Randomized controlled trial of a paraprofessional-delivered in-home intervention for young reservation-based American Indian mothers.
نویسندگان
چکیده
OBJECTIVE To evaluate the efficacy of a paraprofessional-delivered, home-visiting intervention among young, reservation-based American Indian (AI) mothers on parenting knowledge, involvement, and maternal and infant outcomes. METHOD From 2002 to 2004, expectant AI women aged 12 to 22 years (n = 167) were randomized (1:1) to one of two paraprofessional-delivered, home-visiting interventions: the 25-visit "Family Spirit" intervention addressing prenatal and newborn care and maternal life skills (treatment) or a 23-visit breast-feeding/nutrition education intervention (active control). The interventions began during pregnancy and continued to 6 months postpartum. Mothers and children were evaluated at baseline and 2, 6, and 12 months postpartum. Primary outcomes included changes in mothers' parenting knowledge and involvement. Secondary outcomes included infants' social and emotional behavior; the home environment; and mothers' stress, social support, depression, and substance use. RESULTS Participants were mostly teenaged, first-time, unmarried mothers living in reservation communities. At 6 and 12 months postpartum, treatment mothers compared with control mothers had greater parenting knowledge gains, 13.5 (p < .0001) and 13.9 (p < .0001) points higher, respectively (100-point scale). At 12 months postpartum, treatment mothers reported their infants to have significantly lower scores on the externalizing domain (beta = -.17, p < .05) and less separation distress in the internalizing domain (beta = -.17, p < .05). No between-group differences were found for maternal involvement, home environment, or mothers' stress, social support, depression, or substance use. CONCLUSIONS This study supports the efficacy of the paraprofessional-delivered Family Spirit home-visiting intervention for young AI mothers on maternal knowledge and infant behavior outcomes. A longer, larger study is needed to replicate results and evaluate the durability of child behavior outcomes.
منابع مشابه
Home-visiting intervention to improve child care among American Indian adolescent mothers: a randomized trial.
OBJECTIVE To assess the impact of a paraprofessional-delivered home-visiting intervention to promote child care knowledge, skills, and involvement among pregnant American Indian adolescents. DESIGN Randomized controlled trial comparing a family-strengthening intervention with a breastfeeding education program. SETTING One Apache and 3 Navajo communities. PARTICIPANTS Fifty-three pregnant ...
متن کاملBreastfeeding and complementary food: randomized trial of community doula home visiting.
OBJECTIVES Despite recent efforts to increase breastfeeding, young African American mothers continue to breastfeed at low rates, and commonly introduce complementary foods earlier than recommended. This study examines the effects of a community doula home visiting intervention on infant feeding practices among young mothers. METHODS Low-income, African American mothers (n = 248) under age 22 ...
متن کاملTraining Mothers to Improve Gross Motor Skills in Children With Cerebral Palsy: A Randomized Controlled Trial
Objectives: The present study examined the effect of home-based handling training of mothers on the improvement of gross motor function of children with Cerebral Palsy (CP). Methods: In this randomized control trial, 42 children with CP (5-12 years old) were randomly assigned into the intervention and control groups. Data were collected using the Gross Motor Function Classification System and ...
متن کاملChallenges Faced in Engaging American Indian Mothers in an Early Childhood Caries Preventive Trial
Objective. This study explores the challenges faced by the research implementation team in engaging new mothers in a community oral health prevention intervention in an American Indian (AI) reservation community. Methods. Qualitative methods in the form of in-depth interviews were used in the study. Qualitative data were collected from research staff workers at a field site, who were involved i...
متن کاملBreastfeeding and Complementary Food: Randomized Trial of Community Doula Home Visiting abstract
OBJECTIVES: Despite recent efforts to increase breastfeeding, young African American mothers continue to breastfeed at low rates, and commonly introduce complementary foods earlier than recommended. This study examines the effects of a community doula home visiting intervention on infant feeding practices among young mothers. METHODS: Low-income, African American mothers (n = 248) under age 22 ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of the American Academy of Child and Adolescent Psychiatry
دوره 48 6 شماره
صفحات -
تاریخ انتشار 2009