Predictors of early engagement in home visitation
Predictors of early engagement in home visitation
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DOI：
10.1007/s10896-005-9009-8
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发表时间：
2006-02-01
影响因子：
3.8
通讯作者：
Van Ginkel, Judith B.
中科院分区：
文献类型：
--
作者：
Ammerman, Robert T.;Stevens, Jack;Van Ginkel, Judith B.
研究了在服务第一年接受家访的母亲参与度的预测因素。通过三种方式研究早期参与：(1) 第一年服务期间参与该计划的时间长度（持续时间），(2) 接受的访问次数（数量），以及 (3) 访问之间的服务差距（一致性）。对美国健康家庭 (HFA) 计划中 515 名首次当妈妈的人进行的访问进行了调查。我们对敬业度参数进行了调查，并使用人口统计数据和肯普家庭压力量表确定了敬业度的预测因素。包括评估访问在内，31.8% 的母亲在服务第一个月之前就脱离了。继续参与该计划与白人身份和养育风险增加有关（心理健康/药物滥用史、社会支持低、压力增加）。大多数母亲的家访次数少于规定的次数。处方服务的差距很常见，89.4% 的母亲的就诊间隔为 1 个月，而间隔为 2 个月的母亲则下降至 16.4%。与基于临床的干预措施的发现相反，早期参与家访与较低水平的功能和紧急需求相关。这些发现增加了越来越多的文献表明，逆境的增加总体上促进了预防计划，特别是家访计划的参与。如果积极参与家访的母亲可能有更多的社会心理需求，课程可能需要修改和扩充，以满足这些需求并优化计划的有效性。
Predictors of engagement in mothers receiving home visitation in the first year of service was examined. Early engagement was studied in three ways: (1) length of time active in the program during the first year of service (duration), (2) number of visits received (quantity), and (3) gaps in service between visits (consistency). Examined visits received in 515 first-time mothers in a Healthy Families America (HFA) program. Parameters of engagement were investigated, and predictors of engagement were identified using demographics and the Kempe Family Stress Inventory. Inclusive of the Assessment Visit, 31.8% of mothers disengaged prior to the first month of service. Remaining active in the program was associated with being Caucasian, and increased parenting risk (mental health/substance abuse history, low social support, increased stress). Most mothers had fewer home visits than prescribed. Gaps in prescribed service were common, with 89.4% of mothers experiencing gaps between visits of 1 month, and dropping to 16.4% having gaps of 2 months. In contrast to findings from clinic-based interventions, early engagement in home visitation is associated with lower levels of functioning and acute needs. These findings add to a growing body of literature suggesting that increased adversity promotes engagement in prevention programs in general, and home visitation programs in particular. To the extent that mothers who are actively engaged in home visitation are likely to have increased psychosocial needs, curricula may require modification and augmentation to address these needs and optimize program effectiveness.