Home Visitation Program for New Parent Support

Overseen By Daniel F Perkins, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Penn State University

Disqualifiers: Under 18, Not military, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

600 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial evaluates the TRHV program, where trained professionals visit new parents in the Navy and Marine Corps to provide parenting support. It aims to help families with young children at risk for abuse and neglect by improving parenting practices and child development through direct home visits.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on evaluating a home visitation program rather than medical treatments.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Services as Usual (SAU) and Take Root Home Visitation (TRHV) for new parent support?

Research shows that home visitation programs can improve health behaviors during pregnancy, enhance parent-child interactions, and reduce child abuse and neglect. Programs that involve both parents, like 'Dads Matter', have shown positive effects on family relationships and child well-being. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Services as Usual (SAU) and Take Root Home Visitation (TRHV)?

Research shows that home visitation programs can improve health behaviors during pregnancy, enhance parent-child interactions, and reduce child abuse and neglect. Programs that involve frequent visits by nurses and target high-risk families are particularly effective. ^{1 2 3 4 5}

Is the Home Visitation Program for New Parent Support safe for participants?

Research on home visitation programs shows they can improve health behaviors and reduce risks like child abuse and emergency visits, suggesting they are generally safe. However, some mothers with high relationship anxiety and avoidance may experience adverse effects, indicating the need for careful participant selection and program tailoring. ^{1 2 6 7 8}

Is the Home Visitation Program for New Parent Support safe for participants?

Research on home visitation programs shows they can improve health behaviors and reduce risks like child abuse and emergency visits, suggesting they are generally safe. However, some mothers with high relationship anxiety and avoidance may experience adverse effects, indicating the need for careful participant assessment. ^{1 2 6 7 8}

How is the Take Root Home Visitation (TRHV) treatment different from other treatments for new parent support?

The Take Root Home Visitation (TRHV) treatment is unique because it involves trained personnel visiting new parents at home to provide information, support, and training on child health and development, which is not typically part of standard treatments for new parent support. This approach is designed to improve the home environment and prevent child behavior problems, making it distinct from other interventions that may not offer such personalized, in-home guidance. ^{9 10 11 12 13}

How is the Take Root Home Visitation (TRHV) treatment different from other treatments for new parent support?

The Take Root Home Visitation (TRHV) treatment is unique because it involves trained personnel visiting new parents at home to provide information, support, and training on child health and development, which is not typically part of standard treatments for new parent support. This approach is designed to improve the home environment and prevent child behavior problems, making it distinct from other interventions that may not offer such personalized, in-home guidance. ^{9 10 11 12 13}

Research Team

Daniel F Perkins, PhD

Principal Investigator

The Pennsylvania State University

Ryan P Chesnut, PhD

Principal Investigator

The Pennsylvania State University

Eligibility Criteria

This trial is for families with children aged 0-3, or expecting parents, who are active duty, retired, National Guard or Reserves service members (or their partners) stationed at certain military installations. They must speak English well and be eligible for the New Parent Support Program home visits.

Inclusion Criteria

NPSP Home Visitors: Speak and understand English proficiently

NPSP Participants: Eligible to receive NPSP home-visiting services

My child is between 0 and 3 years old.

Exclusion Criteria

My child is older than 3 years.

NPSP Participants: Not an active duty, retired, National Guard or Reserves service member or spouse/partner

NPSP Participants: Not currently pregnant or the parent of a child 0-3-years-old

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Initial assessments including various questionnaires and inventories to establish baseline measures

1-2 weeks

Treatment

Participants receive either the TRHV or SAU home-visiting services

12 months

Follow-up

Participants are monitored for program outcomes and client satisfaction post-treatment

6-7 months post-baseline

Treatment Details

Interventions

• Services as Usual (SAU)
• Take Root Home Visitation (TRHV)

Trial Overview The study evaluates a new program called Take Root Home Visitation (TRHV), which aims to improve child development and parenting behaviors while reducing child abuse risk. It will be compared to the usual support services provided by the military.

Participant Groups

Group I: Take Root Home Visitation (TRHV) Experimental Treatment 1 Intervention

TRHV is an evidence-informed, manualized home-visiting curriculum.

