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风险、首次怀孕母亲及其家庭的预防计划，旨在优化儿童健康和发育。大多数家访方案都力求让父亲参与这项服务，并促进他们更积极地参与子女的事务，尽管尚未制定和测试实现这一目标的系统和有效战略。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对子女及其父母都有直接的好处。在以前努力将循证干预纳入家访环境的基础上， 本研究旨在调整家庭基金会，这是一种具有强大经验基础的共同育儿干预措施，作为正在进行的家访的增强战略。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，以便在家中实施，满足高危母亲和父亲的需求，并将其纳入标准家访服务。在第二阶段，将进行一项临床试验，以确定适应性干预（HVFF）与单独家访（HVA）对照条件的疗效。具体而言，将在产前招募300名接受家访的母亲/父亲配对，并随机分配至HVFF和HVA条件。HVFF将包括8次家庭治疗和2次小组治疗，每周一次，在产前约2个月和产后4个月分两等份进行。HVFF和HVA参与者将在干预前、干预后（产后5个月）以及9个月和18个月随访时进行评估。在每次评估时，将进行一系列综合评估，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、父母的心理调整和亲密伴侣的暴力行为。在孩子出生后，将测量孩子的发育和社会/情感适应情况，并对父母的做法进行录像，随后对父母的质量进行评级。据推测， 与对照组相比，HVFF组的父亲会更频繁、更积极地参与标准的家访，也会更多地与他们的孩子相处; 2 HVFF组的母亲和父亲会有更高水平的共同养育，而抑郁、父母压力和虐待儿童的可能性会更低; 3 HVFF组的孩子在行为和情感上会更好地适应。还将探讨干预结果的调解人。HVFF将被手册化，并随时传播到其他家访计划。这项研究的结果将有显着的公共政策的影响，考虑到相当大的公共投资，已在全国各地的家访。

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.