Including manualized components in home visitation to reduce risk for child maltreatment

This study tests whether home visitation to prevent child maltreatment can be improved by including discrete manualized components targeting four key risk factors for child maltreatment (low parental self-efficacy, high levels of perceived stress, parental anger, and post-traumatic stress symptoms). Home visitation is widely implemented, but effects on child maltreatment risk tend to be modest at best. Home visitation tends to have the benefit of flexibility and we will test whether including discrete manualized components increases program effectiveness, by ensuring that key risk factors are addressed, while maintaining flexibility. In addition to the overall components effects, we will test whether any component effects on reduced risk for child maltreatment can be explained (i.e., is mediated) by ameliorated risk factors. Lastly, we will use moderator analyses to test whether the components are more effective for some mothers (e.g., those at highest risk for child maltreatment) than for others.

(1) Including manualized components designed to target four key risk factors for child maltreatment (low parental self-efficacy, stress, parental anger, and post-traumatic stress symptoms) ameliorates these risk factors;

(2) including these manualized components in a home visiting program improves parenting practices and reduces the risk for child maltreatment;

(3) the effect of the manualized components on reduced risk for child maltreatment can be explained (i.e., is mediated) by amelioration of the four targeted risk factors;

Mothers will fill out questionnaires at four time points: before and after each of the two home visits. Outcome variables include ,

Mothers (398) in the experimental group will receive two consecutive home visits including the manualized components, while mothers in the control group will receive regular home visits (care as usual).