement of families at high risk for SUDI, so these wider engagement studies were included. The different types of intervention reported in the included studies are described under two broad themes: Enablers (including parental motivation and working with families) and Barriers. Given the focus in the studies on interventions that support parental engagement, the Enablers theme is more extensive than the Barriers reported although all studies noted well-understood barriers. The evidence underpinning these interventions and approaches are reviewed in this paper. We conclude that effective engagement is facilitated by experienced professionals given time to develop supportive non-judgemental relationships with families in their homes, working long-term, linking with communities and other services. While these conclusions have been drawn from wider studies aimed at reducing child maltreatment, we emphasize lessons to be drawn for SUDI prevention work with families with children at risk of significant harm.
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Affiliation(s)
- Joanna Garstang
- Birmingham Community Healthcare NHS Trust and Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Debbie Watson
- Children and Families Research Centre, School for Policy Studies, University of Bristol, Bristol, UK
| | - Anna Pease
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Catherine Ellis
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Peter S Blair
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Peter Fleming
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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Villodas MT, Moses JO, Cromer KD, Mendez L, Magariño LS, Villodas FM, Bagner DM. Feasibility and promise of community providers implementing home-based parent-child interaction therapy for families investigated for child abuse: A pilot randomized controlled trial. CHILD ABUSE & NEGLECT 2021; 117:105063. [PMID: 33930663 DOI: 10.1016/j.chiabu.2021.105063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/22/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite evidence supporting Parent-Child Interaction Therapy's (PCIT) effectiveness for maltreatment prevention, its integration in child welfare services (CWS) has been challenging. OBJECTIVE Using a pilot randomized controlled trial design, we evaluated the (1) feasibility of training therapists from CWS providers to implement home-based PCIT (2) feasibility of retaining parent-child dyads at-risk for child abuse in voluntary PCIT services, and (3) promise of PCIT for improving parenting skills. PARTICIPANTS AND SETTING Between 2015-2017, 23 therapists from CWS providers and 55 caregiver-child dyads who were determined to be at moderate-to-high risk for physical and/or emotional abuse, remained in the same home, and were referred for voluntary parenting services following a child protective investigation participated. METHODS We trained 14 therapists in home-based PCIT and randomly assigned participating dyads to receive PCIT or services as usual (SAU). Dyads completed baseline and post-treatment assessments, including self-reported and observed parenting skills. RESULTS All therapists successfully completed the PCIT training; none completed full certification requirements. Of all randomized dyads, 51 % completed at least one treatment session, and the mean number of treatment sessions was 10.83. Caregivers assigned to PCIT used more self-reported (d = .72) and observed (d = .59) positive parenting skills post-treatment than caregivers assigned to SAU. Negative, inconsistent, and punitive parenting strategies and parenting stress did not significantly differ between caregivers assigned to PCIT and SAU. CONCLUSIONS Despite several challenges to feasibly implementing PCIT in community-based child welfare settings, even a small dose of PCIT improved positive parenting skills among at-risk parent-child dyads.
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Affiliation(s)
- Miguel T Villodas
- Department of Psychology, San Diego State University, United States; Department of Psychology, Florida International University, United States; Department of Psychology, University of Utah, United States.
| | - Jacqueline O Moses
- Department of Psychology, Florida International University, United States
| | - Kelly D Cromer
- Department of Psychology, Florida International University, United States
| | - Lucybel Mendez
- Center for Children and Families, Florida International University, United States
| | - Loreen S Magariño
- Department of Psychology, Florida International University, United States
| | - Feion M Villodas
- Department of Psychology, San Diego State University, United States; Department of Psychology, Florida International University, United States; Department of Psychology, University of Utah, United States
| | - Daniel M Bagner
- Department of Psychology, Florida International University, United States; Department of Psychology, University of Utah, United States
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Whitaker DJ, Self-Brown S, Weeks EA, O'Connor MH, Lyons M, Willging C, Lee NH, Kumar JL, Joseph H, Reidy DE, Rivers D, Rao N. Adaptation and implementation of a parenting curriculum in a refugee/immigrant community using a task-shifting approach: a study protocol. BMC Public Health 2021; 21:1084. [PMID: 34090408 PMCID: PMC8180157 DOI: 10.1186/s12889-021-11148-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Delivering evidence-based interventions to refugee and immigrant families is difficult for several reasons, including language and cultural issues, and access and trust issues that can lead to an unwillingness to engage with the typical intervention delivery systems. Adapting both the intervention and the delivery system for evidence-based interventions can make those interventions more appropriate and palatable for the targeted population, increasing uptake and effectiveness. This study focuses on the adaptation of the SafeCare© parenting model, and its delivery through either standard implementation methods via community-based organizations (CBO) and a task-shifted implementation in which members of the Afghans, Burmese, Congolese community will be trained to deliver SafeCare. METHOD An adaptation team consisting of community members, members of CBO, and SafeCare experts will engage a structured process to adapt the SafeCare curriculum for each targeted community. Adaptations will focus on both the model and the delivery of it. Data collection of the adaptation process will focus on documenting adaptations and team member's engagement and satisfaction with the process. SafeCare will be implemented in each community in two ways: standard implementation and task-shifted implementation. Standard implementation will be delivered by CBOs (n = 120), and task-shifted implementation will be delivered by community members (n = 120). All interventionists will be trained in a standard format, and will receive post-training support. Both implementation metrics and family outcomes will be assessed. Implementation metrics will include ongoing adaptations, delivery of services, fidelity, skill uptake by families, engagement/completion, and satisfaction with services. Family outcomes will include assessments at three time points (pre, post, and 6 months) of positive parenting, parent-child relationship, parenting stress, and child behavioral health. DISCUSSION The need for adapting of evidence-based programs and delivery methods for specific populations continues to be an important research question in implementation science. The goal of this study is to better understand an adaptation process and delivery method for three unique populations. We hope the study will inform other efforts to deliver health intervention to refugee communities and ultimately improve refugee health.
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Beasley LO, King C, Esparza I, Harnden A, Robinson LR, So M, Morris A, Silovsky JF. Understanding Initial and Sustained Engagement of Spanish-Speaking Latina Mothers in the Legacy for Children Program™: A Qualitative Examination of a Group-Based Parenting Program. EARLY CHILDHOOD RESEARCH QUARTERLY 2021; 54:99-109. [PMID: 34737489 PMCID: PMC8563015 DOI: 10.1016/j.ecresq.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Culturally congruent parenting programs delivered during early childhood have the potential to support diverse families. Legacy for Children™ (Legacy) is a group-based prevention program designed to promote child development by reinforcing sensitive, responsive mother-child relationships, building maternal self-efficacy, and fostering peer networks of support among mothers living in poverty (Perou et al., 2012). The Legacy program was translated and culturally adapted for Spanish-speaking Latina mothers and their infants (hereafter referred to as Latina mothers) with a feasibility trial conducted to determine the cultural congruency of the adaptation. Feasibility results were positive with no previous studies validating the adapted Legacy Spanish language program (Legacy Spanish). The current manuscript focuses on understanding factors of engagement of the culturally adapted model. Specifically, we examined the factors that were perceived to have enhanced or hindered both initial and sustained engagement in the adapted Legacy Spanish program for Latina mothers. Individual interviews were conducted with Latina mothers (N=26) who attended the Legacy Spanish program. We used a template approach within NVivo 11© software to identify broad themes in Latina mothers' responses. Themes emerged regarding the importance of using home-based recruitment strategies and pairing verbal information with written brochures to foster initial engagement. Sustained engagement themes focused on the provision of support from other Latina mothers in the Legacy group and the relationships with the group leaders. Having group leaders who were perceived as genuine, kind, positive, "good" at teaching, and persistent emerged as themes that facilitated initial and ongoing engagement. Barriers to engagement centered primarily on logistics rather than characteristics of the program itself. Thus, Latina mothers attributed importance to aspects of the curriculum, logistics, and implementation with respect to program engagement. Application of similar engagement strategies could enhance the success of early childhood parenting programs and linkages with early educational programming.
