Minding the Baby®: Enhancing parental reflective functioning and infant attachment in an attachment-based, interdisciplinary home visiting program

2019 ◽  
Vol 32 (1) ◽  
pp. 123-137 ◽  
Author(s):  
Arietta Slade ◽  
Margaret L. Holland ◽  
Monica Roosa Ordway ◽  
Elizabeth A. Carlson ◽  
Sangchoon Jeon ◽  
...  
Keyword(s):  
Urban Communities ◽  
Home Visiting ◽  
Controlled Trial ◽  
Reflective Functioning ◽  
Control Group ◽  
Second Phase ◽  
Infant Attachment ◽  
Vulnerable Families ◽  
Reflective Parenting ◽  
Home Visiting Program

AbstractIn this article, we describe the results of the second phase of a randomized controlled trial of Minding the Baby (MTB), an interdisciplinary reflective parenting intervention for infants and their families. Young first-time mothers living in underserved, poor, urban communities received intensive home visiting services from a nurse and social worker team for 27 months, from pregnancy to the child's second birthday. Results indicate that MTB mothers' levels of reflective functioning was more likely to increase over the course of the intervention than were those of control group mothers. Likewise, infants in the MTB group were significantly more likely to be securely attached, and significantly less likely to be disorganized, than infants in the control group. We discuss our findings in terms of their contribution to understanding the impacts and import of intensive intervention with vulnerable families during the earliest stages of parenthood in preventing the intergenerational transmission of disrupted relationships and insecure attachment.

scholarly journals A Home Visiting Parenting Program and Child Obesity: A Randomized Trial

2018 ◽  
pp. 117-126
Author(s):  
Monica Roosa Ordway ◽  
Lois S. Sadler ◽  
Margaret L. Holland ◽  
Arietta Slade ◽  
Nancy Close ◽  
...  
Keyword(s):  
Young Children ◽  
Low Socioeconomic Status ◽  
Home Visiting ◽  
Maternal Mental Health ◽  
Controlled Trial ◽  
Intervention Group ◽  
Overweight And Obesity ◽  
Control Group ◽  
Home Visiting Program ◽  
Overweight Or Obesity

BACKGROUND Young children living in historically marginalized families are at risk for becoming adolescents with obesity and subsequently adults with increased obesity-related morbidities. These risks are particularly acute for Hispanic children. We hypothesized that the prevention-focused, socioecological approach of the “Minding the Baby” (MTB) home visiting program might decrease the rate of childhood overweight and obesity early in life. METHODS This study is a prospective longitudinal cohort study in which we include data collected during 2 phases of the MTB randomized controlled trial. First-time, young mothers who lived in medically underserved communities were invited to participate in the MTB program. Data were collected on demographics, maternal mental health, and anthropometrics of 158 children from birth to 2 years. RESULTS More children in the intervention group had a healthy BMI at 2 years. The rate of obesity was significantly higher (P < .01) in the control group (19.7%) compared with the intervention group (3.3%) at this age. Among Hispanic families, children in the MTB intervention were less likely to have overweight or obesity (odds ratio = 0.32; 95% confidence interval: 0.13–0.78). CONCLUSIONS Using the MTB program, we significantly lowered the rate of obesity among 2-year-old children living in low-socioeconomic-status communities. In addition, children of Hispanic mothers were less likely to have overweight or obesity at 2 years. Given the high and disproportionate national prevalence of Hispanic young children with overweight and obesity and the increased costs of obesity-related morbidities, these findings have important clinical, research, and policy implications.

scholarly journals Effectiveness of the Volunteer Family Connect Program in Reducing Isolation of Vulnerable Families and Supporting Their Parenting: Randomized Controlled Trial With Intention-To-Treat Analysis of Primary Outcome Variables

10.2196/13023 ◽  
2019 ◽  
Vol 2 (2) ◽  
pp. e13023
Author(s):  
Rebekah Grace ◽  
Kelly Baird ◽  
Emma Elcombe ◽  
Vana Webster ◽  
Jacqueline Barnes ◽  
...  
Keyword(s):  
Young Children ◽  
Home Visiting ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Outcome Variable ◽  
Control Group ◽  
Primary Outcome Variable ◽  
Community Connectedness ◽  
Vulnerable Families ◽  
Secondary Outcomes

