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


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • 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

Published Date

  • November 2006

Published In

Volume / Issue

  • 160 / 11

Start / End Page

  • 1101 - 1107

PubMed ID

  • 17088511

Pubmed Central ID

  • 17088511

Electronic International Standard Serial Number (EISSN)

  • 1538-3628

International Standard Serial Number (ISSN)

  • 1072-4710

Digital Object Identifier (DOI)

  • 10.1001/archpedi.160.11.1101


  • eng