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 journalArticle

39 Citations (Scopus)

Abstract

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
Volume160
Issue number11
DOIs
StatePublished - Jan 1 2006

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North American Indians
Child Care
Mothers
Confidence Intervals
Infant Care
Prenatal Care
Parenting
Breast Feeding
Randomized Controlled Trials
Outcome Assessment (Health Care)
Education
Pregnancy
Control Groups

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Barlow, Allison ; Varipatis-Baker, Elena ; Speakman, Kristen ; Ginsburg, Golda ; Friberg, Ingrid ; Goklish, Novalene ; Cowboy, Brandii ; Fields, Pauline ; Hastings, Ranelda ; Pan, William ; Reid, Raymond ; Santosham, Mathuram ; Walkup, John. / Home-visiting intervention to improve child care among American Indian Adolescent mothers : A randomized trial. In: Archives of Pediatrics and Adolescent Medicine. 2006 ; Vol. 160, No. 11. pp. 1101-1107.
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abstract = "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.",
author = "Allison Barlow and Elena Varipatis-Baker and Kristen Speakman and Golda Ginsburg and Ingrid Friberg and Novalene Goklish and Brandii Cowboy and Pauline Fields and Ranelda Hastings and William Pan and Raymond Reid and Mathuram Santosham and John Walkup",
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Barlow, A, Varipatis-Baker, E, Speakman, K, Ginsburg, G, Friberg, I, Goklish, N, Cowboy, B, Fields, P, Hastings, R, Pan, W, Reid, R, Santosham, M & Walkup, J 2006, 'Home-visiting intervention to improve child care among American Indian Adolescent mothers: A randomized trial', Archives of Pediatrics and Adolescent Medicine, vol. 160, no. 11, pp. 1101-1107. https://doi.org/10.1001/archpedi.160.11.1101

Home-visiting intervention to improve child care among American Indian Adolescent mothers : A randomized trial. / Barlow, Allison; Varipatis-Baker, Elena; Speakman, Kristen; Ginsburg, Golda; Friberg, Ingrid; Goklish, Novalene; Cowboy, Brandii; Fields, Pauline; Hastings, Ranelda; Pan, William; Reid, Raymond; Santosham, Mathuram; Walkup, John.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 160, No. 11, 01.01.2006, p. 1101-1107.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Home-visiting intervention to improve child care among American Indian Adolescent mothers

T2 - A randomized trial

AU - Barlow, Allison

AU - Varipatis-Baker, Elena

AU - Speakman, Kristen

AU - Ginsburg, Golda

AU - Friberg, Ingrid

AU - Goklish, Novalene

AU - Cowboy, Brandii

AU - Fields, Pauline

AU - Hastings, Ranelda

AU - Pan, William

AU - Reid, Raymond

AU - Santosham, Mathuram

AU - Walkup, John

PY - 2006/1/1

Y1 - 2006/1/1

N2 - 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.

AB - 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.

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