OBJECTIVE: To assess the impact of a paraprofessional-delivered home-visiting intervention to promote child care knowledge, skills, and involvement among pregnant American Indian adolescents. DESIGN: Randomized controlled trial comparing a family-strengthening intervention with a breastfeeding education program. SETTING: One Apache and 3 Navajo communities. PARTICIPANTS: Fifty-three pregnant American Indian adolescents were randomly assigned to intervention (n = 28) or control (n = 25) groups. Follow-up data were available for 19 intervention and 22 control participants. Intervention Paraprofessionals delivered 41 prenatal and infant care lessons in participants' homes from 28 weeks' gestation to 6 months post partum. MAIN OUTCOME MEASURES: Child care knowledge, skills, and involvement. RESULTS: Mothers in the intervention compared with the control group had significantly higher parent knowledge scores at 2 months (adjusted mean difference [AMD], +14.9 [95% confidence interval (CI), +7.5 to +22.4]) and 6 months post partum (AMD, +15.3 [95% CI, +5.9 to +24.7]). Intervention group mothers scored significantly higher on maternal involvement scales at 2 months post partum (AMD, +1.5 [95% CI, -0.02 to +3.02]), and scores approached significance at 6 months post partum (AMD, +1.1 [95% CI, -0.06 to +2.2]). No between-group differences were found for child care skills. CONCLUSIONS: A paraprofessional-delivered, family-strengthening home-visiting program significantly increased mothers' child care knowledge and involvement. A longer and larger trial is needed to understand the intervention's potential to improve adolescent parenting and related child outcomes in American Indian communities.
RCT Entities:
OBJECTIVE: To assess the impact of a paraprofessional-delivered home-visiting intervention to promote child care knowledge, skills, and involvement among pregnant American Indian adolescents. DESIGN: Randomized controlled trial comparing a family-strengthening intervention with a breastfeeding education program. SETTING: One Apache and 3 Navajo communities. PARTICIPANTS: Fifty-three pregnant American Indian adolescents were randomly assigned to intervention (n = 28) or control (n = 25) groups. Follow-up data were available for 19 intervention and 22 control participants. Intervention Paraprofessionals delivered 41 prenatal and infant care lessons in participants' homes from 28 weeks' gestation to 6 months post partum. MAIN OUTCOME MEASURES: Child care knowledge, skills, and involvement. RESULTS: Mothers in the intervention compared with the control group had significantly higher parent knowledge scores at 2 months (adjusted mean difference [AMD], +14.9 [95% confidence interval (CI), +7.5 to +22.4]) and 6 months post partum (AMD, +15.3 [95% CI, +5.9 to +24.7]). Intervention group mothers scored significantly higher on maternal involvement scales at 2 months post partum (AMD, +1.5 [95% CI, -0.02 to +3.02]), and scores approached significance at 6 months post partum (AMD, +1.1 [95% CI, -0.06 to +2.2]). No between-group differences were found for child care skills. CONCLUSIONS: A paraprofessional-delivered, family-strengthening home-visiting program significantly increased mothers' child care knowledge and involvement. A longer and larger trial is needed to understand the intervention's potential to improve adolescent parenting and related child outcomes in American Indian communities.
Authors: Phyllis A Wingo; Catherine A Lesesne; Ruben A Smith; Lori de Ravello; David K Espey; Teshia G Arambula Solomon; Myra Tucker; Judith Thierry Journal: Matern Child Health J Date: 2012-12
Authors: Alison McFadden; Anna Gavine; Mary J Renfrew; Angela Wade; Phyll Buchanan; Jane L Taylor; Emma Veitch; Anne Marie Rennie; Susan A Crowther; Sara Neiman; Stephen MacGillivray Journal: Cochrane Database Syst Rev Date: 2017-02-28
Authors: Golda S Ginsburg; Elena Varipatis Baker; Britta C Mullany; Allison Barlow; Novalene Goklish; Ranelda Hastings; Audrey E Thurm; Kristen Speakman; Raymond Reid; John Walkup Journal: Matern Child Health J Date: 2008-05-03