Maternal Relationship Security as a Moderator of Home Visiting Impacts on Maternal Psychosocial Functioning

• Published in: Prevention science Vol. 14; no. 1; pp. 25 - 39
• Main Authors: McFarlane, Elizabeth, Burrell, Lori, Crowne, Sarah, Cluxton-Keller, Fallon, Fuddy, Loretta, Leaf, Philip J., Duggan, Anne
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.02.2013; Springer; Springer Nature B.V
• Subjects: Adaptation, Psychological; Adult; Adults; Alcoholism - epidemiology; Alcoholism - psychology; Anxiety; Benefits; Biological and medical sciences; Child; Child abuse & neglect; Child Abuse - prevention & control; Child Abuse - psychology; Child Abuse - statistics & numerical data; Child and School Psychology; Child, Preschool; Children; Demographics; Domestic violence; Education - methods; Ethnicity; Family; Family Conflict - psychology; Female; Hawaii; Health care policy; Health Psychology; House Calls; Humans; Illicit Drugs; Infant; Infant, Newborn; Interview, Psychological; Male; Mass Screening; Medical sciences; Medicine; Medicine & Public Health; Mental health; Miscellaneous; Mother-Child Relations; Mothers; Mothers - psychology; Mothers - statistics & numerical data; Object Attachment; Paraprofessionals; Population; Pregnancy; Prognosis; Psychosociology; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Risk; Risk Assessment; Social Adjustment; Social Support; Socioeconomic Factors; Spouse Abuse - psychology; Spouse Abuse - statistics & numerical data; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Surveys and Questionnaires; Violence; Young Adult; Hawaii; United States > US; Baltimore Maryland; Home visiting; Attachment style; Psychosocial outcomes; Prognosis; Affective attachment; Mother; Evolution; Psychosocial factor; Social aspect; Public health
• ISSN: 1389-4986; 1573-6695
• DOI: 10.1007/s11121-012-0297-y

There is variability in home visiting program impacts on the outcomes achieved by high risk families. An understanding of how effects vary among families is important for refining service targeting and content. The current study assessed whether and how maternal attributes, including relationship security, moderate short- and long-term home visiting impacts on maternal psychosocial functioning. In this multisite RCT of home visiting in a population-based, ethnically-diverse sample of families at risk for maltreatment of their newborns ( n  = 643), families were randomly assigned to home visited (HV) and control groups. HV families were to receive intensive services by trained paraprofessionals from birth-3 years. Outcome data were collected when children were 1, 2, and 3 years old and 7, 8, and 9 years old. Overall, short- and long-term outcomes for HV and control mothers did not differ significantly. Demographic attributes, a general measure of overall maternal risk, and partner violence did not moderate program impact on psychosocial functioning outcomes. Maternal relationship security did moderate program impact. Mothers who scored high on relationship anxiety but not on relationship avoidance showed the greatest benefits, particularly at the long-term follow-up. Mothers scoring high for both relationship anxiety and avoidance experienced some adverse consequences of home visiting. Further research is needed to determine mediating pathways and to inform and test ways to improve the targeting of home visiting and the tailoring of home visit service models to extend positive home visiting impacts to targeted families not benefiting from current models.