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Open Access 01-10-2018

Keeping Our Eyes on the Prize: Focusing on Parenting Supports Depressed Parents’ Involvement in Home Visiting Services

Authors: Lorraine M. McKelvey, Shalese Fitzgerald, Nicola A. Conners Edge, Leanne Whiteside-Mansell

Published in: Maternal and Child Health Journal | Special Issue 1/2018

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.

Aiken, L. S., West, S. G., & Reno, R. R. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: SAGE.

Ammerman, R. T., Altaye, M., Putnam, F. W., Teeters, A. R., Zou, Y., & Van Ginkel, J. B. (2015). Depression improvement and parenting in low-income mothers in home visiting. Archives of Women’s Mental Health, 18(3), 555–563. https://doi.org/10.1007/s00737-014-0479-7.CrossRefPubMed

Ammerman, R. T., Putnam, F. W., Altaye, M., Chen, L., Holleb, L. J., Stevens, J., … Van Ginkel, J. B. (2009). Changes in depressive symptoms in first time mothers in home visitation. Child Abuse and Neglect, 33(3), 127–138. https://doi.org/10.1016/j.chiabu.2008.09.005.CrossRefPubMed

Ammerman, R. T., Steens, J., Putnam, F. W., Altaye, M., Hulsmann, J. E., Lehmkuhl, H. D., … Van Ginkel, J. B. (2006). Predictors of early engagement in home visitation. Journal of Family Violence, 21(2), 105–115. https://doi.org/10.1007/s10896-005-9009-8.CrossRef

Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., … Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, 8(4), 348–353. https://doi.org/10.1370/afm.1139.CrossRefPubMedPubMedCentral

Azzi-Lessing, L. (2011). Home visitation programs: Critical issues and future directions. Early Childhood Research Quarterly, 26(4), 387–398. https://doi.org/10.1016/j.ecresq.2011.03.005.CrossRef

Azzi-Lessing, L. (2013). Serving highly vulnerable families in home-visitation programs. Infant Mental Health Journal, 34(5), 376–390. https://doi.org/10.1002/imhj.21399.CrossRef

Bates, D., Mächler, M., Bolker, B., & Walker, S. (2014). Fitting linear mixed-effects models using lme4. Journal of Statistical Software. https://doi.org/10.18637/jss.v067.i01.CrossRef

Bennett, D. A. (2001). How can I deal with missing data in my study? Australian and New Zealand Journal of Public Health, 25(5), 464–469. https://doi.org/10.1111/j.1467-842X.2001.tb00294.x.CrossRefPubMed

Boller, K., Daro, D., Del Grosso, P., Cole, R., Paulsell, D., Hart, B., … Hargreaves, M. (2014). Making replication work: Building infrastructure to implement, scale-up, and sustain evidence-based early childhood home visiting programs with fidelity. Washington, DC: Children’s Bureau, Administration for Children and Families, US Department of Health and Human Services.

Booth, A., Munsell, E. P., & Doyle, O. (2014). Maternal engagement in a home visiting intervention: What lies beneath psychological resources? Journal of Community Psychology, 42(1), 29–46. https://doi.org/10.1002/jcop.21592.CrossRef

Brand, T., & Jungmann, T. (2014). Participant characteristics and process variables predict attrition from a home-based early intervention program. Early Childhood Research Quarterly, 29(2), 155–167. https://doi.org/10.1016/j.ecresq.2013.12.001.CrossRef

Brophy-Herb, H., Schiffman, R., McKelvey, L. M., Cunningham-Deluca, M., & Hawver, M. (2001). Innovations in practice quality improvement: Lessons learned from an infant mental health–based early head start program. Infants & Young Children, 14(2), 77–85.CrossRef

Brown, S., Venkatesh, V., Kuruzovich, J., & Massey, A. P. (2008). Expectation confirmation: An examination of three competing models. Organizational Behavior and Human Decision Processes, 105(1), 52–66. https://doi.org/10.1016/j.obhdp.2006.09.008.CrossRef

Burrell, L., Crowne, S., Ojo, K., Snead, R., O’Neill, K., Cluxton-Keller, F., & Duggan, A. (in press). Characteristics of mothers and visitors and their alignment on goals for home visiting as factors for program engagement. Maternal and Child Health Journal.

