Home-visiting intervention to improve child care among American Indian Adolescent mothers: A randomized trial

Allison Barlow*, Elena Varipatis-Baker, Kristen Speakman, Golda Ginsburg, Ingrid Friberg, Novalene Goklish, Brandii Cowboy, Pauline Fields, Ranelda Hastings, William Pan, Raymond Reid, Mathuram Santosham, John Walkup

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Objective: To assess the impact of a paraprofessional-delivered home-visiting intervention to promote child care knowledge, skills, and involvement among pregnant American Indian adolescents. Design: Randomized controlled trial comparing a family-strengthening intervention with a breastfeeding education program. Setting: One Apache and 3 Navajo communities. Participants: Fifty-three pregnant American Indian adolescents were randomly assigned to intervention (n=28) or control (n=25) groups. Follow-up data were available for 19 intervention and 22 control participants. Intervention: Paraprofessionals delivered 41 prenatal and infant care lessons in participants' homes from 28 weeks' gestation to 6 months post partum. Main Outcome Measures: Child care knowledge, skills, and involvement. Results: Mothers in the intervention compared with the control group had significantly higher parent knowledge scores at 2 months (adjusted mean difference [AMD], +14.9 [95% confidence interval (CI), +7.5 to +22.4]) and 6 months post partum (AMD, +15.3 [95% CI, -5.9 to +24.7]). Intervention group mothers scored significantly higher on maternal involvement scales at 2 months post partum (AMD, +1.5 [95% CI, -0.02 to +3.02]), and scores approached significance at 6 months post partum (AMD, +1.1 [95% CI, -0.06 to +2.2]). No between-group differences were found for child care skills. Conclusions: A paraprofessional-delivered, family-strengthening home-visiting program significantly increased mothers' child care knowledge and involvement. A longer and larger trial is needed to understand the intervention's potential to improve adolescent parenting and related child outcomes in American Indian communities.

Original languageEnglish (US)
Pages (from-to)1101-1107
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Issue number11
StatePublished - Nov 2006

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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