Adapting a Co-Parenting Prevention Program to Home Visiting: Maximizing Fit, Feasibility, and Cultural Relevance
Thursday, November 12, 2015 : 9:10 AM
Merrick I (Hyatt Regency Miami)
*Names in bold indicate Presenter
Home visiting programs are focused on optimizing child development in families at risk for poor parenting. Mothers are typically identified as the primary caregiver in these programs, and materials and content often emphasizes mothers. Although fathers are often encouraged to participate, their involvement is secondary given the structure of home visiting programs. This presentation has two parts. The first is a qualitative study designed to identify barriers and facilitators to father involvement. The second describes adaptations to a co-parenting intervention using learnings from this study that is currently the subject of a clinical trial. Separate focus groups were conducted with seven mother-father couples and 10 home visitors. Couples included mothers participating in home visiting, had a child <1 year old, and most (6) were unmarried. Home visitors were 26-54 years of age, racially diverse, and had a mean of 7.3 years in the home visiting role. Themes emerging from both parent and home visitor focus groups involved expectations and realities of parenting, challenges of living apart, varied family support, challenges in negotiating roles against the back drop of intermittent employment and efforts to go back to school, fathers viewing home visiting as exclusively for mothers, and difficulty resolving conflict. Parents talked about having few role models, inadequate upbringings characterized by violence and neglect, and a strong desire to succeed with their families in contrast to their own experiences growing up. Home visitors emphasized that new mothers and fathers in the program struggled to resolve conflicts in emotionally healthy ways. Home visitors also spoke of the challenge of convincing fathers that home visiting was not only for mothers. Taken together, these observations underscore the need for interventions that teach mothers and fathers strategies to resolve conflict, work together effectively on behalf of the child, and negotiate roles and responsibilities that provide a stable and healthy structure for children. Accordingly, we adapted Family Foundations (FF) as an enhancement to home visiting and its implementation as part of an NICHD-funded clinical trial in a Healthy Families America program. Family Foundations (FF) is a strengths-based intervention designed to promote co-parenting in new mothers and fathers. The FF curriculum teaches skills that enable them to communicate more effectively and foster positive relationships. Couples receive 6 prenatal sessions and 5 postnatal sessions led by both a female and male facilitator. Topics addressed include setting parenting goals, recognizing and understanding feelings, managing conflict, and managing stress. FF is an experiential intervention that utilizes modeling, interactive activities, and instructive video clips. Adaptations were specifically directed towards increasing the relevance of this program for parents who may not be living together or in a romantic relationship but who are committed to parenting their child together. To increase father engagement, we added a prenatal and postnatal one-on-one session between the male facilitator and father. Other adaptations included how to deliver services in the home, working with home visitors, creating new video clips based on the racial and ethnic make-up of our population, and increasing types of interactive activities.