TY - JOUR
T1 - Towards precision home visiting
T2 - results at six months postpartum from a randomized pilot implementation trial to assess the feasibility of a precision approach to Family Spirit
AU - Ingalls, Allison N.
AU - Rebman, Paul
AU - Martin, Lisa
AU - Kushman, Elizabeth
AU - Leonard, Amanda
AU - Cisler, Aimee
AU - Gschwind, Ingrid
AU - Brayak, Amanda
AU - Amsler, Ann Marie
AU - Haroz, Emily E.
N1 - Funding Information:
This research was funded by Annie E. Casey Foundation, Inc. (Grant #: GA-2019-B6981, GA-2020-B6981, GA-2021-B6981), and we thank them for their support; however, the findings and conclusions presented in this report are those of the author(s) alone, and do not necessarily reflect the opinions of the Foundation.
Funding Information:
We thank all the participating mothers for their contributions to this research. We also thank additional study team members who are not listed as co-authors of this manuscript: Heather Wood, Elizabeth Leffler, Angelina Herman, Amber Gauthier, Amanda Braun, Fiona Grubin, and Helen Russette.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Shared implementation challenges at scale in early childhood home visiting have led researchers to explore precision home visiting as a promising service delivery mechanism to better address families’ unique needs and build greater program efficiencies. This randomized controlled pilot study aimed to assess the acceptability of a precision approach to one home visiting model, Family Spirit® and explore potential differences between Precision Family Spirit (PFS) and Standard Family Spirit (Standard FS) on participant-home visitor relationship and maternal outcomes. Methods: Participants (N = 60) were at least 14 years old, pregnant or within 2 months postpartum, and enrolled in Family Spirit. Four sites in Michigan were randomized 1:1 to deliver PFS (up to 17 core lessons plus up to 13 additional lessons as needed) or Standard FS (home visiting services as usual). Primary (program acceptability, participant satisfaction, home visitor-participant relationship quality, retention, adherence) and secondary (knowledge, quality of life, difficulty with parenting problems, substance use, depression, stress) outcomes at 6 months postpartum are presented. PFS participants also self-reported on quality of life, difficulty with parenting problems, stress, substance use, and concerns with sexual and reproductive health and self and child’s nutrition status at each home visit. This informed which lessons they should receive. Results: Mothers in both groups reported positive program acceptability, satisfaction, and home visitor-participant relationships at 6 months postpartum. However, open-ended feedback from Standard FS participants indicates that some lesson content may not be applicable to all participants. At 6 months, retention was 82.3% for PFS and 66.7% for Standard FS, and adherence was 30.1% for PFS and 20.6% for Standard FS. Conclusions: Preliminary findings indicate that precision home visiting may be acceptable and feasible. A definitive trial is needed to build on this pilot data, assess outcomes for mothers and children participating in a precision approach to home visiting as compared to standard home visiting, and ready this approach for scale. Trial registration: ClinicalTrials.govNCT03975530 (first posted on 05/06/2019).
AB - Background: Shared implementation challenges at scale in early childhood home visiting have led researchers to explore precision home visiting as a promising service delivery mechanism to better address families’ unique needs and build greater program efficiencies. This randomized controlled pilot study aimed to assess the acceptability of a precision approach to one home visiting model, Family Spirit® and explore potential differences between Precision Family Spirit (PFS) and Standard Family Spirit (Standard FS) on participant-home visitor relationship and maternal outcomes. Methods: Participants (N = 60) were at least 14 years old, pregnant or within 2 months postpartum, and enrolled in Family Spirit. Four sites in Michigan were randomized 1:1 to deliver PFS (up to 17 core lessons plus up to 13 additional lessons as needed) or Standard FS (home visiting services as usual). Primary (program acceptability, participant satisfaction, home visitor-participant relationship quality, retention, adherence) and secondary (knowledge, quality of life, difficulty with parenting problems, substance use, depression, stress) outcomes at 6 months postpartum are presented. PFS participants also self-reported on quality of life, difficulty with parenting problems, stress, substance use, and concerns with sexual and reproductive health and self and child’s nutrition status at each home visit. This informed which lessons they should receive. Results: Mothers in both groups reported positive program acceptability, satisfaction, and home visitor-participant relationships at 6 months postpartum. However, open-ended feedback from Standard FS participants indicates that some lesson content may not be applicable to all participants. At 6 months, retention was 82.3% for PFS and 66.7% for Standard FS, and adherence was 30.1% for PFS and 20.6% for Standard FS. Conclusions: Preliminary findings indicate that precision home visiting may be acceptable and feasible. A definitive trial is needed to build on this pilot data, assess outcomes for mothers and children participating in a precision approach to home visiting as compared to standard home visiting, and ready this approach for scale. Trial registration: ClinicalTrials.govNCT03975530 (first posted on 05/06/2019).
KW - Home visiting
KW - Hybrid design
KW - Implementation
KW - Precision
KW - Precision home visiting
KW - Precision prevention science
UR - http://www.scopus.com/inward/record.url?scp=85138459886&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138459886&partnerID=8YFLogxK
U2 - 10.1186/s12884-022-05057-4
DO - 10.1186/s12884-022-05057-4
M3 - Article
C2 - 36151535
AN - SCOPUS:85138459886
SN - 1471-2393
VL - 22
JO - BMC pregnancy and childbirth
JF - BMC pregnancy and childbirth
IS - 1
M1 - 725
ER -