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Affiliation(s)
- Lana O Beasley
- Oklahoma State University, 340 Human Sciences, Stillwater, OK 74078
- University of Oklahoma Health Sciences Center, 1100 NE 13 St., Oklahoma City, OK 73117
| | - Corie King
- University of Oklahoma Health Sciences Center, 1100 NE 13 St., Oklahoma City, OK 73117
| | - Irma Esparza
- University of Oklahoma Health Sciences Center, 1100 NE 13 St., Oklahoma City, OK 73117
| | - Angela Harnden
- University of Oklahoma Health Sciences Center, 1100 NE 13 St., Oklahoma City, OK 73117
| | - Lara R Robinson
- Child Development Studies Team, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341
| | - Marvin So
- Child Development Studies Team, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341
| | - Amanda Morris
- Oklahoma State University, 340 Human Sciences, Stillwater, OK 74078
| | - Jane F Silovsky
- University of Oklahoma Health Sciences Center, 1100 NE 13 St., Oklahoma City, OK 73117
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Parent Involvement in Maternal, Infant, and Early Childhood Home Visiting Programs: an Integrative Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:728-747. [PMID: 32436153 DOI: 10.1007/s11121-020-01129-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite the evidence and investment in evidence-based federally funded maternal, infant, and early childhood home visiting, substantial challenges persist with parent involvement: enrolling, engaging, and retaining participants. We present an integrative review and synthesis of recent evidence regarding the influence of multi-level factors on parent involvement in evidence-based home visiting programs. We conducted a search for original research studies published from January 2007 to March 2018 using PubMed, Embase, Cochrane, and CINAHL databases. Twenty-two studies met criteria for inclusion. Parent and family characteristics were the most commonly studied influencing factor; however, consistent evidence for its role in involvement was scarce. Attributes of the home visitor and quality of the relationship between home visitor and participant were found to promote parent involvement. Staff turnover was found to be a barrier to parent involvement. A limited number of influencing factors have been adequately investigated, and those that have reveal inconsistent findings regarding factors that promote parent involvement in home visiting. Future research should move beyond the study of parent- and family-level characteristics and focus on program- and home visitor-level characteristics which, although still limited, have demonstrated some consistent association with parent involvement. Neighborhood characteristics have not been well studied and warrant future research.
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Wolfe Turner M, Cabello-De la Garza A, Kazouh A, Zolotor AJ, Klika JB, Wolfe C, Lanier P. Intention to Engage in Maternal and Child Health Home Visiting. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:197-212. [PMID: 32431243 DOI: 10.1080/19371918.2020.1767751] [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: 06/11/2023]
Abstract
Home visiting (HV) programs have the potential to improve maternal and child health. As federal and state initiatives expand the reach of these programs, understanding what factors enhance uptake and retention of the services becomes increasingly important. This qualitative study used a Reasoned Action Model (RAM) and a cultural lens to explore factors influencing the engagement of women with low-income in HV programs. We conducted 21 semi-structured interviews in both English and Spanish in a prenatal clinic in an urban public health department. The constructs most salient for participants were emotions and affect, behavioral beliefs, and self-efficacy. In the context of an urban public health prenatal clinic, HV marketing and outreach should highlight convenience and social support, as well as clearly communicate program content and intent. In practice, HV programs must be flexible to work around work and home schedules; marketing and outreach should emphasize that flexibility.
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Affiliation(s)
| | - Ana Cabello-De la Garza
- University of North Carolina Health Sciences at Mountain Area Health Education Center , Asheville, NC, USA
| | - Ashley Kazouh
- University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Adam J Zolotor
- University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - J Bart Klika
- Prevent Child Abuse America , Chicago, Illinois, USA
| | - Cindy Wolfe
- Wake County Human Services , Raleigh, North Carolina, USA
| | - Paul Lanier
- University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
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Ilori TO, Viera E, Wilson J, Moreno F, Menon U, Ehiri J, Peterson R, Vemulapalli T, StimsonRiahi SC, Rosales C, Calhoun E, Sokan A, Karnes JH, Reiman E, Ojo A, Theodorou A, Ojo T. Approach to High Volume Enrollment in Clinical Research: Experiences from an All of Us Research Program Site. Clin Transl Sci 2020; 13:685-692. [PMID: 32004412 PMCID: PMC7359931 DOI: 10.1111/cts.12759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/20/2020] [Indexed: 11/29/2022] Open
Abstract
Clinical trials and cohort studies are required to meet target recruitment of study participants within stipulated timelines, especially when the priority is to include populations traditionally unrepresented in biomedical research. By the third quarter of 2019, the University of Arizona‐Banner Health Provider Organization (UA‐Banner HPO) has enrolled > 30,000 core participants into the All of Us Research Program (AoURP), the research cohort of the Precision Medicine Initiative. The majority of enrolled participants meet the criteria for individuals under‐represented in biomedical research. The enrollment goals were calculated based on a target of 20,000 as set by the National Institutes of Health and our health provider organization achieved enrollment numbers between 17% and 86% above the targeted daily enrollment. We evaluated enrollment methods and challenges to enrollments encountered by the UA‐Banner Health Provider Organization into the AoURP. Challenges to enrollment centered around the need for high‐touch engagement methods, time investment necessary for stakeholder inclusion, and the use of purely digital enrollment methods especially in populations under‐represented in biomedical research. These challenges occurred at the level of the individual, provider, institutions, and community, and cumulatively impacted participant enrollment. Successful strategies for engagement and enrollment leveraged provider partners as advocates for the program. For high‐volume enrollment in clinical research, it is important to engage leaders in the healthcare setting, patient providers, and tailor engagement and enrollment to potential participant needs. We emphasize the need for precision engagement and enrollment methods tailored to individual needs.
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Affiliation(s)
- Titilayo O Ilori
- Renal Section, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Emma Viera
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jillian Wilson
- Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA
| | - Francisco Moreno
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Usha Menon
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | | | - Tejo Vemulapalli
- Department of Medicine, College of Medicine Tucson, University of Arizona, Tucson, Arizona, USA
| | - Sara C StimsonRiahi
- Department of Medicine, College of Medicine Phoenix, University of Arizona, Tucson, Arizona, USA
| | - Cecilia Rosales
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth Calhoun
- Division of Community, Environment, and Policy of the UA Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Amanda Sokan
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jason H Karnes
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona, USA
| | - Eric Reiman
- Banner Alzheimer's Institute, Phoenix, Arizona, USA
| | - Akinlolu Ojo
- Kansas University Medical Center, Kansas City, Kansas, USA
| | - Andreas Theodorou
- Department of Pediatrics, University of Arizona, Tucson, Arizona, USA.,Banner University Medical Group, Tucson, Arizona, USA
| | - Tammy Ojo
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA
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Guastaferro K, Self-Brown S, Shanley JR, Whitaker DJ, Lutzker JR. Engagement in home visiting: An overview of the problem and how a coalition of researchers worked to address this cross-model concern. JOURNAL OF CHILD AND FAMILY STUDIES 2020; 29:4-10. [PMID: 32292264 PMCID: PMC7156135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Home visiting is a widely supported intervention strategy for parents of young children who are in need of parenting skill improvement. However, parental engagement limits the potential public health impact of home visiting, as these programs often have low enrollment rates, as well as high attrition and low completion rates for those who enroll in these programs. The Coalition for Research on Engagement and Well-being (CREW) provided support for three pilot projects representing different home visiting models and aspects of engagement. The results of these pilot projects are presented in this special section. The purpose of this commentary is to introduce CREW and highlight the importance of a cross-model project to improve engagement among home visiting programs.
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Supplee LH, Parekh J, Johnson M. Principles of Precision Prevention Science for Improving Recruitment and Retention of Participants. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019. [PMID: 29532364 DOI: 10.1007/s11121-018-0884-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Precision medicine and precision public health focus on identifying and providing the right intervention to the right population at the right time. Expanding on the concept, precision prevention science could allow the field to examine prevention programs to identify ways to make them more efficient and effective at scale, including addressing issues related to engagement and retention of participants. Research to date on engagement and retention has often focused on demographics and risk factors. The current paper proposes using McCurdy and Daro (Family Relations, 50, 113-121, 2001) model that posits a complex mixture of individual, provider, program, and community-level factors synergistically affect enrollment, engagement, and retention. The paper concludes recommending the use of research-practice partnerships and innovative, rapid cycle methods to design and improve prevention programs related to participant engagement and retention at scale.