Background Volunteer home visiting is a widely adopted community-based approach to support families by linking isolated or vulnerable families with community volunteers who visit their homes weekly over approximately 12 months. This study seeks to robustly evaluate the effectiveness of this model of support for families with young children. Objective This paper reports the intention-to-treat analysis of primary and secondary outcomes for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home-visiting program designed to support families with young children who experience social isolation or a lack of parenting confidence and skills. Methods The RCT was conducted across seven sites in Australia. Overall, 341 families were recruited: 169 intervention (services as usual+volunteer home visits) and 172 control (services as usual) families. Intervention families received the program for 3-12 months. Participants were invited to complete six data collection points over a 15-month period. Primary outcomes were community connectedness and parenting competence. Secondary outcomes included parent physical and mental health, general parent wellbeing, parent empowerment, the sustainability of family routines, and the parent-child relationship. According to the protocol, the program would be judged to be effective if at least one of the primary outcomes was significantly positive and the other was neutral (ie, intervention families did not demonstrate positive or negative outcomes compared to the control group). Results The intervention group demonstrated significant improvement in the primary outcome variable parenting sense of competence as compared to the control group. Overall, there was no significant difference between the intervention and control groups with regard to the primary outcome variable community connectedness, other than on the “Guidance” subscale of the Social Provisions Scale. Because there were statistically significant findings for the total score of one primary outcome variable “parenting sense of competence” and largely neutral findings for the primary outcome variable “community connectedness,” the program met the previously defined criteria for program effectiveness. In relation to secondary outcomes, intervention families reported significantly higher wellbeing and were significantly more likely to feel that life was improving. Conclusions The Volunteer Family Connect intervention was considered an effective intervention, with a role to play on the landscape of services available to support vulnerable families with young children. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12616000396426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370304

Breastfeeding Training through Role-Play and Effects on Mother-infant Attachment Behaviours: A Randomised Controlled Trial

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Farokh Saljughi ◽  
Mitra Savabi-Esfahani ◽  
Shahnaz Kohan ◽  
Soheila Ehsanpour
Keyword(s):  
Pregnant Women ◽  
Maternal Employment ◽  
Controlled Trial ◽  
Role Play ◽  
Intervention Group ◽  
Control Group ◽  
Maternal Behaviour ◽  
Infant Attachment ◽  
Significant Difference ◽  
History Of

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.

scholarly journals Improving Adolescent Parenting: Results From a Randomized Controlled Trial of a Home Visiting Program for Young Families

2016 ◽  
Vol 106 (2) ◽  
pp. 342-349 ◽  
Author(s):  
Francine Jacobs ◽  
M. Ann Easterbrooks ◽  
Jessica Goldberg ◽  
Jayanthi Mistry ◽  
Erin Bumgarner ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Home Visiting ◽  
Controlled Trial ◽  
Adolescent Parenting ◽  
Randomized Controlled ◽  
Home Visiting Program

scholarly journals A randomized controlled trial testing the efficacy of a Nurse Home Visiting Program for Pregnant Adolescents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniel Fatori ◽  
Pedro Fonseca Zuccolo ◽  
Elizabeth Shephard ◽  
Helena Brentani ◽  
Alicia Matijasevich ◽  
...  
Keyword(s):  
Child Development ◽  
Home Environment ◽  
Adolescent Mothers ◽  
Home Visiting ◽  
Controlled Trial ◽  
Effect Sizes ◽  
Randomized Controlled ◽  
Nurse Home Visiting ◽  
Standardized Effect Sizes ◽  
Home Visiting Program

