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Development and implementation of a screen-and-refer approach to addressing maternal depression, substance use, and intimate partner violence in home visiting clients

Author

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  • Dauber, Sarah
  • John, Tiffany
  • Hogue, Aaron
  • Nugent, Jessica
  • Hernandez, Gina

Abstract

Perinatal maternal depression (MD), substance use (SU), and intimate partner violence (IPV) are critical public health concerns with significant negative impacts on child development. Bolstering the capacity of home visiting (HV) programs to address these significant risk factors has potential to improve child and family outcomes. This study presents a description and mixed-methods feasibility evaluation of the “Home Visitation Enhancing Linkages Project (HELP),” a screen-and-refer approach to addressing MD, SU, and IPV within HV aimed at improving risk identification and linkage to treatment among HV clients. HELP was a three-phase intervention that included three evidence-based interventions: screening, motivational interviewing (MI), and case management (CM). This study presents quantitative fidelity data from 21 home visitors reporting on 116 clients in 4HV programs, as well as qualitative data from structured interviews with 14 home visitors. Nearly all clients were screened and 22% screened positive on at least one risk domain. Rates of MI and CM implementation were lower than expected, however home visitors implemented general supportive interventions at high rates. Home visitor interviews revealed the following factors that may have impacted HELP implementation: client disclosure of risk, barriers to treatment access, systems integration, home visitor role perception, and integration of HELP into the broader HV curriculum. Implications of study findings for the design of future attempts to address maternal risk within HV are discussed.

Suggested Citation

  • Dauber, Sarah & John, Tiffany & Hogue, Aaron & Nugent, Jessica & Hernandez, Gina, 2017. "Development and implementation of a screen-and-refer approach to addressing maternal depression, substance use, and intimate partner violence in home visiting clients," Children and Youth Services Review, Elsevier, vol. 81(C), pages 157-167.
    • Handle: RePEc:eee:cysrev:v:81:y:2017:i:c:p:157-167
    DOI: 10.1016/j.childyouth.2017.07.021
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    1. Mynti Hossain & Lauren Akers & Patricia Del Grosso & Marisa Shenk & Michael Cavanaugh & Melissa Azur, "undated". "Touchpoints for Addressing Substance Use Issues in Home Visiting: Executive Summary of Phase 1 Final Report," Mathematica Policy Research Reports 4f5c1fb4215443039340f5eee, Mathematica Policy Research.
    2. Kafka, Julie M. & Moracco, Kathryn E. & Williams, Deanna S. & Hoffman, Claire G., 2021. "What is the role of firearms in nonfatal intimate partner violence? Findings from civil protective order case data," Social Science & Medicine, Elsevier, vol. 283(C).
    3. Mynti Hossain & Lauren Akers & Patricia Del Grosso & Marisa Shenk & Michael Cavanaugh & Melissa Azur, "undated". "Touchpoints for Addressing Substance Use Issues in Home Visiting: Phase 1 Final Report," Mathematica Policy Research Reports 0761ea54498b4f27b8d238e2b, Mathematica Policy Research.
    4. Barton, Jared & Naemi Jimenez, Pegah & Biggs, Jacklyn & Garstka, Teri A. & Ball, Thomas C., 2020. "Strengthening family retention and relationships in home visiting programs through early screening and assessment practices," Children and Youth Services Review, Elsevier, vol. 118(C).
    5. Rahman, Rahbel & Ross, Abigail M. & Spector, Anya Y. & Huang, Debbie & Chesna, Sharon & Patel, Rupal, 2023. "Predictors of service integration by community based providers in New York State offering maternal and infant services," Children and Youth Services Review, Elsevier, vol. 153(C).
    6. Janczewski, Colleen E. & Nitkowski, Jenna, 2023. "Predicting mental and behavioral health service utilization among child welfare-involved caregivers: A machine learning approach," Children and Youth Services Review, Elsevier, vol. 155(C).

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