Related Experiment Video
Updated: Oct 10, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Home visiting intervention for vulnerable families with newborns: follow-up results of a randomized controlled trial
J A Fraser1, K L Armstrong, J P Morris
1School of Applied Psychology, Griffith University, Nathan, Queensland, Australia.
Insights
A postnatal home visiting program showed initial positive impacts on families but did not significantly improve parenting adjustment or home environment by follow-up. This highlights the need for longer-term outcome studies and challenges traditional demographic targeting for child abuse prevention.
Area of Science:
- Public Health
- Child Development
- Social Work
Background:
- Identifying families at risk for child abuse and neglect in the postnatal period is crucial for early intervention.
- Home visiting programs offer a potential avenue for supporting at-risk families during this critical developmental stage.
- Understanding predictive factors for poor parenting adjustment in the early postnatal period is essential for targeted support.
Purpose of the Study:
- To evaluate the utility of a screening tool for identifying families with child abuse or neglect risk factors.
- To determine the social validity and effectiveness of a postnatal home visiting program for at-risk families.
- To identify immediate postnatal factors predicting poor adjustment to the parenting role.
Main Methods:
- A randomized controlled trial involving 181 families recruited in the immediate postnatal period.
- Families were allocated to a home visiting program with community child health nurses and social work services or a comparison group.
- Repeated measures assessed parenting stress, maternal depression, and child abuse potential; linear regression analyzed predictive factors.
Main Results:
- The screening tool demonstrated utility in recruitment, and mothers accepted the home visiting program.
- The program showed early positive impacts on maternal, infant, family, and home environment variables at 6 weeks.
- No significant differences in parental adjustment or home environment scores were found at follow-up; demographic factors were not predictive.
Conclusions:
- The home visiting program did not demonstrate a positive impact on parenting stress, competence, or home environment quality at follow-up.
- Findings challenge demographic targeting for child abuse and neglect risk, suggesting a relationship between early factors and parenting adjustment.
- The immediate postnatal period offers a critical opportunity to engage high-risk families who might otherwise be missed by traditional services.
Objective:
This study aimed to: (1) Assess the community utility of a screening tool to identify families with child abuse or neglect risk factors in the immediate postnatal period (2) Determine the social validity and effectiveness of a home visiting program using community child health nurses and offering social work services for identified families, and (3) Identify factors in the immediate postnatal period associated with the child's environment that predict poor adjustment to the parenting role.
Method:
A randomized controlled trial using a cohort of 181 families was undertaken to evaluate the impact of a home visiting program. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting program or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. A repeated measures design was used to test parenting stress and maternal depression from the immediate postnatal period to 12-month follow-up and physical child abuse potential to 18-month follow-up. To test whether measures taken in the immediate postnatal period were predictive for poor adjustment to the parenting role, a linear regression model was used.
Results:
The screening procedure was shown to have utility in the context of recruitment to a research trial and mothers were willing to accept the home visiting program examined by this study from the immediate postnatal period. From as early as 6 weeks the program demonstrated ability to impact positively on maternal, infant, family, and home environment variables (testing 90 randomly allocated intervention vs. 91 comparison families). At follow-up, parental adjustment variables were not significantly different between groups (testing the remaining 68 (75.5%) intervention vs. 70 (76.9%) comparison families) and home environment assessment scores had converged. Predictive analysis of factors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target.
Conclusions:
Follow-up evaluation did not demonstrate a positive impact on parenting stress, parenting competence, or quality of the home environment confirming the need to test early program success on longer term outcomes. Further, thestudy not only demonstrated that there was a relationship between maternal, family and environmental factors identified in the immediate postnatal period. and adjustment to the parenting role, but also challenged demographic targeting for child abuse and neglect risk. At the same time, the immediate postnatal period presented an exciting window of opportunity to access high-risk families who may otherwise have become marginalized from traditional services.