AbstractTo test the efficacy of a nurse home visiting program (HVP) on child development, maternal and environmental outcomes in the first years of life. We conducted a randomized controlled trial to test the efficacy of Primeiros Laços, a nurse HVP for adolescent mothers living in a poor urban area of São Paulo, Brazil. Eighty adolescent mothers were included and randomized to receive either Primeiros Laços (intervention group, n = 40) or healthcare as usual (control group, n = 40). Primeiros Laços is a home visiting intervention delivered by trained nurses that starts during the first 16 weeks of pregnancy and continues to the child’s age of 24 months. Participants were assessed by blind interviewers at 8–16 weeks of pregnancy (baseline), 30 weeks of pregnancy, and 3, 6, 12, and 24 months of child’s age. We assessed oscillatory power in the mid-range alpha frequency via electroencephalography when the children were aged 6 months. Child development was measured by the Bayley Scales of Infant Development Third Edition (BSID-III). Weight and length were measured by trained professionals and anthropometric indexes were calculated. The home environment and maternal interaction with the child was measured by the Home Observation and Measurement of the Environment. Generalized estimating equation models were used to examine intervention effects on the trajectories of outcomes. Standardized effect sizes (Cohen’s d) were calculated using marginal means from endpoint assessments of all outcomes. The trial was registered at clinicaltrial.gov: NCT02807818. Our analyses showed significant positive effects of the intervention on child expressive language development (coefficient = 0.89, 95% CI [0.18, 1.61], p = 0.014), maternal emotional/verbal responsivity (coefficient = 0.97, 95% CI [0.37, 1.58], p = 0.002), and opportunities for variety in daily stimulation (coefficient = 0.37, 95% CI [0.09, 0.66], p = 0.009). Standardized effect sizes of the intervention were small to moderate. Primeiros Laços is a promising intervention to promote child development and to improve the home environment of low-income adolescent mothers. However, considering the limitations of our study, future studies should be conducted to assess Primeiros Laços potential to benefit this population.Clinical Trial Registration: The study was registered at clinicaltrial.gov (Registration date: 21/06/2016 and Registration number: NCT02807818).

scholarly journals Infant Mother’s Experiences with the Sustained Nurse Home-Visiting Program

2021 ◽  
Vol 25 (1) ◽  
pp. 31-41
Author(s):  
Kyung Ja June ◽  
Ji Yun Lee ◽  
Sung-Hyun Cho
Keyword(s):  
Home Visiting ◽  
Intervention Program ◽  
Community Resources ◽  
Education Practice ◽  
Nurse Home ◽  
Qualitative Approaches ◽  
Nursing Services ◽  
Vulnerable Families ◽  
Nurse Home Visiting ◽  
Home Visiting Program

Purpose: The purpose of this study was to understand the experiences of mothers of infants who received sustained nurse home visiting services. The program of sustained home visit by nurses (Seoul Maternal Early Childhood Sustained Home-Visiting Program) is an intervention program. Its effectiveness has been verified in Australia, where services are provided to families in a vulnerable families during the period from prenatal period until the newborn is 2 years old.Methods: The study protocol used qualitative approaches. Eleven mothers of infants who received nursing services in December 2015 were invited for an in-depth interview. The data collected were subjected to directed content analysis.Results: The following 4 themes were identified from the analysis: (1) reduction in suspicion and increased feeling of benefit from the visiting service, (2) emotional support to the parents and use of community resources, (3) reliance on friendly nurses, and (4) gaining confidence about parenting and motherhood.Conclusion: Sustained nursing home visiting services can be applied effectively in South Korea. The concrete narrations and descriptions of the experiences of mothers in this study can be used as a base for education, practice, and research.

Home visiting intervention for vulnerable families with newborns: follow-up results of a randomized controlled trial

2000 ◽  
Vol 24 (11) ◽  
pp. 1399-1429 ◽  
Author(s):  
Jennifer A Fraser ◽  
Kenneth L Armstrong ◽  
Jeanette P Morris ◽  
Mark R Dadds
Keyword(s):  
Randomized Controlled Trial ◽  
Home Visiting ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Vulnerable Families

scholarly journals A randomised controlled trial to evaluate a medication monitoring system for TB treatment

2022 ◽  
Vol 26 (1) ◽  
pp. 44-49
Author(s):  
J. Acosta ◽  
P. Flores ◽  
M. Alarcón ◽  
M. Grande-Ortiz ◽  
L. Moreno-Exebio ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Treatment Success ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Second Phase ◽  
Open Label ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
Significant Difference

