title: Effects of Home Visitation on Maternal Competencies, Family Environment, and Child Development: a Randomized Controlled Trial.
abstract: Based on the US Nurse-Family Partnership (NFP) program, the German home visiting program "Pro Kind" offered support for socially and financially disadvantaged first-time mothers from pregnancy until the children's second birthday. A multi-centered, longitudinal randomized controlled trial (RCT) was conducted to assess its effectiveness on mothers and children. A total of 755 women with multiple risk factors were recruited, 394 received regular home visits (treatment group), while 361 only had access to standard community services (control group). Program influences on family environment (e.g., quality of home, social support), maternal competencies (e.g., maternal self-efficacy, empathy, parenting style), and child development (e.g., cognitive and motor development) were assessed from mothers' program intake in pregnancy to children's second birthday based on self-reports in regular interviews and developmental tests. Generalized estimating equations (GEE) models showed small, but significant positive treatment effects on parental self-efficacy, and marginally significant effects on social support, and knowledge on child rearing. Maternal stress, self-efficacy, and feelings of attachment in the TG tend to show a more positive development over time. Subgroup effects were found for high-risk mothers in the TG, who reported more social support over time and, generally, had children with higher developmental scores compared to their CG counterparts. Post hoc analyses of implementation variables revealed the quality of the helping relationship as a significant indicator of treatment effects. Results are discussed in terms of implementation and public policy differences between NFP and Pro Kind.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany. susan.sierau@medizin.uni-leipzig.de.
authors.forename: Susan
authors.initials: S
authors.lastname: Sierau
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Dähne
authors.affiliation: Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Brand
authors.affiliation: Department Youth and Family, Capital City of Hannover, Sutelstrasse 18, 30659, Hannover, Germany.
authors.forename: Vivien
authors.initials: V
authors.lastname: Kurtz
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: von Klitzing
authors.affiliation: Faculty of Humanities, Institute for Special Educational Intervention and Rehabilitation, University of Rostock, August-Bebel-Strasse 28, 18051, Rostock, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Jungmann
mesh_terms: D000328:Adult; D002648:Child; D002657:Child Development; D005190:Family; D005260:Female; D006792:House Calls; D006801:Humans; D011247:Pregnancy; D055815:Young Adult
keywords: Early intervention; Nurse-family partnership; Program implementation; Socially disadvantaged families