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Affiliation(s)
- Lauren H Supplee
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD, 20814, USA.
| | - Jenita Parekh
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD, 20814, USA
| | - Makedah Johnson
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD, 20814, USA
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20
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Beasley LO, Ridings LE, Smith TJ, Shields JD, Silovsky JF, Beasley W, Bard D. A Qualitative Evaluation of Engagement and Attrition in a Nurse Home Visiting Program: From the Participant and Provider Perspective. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:528-537. [PMID: 29022144 DOI: 10.1007/s11121-017-0846-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Beginning parenting programs in the prenatal and early postnatal periods have a large potential for impact on later child and maternal outcomes. Home-based parenting programs, such as the Nurse Family Partnership (NFP), have been established to help address this need. Program reach and impact is dependent on successful engagement of expecting mothers with significant risks; however, NFP attrition rates remain high. The current study qualitatively examined engagement and attrition from the perspectives of NFP nurses and mothers in order to identify mechanisms that enhance service engagement. Semi-structured interviews were conducted in focus groups composed of either engaged (27 total mothers) or unengaged (15 total mothers) mothers from the NFP program. NFP nurses (25 total nurses) were recruited for individual semi-structured interviews. Results suggest that understanding engagement in the NFP program requires addressing both initial and sustained engagement. Themes associated with enhanced initial engagement include nurse characteristics (e.g., flexible, supportive, caring) and establishment of a solid nurse-family relationship founded on these characteristics. Factors impacting sustained engagement include nurse characteristics, provision of educational materials on child development, individualized services for families, and available family support. Identified barriers to completing services include competing demands and lack of support. Findings of this study have direct relevance for workforce planning, including hiring and training through integrating results regarding effective nurse characteristics. Additional program supports to enhance parent engagement may be implemented across home-based parenting programs in light of the current study's findings.
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Affiliation(s)
- Lana O Beasley
- Oklahoma State University, Stillwater, OK, USA. .,University of Oklahoma Health Science Center, Oklahoma City, OK, USA.
| | | | | | | | - Jane F Silovsky
- University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - William Beasley
- University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - David Bard
- University of Oklahoma Health Science Center, Oklahoma City, OK, USA
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21
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Schultz DA, Schacht RL, Shanty LM, Dahlquist LM, Barry RA, Wiprovnick AE, Groth EC, Gaultney WM, Hunter BA, DiClemente CC. The Development and Evaluation of a Statewide Training Center for Home Visitors and Supervisors. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 63:418-429. [PMID: 30851132 DOI: 10.1002/ajcp.12320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This paper informs practice in community-based home visiting workforce development by describing the development and evaluation of a university-based training certificate program for home visitors and supervisors. The Interactive Systems Framework for Dissemination and Implementation (ISF; Wandersman et al., 2008) guides our conceptualization and paper organization. The ISF describes the components involved in translating research findings into effective implementation of prevention programs. We describe implementation and lessons learned from seven development activities: (a) review of the literature, (b) survey of other training initiatives across the country, (c) focus groups with home visitors and supervisors, (d) consultation with individual home visitors, (e) creation of a state advisory board of home visiting providers and stakeholders, (f) evaluation of two pilot trainings, and (g) video development. We then present evaluation data from 49 home visitors and 23 supervisors who completed the training certificate program after the pilot trainings. Both home visitors and supervisors rated training satisfaction highly, reported significant increases in self-efficacy related to the training topics, and reported extensive use of motivational communication techniques, which are the foundational skills of the training content. These and other favorable results reflect the benefits of building on advances in theory and science-based practice and of involving providers and stakeholders repeatedly throughout the development process.
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Affiliation(s)
- David A Schultz
- University of Maryland, Baltimore County, Baltimore, MD, USA
| | | | - Lisa M Shanty
- University of Maryland, Baltimore County, Baltimore, MD, USA
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Quality of delivery of "right@home": Implementation evaluation of an Australian sustained nurse home visiting intervention to improve parenting and the home learning environment. PLoS One 2019; 14:e0215371. [PMID: 31059504 PMCID: PMC6502332 DOI: 10.1371/journal.pone.0215371] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background Home visiting programs are implemented in high income countries to improve outcomes for families with young children. Significant resources are invested in such programs and high quality evaluations are important. In the context of research trials, implementation quality is often poorly reported and, when reported, is variable. This paper presents the quality of implementation of the right@home program, a sustained nurse home visiting intervention trialled in Australia, and delivered in a ‘real world’ context through usual child and family health services. right@home is structured around the core Maternal Early Childhood Sustained Home-visiting (MECSH) program, which is a salutogenic, child focused prevention model. Method At each visit right@home practitioners completed a checklist detailing the client unique identifier, date of contact and activities undertaken. These checklists were collated to provide data on intervention dose, retention to program completion at child age 2 years, and visit content, which were compared with the program schedule. Quality of family-provider relationship was measured using the Session Rating Scale. Exploratory factor analysis was conducted to identify clusters of activities and allow qualitative assessment of concordance between program aims and program delivery. Results Of 363 intervention families offered the program, 352 (97·0%) commenced the program and 304 (87·3%) completed the program to child age 2 years. 253 of 352 (71·9%) families who commenced the program received more than 75 percent of scheduled visits including at least one antenatal visit. Families rated the participant-practitioner relationship highly (mean 39.4/40). The factor analysis identified six antenatal and six postnatal components which were concordant with the program aims. Conclusions The right@home program was delivered with higher adherence to program dose, schedule and content, and retention than usually reported in other home visiting research. Program compliance may have resulted from program design (visit schedule, dose, content and delivery flexibility) that was consistent with family aims.
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Flynn E, Roguski J, Wolf J, Trujillo K, Tedeschi P, Morris KN. A Randomized Controlled Trial of Animal-Assisted Therapy as an Adjunct to Intensive Family Preservation Services. CHILD MALTREATMENT 2019; 24:161-168. [PMID: 30537874 DOI: 10.1177/1077559518817678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
METHOD Families referred by Child Protective Services ( M child age = 6 years ± 4; M parent age = 32 years ± 8.26) were individually randomized to experimental ( n = 14) or control ( n = 14) intervention. Family functioning outcomes were measured using the North Carolina Family Assessment Scale for Reunification. RESULTS All four targeted family functioning outcomes were significantly increased for participants who received animal-assisted therapy as an adjunct to intensive family preservation services ( n = 14) with medium to large effect sizes. These improvements were sustained in two of the subscales through discharge. No significant differences were measured for the distal clinical outcome of disposition of children at discharge. CONCLUSIONS Findings suggest that adding animal-assisted therapy as an adjunct can improve evidence-based clinical interventions aimed at enhancing the caregiving contexts of children.
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Affiliation(s)
- Erin Flynn
- 1 Graduate School of Social Work, University of Denver, Denver, CO, USA
| | | | | | - Kate Trujillo
- 4 Department of Social Work, Metropolitan State University of Denver, Denver, CO, USA
| | - Philip Tedeschi
- 1 Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Kevin N Morris
- 1 Graduate School of Social Work, University of Denver, Denver, CO, USA
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Janczewski CE, Mersky JP, Brondino MJ. Those Who Disappear and Those Who Say Goodbye: Patterns of Attrition in Long-Term Home Visiting. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 20:609-619. [PMID: 30788693 DOI: 10.1007/s11121-019-01003-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Most evidence-based home visiting models are designed to support families from pregnancy through a child's second birthday, though programs often struggle to retain families for this long. Previous research on client and program factors that predict attrition has produced mixed results, which may be partly because attrition is typically conceptualized as a homogeneous phenomenon. The current study sampled 991 women who received home visiting services from one of 26 agencies in a statewide network of evidence-based programs. Participants who remained in services were compared to three types of early leavers: those who communicated their intent to leave (active attrition), those whose cases closed due to non-participation (passive attrition), and those who moved from the service area. Within a year of enrollment, 42% of women exited services. Cox regression results suggested no differences in the timing of service exit among the three attrition types. Multinomial analyses revealed that, when compared to participants who remained in services, active leavers were more likely to be married or cohabitating, while passive leavers were more likely to be younger, African American, unemployed, and to have a home visitor with low job satisfaction. Participants who moved were less likely to be Latina and employed. An early pattern of inconsistent attendance was the strongest predictor of active and passive withdrawal. Rates of attrition varied by home visiting model, though inconsistent attendance was a robust predictor of passive attrition across models. This study underscores the need to scrutinize service duration as a metric of success in home visiting.