BACKGROUND: Adherence to TB treatment and therefore treatment success could be improved using digital adherence technology.OBJECTIVE: To evaluate the effectiveness of a medication event reminder monitor system (MERM) on treatment success and treatment adherence in patients with drug-susceptible pulmonary TB in Perú.METHODS: This was an experimental, randomised, open-label, controlled study conducted among patients in the second phase of TB treatment. The intervention group received their medications through MERM with the support of a treatment monitor, whereas the control group used the usual strategy. Participants were followed until they completed the 54 doses of the second phase of treatment.RESULTS: The study included 53 patients in each group; four in the intervention group withdrew from the study. Treatment success was significantly more frequent in the MERM group (RR 1.15, 95% CI 1.02–1.30; P = 0.0322). There was no significant difference in the adherence outcomes; however, the percentage of patients who missed at least one dose and patients with more than 10% of total doses missed were lower in the intervention group.CONCLUSION: The use of MERM in the second phase of treatment showed a significant improvement in the treatment success rate in patients with drug-susceptible pulmonary TB.

scholarly journals The effectiveness of the Volunteer Family Connect Program in supporting vulnerable families: A randomised controlled trial intention-to-treat analysis of primary outcome variables (Preprint)

2018 ◽  
Author(s):  
Rebekah Grace ◽  
Kelly Baird ◽  
Emma Elcombe ◽  
Vana Webster ◽  
Jacqueline Barnes ◽  
...  
Keyword(s):  
Young Children ◽  
Home Visiting ◽  
Controlled Trial ◽  
Intervention Group ◽  
Parenting Competence ◽  
Community Connectedness ◽  
Intention To Treat ◽  
Vulnerable Families ◽  
Secondary Outcomes ◽  
Treat Analysis

BACKGROUND Volunteer home visiting is a widely adopted community-based approach to supporting families by linking isolated or vulnerable families with community volunteers. This study seeks to robustly evaluate the effectiveness of this model of support for families with young children. OBJECTIVE This paper reports the intention-to-treat analysis of primary and secondary outcomes for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home visiting program designed to support families with young children who experience social isolation or a lack of parenting confidence and skills. METHODS The RCT was conducted across seven sites in Australia. Overall, 341 families were recruited: 169 intervention (services as usual + volunteer home visiting) and 172 control (services as usual) families. Intervention families received the program for 3-12 months. Participants were invited to complete six data collection points over a 15-month period. Primary outcomes were community connectedness and parenting competence. Secondary outcomes included parent physical and mental health, general parent wellbeing, parent empowerment, the sustainability of family routines, and the parent-child relationship. RESULTS The intervention group demonstrated significant improvement compared to the control group in both of the primary outcomes. They were significantly more like to report improvements in the guidance available to them as measured by the Social Provisions Scale, a key measure of community connectedness and scores on the Parenting Sense of Competence Scale were significantly in favour of the intervention group. Intervention families also reported significantly higher wellbeing, and were significantly more likely to feel that life was improving. A number of positive trends were also evident within the findings. CONCLUSIONS The Volunteer Family Connect intervention was considered to be an effective intervention for improving the community connectedness and parenting competence of families with young children. CLINICALTRIAL Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12616000396426).

Healthy Start Home Visiting Program—School-Based Model: Cluster Randomized Controlled Trial

2018 ◽  
Vol 29 (6) ◽  
pp. 628-643 ◽  
Author(s):  
Cynthia Leung ◽  
Sandra Tsang ◽  
Kitty Heung ◽  
Mia Tam
Keyword(s):  
Randomized Controlled Trial ◽  
Home Visiting ◽  
Controlled Trial ◽  
Healthy Start ◽  
Control Groups ◽  
Randomized Controlled ◽  
Children's Behavior ◽  
School Based ◽  
Home Visiting Program ◽  
Cluster Randomized

Objective: This study evaluated the effectiveness of the Healthy Start Home Visiting Program—School-Based Model (HSS), using a cluster randomized controlled trial design. Methods: Participants included 224 parents from 20 preschools randomized into intervention and wait-list control groups at the preschool level. Furthermore, 105 parents from the participating preschools were trained as parent ambassadors to assist in program delivery. They were randomized into intervention and control groups at the preschool level. Outcome measures included parent and teacher reports on children’s learning, parent report on children’s behavior and health, their own parenting, and direct assessment of children. Parent ambassadors completed measures on parenting and their children’s behavior before training and after program delivery. Results: There was significant improvement at postintervention in parenting, children’s behavior, and learning and health in the intervention group, compared with the control group. Conclusions: The results provided evidence on the effectiveness of the HSS program.

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