RESUMEN
Home-visiting programs have gained increasing importance in family-centered prevention and intervention. However, few studies have examined the mechanisms underlying early intervention treatment effects. The goal of this study is to analyze the mediating role of maternal sensitivity in enhancing language development with the home-visiting program Parents as Teachers (PAT). Data were collected and analyzed within the ongoing, long-term ZEPPELIN study, a randomized controlled trial with 251 participating at-risk families. Via longitudinal mediation analysis, we examined whether effects of the PAT on receptive and expressive language outcomes at 24 and 36 months were mediated by maternal sensitivity at 12 months. Within a moderated mediation framework, we investigated whether the level of family psychosocial stress affects this mediation. Results showed that intervention effects on language outcomes are mediated by maternal sensitivity-weakly and through specific pathways. Moderation and moderated mediation analyses indicated that effects of the PAT and also specific mediation effects increase with the level of psychosocial stress. Implications of the results for practice are discussed.
Asunto(s)
Intervención Educativa Precoz/métodos , Familia/psicología , Visita Domiciliaria , Desarrollo del Lenguaje , Conducta Materna/psicología , Adulto , Femenino , Humanos , Estudios Longitudinales , Sistemas de Apoyo Psicosocial , AutoimagenRESUMEN
The Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is designed to support pregnant women and families in developing skills and utilizing resources necessary to promote their children's physical, social, and emotional development. Little evaluation attention has focused on large-scale, public policy driven home-visiting programs. Social support provision is a critical component of a successful home-visiting program; therefore, there is a need to better understand participants' perceptions of social support provided to them in this context. Forty-five home-visiting participants from five Florida MIECHV programs completed semistructured telephone interviews. Participants discussed their experiences with the MIECHV program, including descriptions of their interactions with home visitors. Content analysis revealed that participants experienced multilayered social support from home-visiting staff. Families needed and received substantial emotional, instrumental, informational, and appraisal support at the individual level. This support was embedded within and strengthened by the strategies and activities of the home-visiting model of service provision. Results highlight the powerful opportunity home visiting offers as a method of service delivery within the larger system of care to increase social support in families experiencing high risk for negative maternal and child health outcomes. Implications for policy and practice are discussed.
Asunto(s)
Educación no Profesional/métodos , Familia/psicología , Visita Domiciliaria , Conducta Materna/psicología , Adulto , Preescolar , Intervención Educativa Precoz/métodos , Intervención Educativa Precoz/organización & administración , Ajuste Emocional , Emociones , Femenino , Florida , Humanos , Lactante , Masculino , Evaluación de Programas y Proyectos de Salud , Sistemas de Apoyo PsicosocialRESUMEN
The expansion of infant mental health (IMH) to at-risk preschoolers and their families has contributed to the integration of relational play therapy (RPT) into IMH treatment services for this population. Integrating RPT allows access to specialized play and expressive techniques specific to preschool and family development, which improves the clinical ability to meet the multiple and complex needs of at-risk parent-child dyads and their families. This article will examine the RPT literature and explore the similarities and differences between IMH and RPT. In addition, two case studies will highlight a five-phase, integrative clinical-treatment process and provide insight into how IMH clinicians are integrating RPT models and maintaining adherence to the IMH treatment approach.