title: Supplementation of urban home visitation with a series of group meetings for parents and infants: results of a "real-world" randomized, controlled trial.
abstract: OBJECTIVE
  Home visitation has been shown to be effective in reducing rates of child maltreatment and in enhancing psychosocial outcomes in children and their parents. Even when available, however, it is underutilized by parents in some urban settings. We tested a supplemental 10-session group intervention for its ability to increase active participation in home visitation, enhance the quality of caregiving behavior of parents, and improve social developmental outcome in children.
  
  
  METHODS
  A randomized controlled design was utilized, involving two separate cohorts of parents of 3- to 18-month old infants, totaling 148 parent-child dyads. The intervention focused on practical experience in promoting parent-infant attachment relationships.
  
  
  RESULTS
  At 6 months follow-up, there was a substantial increase in the proportion of intervention group parents participating in home visitation, compared to parents in the control group (Fisher's exact p = .008). Parents in the intervention group exhibited a trend for improvement in their capacity to appropriately interpret infants' emotional cues (p = .08), independent of the effects of home visitation itself. Attrition in both the treatment and control groups was inversely associated with income and level of education.
  
  
  CONCLUSIONS
  Group meetings may constitute an effective means of engaging stressed urban families in home visitation.
authors.affiliation: Department of Psychiatry & Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Constantino
authors.forename: N
authors.initials: N
authors.lastname: Hashemi
authors.forename: E
authors.initials: E
authors.lastname: Solis
authors.forename: T
authors.initials: T
authors.lastname: Alon
authors.forename: S
authors.initials: S
authors.lastname: Haley
authors.forename: S
authors.initials: S
authors.lastname: McClure
authors.forename: N
authors.initials: N
authors.lastname: Nordlicht
authors.forename: M A
authors.initials: MA
authors.lastname: Constantino
authors.forename: J
authors.initials: J
authors.lastname: Elmen
authors.forename: V K
authors.initials: VK
authors.lastname: Carlson
mesh_terms: D000328:Adult; D002649:Child Abuse / Q000517:prevention & control* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006266:Health Education; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008923:Missouri; D009035:Mothers / Q000193:education* / Q000523:psychology; D009769:Object Attachment; D017063:Outcome Assessment, Health Care; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D012944:Social Support; D014505:Urban Population