Chazan-Cohen, R., Ayoub, C., Pan, B. A., Roggman, L., Raikes, H. H., McKelvey, L. M., … Hart, A. (2007). It takes time: Impacts of early head start that lead to reductions in maternal depression two years later. Infant Mental Health Journal, 28(2), 151–170. https://doi.org/10.1002/imhj.20127.CrossRefPubMed

Conners-Burrow, N. A., Bokony, P., Whiteside-Mansell, L., Jarrett, D., Kraleti, S., McKelvey, L. M., & Kyzer, A. (2014). Low-level depressive symptoms reduce maternal support for child cognitive development. Journal of Pediatric Health Care, 28(5), 404–412. https://doi.org/10.1016/j.pedhc.2013.12.005.CrossRefPubMed

Conners-Burrow, N. A., McKelvey, L. M., Perry, D., Whiteside-Mansell, L., Kraleti, S., Mesman, G. R., … Kyzer, A. (2016). Low-level symptoms of depression in mothers of young children are associated with behavior problems in middle childhood. Maternal and Child Health Journal, 20(3), 516–524. https://doi.org/10.1007/s10995-015-1849-0.CrossRefPubMed

Conners-Burrow, N. A., Swindle, T., McKelvey, L. M., & Bokony, P. (2015). A little bit of the blues: Low-level symptoms of maternal depression and classroom behavior problems in preschool children. Early Education and Development, 26(2), 230–244. https://doi.org/10.1080/10409289.2015.979725.CrossRef

Damashek, A., Doughty, D., Ware, L., & Silovsky, J. (2011). Predictors of client engagement and attrition in home-based child maltreatment prevention services. Child Maltreatment, 16(1), 9–20. https://doi.org/10.1177/1077559510388507.CrossRefPubMed

Daro, D., McCurdy, K., Falconnier, L., & Stojanovic, D. (2003). Sustaining new parents in home visitation services: Key participant and program factors. Child Abuse and Neglect, 27(10), 1101–1125. https://doi.org/10.1016/j.chiabu.2003.09.007.CrossRefPubMed

Dawson, J. J. F., & Richter, A. A. W. (2006). Probing three-way interactions in moderated multiple regression: Development and application of a slope difference test. The Journal of Applied Psychology, 91(4), 917–926. https://doi.org/10.1037/0021-9010.91.4.917.CrossRefPubMed

Dong, Y., & Peng, C.-Y. J. (2013). Principled missing data methods for researchers. SpringerPlus, 2(1), 222. https://doi.org/10.1186/2193-1801-2-222.CrossRefPubMedPubMedCentral

Foulon, S., Greacen, T., Pasquet, B., Dugravier, R., Saïas, T., Guedeney, N., … Tubach, F. (2015). Predictors of study attrition in a randomized controlled trial evaluating a perinatal home-visiting program with mothers with psychosocial vulnerabilities. PLoS ONE, 10(11), e0142495. https://doi.org/10.1371/journal.pone.0142495.CrossRefPubMedPubMedCentral

Girvin, H., DePanfilis, D., & Daining, C. (2007). Predicting program completion among families enrolled in a child neglect preventive intervention. Research on Social Work Practice, 17(6), 674–685. https://doi.org/10.1177/1049731507300285.CrossRef

Hicks, D., Larson, C., Nelson, C., Olds, D. L., & Johnston, E. (2008). The influence of collaboration on program outcomes: The Colorado Nurse-Family Partnership. Evaluation Review, 32(5), 453–477. https://doi.org/10.1177/0193841X08315131.CrossRefPubMed

Holland, M. L., Christensen, J. J., Shone, L. P., Kearney, M. H., & Kitzman, H. J. (2014). Women’s reasons for attrition from a nurse home visiting program. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN, 43(1), 61–70. https://doi.org/10.1111/1552-6909.12263.CrossRefPubMed

Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19(5), 629–645. https://doi.org/10.1007/s10826-009-9350-2.CrossRefPubMedPubMedCentral

Jones Harden, B., Denmark, N., & Saul, D. (2010). Understanding the needs of staff in Head Start programs: The characteristics, perceptions, and experiences of home visitors. Children and Youth Services Review, 32(3), 371–379. https://doi.org/10.1016/j.childyouth.2009.10.008.CrossRef

