Engaging Fathers in Home Visitation

Home visitation is a prevention program for sociodemographically high risk, first-time
mothers and their families that is designed to optimize child health and development. Most
home visitation programs seek to engage fathers in the service and promote greater positive
involvement with their children, although systematic and efficacious strategies to achieve
this have not been developed and tested. Yet, it is well-documented that positive father
involvement and mutually supportive relationships between fathers and mothers impart direct
benefits to both children and their parents. Building upon previous efforts to incorporate
evidence-based interventions into the home visitation setting, this study seeks to adapt
Family Foundations, a coparenting intervention with a strong empirical foundation, as an
augmented strategy in ongoing home visitation. In a first phase of qualitative investigation,
we will adapt the format and content of Family Foundations for implementation in the home,
addressing the needs of high risk mothers and fathers, and integrate it into standard home
visitation services. In a second phase, a clinical trial will be conducted to determine the
efficacy of the adapted intervention (HVFF) in contrast to a control condition of home
visitation alone (HVA). Specifically, 300 mother/father dyads in home visitation will be
recruited prenatally and randomly assigned to HVFF and HVA conditions. HVFF will consist of 8
in-home and 2 group sessions administered weekly and in two equal parts at approximately 2
months before birth and 4 months postpartum. Both the HVFF and HVA participants will be
assessed at pre-intervention, post-intervention (5 months postpartum), and 9 and 18 month
follow-ups. A comprehensive assessment battery will be administered at each assessment
measuring parental cooperation, quality of parental relationship, father involvement, beliefs
about parenting, parental psychological adjustment, and intimate partner violence. After the
child's birth, child development and social/emotional adjustment will be measured and
parenting practices will be videotaped and subsequently rated for parenting quality. It is
hypothesized that, relative to controls, fathers in the HVFF condition will participate more
frequently and more positively in standard home visits and will be more involved with their
children; mothers and fathers in the HVFF condition will have higher levels of coparenting,
and lower levels of depression, parental stress, and child abuse potential; and children in
the HVFF condition will be more behaviorally and emotionally well-adjusted. Mediators of
intervention outcomes will also be explored.

Inclusion Criteria:

- First time, prenatal mother participating in a home visiting program

- Biological father interested in being involved with child

- 18 years of age or older

- English speaking

Exclusion Criteria:

- Current substance dependence

- Current psychosis

- Current intimate partner violence