This study used longitudinal data from 307 mothers with firstborn infants participating in a home-visitation, child-abuse prevention program. A self-report measure of specific constructs the program hoped to affect showed that the retrospective pretest methodology produced a more legitimate assessment of program outcomes than did the traditional pretest-posttest methodology. Results showed that when response shift bias was present, traditional pretest-posttest comparisons resulted in an underestimation of program effects that could easily be avoided by the retrospective pretest methodology. With demands for documenting program outcomes increasing, retrospective pretest designs are shown to be a simple, convenient, and expeditious method for assessing program effects in responsive interventions. The limits of retrospective pretests, and methods for strengthening their use, are discussed.

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Little is known as to why some parents choose to engage in voluntary home visitation services while others refuse or avoid services. To address this knowledge gap, this study tests several hypotheses about the factors that influence maternal intentions to engage in home visitation services and the link between these intentions and the receipt of a home visit. The sample consists of an ethnically diverse group of mothers identified as at-risk for parenting difficulties (N = 343). These mothers were offered home visitation services from nine home visiting programs located across six states. Regardless of service acceptance or refusal, all mothers were interviewed within 2 weeks of the service offer and 3 months later.The findings suggest that mothers who intend to use services look substantially different from those who do not state an intention to participate in home visitation. The results indicate that lower infant birth weight and greater comfort with a provider in one's home are significant predictors of maternal intentions to utilize home visiting services. The study results also support the connection between intent and behavior as the expressed intention to engage in home visitation services was a key predictor of the receipt of a visit.

A two-level hierarchical linear model was used to investigate the impact of poor community health and maternal isolation on mothers' active engagement in a home-visiting family support program. Data came from 4,057 mothers with firstborn infants who enrolled in the Oregon Healthy Start (OHS) home-visiting program from 1995 through 1998. At the time of this study OHS operated in 15 Oregon counties. Results showed that if the mother was living in a county that displayed poor community health, or if the mother was isolated from immediate family and friendship networks, the likelihood of actively engaging in home visits was significantly reduced. Implications for programming and study limitations are discussed.