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Affiliation(s)
- Colleen E Janczewski
- Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee, 2400 E. Hartford Ave, Milwaukee, WI, 53201, USA.
| | - Joshua P Mersky
- Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee, 2400 E. Hartford Ave, Milwaukee, WI, 53201, USA
| | - Michael J Brondino
- Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee, 2400 E. Hartford Ave, Milwaukee, WI, 53201, USA
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Maltais C, Cyr C, Parent G, Pascuzzo K. Identifying effective interventions for promoting parent engagement and family reunification for children in out-of-home care: A series of meta-analyses. CHILD ABUSE & NEGLECT 2019; 88:362-375. [PMID: 30579168 DOI: 10.1016/j.chiabu.2018.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND An important obstacle for family reunification following child placement in residential care and other temporary out-of-home care services is the lack of engagement among parents. OBJECTIVE The aim of this meta-analysis is to identify the most effective interventions to promote parental engagement and family reunification. METHOD AND PARTICIPANTS Eight studies, for a total of 2996 families, were used to conduct two series of meta-analyses. Each study examined the effectiveness of a goal-oriented parental engagement intervention, relative to a control group made up of parents who received standard services. Six moderators were analyzed: type of clinical modality, number of clinical strategies, sources of motivation for intervention, focus on the child care staff-parent relationship, child care staff training, and strategies to promote access to intervention. RESULTS Results indicate that parents exposed to goal-oriented engagement interventions showed greater engagement (effect size d = 0.71, CI: 0.35-1.07, p < 0.001) and likelihood of reunification (effect size OR = 2.49, CI: 1.22-5.10, p < 0.05) than parents who received standard services. In particular, moderator analysis showed that parents who specifically participated in a family-focused intervention showed the highest engagement in comparison to parents involved in other types of interventions or who received standard services (effect size d = 1.08, CI: 0.58-1.59, p < 0.001). No moderators significantly explained heterogeneity of studies on family reunification. CONCLUSION Overall, the results underline the effectiveness of family-focused interventions to promote parental engagement. Nevertheless, greater knowledge on the mechanisms by which interventions can increase parents' engagement and family reunification is still needed.
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Affiliation(s)
- Christine Maltais
- Unité d'évaluation des technologies et des modes d'intervention, Direction de l'enseignement universitaire et de la recherché, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary, Montreal, Québe H3W 1W5, Canada.
| | - Chantal Cyr
- Département de psychologie, Université du Québec à Montréal, Québec, Canada
| | - Geneviève Parent
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada
| | - Katherine Pascuzzo
- Département de psychologie, Université du Québec à Montréal, Québec, Canada; Institut universitaire jeunes en difficulté, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'île-de-Montréal, Québec, Canada
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Fedock G, Garthe RC, Sarantakos S, Golder S, Higgins GE, Logan TK. A life course perspective of victimization, child welfare involvement, cumulative stress and mental health for mothers on probation and parole. CHILD ABUSE & NEGLECT 2018; 86:235-246. [PMID: 30388707 DOI: 10.1016/j.chiabu.2018.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/31/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Abstract
Women involved in the criminal justice system experience multiple forms of adversity over their lifetimes. These events may include childhood abuse, involvement in the child welfare system as children, intimate partner violence victimization during adulthood, and punitive interactions with the child welfare system as mothers. Community supervision (e.g. probation or parole) entails particular stressors, such as obtaining basic needs and employment. A majority of women under community supervision also experience depression and anxiety. The current study used the Stress Process Model to investigate associations between childhood and adulthood stressors (including childhood abuse, intimate partner violence and child welfare system involvement), recent stressful life events, and symptoms of depression and anxiety for mothers (n = 348) on probation and parole. All of the mothers had experienced some form of childhood and/or adulthood victimization. Structural equation modeling was conducted to examine how childhood abuse, adulthood victimization, and child welfare system involvement as a child and a mother were associated with recent stressful life events and symptoms of depression and anxiety. Results indicated multiple direct and indirect relationships from childhood and adulthood stressors to mental health symptoms as women navigated probation and parole. For example, adverse childhood experiences were associated with elevated anxiety and depression symptoms via higher levels of recent stressful life events and adverse adulthood experiences. These findings highlight relationships between childhood abuse and adulthood factors and the mental health of mothers involved in the criminal justice system, with implications for theory, practice, and research.
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Affiliation(s)
- Gina Fedock
- University of Chicago, School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States.
| | - Rachel C Garthe
- University of Illinois at Urbana-Champaign, School of Social Work, 1010 W. Nevada Street Urbana, IL 61801
| | - Sophia Sarantakos
- University of Chicago, School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States
| | - Seana Golder
- University of Louisville, Kent School of Social Work, Oppenheimer Hall, Louisville, KY 40292, United States
| | - George E Higgins
- University of Louisville, Department of Criminal Justice, Brigman Hall, Room 207, Louisville, KY 40292, United States
| | - T K Logan
- University of Kentucky, College of Medicine, Medical Behavioral Science Building, Lexington, KY 40536-0086, United States
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Lanier P, Dunnigan A, Kohl PL. Impact of Pathways Triple P on Pediatric Health-Related Quality of Life in Maltreated Children. J Dev Behav Pediatr 2018; 39:701-708. [PMID: 30074927 PMCID: PMC6263793 DOI: 10.1097/dbp.0000000000000608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Child maltreatment is an adverse childhood experience associated with reductions in child well-being. This study examines whether an evidence-based parenting intervention delivered to families served by the child welfare system (CWS) affects pediatric health-related quality of life (HRQoL). METHOD This study is a randomized controlled trial of Pathways Triple P (PTP) delivered to families with open child welfare cases for child physical abuse or neglect (N = 119). Children were 5 to 11 years old and remained in the home after the investigation. The primary outcome measure for this study was the Pediatric Quality of Life Inventory (PedsQL) 4.0, which measures HRQoL across 4 subdomains: physical functioning, emotional functioning, social functioning, and school functioning. Child- and parent-reported PedsQL 4.0 was assessed at baseline and post-test after the 14-week intervention. RESULTS Controlling for other factors, children in families randomly assigned to the PTP condition had a significant improvement in overall HRQoL after the intervention compared with families receiving usual services (βchild-report = 6.08, SE = 2.77, p = 0.03; βparent-report = 3.83, SE = 1.88, p = 0.04). Subdomain effect sizes differed when considering children's self-report or parents' proxy report. Children's self-report yielded the largest improvement in emotional functioning, whereas social functioning had the largest gain based on parents' proxy report. CONCLUSION The PTP parenting intervention was associated with higher pediatric HRQoL as reported by both the child and parent. This intervention holds promise to improve child well-being when implemented in the CWS.
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McKelvey LM, Fitzgerald S, Conners Edge NA, Whiteside-Mansell L. Keeping Our Eyes on the Prize: Focusing on Parenting Supports Depressed Parents' Involvement in Home Visiting Services. Matern Child Health J 2018; 22:33-42. [PMID: 29808468 PMCID: PMC6153772 DOI: 10.1007/s10995-018-2533-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Improving family retention and engagement is crucial to the success of home visiting programs. Little is known about retaining and engaging depressed parents in services. The purpose of the study is to examine how home visit content moderates the association between depression and retention and engagement. Methods The sample (N = 1322) was served by Healthy Families America (n = 618) and Parents as Teachers (n = 704) between April 1, 2012 and June 30, 2016. Parents averaged 23 years (SD = 6). Nearly half of the parents were White (48%) and the majority was single (71%). Depression was screened with the Patient Health Questionnaire-2. Home visitors reported the percent of time focused on particular content and parent engagement at every home visit. Results Multilevel regression analyses showed the amount of time that home visitors spent supporting parent-child interaction moderated the association between depression and retention at 6 (B = .08, SE = .03, p = .003) and 12 (B = .1, SE = .03, p < .001) months, such that there was a stronger positive association for depressed parents. The main effects of child development focused content and retention at 6 (B = .07, SE = .01, p < .001) and 12 (B = .08, SE = .01, p < .001) months were positive, while effects of case management focused content at 6 (B = - .06, SE = .01, p < .001) and 12 (B = - .07, SE = .01, p < .001) months were negative. Conclusions Families were more likely to be retained when home visitors focused on child development and parent-child interaction, but less likely with more case management focus. Parents with positive depression screens were more likely to remain in services with more time spent focused on supporting parent-child interactions.
