The effect of volunteer home visitation for adolescent mothers on parenting and mental health outcomes: a randomized trial.

BACKGROUND Children of adolescent mothers may suffer because of parenting inadequacies. The use of volunteer home visitors to enhance parenting skills has not been well studied. OBJECTIVE To evaluate the effect of a volunteer model home visitation program on adolescent parenting outcomes. DESIGN Randomized trial with assignment to home visitation or control group. SETTING Urban, African American community. PARTICIPANTS Adolescents aged 12 to 18 years at 28 or more weeks' gestation or who had delivered a baby in the past 6 months were recruited between February 1996 and August 1999. INTERVENTION Volunteers were recruited from the community and trained to implement a parenting curriculum during weekly home visits. Each volunteer was paired with one teenager. MAIN OUTCOME MEASURE Validated instruments measuring parenting stress, parenting behaviors, and mental health. RESULTS A total of 232 teenagers were successfully randomized to home visitation and control groups. At baseline, the groups were comparable on demographic, social support, and mental health measures. Almost half the teenagers had poor mental health at baseline, and high rates persisted at follow-up in both groups. In multivariate models, the home visitation group demonstrated significantly better parenting behavior scores at follow-up than did the control group (P =.01) but showed no differences in parenting stress or mental health. CONCLUSIONS The volunteer home visitation program significantly improved some parenting outcomes but not parental distress or poor mental health. Volunteers may be an effective means of providing parenting education, but interventions that include specific means of addressing poor mental health are likely to have greater effects.