TY - JOUR
T1 - Randomized controlled trial of a paraprofessional-delivered in-home intervention for young reservation-based american indian mothers
AU - Walkup, John T.
AU - Barlow, Allison
AU - Mullany, Britta C.
AU - Pan, William
AU - Goklish, Novalene
AU - Hasting, Ranelda
AU - Cowboy, Brandii
AU - Fields, Pauline
AU - Baker, Elena Varipatis
AU - Speakman, Kristen
AU - Ginsburg, Golda
AU - Reid, Raymond
N1 - Funding Information:
Financial support for this work was provided by the Substance Abuse Mental Health Services Administration (SAMHSAI: Grant No. UD1SP08860, SAMHSA II: Grant No. UD1SP09588), and the Ford Foundation, the Annie E. Casey Foundation, and the C.S. Mott Foundation. The PI for this work, John Walkup, M.D., had full access to the study data and takes responsibility for the data integrity and accuracy of the analyses.
PY - 2009/6
Y1 - 2009/6
N2 - Objective: To evaluate the efficacy of a paraprofessional-delivered, home-visiting intervention among young, reservation-based American Indian (Al) mothers on parenting knowledge, involvement, and maternal and infant outcomes. Method: From 2002 to 2004, expectant Al women aged 12 to 22 years (n = 167) were randomized (1:1) to one of two paraprofessional-delivered, home-visiting interventions: the 25-visit "Family Spirit" intervention addressing prenatal and newborn care and maternal life skills (treatment) or a 23-visit breast-feeding/nutrition education intervention (active control). The interventions began during pregnancy and continued to 6 months postpartum. Mothers and children were evaluated at baseline and 2,6, and 12 months postpartum. Primary outcomes included changes in mothers' parenting knowledge and involvement. Secondary outcomes included infants' social and emotional behavior; the home environment; and mothers' stress, social support, depression, and substance use. Results: Participants were mostly teenaged, first-time, unmarried mothers living in reservation communities. At 6 and 12 months postpartum, treatment mothers compared with control mothers had greater parenting knowledge gains, 13.5 (p< .0001) and 13.9 (p< .0001) points higher, respectively (100-point scale). At 12 months postpartum, treatment mothers reported their infants to have significantly lower scores on the externalizing domain (β = -.17, p < .05) and less separation distress in the internalizing domain (p = -.17, p < .05). No between-group differences were found for maternal involvement, home environment, or mothers' stress, social support, depression, or substance use. Conclusions: This study supports the efficacy of the paraprofessional-delivered Family Spirit home-visiting intervention for young Al mothers on maternal knowledge and infant behavior outcomes. A longer, larger study is needed to replicate results and evaluate the durability of child behavior outcomes. J. Am. Acad. Child Adolesc.
AB - Objective: To evaluate the efficacy of a paraprofessional-delivered, home-visiting intervention among young, reservation-based American Indian (Al) mothers on parenting knowledge, involvement, and maternal and infant outcomes. Method: From 2002 to 2004, expectant Al women aged 12 to 22 years (n = 167) were randomized (1:1) to one of two paraprofessional-delivered, home-visiting interventions: the 25-visit "Family Spirit" intervention addressing prenatal and newborn care and maternal life skills (treatment) or a 23-visit breast-feeding/nutrition education intervention (active control). The interventions began during pregnancy and continued to 6 months postpartum. Mothers and children were evaluated at baseline and 2,6, and 12 months postpartum. Primary outcomes included changes in mothers' parenting knowledge and involvement. Secondary outcomes included infants' social and emotional behavior; the home environment; and mothers' stress, social support, depression, and substance use. Results: Participants were mostly teenaged, first-time, unmarried mothers living in reservation communities. At 6 and 12 months postpartum, treatment mothers compared with control mothers had greater parenting knowledge gains, 13.5 (p< .0001) and 13.9 (p< .0001) points higher, respectively (100-point scale). At 12 months postpartum, treatment mothers reported their infants to have significantly lower scores on the externalizing domain (β = -.17, p < .05) and less separation distress in the internalizing domain (p = -.17, p < .05). No between-group differences were found for maternal involvement, home environment, or mothers' stress, social support, depression, or substance use. Conclusions: This study supports the efficacy of the paraprofessional-delivered Family Spirit home-visiting intervention for young Al mothers on maternal knowledge and infant behavior outcomes. A longer, larger study is needed to replicate results and evaluate the durability of child behavior outcomes. J. Am. Acad. Child Adolesc.
KW - American Indian
KW - Home visiting
KW - Infant development. Clinical trial registry information - Family Spirit Study
KW - Parenting
UR - http://www.scopus.com/inward/record.url?scp=67049099127&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67049099127&partnerID=8YFLogxK
U2 - 10.1097/CHI.0b013e3181a0ab86
DO - 10.1097/CHI.0b013e3181a0ab86
M3 - Article
C2 - 19454915
AN - SCOPUS:67049099127
SN - 0890-8567
VL - 48
SP - 591
EP - 601
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 6
ER -