title: Family risk as a predictor of initial engagement and follow-through in a universal nurse home visiting program to prevent child maltreatment.
abstract: OBJECTIVE
  As nurse home visiting to prevent child maltreatment grows in popularity with both program administrators and legislators, it is important to understand engagement in such programs in order to improve their community-wide effects. This report examines family demographic and infant health risk factors that predict engagement and follow-through in a universal home-based maltreatment prevention program for new mothers in Durham County, North Carolina.
  
  
  METHODS
  Trained staff members attempted to schedule home visits for all new mothers during the birthing hospital stay, and then nurses completed scheduled visits three to five weeks later. Medical record data was used to identify family demographic and infant health risk factors for maltreatment. These variables were used to predict program engagement (scheduling a visit) and follow-through (completing a scheduled visit).
  
  
  RESULTS
  Program staff members were successful in scheduling 78% of eligible families for a visit and completing 85% of scheduled visits. Overall, 66% of eligible families completed at least one visit. Structural equation modeling (SEM) analyses indicated that high demographic risk and low infant health risk were predictive of scheduling a visit. Both low demographic and infant health risk were predictive of visit completion.
  
  
  CONCLUSIONS
  Findings suggest that while higher demographic risk increases families' initial engagement, it might also inhibit their follow-through. Additionally, parents of medically at-risk infants may be particularly difficult to engage in universal home visiting interventions. Implications for recruitment strategies of home visiting programs are discussed.
authors: Center for Child and Family Policy, Duke University, Durham, NC 27708-0545, USA.
authors: Shelley
authors: S
authors: Alonso-Marsden
authors: Kenneth A
authors: KA
authors: Dodge
authors: Karen J
authors: KJ
authors: O'Donnell
authors: Robert A
authors: RA
authors: Murphy
authors: Jeannine M
authors: JM
authors: Sato
authors: Christina
authors: C
authors: Christopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D002649:Child Abuse / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008297:Male; D008423:Maternal Age; D009657:North Carolina / Q000453:epidemiology; D016487:Parenting / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011203:Poverty; D012307:Risk Factors; D055815:Young Adult
keywords: Engagement; Follow-through; Home visiting; Maltreatment; Prevention; Risk
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