160339 Impact of a home-based intervention for American Indian teen parents on parenting and maternal and child health outcomes

Monday, November 5, 2007: 2:55 PM

Allison Barlow, MPH, MA , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Britta Mullany, PhD , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Kristen Speakman, MA, MPH , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Elena Varipatis Baker, MPH, MSW , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Golda Ginsburg, PhD , Johns Hopkins School of Medicine, Baltimore, MD
Novalene Goklish , Center for American Indian Health, Johns Hopkins University, Whiteriver, AZ
Brandii Cowboy , Center for American Indian Health, Johns Hopkins University, Fort Defiance, AZ
Pauline Fields , Center for American Indian Health, Johns Hopkins University, Fort Defiance, AZ
Ranelda Hastings , Center for American Indian Health, Johns Hopkins University, Whiteriver, AZ
Raymond Reid, MD, MPH , Johns Hopkins Center for American Indian Health, Shiprock, NM
John Walkup, MD , Division of Child & Adolescent Psychiatry, Weill Cornell Medical College and NewYork-Presbyterian Hospital, New York, NY
           
Background: This randomized controlled study evaluated the impact of an empirically supported home-based intervention delivered by American Indian (AI) paraprofessionals to young AI mothers. Outcomes included mothers' parenting knowledge, skills, and involvement; family conflict and cohesion; mothers' risks for emotional or behavioral problems; and infants' behavioral and emotional outcomes.

Methods: Expectant mothers (n=167) ages 14-22 were randomized to the intervention or a breast feeding education comparison group. The intervention condition included 42 sessions over a fifteen-month period. Outcome assessments occurred at baseline (28 week gestation), and at three follow-up time points (at 2, 6, and 12 months postpartum).

Results: Compared to the comparison group, mothers receiving the intervention had significantly higher parenting knowledge levels at 2 months (48% vs. 45%, p<0.05), 6 months (70% vs. 50%, p<0.001), and 12 months postpartum (72% vs. 58%, p<0.001). At age one, infants of intervention group mothers exhibited less impulsivity (0.69 vs. 0.98, p<0.05), less peer aggression (0.13 vs. 0.30, p<0.05), and less separation distress (0.84 vs. 1.02, p<0.05) than infants of comparison group mothers. Further analysis is being conducted to determine the intervention's impact on parental skills and involvement, family conflict and cohesion, and maternal depressive symptoms and substance abuse.

Conclusions: A home-based parenting intervention delivered by AI paraprofessionals to high-risk expectant AI mothers successfully improved parenting knowledge levels and infant behavioral and emotional outcomes. A larger randomized controlled trial of this home visiting program is currently underway to determine longer-term impact of the intervention on maternal and child health and behavior outcomes.

Learning Objectives:
1. Describe and recognize benefits of home visiting intervention models 2. Assess the impact of a home visiting intervention model on maternal and child outcomes

Keywords: Maternal and Child Health, Adolescent Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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See more of: Maternal and Child Health