Engaging Fathers in Home Visitation
Condition: Interparental Conflict; Parenting; Parent-child Relations; Fathers
Study type: Interventional

Summary: 
      The purpose of this study is to determine the efficacy of Family Foundations that is to be
      delivered concurrently with home visiting. Delivered prenatally and postnatally, Family
      Foundations is a coparenting prevention program for new mothers and fathers that is designed
      to optimize child outcomes by teaching parents how to work together in raising their child.
      Using a randomized clinical trial design, families will be assigned to receive Family
      Foundations + home visiting or home visiting alone. A comprehensive assessment is
      administered at baseline and then at post-intervention, and 9 and 18 months later. It is
      hypothesized that families receiving Family Foundations will improve in their resolving of
      conflict from pre-intervention through follow-up. Additional anticipated outcomes are that
      those receiving the intervention will have more involved fathers, mothers and fathers will
      report less conflict, and children will have better emotional and behavioral outcomes
      relative to those who receive home visiting alone.
    

Detailed description: 
      Home visitation is a prevention program for sociodemographically high risk, first-time
      mothers and their families that is designed to optimize child health and development. Most
      home visitation programs seek to engage fathers in the service and promote greater positive
      involvement with their children, although systematic and efficacious strategies to achieve
      this have not been developed and tested. Yet, it is well-documented that positive father
      involvement and mutually supportive relationships between fathers and mothers impart direct
      benefits to both children and their parents. Building upon previous efforts to incorporate
      evidence-based interventions into the home visitation setting, this study seeks to adapt
      Family Foundations, a coparenting intervention with a strong empirical foundation, as an
      augmented strategy in ongoing home visitation. In a first phase of qualitative investigation,
      we will adapt the format and content of Family Foundations for implementation in the home,
      addressing the needs of high risk mothers and fathers, and integrate it into standard home
      visitation services. In a second phase, a clinical trial will be conducted to determine the
      efficacy of the adapted intervention (HVFF) in contrast to a control condition of home
      visitation alone (HVA). Specifically, 300 mother/father dyads in home visitation will be
      recruited prenatally and randomly assigned to HVFF and HVA conditions. HVFF will consist of 8
      in-home and 2 group sessions administered weekly and in two equal parts at approximately 2
      months before birth and 4 months postpartum. Both the HVFF and HVA participants will be
      assessed at pre-intervention, post-intervention (5 months postpartum), and 9 and 18 month
      follow-ups. A comprehensive assessment battery will be administered at each assessment
      measuring parental cooperation, quality of parental relationship, father involvement, beliefs
      about parenting, parental psychological adjustment, and intimate partner violence. After the
      child's birth, child development and social/emotional adjustment will be measured and
      parenting practices will be videotaped and subsequently rated for parenting quality. It is
      hypothesized that, relative to controls, fathers in the HVFF condition will participate more
      frequently and more positively in standard home visits and will be more involved with their
      children; mothers and fathers in the HVFF condition will have higher levels of coparenting,
      and lower levels of depression, parental stress, and child abuse potential; and children in
      the HVFF condition will be more behaviorally and emotionally well-adjusted. Mediators of
      intervention outcomes will also be explored.
    

Intervention name(s): Family Foundations coparenting program; Home visiting
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Family Foundations is a coparenting program for new mothers and fathers designed to teach them skills needed to parent together effectively and facilitate healthy child development. Family Foundations will be administered concurrently with home visiting.; Home visiting is a child abuse prevention approach for new mothers designed to strengthen protective factors and mitigate risk factors in order to promote optimal child development.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Coparenting; Problem solving; Child development; Father involvement