Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY 12222, USA.
Child Abuse Negl. 2010 Oct;34(10):711-23. doi: 10.1016/j.chiabu.2010.03.004. Epub 2010 Sep 17.
This paper examines the effectiveness of the Healthy Families New York (HFNY) home visiting program in promoting parenting competencies and preventing maladaptive parenting behaviors in mothers at risk for child abuse and neglect.
The study used microlevel observational assessments of mother-child interactions in the third wave of a randomized controlled trial to evaluate whether mothers who received home visiting services were more likely to exhibit positive parenting and less likely to display negative parenting behaviors than those who did not receive these services. Women were randomly assigned during pregnancy or shortly after the birth of the target child to an intervention group that was offered home visiting services or a control group that was given referrals to other services. At Year 3, 522 mother and child pairs were systematically observed while they interacted in semistructured tasks presenting varied parenting challenges. The study also sought to replicate a finding from Year 2, which revealed that program effects on harsh parenting were stronger among young, first-time mothers who were randomly assigned during pregnancy (the High Prevention Opportunity subgroup) than among the other mothers (the Limited Prevention Opportunity subgroup).
Results indicate that HFNY was effective in fostering positive parenting, such as maternal responsivity and cognitive engagement. With respect to negative parenting, HFNY mothers in the High Prevention Opportunity subgroup were less likely than their counterparts in the control group to use harsh parenting, while no differences were detected for the Limited Prevention Opportunity subgroup.
HFNY was successful in promoting positive parenting among mothers at risk for child abuse and neglect, which may reflect the program's strength-based approach. The replication of the High Prevention Opportunity subgroup as a moderator of program effects on harsh parenting further suggests that HFNY may be more useful for preventing the initiation rather than the recurrence of child abuse and neglect.
To optimize service delivery, HFNY should continue to focus on enhancing parent-child interactions, prioritize HFNY services for young, first-time mothers who are offered the program during pregnancy, and investigate effective strategies to reduce negative parenting practices among the Limited Prevention Opportunity subgroup.
本文旨在研究纽约健康家庭（HFNY）家访项目在促进有受虐和忽视儿童风险的母亲的育儿能力和预防不良育儿行为方面的有效性。
该研究使用随机对照试验第三波的微观观察评估母亲与孩子的互动，以评估接受家访服务的母亲是否更有可能表现出积极的育儿行为，而不是表现出消极的育儿行为，而不是没有接受这些服务的母亲。在怀孕期间或目标孩子出生后不久，将女性随机分配到干预组，该组提供家访服务，或分配到对照组，该组获得其他服务的转介。在第 3 年，对 522 对母婴对进行了系统观察，当他们在呈现各种育儿挑战的半结构化任务中互动时。该研究还试图复制第 2 年的发现，该发现表明，在怀孕期间随机分配的年轻、首次生育的母亲（高预防机会亚组）中，方案对严厉育儿的影响比其他母亲（有限预防机会亚组）更强。
结果表明，HFNY 有效地促进了积极的育儿方式，例如母亲的反应性和认知参与。关于消极的育儿方式，高预防机会亚组的 HFNY 母亲比对照组的母亲更不可能使用严厉的育儿方式，而有限预防机会亚组则没有差异。
HFNY 成功地促进了有受虐和忽视儿童风险的母亲的积极育儿方式，这可能反映了该方案的基于优势的方法。高预防机会亚组作为方案对严厉育儿影响的调节因子的复制进一步表明，HFNY 可能更有助于预防虐待和忽视的发生，而不是复发。
为了优化服务提供，HFNY 应继续专注于增强亲子互动，为怀孕期间提供该方案的年轻、首次生育的母亲优先提供 HFNY 服务，并研究有效策略，以减少有限预防机会亚组的消极育儿行为。