Group II: Services as Usual (SAU) Active Control 1 Intervention

SAU involves the current standard of care implemented at the participating Navy and Marine Corps installations.

Who Is Running the Clinical Trial?

Penn State University

Lead Sponsor

Trials

380

Recruited

131,000+

United States Department of Agriculture (USDA)

Collaborator

Trials

103

Recruited

287,000+

Findings from Research

In a study of 816 participants in a national home visitation program, factors such as being older, unemployed, or enrolling early in pregnancy were linked to longer service duration and more home visits, indicating these characteristics may enhance program retention.

Programs with lower caseloads and better matching of participants and providers based on parenting status and race/ethnicity showed improved enrollment and retention rates, highlighting the importance of tailored support in home visitation services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sustaining new parents in home visitation services: key participant and program factors. Daro, D., McCurdy, K., Falconnier, L., et al.[2019]

Home-visitation programs for socially disadvantaged women and children can significantly improve maternal health behaviors, birth outcomes, and child development, while also reducing child abuse and hospital visits.

The most effective programs involved nurses who started visits during pregnancy, maintained frequent contact, and focused on addressing behavioral and psychosocial factors, particularly for families at higher risk due to poverty.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can home visitation improve the health of women and children at environmental risk? Olds, DL., Kitzman, H.[2022]

The 'Dads Matter' program was successfully integrated into standard home visiting services, showing feasibility and acceptability in a pilot study with 24 families.

Preliminary results indicated that the program positively impacted various outcomes, including the quality of the mother-father relationship and fathers' involvement with their children, with effect sizes generally larger than those seen in previous home visitation studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting father involvement in early home visiting services for vulnerable families: Findings from a pilot study of "Dads matter". Guterman, NB., Bellamy, JL., Banman, A.[2019]

In a study involving 413 mothers, the use of interactive software in the e-Parenting Program (ePP) improved working alliance ratings at 6 months compared to standard services, indicating better engagement with the program.

However, despite the software's good acceptability, there were no significant differences in child maltreatment or risk factors between the ePP and other conditions at either the 6 or 12-month follow-ups, suggesting limited efficacy in preventing maltreatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Technology to Augment Early Home Visitation for Child Maltreatment Prevention: A Pragmatic Randomized Trial. Ondersma, SJ., Martin, J., Fortson, B., et al.[2018]

The randomized trial demonstrated that a home visitation model for at-risk women significantly improved their social support and access to services after an average of ten months.

Participants in the experimental group also experienced decreased psychological distress, highlighting the model's effectiveness in supporting families at risk of out-of-home placement for their newborns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home visitation services for at-risk pregnant and postpartum women: a randomized trial. Marcenko, MO., Spence, M.[2022]

The Nurse-Family Partnership program showed a significant reduction in subsequent pregnancies for first-time mothers, particularly for those whose first infants were born after 2003, with a hazard ratio of 0.87 indicating a 13% lower risk of a second pregnancy compared to controls.

The program was especially effective for mothers aged 18 years or younger, with a remarkable hazard ratio of 0.40 in rural areas, suggesting that younger mothers in these locations were significantly less likely to have a second pregnancy within two years of their first child's birth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variation in pregnancy outcomes following statewide implementation of a prenatal home visitation program. Rubin, DM., O'Reilly, AL., Luan, X., et al.[2022]

In a study of 643 high-risk families, home visiting programs did not show significant differences in short- and long-term outcomes for mothers compared to control groups, indicating that the overall effectiveness may be limited.

However, maternal relationship security played a crucial role; mothers with high relationship anxiety but low avoidance benefited the most from home visiting, while those with high anxiety and avoidance experienced negative effects, suggesting the need for tailored approaches in home visiting services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning. McFarlane, E., Burrell, L., Crowne, S., et al.[2021]

In a study involving 2,357 families from 21 Healthy Families America and 9 Nurse-Family Partnership sites in New Jersey, both programs showed high levels of family engagement, with 59% of HFA and 64% of NFP families receiving a high dose of services in the first 6 months.

