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Home-visiting intervention to improve child care among American Indian adolescent mothers: a randomized trial

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Barlow, A,, Varipatis-Baker, E., Speakman, K., Ginsburg, G., Friberg, I., Goklish, N., Cowboy, B., Fields, P., Hastings, R., Pan, W., Reid, R., Santosham, M., Walkup, J. (2006). Home-visiting intervention to improve child care among American Indian adolescent mothers: a randomized trial. Archives of Pediatrics and Adolescent Medicine,160(11), 1101-7.

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.