Minding the Baby Home Visiting: Program Evaluation
Condition: Attachment; Child Maltreatment; Maternal Sensitivity; Infant Health
MeSH terms: Hypersensitivity
Study type: Interventional

Summary: 
      This is an efficacy study of an intensive home visitation intervention, "Minding the Baby"
      (MTB). This reflective parenting program (aimed at enhancing maternal reflective capacities),
      is focused on first-time young mothers and infants living in an urban community. The study,
      grounded in attachment and human ecology theories integrates advanced practice nursing and
      mental health care by pairing master's level nurse practitioners and social workers with
      at-risk young families. Aims of the study are: 1) to determine the efficacy of the MTB
      intervention in young mothers and infants with respect to a) maternal outcome variables
      including the quality of the mother-infant relationship, maternal reflective capacities,
      maternal mastery/self-efficacy, parental competence, and maternal health and life course
      outcomes (educational success, employment, delaying subsequent child-bearing); and b) infant
      outcome variables including early attachment, infant health, and developmental outcomes; 2)
      to monitor fidelity and dose of the program with young mothers; 3) to describe the evolution
      of reflective capacities in adolescent mothers (contrasting intervention group with control
      group) through descriptive qualitative analyses of transcribed Pregnancy Interviews and
      Parent Development Interviews at the last trimester of pregnancy and at 24 months; 4) to
      conduct cost-effectiveness analyses of the program. The longitudinal two-group study
      (subjects nested within randomly assigned groups), will include multi-method (self report,
      interview and direct observation and coding of behaviors) approaches with a cohort of
      first-time multi-ethnic mothers between the ages of 14-25 (and their infants). MTB home
      visits occur weekly for intervention families (n=69) beginning in mid pregnancy and
      continuing through the first year, and then bi-weekly through the second year. Mothers and
      infants (n=69) in the control group will receive standard prenatal, postpartum and pediatric
      primary care in one of two community health centers (as will the intervention group) and also
      receive monthly educational materials about child health and development mailed to their
      homes. Maternal and infant outcome variables will be followed over time (pregnancy, 4, 12,
      and 24 months) as well as compared between the 2 groups. Cost analyses and analysis of the
      dose and sample characteristics linked to efficacy, will allow us to plan for translation of
      the model into clinical care and community sustainability.
    


Intervention name(s): Minding the Baby Home Visiting Program
Intervention type(s): Behavioral
Intervention description(s): Weekly home visits for one year followed by bi-weekly home visits until child is 24 months of age provided to young at risk families by a team of nurse practitioner and social worker home visitors
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention