Engaging Fathers in Home Visitation: Incorporation of Co-Parenting Intervention

描述(由申请人提供)：家访是一项针对社会人口学高危、首次怀孕的母亲及其家庭的预防计划，旨在优化儿童健康和发展。大多数家访计划寻求让父亲参与到这项服务中来，并促进更多的积极参与他们的孩子，尽管实现这一目标的系统和有效的战略尚未制定和测试。然而，有充分的证据表明，父亲的积极参与和父母之间的相互支持关系会给孩子和他们的父母带来直接好处。在之前将循证干预措施纳入家访环境的努力的基础上，这次 这项研究试图采用家庭基金会，这是一种具有强大经验基础的共同干预措施，作为正在进行的家访中的一种增强策略。在定性调查的第一阶段，我们将调整家庭基金会的形式和内容，以便在家庭中实施，满足高危父母的需求，并将其纳入标准的家访服务。在第二阶段，将进行临床试验，以确定适应性干预(HVFF)与单独家访(HVA)对照条件的有效性。具体地说，将在产前招募300名接受家庭探视的母亲/父亲二人组，并随机分配到HVFF和HVA条件下。家庭助产士计划包括8次家庭治疗和2次小组治疗，每周进行一次，并在出生前2个月和产后4个月分两次进行。将在干预前、干预后(产后5个月)以及9个月和18个月的随访中对HVFF和HVA参与者进行评估。在每次评估中将进行一组全面的评估，衡量父母的合作、父母关系的质量、父亲的参与、对养育子女的信念、父母的心理调整以及亲密伴侣的暴力。在孩子出生后，将测量儿童的发展和社会/情绪适应，并对育儿实践进行录像，随后对育儿质量进行评级。据推测， 与对照组相比，处于高压家庭状况的父亲将更频繁和更积极地参与标准的家访，并将更多地参与到他们的孩子中；处于高压家庭状况的母亲和父亲将有更高的伙伴关系水平，以及更低的抑郁、父母压力和儿童虐待可能性；并且处于高压家庭状况的儿童将在行为和情绪上得到更好的调整。还将探讨干预结果的调解人。卫生与家庭福利基金会将被手册化，并随时传播到其他家访计划中。这项研究的结果将具有重大的公共政策影响，因为全国各地在家访方面已经进行了相当大的公共投资。

DESCRIPTION (provided by applicant): Home visitation is a prevention program for sociodemographically high risk, first-time mothers and their families that is designed to optimize child health and development. Most home visitation programs seek to engage fathers in the service and promote greater positive involvement with their children, although systematic and efficacious strategies to achieve this have not been developed and tested. Yet, it is well-documented that positive father involvement and mutually supportive relationships between fathers and mothers impart direct benefits to both children and their parents. Building upon previous efforts to incorporate evidence-based interventions into the home visitation setting, this study seeks to adapt Family Foundations, a coparenting intervention with a strong empirical foundation, as an augmented strategy in ongoing home visitation. In a first phase of qualitative investigation, we will adapt the format and content of Family Foundations for implementation in the home, addressing the needs of high risk mothers and fathers, and integrate it into standard home visitation services. In a second phase, a clinical trial will be conducted to determine the efficacy of the adapted intervention (HVFF) in contrast to a control condition of home visitation alone (HVA). Specifically, 300 mother/father dyads in home visitation will be recruited prenatally and randomly assigned to HVFF and HVA conditions. HVFF will consist of 8 in-home and 2 group sessions administered weekly and in two equal parts at approximately 2 months before birth and 4 months postpartum. Both the HVFF and HVA participants will be assessed at pre-intervention, post-intervention (5 months postpartum), and 9 and 18 month follow-ups. A comprehensive assessment battery will be administered at each assessment measuring parental cooperation, quality of parental relationship, father involvement, beliefs about parenting, parental psychological adjustment, and intimate partner violence. After the child's birth, child development and social/emotional adjustment will be measured and parenting practices will be videotaped and subsequently rated for parenting quality. It is hypothesized that, relative to controls, fathers in the HVFF condition will participate more frequently and more positively in standard home visits and will be more involved with their children; mothers and fathers in the HVFF condition will have higher levels of coparenting, and lower levels of depression, parental stress, and child abuse potential; and children in the HVFF condition will be more behaviorally and emotionally well- adjusted. Mediators of intervention outcomes will also be explored. HVFF will be manualized and readily disseminated to other home visitation programs. Results from this study will have significant public policy implications given the sizable public investment that has been made in home visitation around the country.