Characteristics Associated with Participant Attrition and Retention in a Perinatal Home Visiting Program

Ramakrishnan, Rema; Holland, Virginia; Agu, Ngozichukwuka; Brady, Carol; Marshall, Jennifer

doi:10.1007/s11121-022-01338-8

Cited by 7 publications

(2 citation statements)

References 30 publications

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“…These rates are consistent with or higher than previously found reported national rates, depending on how retention was operationalized (i.e., 39.5-82.3% by 6 months; 46% by 12 months) (3,43). They were also higher than rates found by an evaluation of programs in Florida which showed retention of 62.9% six months after enrollment (44). It is important to note, however, that all previous studies on retention rates happened before the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 55%

Towards Precision Home Visiting: Results at Six Months Postpartum from a Randomized Pilot Implementation Trial to Assess the Feasibility of a Precision Approach to Family Spirit

Ingalls

Rebman

Martin

et al. 2022

Preprint

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Background: Shared implementation challenges at scale in early childhood home visiting have led researchers to explore precision home visiting as a promising service delivery mechanism to better address families’ unique needs and build greater program efficiencies. This randomized controlled pilot study aimed to assess the acceptability of a precision approach to one home visiting model, Family Spirit® and explore potential differences between Precision Family Spirit (PFS) and Standard Family Spirit (Standard FS) on participant-home visitor relationship and maternal outcomes. Methods: Participants (N=60) were at least 14 years old, pregnant or within two months postpartum, and enrolled in Family Spirit. Four sites in Michigan were randomized 1:1 to deliver PFS (up to 17 core lessons plus up to 13 additional lessons as needed) or Standard FS (home visiting services as usual). Primary (program acceptability, participant satisfaction, home visitor-participant relationship quality, retention, adherence) and secondary (knowledge, quality of life, difficulty with parenting problems, substance use, depression, stress) outcomes at 6 months postpartum are presented. PFS participants only were assessed during home visits on a subset of secondary measures that informed which lessons they should receive. Results: Mothers in both groups reported positive program acceptability, satisfaction, and home visitor-participant relationships at 6 months postpartum. However, open-ended feedback from Standard FS participants indicates that some lesson content may not be applicable to all participants. At six months, retention was 82.3% for PFS and 66.7% for Standard FS, and adherence was 30.1% for PFS and 20.6% for Standard FS. Conclusions: Preliminary findings indicate that precision home visiting may be acceptable and feasible, yet more research is needed to understand its impact as an implementation strategy. Trial registration: ClinicalTrials.gov NCT03975530 (first posted on 05/06/2019)

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Section: Discussionmentioning

confidence: 55%

Towards Precision Home Visiting: Results at Six Months Postpartum from a Randomized Pilot Implementation Trial to Assess the Feasibility of a Precision Approach to Family Spirit

Ingalls

Rebman

Martin

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…It is encouraging that intervention feasibility, as demonstrated by high levels of parent engagement within this study, far exceeded engagement levels reported generally within home visiting interventions (42). With 80% of mothers in the sample above the clinical cut-off for classification as at high risk for child abuse potential at pre-intervention, relevance of the intervention for child welfare populations should be considered.…”

Section: Discussionmentioning

confidence: 74%

Pre-intervention child maltreatment risks, intervention engagement, and effects on child maltreatment risk within an RCT of MHealth and parenting intervention

Baggett

Davis

Olwit

et al. 2023

Front. Digit. Health

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IntroductionEvidence-based mental health and parenting support services for mothers postpartum can reduce risk for child maltreatment. However, women suffering economic and cultural stressors disproportionately shoulder the burden of infant caregiving while experiencing profound barriers to accessing mental health and parenting services. This article reports on an MHealth and parenting intervention targeting maternal mood and positive parent practices within a randomized controlled trial, which provided a unique opportunity to view pre-intervention child maltreatment risk, its relationship to subsequent intervention engagement, and intervention engagement effects on pre-post child maltreatment risk reduction.MethodPrincipal component factor analysis was conducted to identify a modifiable pre-intervention child maltreatment risk construct within a combined MHealth and parenting intervention sample of 184 primarily Black mothers and their infants. An independent t-test was conducted to compare pre-intervention child maltreatment risk levels between mothers who went on to complete at least two-thirds of the intervention and those who did not. A GLM repeated measures analysis of variance was conducted to determine effects of intervention engagement on child maltreatment risk reduction.ResultsPre-intervention child maltreatment risk did not differentiate subsequent maternal intervention completion patterns. Mothers who completed two-thirds of the intervention, compared to those who did not, demonstrated significant reductions in pre-post child maltreatment risk.DiscussionFindings underscore the potential of MHealth parenting interventions to reduce substantial child maltreatment risk through service delivery addressing a range of positive parenting and behavioral health needs postpartum, a particularly vulnerable developmental period for maternal depression and child maltreatment risk.

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Home-Visiting Programming in Kindergarten-Readiness Interventions: Retention and Loss of Families

Justice,

Jiang,

Planke

et al. 2024

Child Youth Care Forum

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Background Home-visiting programs are an often-used intervention for supporting the well-being of families with young children, and there is long-standing interest among researchers in ensuring the effectiveness of this practice. Especially, retention and attrition play important roles in achieving desired outcomes of the intervention. Objective This study aims to examine home-visit participation levels among low-income families and explore correlates of the participation levels. It also aims to evaluate patterns of attrition over time and to investigate child and family characteristics that potentially contribute to completion of the program. Methods We examined data from 113 families whose children participated in a 15-month kindergarten-transition intervention. All families received supplemental home-visiting activities as a key component of the intervention, beginning at the start of preschool and extending through middle of kindergarten year. Results We found that, on average, families completed four out of nine planned home visits, with large dispersion in the number of visits completed. Survival analyses suggested that families who dropped out were most likely to do so at the beginning of the program, with 39% of caregivers maintained to the final visit. Participation in the home-visiting program was related to children’s age and race, as well as children’s academic skill levels. Conclusion Study findings have implications for the design and implementation of kindergarten-readiness initiatives targeting low-income families, especially in terms of advancing strategies to maintain families in longitudinal activities.

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Characteristics Associated with Participant Attrition and Retention in a Perinatal Home Visiting Program

Abstract: Ethics approval: This study was reviewed and considered exempt by the Institutional Review Board at a large public university in Florida as it involved secondary data analysis (not human subjects research) and was part of a program evaluation.

Cited by 7 publications

References 30 publications

Towards Precision Home Visiting: Results at Six Months Postpartum from a Randomized Pilot Implementation Trial to Assess the Feasibility of a Precision Approach to Family Spirit

Towards Precision Home Visiting: Results at Six Months Postpartum from a Randomized Pilot Implementation Trial to Assess the Feasibility of a Precision Approach to Family Spirit

Pre-intervention child maltreatment risks, intervention engagement, and effects on child maltreatment risk within an RCT of MHealth and parenting intervention

Home-Visiting Programming in Kindergarten-Readiness Interventions: Retention and Loss of Families

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