Maternal Relationship Security as a Moderator of Home Visiting Impacts on Maternal Psychosocial Functioning

Abstract

There is variability in home visiting program impacts on the outcomes achieved by high risk families. An understanding of how effects vary among families is important for refining service targeting and content. The current study assessed whether and how maternal attributes, including relationship security, moderate short- and long-term home visiting impacts on maternal psychosocial functioning. In this multisite RCT of home visiting in a population-based, ethnically-diverse sample of families at risk for maltreatment of their newborns (n = 643), families were randomly assigned to home visited (HV) and control groups. HV families were to receive intensive services by trained paraprofessionals from birth-3 years. Outcome data were collected when children were 1, 2, and 3 years old and 7, 8, and 9 years old. Overall, short- and long-term outcomes for HV and control mothers did not differ significantly. Demographic attributes, a general measure of overall maternal risk, and partner violence did not moderate program impact on psychosocial functioning outcomes. Maternal relationship security did moderate program impact. Mothers who scored high on relationship anxiety but not on relationship avoidance showed the greatest benefits, particularly at the long-term follow-up. Mothers scoring high for both relationship anxiety and avoidance experienced some adverse consequences of home visiting. Further research is needed to determine mediating pathways and to inform and test ways to improve the targeting of home visiting and the tailoring of home visit service models to extend positive home visiting impacts to targeted families not benefiting from current models.

Maternal Relationship Insecurity and Depressive Symptoms as Moderators of Home Visiting Impacts on Child Outcomes

“…It is also possible to compare the results of the current study with those of our randomized trial of home visiting impacts on maternal psychosocial functioning in Hawaii (McFarlane et al 2013). As in the current study, we used the Attachment Style Questionnaire to measure maternal relationship anxiety and discomfort with trust.…”

“…For example, research has shown positive program impacts on maternal sensitivity to infant cues for mothers who endorsed depressive symptoms (Spieker et al 2005). Research has also shown that relationship insecurity moderates program impacts (McFarlane et al 2013). For example, mothers with high relationship anxiety but not avoidance showed the greatest benefits in psychosocial functioning (McFarlane et al 2013).…”

“…Research has also shown that relationship insecurity moderates program impacts (McFarlane et al 2013). For example, mothers with high relationship anxiety but not avoidance showed the greatest benefits in psychosocial functioning (McFarlane et al 2013). Yet, mothers with both high relationship anxiety and avoidance experienced some adverse consequences of home visiting (McFarlane et al 2013).…”

“…For example, mothers with high relationship anxiety but not avoidance showed the greatest benefits in psychosocial functioning (McFarlane et al 2013). Yet, mothers with both high relationship anxiety and avoidance experienced some adverse consequences of home visiting (McFarlane et al 2013). Finally, there is evidence that maternal depression in combination with relationship insecurity moderate program impacts (e.g., Duggan et al 2009; Robinson and Emde 2004).…”

Élaboration d’un outil écosystémique et participatif pour l’analyse des besoins des enfants en contexte de négligence : L’outil Place aux parents

“…Cette évaluation a mis en lumière la nécessité de documenter de manière flexible et évolutive les changements qui s'opèrent au sein des familles et qui ne sont pas toujours perceptibles dans le contexte d'une visite ponctuelle effectuée dans le cadre d'un projet de recherche. Ce constat est partagé par plusieurs études qui soulignent la difficulté de démontrer les effets positifs associés aux programmes en négligence (MacMillan et al, 2009;McFarlane et al, 2012).…”