Korfmacher, J., Green, B., Staerkel, F., Peterson, C. A., Cook, G., Roggman, L., … Schiffman, R. (2008). Parent involvement in early childhood home visiting. Child and Youth Care Forum, 37(4), 171–196. https://doi.org/10.1007/s10566-008-9057-3.CrossRef

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292. https://doi.org/10.1097/01.MLR.0000093487.78664.3C.CrossRefPubMed

Lovejoy, M. C. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior. Clinical Psychology Review, 20(5), 561–592. https://doi.org/10.1016/S0272-7358(98)00100-7.CrossRefPubMed

McCurdy, K., & Daro, D. (2001). Parent involvement in family support programs: An integrated theory. Family Relations, 50(2), 113–121. https://doi.org/10.1111/j.1741-3729.2001.00113.x.CrossRef

Mckelvey, L. M., Schiffman, R. F., Brophy-Herb, H. E., Bocknek, E. L., Fitzgerald, H. E., Reischl, T. M., … Deluca, M. C. (2015). Examining long-term effects of an infant mental health home-based early head start program on family strengths and resilience. Infant Mental Health Journal, 36(4), 353–365. https://doi.org/10.1002/imhj.21518.CrossRefPubMed

MDRC. (2017). A profile of women when they enrolled in MIHOPE. Retrieved May 8, 2017, from http://www.mdrc.org/profile-women-when-they-enrolled-mihope.

Navaie-Waliser, M., Martin, S. L., Campbell, M. K., Tessaro, I., Kotelchuck, M., & Cross, A. W. (2000). Factors predicting completion of a home visitation program by high-risk pregnant women: The North Carolina Maternal Outreach Worker Program. American Journal of Public Health, 90(1), 121–124. https://doi.org/10.2105/AJPH.90.1.121.CrossRefPubMedPubMedCentral

O’Brien, R. A., Moritz, P., Luckey, D. W., McClatchey, M. W., Ingoldsby, E. M., Olds, D. L., … Olds, D. L. (2012). Mixed methods analysis of participant attrition in the nurse-family partnership. Prevention Science, 13(3), 219–228. https://doi.org/10.1007/s11121-012-0287-0.CrossRefPubMedPubMedCentral

Olson, A. L., Dietrich, A. J., Prazar, G., Hurley, J., Tuddenham, A., Hedberg, V., & Naspinsky, D. A. (2005). Two approaches to maternal depression screening during well child visits. Journal of Developmental & Behavioral Pediatrics, 26(3), 169–176.CrossRef

Peterson, C. A., Luze, G. J., Eshbaugh, E. M., Jeon, H.-J., & Kantz, K. R. (2007). Enhancing parent-child interactions through home visiting: Promising practice or unfulfilled promise? Journal of Early Intervention, 29(2), 119–140. https://doi.org/10.1177/105381510702900205.CrossRef

Peterson, C. A., Roggman, L. A., Green, B., Chazan-Cohen, R., Korfmacher, J., McKelvey, L. M., … Atwater, J. B. (2013). Home visiting processes: Relations with family characteristics and outcomes. Zero to Three, 33(3), 39–44. Retrieved from http://eric.ed.gov/?id=EJ1003939.

Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., Mulrow, C. D., & Lohr, K. N. (2002). Screening for depression in adults: A summary of the evidence for the U.S. preventive services task force. Annals of Internal Medicine, 136(10), 765. https://doi.org/10.7326/0003-4819-136-10-200205210-00013.CrossRefPubMed

Pinquart, M., & Teubert, D. (2010). Effects of parenting education with expectant and new parents: A meta-analysis. Journal of Family Psychology, 24(3), 316–327. https://doi.org/10.1037/a0019691.CrossRefPubMed

Preacher, K. J. K., Curran, P. J. P., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31(4), 437–448. https://doi.org/10.3102/10769986031004437.CrossRef

R Core Team. (2015). R: The R Project for Statistical Computing. Vienna: R Core Team. Retrieved from https://www.r-project.org/.