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Affiliation(s)
- Lorraine M McKelvey
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199, USA.
| | - Shalese Fitzgerald
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199, USA
| | - Nicola A Conners Edge
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199, USA
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199, USA
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Chiang CJ, Jonson-Reid M, Kim H, Drake B, Pons L, Kohl P, Constantino J, Auslander W. Service Engagement and Retention: Lessons from the Early Childhood Connections Program. CHILDREN AND YOUTH SERVICES REVIEW 2018; 88:114-127. [PMID: 30505049 PMCID: PMC6258043 DOI: 10.1016/j.childyouth.2018.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The high attrition rates found in studies of early childhood home visitation create barriers to measuring the effectiveness of such programs. Most studies examine attrition at program completion. This practice may mask important differences in characteristics between families that end participation at various time points. This study helps address this gap by examining factors associated with percent attrition for early drop out (before three months) compared to the program midpoint (nine months or more) and program completion (18 months) using data from the treatment arm of a small feasibility study of enhanced referral to home visitation among child welfare-involved families (n = 64). Caregivers who identified as White tended to leave by the program midpoint and caregivers who had better social support were more likely to stay at the end of the program. This study is the only published study to date of participation in a community-based home visitation program by child welfare-involved families but several trends identified were consistent with prior studies with other populations. Given the very small sample size, both statistically significant and near significant trends are discussed in the context of existing literature. The practical variation found has implications for continuing to build knowledge of attrition in early childhood home visitation.
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Klein S, Mihalec-Adkins B, Benson S, Lee SY. The benefits of early care and education for child welfare-involved children: Perspectives from the field. CHILD ABUSE & NEGLECT 2018; 79:454-464. [PMID: 29547838 DOI: 10.1016/j.chiabu.2018.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 02/09/2018] [Accepted: 02/15/2018] [Indexed: 06/08/2023]
Abstract
Increasing access to early care and education (ECE) for children in the child welfare system (CWS) remains a critical issue in the United States, as the numbers of young children entering this system steadily increases. Mounting evidence suggests that participation in at least some types of ECE can mitigate the need for child welfare supervision. Moreover, ECE participation has been linked to positive developmental and school readiness outcomes, lower rates of foster placement, and greater placement stability for children in the CWS. Despite this research, ECE is not widely used by this population. This study informs recent local and federal efforts to increase ECE utilization among children in the CWS by exploring the perspectives of three stakeholder groups (child welfare caseworkers, ECE providers, and parents/caregivers) regarding the benefits of CWS-supervised children's participation in ECE for 1) the children themselves, 2) their parents/caregivers, and 3) their caseworkers. A total of ten focus groups were conducted with these stakeholders in a large urban area in the western U.S. (n = 79). Meeting transcripts were analyzed with Atlas TI software to identify themes. Results highlight multiple ways in which participants perceived ECE as being beneficial for CWS-supervised children, as well as for their parents/caregivers, and caseworkers. These findings offer suggestions for ways to motivate caseworkers and parents/caregivers to enroll CWS-supervised children in ECE by educating them about benefits, not only for the children, but also for themselves.
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Affiliation(s)
- Sacha Klein
- Michigan State University, School of Social Work, 655 Auditorium Road, Baker Hall, Room 246, East Lansing, MI, 48824, United States.
| | | | - Stephanie Benson
- University of California, Los Angeles Department of Social Welfare, United States
| | - Sei-Young Lee
- California State University Los Angeles, School of Social Work, United States
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Rostad WL, Moreland AD, Valle LA, Chaffin MJ. Barriers to Participation in Parenting Programs: The Relationship between Parenting Stress, Perceived Barriers, and Program Completion. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:1264-1274. [PMID: 29456438 PMCID: PMC5812022 DOI: 10.1007/s10826-017-0963-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Families experiencing child maltreatment or risk factors for child maltreatment often receive referrals to interventions focused on changing parenting practices. Compliance with specific parenting programs can be challenging as many of the stressors that place families at-risk may also interfere with program participation. Because families may receive limited benefit from programs they do not fully receive, it is critical to understand the relationship between parenting stress and barriers to program completion. We used structural equation modeling to examine the relationship among parenting stress, perceived barriers to program participation, and program completion in two datasets involving low-income parents. Data were collected at two time points from a sample of parents involved with child welfare services and a sample of parents considered at-risk of future involvement (total study n = 803). Direct paths from parenting stress at time 1 to barriers to participation and parenting stress at time 2, and from parenting stress at time 2 to program completion were significant. Interestingly, increased barriers to participation were related to increased parenting stress at time 2, and greater parenting stress was related to increased program completion. Results suggest that with increasing levels of parenting stress, parents have an increased likelihood of completing the program. Assessing and addressing the influence of perceived barriers and parenting stress on program participation may decrease the likelihood of treatment attrition.
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Affiliation(s)
- Whitney L Rostad
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 4770 Buford Highway NE, Atlanta, GA 30341, USA
| | - Angela D Moreland
- Medical University of South Carolina, National Crime Victims Research and Treatment Center, Charleston, SC, USA
| | - Linda Anne Valle
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Mark J Chaffin
- School of Public Health, Georgia State University, Atlanta, GA, USA
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Guastaferro K, Lai BS, Miller K, Chatham JS, Whitaker DJ, Self-Brown S, Kemner A, Lutzker JR. Braiding Two Evidence-based Programs for Families at-risk: Results of a Cluster Randomized Trial. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:535-546. [PMID: 29540976 PMCID: PMC5847301 DOI: 10.1007/s10826-017-0886-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child maltreatment is a significant public health problem best addressed through evidence-based parent-support programs. There is a wide range of programs with different strengths offering a variety of options for families. Choosing one single evidence-based program often limits the range of services available to meet the unique needs of families. This paper presents findings from a study to examine the systematic braiding of two evidence-based programs, Parents as Teachers and SafeCare at Home (PATSCH), with the goal to provide a more robust intervention for higher risk families. A cluster randomized effectiveness trial was conducted to examine if PATSCH improved parenting behaviors known to decrease the risk for child maltreatment compared to Parents as Teachers (PAT) Alone. Parents (N= 159; 92 PAT Alone; 67 PATSCH) were enrolled to complete a baseline, 6-month and 12-month assessment. Results indicate the groups did not differ on number of environmental hazards in the home, parents' health care decision-making abilities, child abuse potential, and physical assault over time. However, with regard to the potential for child abuse, the PATSCH group showed a decrease in nonviolence discipline and increase in psychological aggression compared to the PAT group. Further research is needed to better examine this concept and its implications for the field.
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Self-Brown S, Osborne MC, Lai BS, De Veauuse Brown N, Glasheen TL, Adams MC. Initial Findings from a Feasibility Trial Examining the SafeCare Dad to Kids Program with Marginalized Fathers. JOURNAL OF FAMILY VIOLENCE 2017; 32:751-766. [PMID: 29307956 PMCID: PMC5754193 DOI: 10.1007/s10896-017-9940-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Few studies have explored the direct impact of behavioral parent training programs on child maltreatment behaviors among marginalized, at-risk fathers. This feasibility study examined SafeCare® Dad to Kids (Dad2K), an augmented version of the evidence-based child maltreatment prevention program SafeCare, to determine the acceptability and initial efficacy of the program for improving father parenting skills and reducing maltreatment risk. Ninety-nine fathers were enrolled in the study and randomized to the SafeCare Dad2K Intervention (n=51) or comparison (n=48). Intervention fathers participated in 6 home visiting sessions and comparison fathers received parenting materials via mail. All fathers participating in the study completed a baseline and 8-week assessment (post-intervention) of maltreatment behaviors. In addition, intervention fathers completed feasibility and parenting skill measures. A significant main effect emerged indicating decreases for both groups in psychologically aggressive behaviors. No significant group by time findings emerged for child maltreatment behaviors. Father intervention completers endorsed high satisfaction ratings for the program and demonstrated significant improvements in targeted father-child interaction skills. Based on the high rates of acceptability and initial improvement in positive parenting skills, findings demonstrate the feasibility for involving at-risk fathers in behavioral parent training programs targeting child maltreatment prevention.
