A Mindfulness-Informed Home Visiting Program for Adversity-Exposed Families

Background and Purpose: A significant number of children grow up in homes that are characterized by at least one stressor, such as poverty or family violence. Although exposure to early life stressors may have profound effects on children, a growing body of research shows that the relationship between adversity and later negative outcomes can be mitigated by a buffering adult caregiver. To that end, home visiting is an important mechanism for providing caregivers with additional tools and resources to alleviate children’s risk of adversity. Home visiting programs provide support to families within their own homes, thereby reducing treatment barriers such as access to transportation and childcare as well as improving the ability to customize services to each family. Families enrolled in such programs tend to have better outcomes compared to control groups, particularly in areas of parenting behaviors and attitudes, maltreatment risk, and children’s socioemotional development. Intervention research also suggests that teaching mindfulness, or the ability to be aware of present moment experiences with an attitude of acceptance and non-judgment, may have promising effects in the context of parenting. Mindfulness may not only provide caregivers with adaptive coping skills, but it may also foster resilience in children exposed to early adversity. However, we lack an advanced understanding of the role of mindfulness in home visiting programs. Therefore, this study aimed to examine the impact of a mindfulness-informed home visiting program on multiple domains of family functioning.

Methods: Data from two phases of a mindfulness-informed home visiting program were collected from families (N=56). Families (91% mothers, M_age=31.31, SD_age=8.08) were recruited from local health department and child welfare agencies and randomized to participate in a six-session mindfulness-informed home visiting program or a wait-list control group. Families racially and ethnically identified as White (46.5%), followed by Black (21.4%), Latinx (19.6%), and other (12.5%). The majority of families were low-income (70% <$25,000 annual income). Intention-to-treat (ITT) analyses were conducted on the entire randomized sample for each study phase to assess changes in stress, coping, and parenting from pre- to post-program.

Results: ITT analyses from the first study phase indicated significant group by time differences, with families in the home visiting program demonstrating reductions in parenting stress (F=5.38, p<.05) and child maltreatment potential (F=5.87, p<.05) and improvements in mindfulness awareness (F=8.98, p<.01) and children’s behavior (F=18.12, p<.001) compared to the control group. For the second phase, there were significant group by time differences, such that families in the home visiting program showed improvements in mindfulness non-reactivity (F=4.11, p<.05), parenting sense of competence (F=11.77, p<.01), and cognitive-emotional regulation (F=6.68, p<.05) compared to the control group.

Conclusions and Implications: Families enrolled in the mindfulness-informed home visiting program demonstrated improvements across multiple domains of family functioning, suggesting that mindfulness may be an effective enhancement to extant evidence-based home visiting programs. These findings build on the home visiting and mindfulness literature and offer important implications for social work practice; specifically, the use of mindfulness in home visiting programs may be an effective way to support vulnerable children and families.