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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Formative evaluation of home visitors' role in addressing poor mental health, domestic violence, and substance abuse among low-income pregnant and parenting women

TitleFormative evaluation of home visitors' role in addressing poor mental health, domestic violence, and substance abuse among low-income pregnant and parenting women
Publication TypeJournal Article
Year of Publication2005
AuthorsTandon, SD, Parillo, KM, Jenkins, C, Duggan, AK
JournalMaternal and Child Health Journal
Volume9
Pagination273-283
ISBN Number10927875 (ISSN)
KeywordsAdult, article, Baltimore, child parent relation, clinical protocol, controlled study, Cross-Sectional Studies, depression, Domestic Violence, family life, Female, health survey, high risk population, Home visitation, House Calls, human, Humans, interview, Interviews, lowest income group, major clinical study, maternal care, Maternal risk factors, Mental Health, mental health service, Parenting, population distribution, Poverty, Pregnancy, priority journal, professional competence, professional practice, Professional Role, professionalism, Program implementation, Risk Assessment, risk factor, scoring system, Social Support, statistical analysis, statistical significance, substance abuse, Substance-Related Disorders
Abstract

Objectives: This research assessed home visitor effectiveness in communicating about and responding to poor mental health, domestic violence, and substance abuse among pregnant and parenting women home visited as part of a comprehensive family support strategy in seven urban communities. Methods: Cross-sectional studies were conducted with mothers (n = 189) actively engaged in home visitation programs and home visitors (n = 45). Maternal interviews assessed need for and receipt of mental health, domestic violence, and substance abuse services, and home visitor discussion of these risk areas. Home visitor surveys assessed perceived adequacy of training and personal effectiveness in addressing these risk areas. Results: Over half of mothers needed mental health, domestic vio lence, or substance abuse services; however, only 27% of mothers in need of service received services. Most mothers reported having communicated with their home visitor about the three risk areas, but there were no differences in communication frequency based on whether services were needed. Most home visitors perceived themselves as effective in communicating about and responding to these risk factors but rated the training they had received in these areas as less than adequate. Conclusions: Home visitors could benefit from more intensive training in the formal assessment of risks and the protocols for communication about those risks with their clients. Home visitors could also receive support from and work in collaboration with professionals in addressing client risks. Further research on home visit content is needed to determine which strategies facilitate home visitors' ability to effectively communicate about and address client risks. © Springer Science+Business Media, Inc. 2005.