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Affiliation(s)
| | | | - Betty S Lai
- Georgia State University, School of Public Health
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Dauber S, John T, Hogue A, Nugent J, Hernandez G. Development and implementation of a screen-and-refer approach to addressing maternal depression, substance use, and intimate partner violence in home visiting clients. CHILDREN AND YOUTH SERVICES REVIEW 2017; 81:157-167. [PMID: 29249846 PMCID: PMC5729752 DOI: 10.1016/j.childyouth.2017.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Perinatal maternal depression (MD), substance use (SU), and intimate partner violence (IPV) are critical public health concerns with significant negative impacts on child development. Bolstering the capacity of home visiting (HV) programs to address these significant risk factors has potential to improve child and family outcomes. This study presents a description and mixed-methods feasibility evaluation of the "Home Visitation Enhancing Linkages Project (HELP)," a screen-and-refer approach to addressing MD, SU, and IPV within HV aimed at improving risk identification and linkage to treatment among HV clients. HELP was a three-phase intervention that included three evidence-based interventions: screening, motivational interviewing (MI), and case management (CM). This study presents quantitative fidelity data from 21 home visitors reporting on 116 clients in 4 HV programs, as well as qualitative data from structured interviews with 14 home visitors. Nearly all clients were screened and 22% screened positive on at least one risk domain. Rates of MI and CM implementation were lower than expected, however home visitors implemented general supportive interventions at high rates. Home visitor interviews revealed the following factors that may have impacted HELP implementation: client disclosure of risk, barriers to treatment access, systems integration, home visitor role perception, and integration of HELP into the broader HV curriculum. Implications of study findings for the design of future attempts to address maternal risk within HV are discussed.
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Affiliation(s)
- Sarah Dauber
- The National Center on Addiction and Substance Abuse, 633 Third Avenue, New York, NY 10017, United States
| | - Tiffany John
- The National Center on Addiction and Substance Abuse, 633 Third Avenue, New York, NY 10017, United States
| | - Aaron Hogue
- The National Center on Addiction and Substance Abuse, 633 Third Avenue, New York, NY 10017, United States
| | - Jessica Nugent
- Prevent Child Abuse New Jersey, 103 Church Street, New Brunswick, NJ 08901, United States
| | - Gina Hernandez
- Prevent Child Abuse New Jersey, 103 Church Street, New Brunswick, NJ 08901, United States
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Rostad WL, Self-Brown S, Boyd C, Osborne M, Patterson A. Exploration of Factors Predictive of At-risk Fathers' Participation in a Pilot Study of an Augmented Evidence-Based Parent Training Program: A Mixed Methods Approach. CHILDREN AND YOUTH SERVICES REVIEW 2017; 79:485-494. [PMID: 28845071 PMCID: PMC5568185 DOI: 10.1016/j.childyouth.2017.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers (Mage = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs.
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Affiliation(s)
- Whitney L. Rostad
- Centers for Disease Control and Prevention, National Center for Injury Control and Prevention, Division of Violence Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA
| | - Shannon Self-Brown
- Georgia State University, School of Public Health, PO Box 3995, Atlanta, GA 30302, USA
| | - Clinton Boyd
- Georgia State University, Department of Sociology, PO Box 5020, Atlanta, GA 30302, USA
| | - Melissa Osborne
- Georgia State University, School of Public Health, PO Box 3995, Atlanta, GA 30302, USA
| | - Alexandria Patterson
- Georgia State University, School of Public Health, PO Box 3995, Atlanta, GA 30302, USA
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Birken SA, Bunger AC, Powell BJ, Turner K, Clary AS, Klaman SL, Yu Y, Whitaker DJ, Self SR, Rostad WL, Chatham JRS, Kirk MA, Shea CM, Haines E, Weiner BJ. Organizational theory for dissemination and implementation research. Implement Sci 2017; 12:62. [PMID: 28499408 PMCID: PMC5427584 DOI: 10.1186/s13012-017-0592-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/04/2017] [Indexed: 11/14/2022] Open
Abstract
Background Even under optimal internal organizational conditions, implementation can be undermined by changes in organizations’ external environments, such as fluctuations in funding, adjustments in contracting practices, new technology, new legislation, changes in clinical practice guidelines and recommendations, or other environmental shifts. Internal organizational conditions are increasingly reflected in implementation frameworks, but nuanced explanations of how organizations’ external environments influence implementation success are lacking in implementation research. Organizational theories offer implementation researchers a host of existing, highly relevant, and heretofore largely untapped explanations of the complex interaction between organizations and their environment. In this paper, we demonstrate the utility of organizational theories for implementation research. Discussion We applied four well-known organizational theories (institutional theory, transaction cost economics, contingency theories, and resource dependency theory) to published descriptions of efforts to implement SafeCare, an evidence-based practice for preventing child abuse and neglect. Transaction cost economics theory explained how frequent, uncertain processes for contracting for SafeCare may have generated inefficiencies and thus compromised implementation among private child welfare organizations. Institutional theory explained how child welfare systems may have been motivated to implement SafeCare because doing so aligned with expectations of key stakeholders within child welfare systems’ professional communities. Contingency theories explained how efforts such as interagency collaborative teams promoted SafeCare implementation by facilitating adaptation to child welfare agencies’ internal and external contexts. Resource dependency theory (RDT) explained how interagency relationships, supported by contracts, memoranda of understanding, and negotiations, facilitated SafeCare implementation by balancing autonomy and dependence on funding agencies and SafeCare developers. Summary In addition to the retrospective application of organizational theories demonstrated above, we advocate for the proactive use of organizational theories to design implementation research. For example, implementation strategies should be selected to minimize transaction costs, promote and maintain congruence between organizations’ dynamic internal and external contexts over time, and simultaneously attend to organizations’ financial needs while preserving their autonomy. We describe implications of applying organizational theory in implementation research for implementation strategies, the evaluation of implementation efforts, measurement, research design, theory, and practice. We also offer guidance to implementation researchers for applying organizational theory.
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Affiliation(s)
- Sarah A Birken
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1103E McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA.
| | - Alicia C Bunger
- College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH, 43210, USA
| | - Byron J Powell
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1105C McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA
| | - Kea Turner
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1107C McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA
| | - Alecia S Clary
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1107C McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA
| | - Stacey L Klaman
- Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, 401 Rosenau Hall, Campus Box 7445, Chapel Hill, NC, 27599-7445, USA
| | - Yan Yu
- Department of Family Medicine, University of Calgary, 8th Floor, Sheldon M. Chumir Health Centre, 1213 - 4 Street SW, Calgary, Alberta, T2R 0X7, Canada
| | - Daniel J Whitaker
- School of Public Health, Georgia State University, PO Box 3995, Atlanta, GA, 30302-3995, USA
| | - Shannon R Self
- School of Public Health, Georgia State University, PO Box 3995, Atlanta, GA, 30302-3995, USA
| | - Whitney L Rostad
- School of Public Health, Georgia State University, PO Box 3995, Atlanta, GA, 30302-3995, USA
| | - Jenelle R Shanley Chatham
- School of Public Health, Georgia State University, PO Box 3995, Atlanta, GA, 30302-3995, USA.,National SafeCare Training and Research Center, Mark Chaffin Center for Healthy Development, PO Box 3995, Atlanta, GA, 30302-3995, USA
| | - M Alexis Kirk
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1107C McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA
| | - Christopher M Shea
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1104F McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA
| | - Emily Haines
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1107C McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Box 357965, Seattle, WA, 98195-7965, USA.,Department of Health Services, University of Washington, Box 357965, Seattle, WA, 98195-7965, USA
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Webb HJ, Thomas R, McGregor L, Avdagic E, Zimmer-Gembeck MJ. An Evaluation of Parent–Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 46:537-550. [DOI: 10.1080/15374416.2016.1247357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Haley J. Webb
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University
| | - Rae Thomas
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University
| | - Leanne McGregor
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University
| | - Elbina Avdagic
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University
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Millett LS, Ben-David V, Jonson-Reid M, Echele G, Moussette P, Atkins V. Understanding change among multi-problem families: Learnings from a formative program assessment. EVALUATION AND PROGRAM PLANNING 2016; 58:176-183. [PMID: 27419622 DOI: 10.1016/j.evalprogplan.2016.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/07/2016] [Accepted: 06/17/2016] [Indexed: 06/06/2023]
Abstract
This paper describes the implementation of a long-term voluntary intervention to prevent chronic maltreatment among multi-problem families with histories of child welfare involvement. A small formative evaluation included a limited number of interviews with program participants during the first year of program implementation (n=10), a retrospective case file review (n=17) of closed cases following the first three years of implementation, and notes from ongoing meetings and discussion with program staff. Findings regarding client engagement, long-term interaction between risk and services, and program refinement are discussed. Despite the program's voluntary nature, positive comments from families, and extensive engagement strategies, only about 22% of families remained engaged for the full two-year program. Material hardship was one of the most persistent risk factors from baseline to termination. In many cases, unforeseen negative events occurred that, at least partly, derailed progress. In all cases, progress made was not reflective of a consistent linear process used in the design of most child welfare programs. Implications for program theory and design are discussed.
