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Despite growing recognition of the importance of fathers in child maltreatment risk, the field of perinatal home visitation services to prevent child maltreatment has to date only begun to consider fathers’ roles in the implementation of such services. Presently, there is a paucity of evidence-based strategies that guide home visiting programs to engage fathers aiming to reduce physical child abuse and neglect risk. The “Dads Matter-HV” home visiting service enhancement addresses this gap by providing manualized guidance on ways home visitors can work to optimize fathers’ positive involvement in support of their young children’s development.
This presentation provides the results of a clustered randomized controlled trial (RCT) testing the “Dads Matter-HV” (“DM”) enhancement. We estimate the DM enhancement’s impact on each mothers’ and fathers’ physical child abuse risk, and trace hypothesized mediating pathways through which the intervention influences parents’ physical abuse risk.
Methods:
A multisite clustered RCT was conducted with 17 home visiting teams serving 204 families across study conditions. Supervisors and their home visitor teams were randomized to deliver home visiting services with DM enhanced services (intervention), or home visiting services without DM (control). Fidelity was tracked using a psychometrically-tested instrument, and families and data collectors were masked to condition. This paper presents outcomes of the intervention on mothers’ and fathers’ physical child abuse risk at 4-months (immediately post-intervention), and at 12- month follow-up. Using structural equation modeling (SEM), and accounting for sample clustering, we examine the effect of the intervention on physical child abuse, and hypothesized mediators including the quality of the home visitor-father relationship, partner support and abuse, and the timing of service initiation.
Results:
A high proportion of the families (either mother, father or both parents) (90%) were retained (n=183) to follow-up. Most parents identified as being Latinx (68%) or African American/Black (26%) and reported being married or in cohabiting and romantic relationships (72%). The SEM mediational analyses indicated that the DM enhancement predicted improved home visitor relationships with fathers, but only for families receiving services initiated postnatally. The quality of the home visitor-father relationship predicted improved parents’ support of one another and reduced bidirectional mother-father abuse at 4-months, which in turn predicted lower maternal physical child abuse risk and paternal physical child abuse risk at 12-month follow-up.
Conclusions and Implications:
Dads Matter-HV can strengthen the impact of evidence-based perinatal home visitation services on physical child abuse risk in instances where such services are initiated postnatally. Findings indicate that DM operates through improved home visitor-father relationships, which strengthens support and reduces partner abuse in the mother-father co-parenting dyad. Such evidence-based strategies can help reorient the broad field of home visitation so that it is fully inclusive of both mothers and fathers in young children’s lives.