Raikes, H. H., Green, B. L., Atwater, J., Kisker, E., Constantine, J., & Chazan-Cohen, R. (2006). Involvement in early head start home visiting services: Demographic predictors and relations to child and parent outcomes. Early Childhood Research Quarterly, 21(1), 2–24. https://doi.org/10.1016/j.ecresq.2006.01.006.CrossRef

Raikes, H. H., Roggman, L. A., Peterson, C. A., Brooks-Gunn, J., Chazan-Cohen, R., Zhang, X., & Schiffman, R. F. (2014). Theories of change and outcomes in home-based Early Head Start programs. Early Childhood Research Quarterly, 29(4), 574–585. https://doi.org/10.1016/j.ecresq.2014.05.003.CrossRef

Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods. Thousand Oaks, CA: SAGE.

Raykov, T. (2011). Intraclass correlation coefficients in hierarchical designs: Evaluation using latent variable modeling. Structural Equation Modeling: A Multidisciplinary Journal, 18(1), 73–90. https://doi.org/10.1080/10705511.2011.534319.CrossRef

Roggman, L. A., Cook, G. A., Innocenti, M. S., Jump Norman, V., Boyce, L. K., Christiansen, K., & Peterson, C. A. (2016). Home visit quality variations in two Early Head Start Programs in relation to parenting and child vocabulary outcomes. Infant Mental Health Journal, 37(3), 193–207. https://doi.org/10.1002/imhj.21565.CrossRefPubMed

Roggman, L. A., Cook, G. A., Peterson, C. A., & Raikes, H. H. (2008). Who drops out of early head start home visiting programs? Early Education and Development, 19(4), 574–599. https://doi.org/10.1080/10409280701681870.CrossRef

Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The triple P-positive parenting program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset. Journal of Consulting and Clinical Psychology, 68(4), 624–640. Retrieved from http://doi.apa.org/journals/ccp/68/4/624.html.CrossRefPubMed

Schafer, J. L. (1999). Multiple imputation: A primer. Statistical Methods in Medical Research, 8(1), 3–15. https://doi.org/10.1177/096228029900800102.CrossRefPubMed

Social Solutions. (2016). Case management software | Efforts to Outcomes Software | SSI. Retrieved February 11, 2016, from http://www.socialsolutions.com/case-management-software/.

Staudt, M. (2007). Treatment engagement with caregivers of at-risk children: Gaps in research and conceptualization. Journal of Child and Family Studies, 16(2), 183–196. https://doi.org/10.1007/s10826-006-9077-2.CrossRef

Sweet, M. A., & Appelbaum, M. I. (2004). Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children. Child Development, 75(5), 1435–1456. https://doi.org/10.1111/j.1467-8624.2004.00750.x.CrossRefPubMed

Tandon, S. D., Parillo, K. M., Jenkins, C., & Duggan, A. K. (2005). Formative evaluation of home visitors’ role in addressing poor mental health, domestic violence, and substance abuse among low-income pregnant and parenting women. Maternal and Child Health Journal, 9(3), 273–283.CrossRefPubMed

Vogel, C. A., Boller, K., Xue, Y., Blair, R., Aikens, N., Burwick, A., … Stein, J. (2011). Learning as we Go: A first snapshot of early head start programs, staff, families, and children. DC. Retrieved from http://www.acf.hhs.gov/sites/default/files/opre/as_we_go_tech.pdf.

Whiteside-Mansell, L., Bradley, R., Conners, N., & Bokony, P. (2007). The family map: Structured family interview to identify risks and strengths in head start families. NHSA Dialog, 10(3–4), 189–209. https://doi.org/10.1080/15240750701742239.CrossRef

Whiteside-Mansell, L., Johnson, D., Bokony, P., Mckelvey, L. M., Conners-Burrow, N., Swindle, T., & Conners-, N. (2013). Supporting Family Engagement with Parents of Infants and Toddlers. NHSA Dialog, 16(1), 20–44. Retrieved from https://journals.uncc.edu/dialog/article/view/42.

Zeileis, A., & Hothorn, T. (2002). Diagnostic checking in regression relationships. R News, 2(3), 7–10. Retrieved from http://cran.r-project.org/doc/Rnews.

Title: Keeping Our Eyes on the Prize: Focusing on Parenting Supports Depressed Parents’ Involvement in Home Visiting Services
Authors: Lorraine M. McKelvey
Shalese Fitzgerald
Nicola A. Conners Edge
Leanne Whiteside-Mansell
Publication date: 01-10-2018
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue Special Issue 1/2018
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-018-2533-y

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