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Affiliation(s)
- Lina Sapokaite Millett
- College of Nursing, University of Missouri, One University Blvd, St. Louis, MO, United States.
| | - Vered Ben-David
- Brown School Work, Washington University in St. Louis, United States.
| | | | - Greg Echele
- Family Resource Center, St. Louis, MO, United States.
| | - Pam Moussette
- Family Resource Center, St. Louis, MO, United States.
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Folger AT, Brentley AL, Goyal NK, Hall ES, Sa T, Peugh JL, Teeters AR, Van Ginkel JB, Ammerman RT. Evaluation of a Community-Based Approach to Strengthen Retention in Early Childhood Home Visiting. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:52-61. [PMID: 26292659 DOI: 10.1007/s11121-015-0600-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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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Affiliation(s)
- Alonzo T Folger
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA.
| | - Anita L Brentley
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - Neera K Goyal
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - Eric S Hall
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - Ting Sa
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - James L Peugh
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - Angelique R Teeters
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - Judith B Van Ginkel
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
| | - Robert T Ammerman
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 5041, Cincinnati, OH, 45529, USA
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Robinson L, Adair P, Coffey M, Harris R, Burnside G. Identifying the participant characteristics that predict recruitment and retention of participants to randomised controlled trials involving children: a systematic review. Trials 2016; 17:294. [PMID: 27334018 PMCID: PMC4918126 DOI: 10.1186/s13063-016-1415-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/28/2016] [Indexed: 02/01/2023] Open
Abstract
Background Randomised controlled trials (RCTs) are recommended as the ‘gold standard’ in evaluating health care interventions. The conduct of RCTs is often impacted by difficulties surrounding recruitment and retention of participants in both adult and child populations. Factors influencing recruitment and retention of children to RCTs can be more complex than in adults. There is little synthesised evidence of what influences participation in research involving parents and children. Aim To identify predictors of recruitment and retention in RCTs involving children. Methods A systematic review of RCTs was conducted to synthesise the available evidence. An electronic search strategy was applied to four databases and restricted to English language publications. Quantitative studies reporting participant predictors of recruitment and retention in RCTs involving children aged 0–12 were identified. Data was extracted and synthesised narratively. Quality assessment of articles was conducted using a structured tool developed from two existing quality evaluation checklists. Results Twenty-eight studies were included in the review. Of the 154 participant factors reported, 66 were found to be significant predictors of recruitment and retention in at least one study. These were classified as parent, child, family and neighbourhood characteristics. Parent characteristics (e.g. ethnicity, age, education, socioeconomic status (SES)) were the most commonly reported predictors of participation for both recruitment and retention. Being young, less educated, of an ethnic minority and having low SES appear to be barriers to participation in RCTs although there was little agreement between studies. When analysed according to setting and severity of the child’s illness there appeared to be little variation between groups. The quality of the studies varied. Articles adhered well to reporting guidelines around provision of a scientific rationale for the study and background information as well as displaying good internal consistency of results. However, few studies discussed the external validity of the results or provided recommendations for future research. Conclusion Parent characteristics may predict participation of children and their families to RCTs; however, there was a lack of consensus. Whilst sociodemographic variables may be useful in identifying which groups are least likely to participate they do not provide insight into the processes and barriers to participation for children and families. Further studies that explore variables that can be influenced are warranted. Reporting of studies in this field need greater clarity as well as agreed definitions of what is meant by retention. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1415-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise Robinson
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL, UK. .,R&D Department, Salford Royal NHS Foundation Trust, Summerfield House, Stott Lane, Salford, M6 8HD, UK.
| | - Pauline Adair
- Health Psychology and Behavioural Medicine Research Group, School of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G1 1QE, UK
| | - Margaret Coffey
- School of Health Sciences, University of Salford, Allerton Building, Frederick Road Campus, Salford, M6 6PU, UK
| | - Rebecca Harris
- Department of Health Services Research, Institute of Psychology Health and Society, University of Liverpool, Waterhouse Building, Liverpool, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
| | - Girvan Burnside
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
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Predicting Youths’ Adherence to Treatment and Retention in Teenage Pregnancy Prevention Interventions. SOCIETIES 2016. [DOI: 10.3390/soc6020009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kyzer A, Whiteside-Mansell L, McKelvey L, Swindle T. Supporting Family Engagement in Home Visiting with the Family Map Inventories. INFANTS AND YOUNG CHILDREN 2016; 29:37-52. [PMID: 26681837 PMCID: PMC4677823 DOI: 10.1097/iyc.0000000000000051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (F MI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family need and build on existing strengths. Home visiting coordinators (N = 39) indicated the FMI would provide useful information, and they had the capacity to implement. In total, 70 families who enrolled in a Home Instruction for Parents of Preschool Youngsters (HIPPY) program were screened by the coordinator. The results of the FMI provided meaningful information about the home and parenting environment. Overall, most caregivers provided high levels of school readiness and parental warmth and low levels of family conflict and parenting stress. On the other hand, many families did not provide adequate food quality, exhibited chaotic home environments, and practiced negative discipline. This study demonstrated that the FMI is a feasible and useful option to assess comprehensive family needs in home visiting programs. It also demonstrated that the FMI provided home visiting coordinators a system to measure family strengths and needs. This could provide an assessment of program effectiveness and changes in the family's environment.
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Affiliation(s)
- Angela Kyzer
- Address correspondence to: Angela Kyzer, University of Arkansas for Medical Sciences, Department of Family and Preventive Medicine, College of Medicine, 4301 West Markham Street, Slot #723, Little Rock, Arkansas 72205, United States, , Office: (501) 686-5076, Fax: (501) 686-5214
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Abstract
Pediatricians and other health care providers can play several important roles in the prevention of child maltreatment. This article aims to help pediatricians incorporate child abuse prevention into their practice. Resources for systematizing anticipatory guidance and screening for risk factors in child maltreatment are described. The modalities, strengths, and weaknesses of community-based prevention programs are discussed, and tools with which providers can identify the effectiveness of available community-based programs are offered. On a broader level, ways whereby pediatricians can advocate at the local, state, and national levels for policies and programs that support families and children are described.
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Affiliation(s)
- Wendy Gwirtzman Lane
- Department of Pediatrics, University of Maryland School of Medicine, 660 West Redwood Street, Baltimore, MD 21201, USA.
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Beasley LO, Silovsky JF, Owora A, Burris L, Hecht D, DeMoraes-Huffine P, Cruz I, Tolma E. Mixed-methods feasibility study on the cultural adaptation of a child abuse prevention model. CHILD ABUSE & NEGLECT 2014; 38:1496-1507. [PMID: 24835206 DOI: 10.1016/j.chiabu.2014.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 04/10/2014] [Accepted: 04/23/2014] [Indexed: 06/03/2023]
Abstract
The current study utilized mixed-methods analyses to examine the process of adapting a home-based parenting program for a local Latino community. The study examined the: (a) acceptability and cultural congruence of the adapted SafeCare® protocol, (b) adherence to the core components of SafeCare® while adapting to local community culture, and (c) social validity of the new model in addressing SafeCare® target areas (parenting, home safety, and child health). Participants were 28 Latino mothers and eight providers. After training in the adapted model, providers demonstrated improved knowledge and skills. All providers reached national certification standards for SafeCare®, demonstrating fidelity to the core components of the original model. Positive consumer-provider relationships were developed as reflected by the results on the Working Alliance (collaboration between caregivers and parents). Themes from the integrated results of the social validity measures and individual interviews with parents were perceived benefits of the program on targeted areas and cultural congruency of the approach. Recommendations are to consider using adaptation guidelines as outlined to promote local culturally congruent practices.
