Study protocol: randomized controlled trial of manualized components in home visitation to reduce mothers' risk for child maltreatment

Adding Structured Components to Home Visitation to Reduce Mothers' Risk for Child Maltreatment: a Randomized Controlled Trial

Purpose

Home visitation program effects are generally small, which may be caused by flexible intervention content leading to inconsistent outcomes. In this study we therefore examined whether the effectiveness of a Dutch home visitation program (i.e., Supportive Parenting) can be improved by adding structured intervention components targeting key risk factors for child maltreatment: parental sense of competence, perceived stress, parental anger, and PTSD symptoms.

Method

Participants were randomly assigned to an experimental group (n = 74) that received four additional intervention components in two home visits, or a control group (n = 60) that received regular Supportive Parenting. Outcomes were assessed before (T1) and after (T2) the first, and before (T3) and after (T4) the second home visit. Effects were examined using ANCOVA for primary outcomes: parental sense of competence, perceived stress, parental anger, and PTSD symptoms, and secondary outcomes: risk of child maltreatment, parental warmth, and negative parenting. Moderation effects were examined for T1 scores, child temperament and life events.

Results

Mothers who received the intervention components showed less stress compared to the control group at T3 and T4. There were no differences between groups on other outcomes and no moderation effects, although parental sense of competence reduced and anger increased within the experimental group specifically.

Conclusion

The structured components may enhance the effectiveness of Supportive Parenting to reduce parenting stress. Future research into how other outcomes can be improved is needed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10896-023-00509-7.

Role of maternal emotion in child maltreatment risk during the COVID-19 pandemic

Purpose

Preliminary research early in the COVID-19 pandemic suggested children appeared to be at increased risk for child maltreatment, particularly as parents struggled with mental health and economic strains. Such strains were likely to influence parental emotions about their children, affecting their parent-child interactions to contribute to elevated maltreatment risk. To identify the potential affective elements that may contribute to such increased maltreatment risk, the current study focused on whether maternal worry about children's behavior specifically as well as maternal anger were related to increased risk for neglect or physical or psychological aggression six months into the pandemic.

Method

The racially diverse sample included 193 mothers who completed an online survey during the COVID-19 pandemic in late September-early October 2020.

Results

Mothers' reported increases in neglect and physical and psychological aggression during the pandemic were significantly related with established measures of maltreatment risk. Furthermore, path models indicated that maternal anger and worry about children's behavior, as well as their interaction, were significantly related to indicators of physical aggression risk and neglect during the pandemic, but only maternal anger related to increased psychological aggression during the pandemic.

Conclusions

Maternal worry and anger about children's behavior may have exacerbated risk for maltreatment under the stressful conditions of the COVID-19 pandemic. Findings suggest affective reactions of both parental worry and anger focused on child behavior warrants greater empirical attention and consideration in intervention efforts both during the pandemic and potentially post-pandemic.

Spotlight on Maternal Perceptions of Child Behavior: A Daily Diary Study with Child Welfare-Involved Mothers

Research has documented a variety of factors—including stress, attributions, and anger—that may increase parents’ risk for child maltreatment, but most of this research is based on low-risk, community samples of parents’ perceptions about themselves and their children. Moreover, parents are usually asked to provide self-reports wherein they summarize their general impressions distal from actual parenting. The current study employed experience sampling methods with a high-risk sample. Mothers identified for child maltreatment reported on their stress and coping as well as their perceptions regarding children’s misbehavior and good behavior using end-of-day surveys for up to four weeks. Only maternal reports of children’s good behavior based on personality and mood were relatively stable; stress, coping, and reports on child misbehavior varied considerably across days, implying that contributors to daily fluctuations in these factors could represent intervention targets. Although maternal perceptions of misbehavior severity, anger, and negative attributions were interrelated, only anger about misbehavior related to maternal stress levels. Mothers who reported better coping perceived their child’s behavior more favorably that day and were more likely to ascribe positive behavior to the child’s mood and personality. Current findings highlight the importance of positive coping mechanisms in parental perceptions of children; such findings should be replicated to determine how to maximize parental resources that reduce child maltreatment risk.