Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Maternal Relationship Security as a Moderator of Home Visiting Impacts on Maternal Psychosocial Functioning

TitleMaternal Relationship Security as a Moderator of Home Visiting Impacts on Maternal Psychosocial Functioning
Publication TypeJournal Article
Year of Publication2013
AuthorsMcFarlane, E, Burrell, L, Crowne, S, Cluxton-Keller, F, Fuddy, L, Leaf, PJ, Duggan, A
JournalPrevention Science
Date PublishedFeb
ISBN Number13894986 (ISSN)
Accession Number23104075
KeywordsAdaptation, Psychological, adaptive behavior, Addiction, Adult, alcoholism, article, Attachment style, Child, child abuse, Child, Preschool, controlled clinical trial, controlled study, Education, FAMILY conflict, Female, Hawaii, Home visiting, House Calls, human, Humans, Infant, Infant, Newborn, Interview, Psychological, Male, Mass Screening, methodology, mother, mother child relation, Mother-Child Relations, Mothers, multicenter study, newborn, Object Attachment, object relation, Partner violence, Pregnancy, preschool child, professional practice, prognosis, psychologic test, psychological aspect, Psychosocial outcomes, questionnaire, Questionnaires, randomized controlled trial, Risk Assessment, social adaptation, social adjustment, Social Support, Socioeconomic Factors, socioeconomics, Spouse Abuse, statistics, street drug, Street Drugs, Substance-Related Disorders, United States, Young Adult

There is variability in home visiting program impacts on the outcomes achieved by high risk families. An understanding of how effects vary among families is important for refining service targeting and content. The current study assessed whether and how maternal attributes, including relationship security, moderate short- and long-term home visiting impacts on maternal psychosocial functioning. In this multisite RCT of home visiting in a population-based, ethnically-diverse sample of families at risk for maltreatment of their newborns (n = 643), families were randomly assigned to home visited (HV) and control groups. HV families were to receive intensive services by trained paraprofessionals from birth-3 years. Outcome data were collected when children were 1, 2, and 3 years old and 7, 8, and 9 years old. Overall, short- and long-term outcomes for HV and control mothers did not differ significantly. Demographic attributes, a general measure of overall maternal risk, and partner violence did not moderate program impact on psychosocial functioning outcomes. Maternal relationship security did moderate program impact. Mothers who scored high on relationship anxiety but not on relationship avoidance showed the greatest benefits, particularly at the long-term follow-up. Mothers scoring high for both relationship anxiety and avoidance experienced some adverse consequences of home visiting. Further research is needed to determine mediating pathways and to inform and test ways to improve the targeting of home visiting and the tailoring of home visit service models to extend positive home visiting impacts to targeted families not benefiting from current models. © 2012 Society for Prevention Research.