Home visitor characteristics were the main factor influencing service receipt in HFA (87% of variation), while family characteristics were more significant for NFP (75% of variation), suggesting that tailored engagement strategies could enhance participation, especially for families with lower education and higher risk factors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring Multilevel Factors for Family Engagement in Home Visiting Across Two National Models. Latimore, AD., Burrell, L., Crowne, S., et al.[2018]

Early childhood home visitation programs are effective in preventing child abuse and neglect, as supported by strong evidence from a systematic review conducted by the Task Force on Community Preventive Services.

However, there is insufficient evidence to determine the effectiveness of these programs in preventing other forms of violence, such as violence by visited children or intimate partner violence, indicating that more research is needed in these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

First reports evaluating the effectiveness of strategies for preventing violence: early childhood home visitation. Findings from the Task Force on Community Preventive Services. Hahn, RA., Bilukha, OO., Crosby, A., et al.[2016]

A survey of 42 MIECHV administrators revealed that while MIECHV leadership is strong in many states, there are significant weaknesses in data systems and financial support for coordinating home visiting services with other early childhood programs.

Stronger state leadership and shared goals across sectors were linked to better perceptions of coordination, highlighting the need for states to collaborate and learn from each other to improve their coordination efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of State Context in Promoting Service Coordination in Maternal, Infant, and Early Childhood Home Visiting Programs. West, A., Duggan, AK., Gruss, K., et al.[2021]

The Hawaii Healthy Start Program successfully identified 84% of at-risk families through early screening, with higher enrollment rates among families with greater risk factors, such as young mothers with limited education and infants at biological risk.

Engagement in home visiting services was variable, with about half of enrolled families remaining active after one year, and those facing multiple risk factors were more likely to have frequent visits, highlighting the need for tailored support to retain at-risk families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hawaii's healthy start program of home visiting for at-risk families: evaluation of family identification, family engagement, and service delivery. Duggan, A., Windham, A., McFarlane, E., et al.[2014]

The paper emphasizes the importance of establishing a coordinated national policy for family support at home, highlighting the historical context of home visiting programs.

It provides recommendations for improving practice, training, and research in family support programs, while also discussing the influence of new federal initiatives on these efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family support in the home. Programs, policy, and social change. Roberts, RN., Wasik, BH., Casto, G., et al.[2019]

The adapted Parent And Caregiver Active Participation Toolkit (PACT) significantly improved parent participation in the SafeCare® home visitation program, as evidenced by higher engagement levels compared to a previous group of parents.

Home visitors reported greater fidelity in assigning homework to parents when using the PACT for SC, indicating that the toolkit not only enhanced participation but also supported the implementation of program activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent And Caregiver Active Participation Toolkit (PACT): Adaptation for a Home Visitation Program. Haine-Schlagel, R., Fettes, DL., Finn, N., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Sustaining new parents in home visitation services: key participant and program factors. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Can home visitation improve the health of women and children at environmental risk? [2022]

3. England pubmed.ncbi.nlm.nih.gov

Promoting father involvement in early home visiting services for vulnerable families: Findings from a pilot study of "Dads matter". [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Technology to Augment Early Home Visitation for Child Maltreatment Prevention: A Pragmatic Randomized Trial. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Home visitation services for at-risk pregnant and postpartum women: a randomized trial. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Variation in pregnancy outcomes following statewide implementation of a prenatal home visitation program. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Exploring Multilevel Factors for Family Engagement in Home Visiting Across Two National Models. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

First reports evaluating the effectiveness of strategies for preventing violence: early childhood home visitation. Findings from the Task Force on Community Preventive Services. [2016]

10. United States pubmed.ncbi.nlm.nih.gov

The Role of State Context in Promoting Service Coordination in Maternal, Infant, and Early Childhood Home Visiting Programs. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Hawaii's healthy start program of home visiting for at-risk families: evaluation of family identification, family engagement, and service delivery. [2014]

12. United States pubmed.ncbi.nlm.nih.gov

Family support in the home. Programs, policy, and social change. [2019]

13. United States pubmed.ncbi.nlm.nih.gov

Parent And Caregiver Active Participation Toolkit (PACT): Adaptation for a Home Visitation Program. [2022]