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Affiliation(s)
- Lana O Beasley
- Oklahoma State University, 116 N. Murray, Stillwater, OK 74078, USA; University of Oklahoma Health Sciences Center, 940 NE 13th Street, Oklahoma City, OK 73104, USA
| | - Jane F Silovsky
- University of Oklahoma Health Sciences Center, 940 NE 13th Street, Oklahoma City, OK 73104, USA
| | - Arthur Owora
- University of Oklahoma Health Sciences Center, 940 NE 13th Street, Oklahoma City, OK 73104, USA
| | - Lorena Burris
- University of Oklahoma Health Sciences Center, 940 NE 13th Street, Oklahoma City, OK 73104, USA.
| | - Debra Hecht
- University of Oklahoma Health Sciences Center, 940 NE 13th Street, Oklahoma City, OK 73104, USA
| | - Patty DeMoraes-Huffine
- Oklahoma Latino Community Development Agency, 420 S.W. 10th Street, Oklahoma City, OK 73109, USA
| | - Ivelisse Cruz
- Oklahoma Latino Community Development Agency, 420 S.W. 10th Street, Oklahoma City, OK 73109, USA
| | - Eleni Tolma
- University of Oklahoma Health Sciences Center, College of Public Health, 801 NE 13th Street, Oklahoma City, OK 73126, USA
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Holland ML, Christensen JJ, Shone LP, Kearney MH, Kitzman HJ. Women's reasons for attrition from a nurse home visiting program. J Obstet Gynecol Neonatal Nurs 2013; 43:61-70. [PMID: 24354411 DOI: 10.1111/1552-6909.12263] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe mothers' reasons for leaving a home visiting program early. DESIGN Qualitative descriptive study using semistructured interviews of mothers who dropped out of the Nurse-Family Partnership (NFP) and two focus groups with nurses and nurse supervisors at an NFP site. SETTING A New York State site of a NFP home visitation program for low-income new mothers designed to improve the physical and emotional care of children. PARTICIPANTS Participants included 21 mothers, 8 nurses, and 3 nurse-supervisors. METHODS Semistructured interviews and focus groups were used to collect data, which were analyzed using content analysis. RESULTS The program was not perceived to fit a mother's needs when she was overwhelmed with other responsibilities, the nurse did not meet her expectations, the content was not of interest, or the mother did not desire visits after the infant was born. Nurses and mothers described the need for mothers to have organizational and communication skills, such as keeping track of appointments, calling to reschedule, articulating needs, and asking for assistance. Disruptive external influences included nurse turnover and unstable living situations, including frequent moves and crowded housing. Each of these types of barriers had potential to interact with the others, creating complex combinations of challenges to retention. CONCLUSION NFP retention might be improved by reframing program relevance to individual mothers and increasing maternal organizational and communication skill development.
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Alonso-Marsden S, Dodge KA, O'Donnell KJ, Murphy RA, Sato JM, Christopoulos C. 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 2013; 37:555-65. [PMID: 23660409 PMCID: PMC3760480 DOI: 10.1016/j.chiabu.2013.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 03/22/2013] [Accepted: 03/23/2013] [Indexed: 05/05/2023]
Abstract
OBJECTIVE As nurse home visiting to prevent child maltreatment grows in popularity with both program administrators and legislators, it is important to understand engagement in such programs in order to improve their community-wide effects. This report examines family demographic and infant health risk factors that predict engagement and follow-through in a universal home-based maltreatment prevention program for new mothers in Durham County, North Carolina. METHODS Trained staff members attempted to schedule home visits for all new mothers during the birthing hospital stay, and then nurses completed scheduled visits three to five weeks later. Medical record data was used to identify family demographic and infant health risk factors for maltreatment. These variables were used to predict program engagement (scheduling a visit) and follow-through (completing a scheduled visit). RESULTS Program staff members were successful in scheduling 78% of eligible families for a visit and completing 85% of scheduled visits. Overall, 66% of eligible families completed at least one visit. Structural equation modeling (SEM) analyses indicated that high demographic risk and low infant health risk were predictive of scheduling a visit. Both low demographic and infant health risk were predictive of visit completion. CONCLUSIONS Findings suggest that while higher demographic risk increases families' initial engagement, it might also inhibit their follow-through. Additionally, parents of medically at-risk infants may be particularly difficult to engage in universal home visiting interventions. Implications for recruitment strategies of home visiting programs are discussed.
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Azzi-Lessing L. Serving Highly Vulnerable Families in Home-Visitation Programs. Infant Ment Health J 2013. [DOI: 10.1002/imhj.21399] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Cyr C, Michel G, Dumais M. Child maltreatment as a global phenomenon: From trauma to prevention. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2013; 48:141-8. [DOI: 10.1080/00207594.2012.705435] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
We explored health literacy in parents as an underlying construct that develops through social interaction and reflection and involves an array of skills that enable a parent to manage personal and child health and healthcare. We hypothesized that depression impairs health literacy and impedes efforts to promote health literacy through home visitation. We analyzed an AHRQ/NIH database of 2,572 parent/child dyads compiled in a 2006–2008 quasi-experimental six-site nationwide study using multiple waves of measurement and a matched comparison group. Cohort families participated in home visitation programs augmented to develop parents’ reflective skills. Visitors monitored depression, health- and healthcare-related practices, and surrounding family conditions at baseline and 6-month intervals for up to 36 months using the Life Skills Progression instrument. We examined differences in initial depression ratings for demographic subgroups and explored patterns of change in health literacy among depressed versus not-depressed parents. Correlation analysis showed that at each of four assessments better depression scores were consistently and positively correlated with use of information and services (r = 21–22, P < .001) and with self-management of personal and child health (r = 42–49, P < .001). Overall, parents made significant improvements in health literacy (P < .001). As expected, depressed parents demonstrated lower baseline health literacy scores than not-depressed parents; however, they achieved greater gains (P < .001). While depression is linked with lower parental health literacy, after 1 year of enhanced home visitation, vulnerable parents were better able to manage personal and family health and healthcare, especially if depressed. Enhanced home visitation could be an effective channel to develop health literacy as a life skill, and to improve depression.
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Affiliation(s)
- Sandra A Smith
- Department of Health Services, University of Washington, Seattle, WA, USA.
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Marcenko MO, Hook JL, Romich JL, Lee JS. Multiple jeopardy: poor, economically disconnected, and child welfare involved. CHILD MALTREATMENT 2012; 17:195-206. [PMID: 22917897 DOI: 10.1177/1077559512456737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although the welfare literature reveals a growing number of parents who are economically disconnected, meaning neither employed nor receiving cash assistance, little is known about the prevalence and impacts of disconnection among child welfare-involved parents. This study took advantage of a statewide survey of child welfare-involved parents to examine economic disconnection in this population and to explore the relationship between disconnection and parent engagement in child welfare. One fifth of the sample reported that they were economically disconnected, with several patterns differentiating disconnected caregivers from those who received benefits or earned income through employment. Disconnected caregivers were younger and more frequently had children in out-of-home placements as opposed to receiving services in home than economically connected caregivers. They also reported higher unmet needs for basic services, such as housing and medical care, but were more likely to report financial help from their informal network. Finally, disconnected caregivers reported lower engagement in child welfare services even when controlling for demographic characteristics, chronic psychosocial risk factors, placement status, and maltreatment type. The findings document economic disconnection among child welfare-involved parents and raise important questions about the implications of disconnection for families and for child welfare outcomes.
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Affiliation(s)
- Maureen O Marcenko
- School of Social Work, University of Washington, Partners for Our Children, Seattle, WA 98105, USA.
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