Developing Effective Interventions: A Comparison of Home Visitation Models for High Risk Families

Gayle P. Olsen, RN, MS, C-PNP, College of Nursing and Health Sciences, Winona State University, Rochester, MN, USA and Sharon Tucker, DNSc, RN, Department of Nursing, Division of Nursing Research, Mayo Clinic, Rochester, MN, USA.

Objectives: 1) Describe two home-based intervention models 2) Compare the effectiveness of a standardized parent training program to traditional interventions as the basis for home visiting curriculum for high risk families

Population, Sample, Setting, Years: Forty seven families with children between the age of 15 and 72 months from one county in the midwestern US were enrolled in an early intervention program from 2001-2003. To be eligible, families met at least two of the following criteria: low income, limited support, mental illness, chemical abuse, developmental disability, less than high school education, history of abuse, or involvement with the criminal system.

Intervention and Outcome Variables: Traditional home visiting interventions will be compared to a structured parent training curriculum. Outcome variables included parenting stress, maternal depression, child’s development, number and intensity of child behavior problems and family satisfaction.

Methods: An empirically validated parent training program, demonstrated to improve parent-child interaction and prevent child behavior problems, was adapted for use as an intervention for home-based early intervention program. Families were randomized to receive either traditional home visiting interventions or the standardized program. Baseline data were collected in May-June, 2003. Home visits were begun in August, 2003, by senior nursing students under supervision of faculty and public health staff. Visits will continue until May, 2004 at which time outcomes will be measured and compared.

Findings: Baseline data indicated that the mean parenting stress score was above the normative cutoff and 43% of mothers screened positive for depression.

Implications: This study will inform nurses on the relative effectiveness of two models of intervening with high risk families.