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Barlow, A., Mullany, B., Neault, N., Compton, S., Carter, A., Hastings, R., Billy, T., CohoMescal, V., Lorenzo, S., & Walkup, J. T. (Jan 2013). Effect of a paraprofessional home-visiting intervention on American Indian teen mothers’ and infants’ behavioral risks: A randomized controlled trial. The American Journal of Psychiatry, 170(1), 83-93.

Model(s) Reviewed: Family Spirit®
Additional Sources:

WWHV035854

Mullany, B., Barlow, A., Neault, N., Billy, T., Jones, T., Tortice, I., Lorenzo, S., Powers, J., Lake, K., Reid, R., & Walkup, J. (2012). The Family Spirit trial for American Indian teen mothers and their children: CBPR rationale, design, methods and baseline characteristics. Society of Prevention Research, 13, 504-518.
Manuscript Screening Details
Screening Decision Screening Conclusion
Passes Screens Eligible for review
Study Design Details
Rating Design Attrition Baseline Equivalence Reassignment Confounding Factors
High Randomized controlled trial Low Established on race/ethnicity, SES, and baseline measures of the outcome. None None
Study Characteristics
Study Participants American Indian adolescent females ages 12 to 19 years at conception and at 32 weeks or earlier gestation who resided in one of four participating communities were recruited. The study sample included 322 participants who were randomly assigned to either the Family Spirit group (159) or the control group (163). The average age of participants at baseline was 18.1 years. Sixty percent lived with their parents and slightly more than half lived in two or more homes within the past year. Seventy-seven percent of participants were pregnant with their first child. During pregnancy, 14 percent of participants drank alcohol, 19 percent smoked cigarettes, and 13 percent used marijuana.
Setting The program was implemented in four tribal communities across three reservations in Arizona.
Intervention Services Family Spirit is a home visiting program for young American Indian pregnant and parenting mothers staffed by American Indian paraprofessionals. The program’s goals are to increase mothers’ parenting knowledge and involvement, mothers’ psychosocial functioning, and children’s emotional and behavioral outcomes. The curriculum includes 43 lessons that cover parenting skills, infant development, and maternal psychosocial development. The frequency of the visits depends upon the stage of the program. One-hour home visits are provided weekly during pregnancy, biweekly visits for the first four months following the child’s birth, monthly from 4 to 14 months postpartum, and then bimonthly until the child’s third birthday. The study did not specify the dosage of services that program participants actually received.
Comparison Conditions Participants in the control group received transportation to and from prenatal and well-baby visits, information on child care and community resources, and referrals for services.
Staff Characteristics and Training Home visitors were trained for more than 80 hours on the evaluation protocol and delivering the intervention. After training, home visitors were required to demonstrate 85 percent mastery or better of the Family Spirit curriculum. Quarterly supervision visits and review of an audio recording of 20 percent of visits were administered to examine whether home visitors adhered to the intervention protocol
Funding Sources Support for this research was provided by the National Institute on Drug Abuse.
Author Affiliation Ms. Barlow is part of the team that developed this model. Dr. Walkup was affiliated with the Center for American Indian Health at the Johns Hopkins Bloomberg School of Public Health, where the team that developed this model is based.
Study Registration:
Clinicaltrials.gov Identifier: NCT00373750

Findings Details

Outcome Domain: Maternal Health
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type Notes
High ASEBA - Externalizing
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 40.09 Adjusted mean = 41.46 Mean difference = -1.37 Study reported = -0.13 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ASEBA - Externalizing
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 38.20 Adjusted mean = 40.70 Mean difference = -2.50 Study reported = -0.20 Statistically significant,
p = 0.04
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ASEBA - Internalizing
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 43.80 Adjusted mean = 45.12 Mean difference = -1.32 Study reported = -0.12 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ASEBA - Internalizing
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 41.48 Adjusted mean = 43.99 Mean difference = -2.51 Study reported = -0.19 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ASEBA - Total Problems
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 38.01 Adjusted mean = 40.37 Mean difference = -2.36 Study reported = -0.18 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ASEBA - Total Problems
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 40.27 Adjusted mean = 41.65 Mean difference = -1.38 Study reported = -0.13 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High CES-D
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted mean = 13.06 Adjusted mean = 13.40 Mean difference = -0.34 Study reported = -0.07 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High CES-D
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 12.46 Adjusted mean = 13.41 Mean difference = -0.95 Study reported = -0.16 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High CES-D
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 11.54 Adjusted mean = 13.41 Mean difference = -1.89 Study reported = -0.20 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High POSIT Mental Health
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted mean = 3.23 Adjusted mean = 3.56 Mean difference = -0.33 Study reported = -0.13 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High POSIT Mental Health
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 3.05 Adjusted mean = 3.30 Mean difference = -0.25 Study reported = -0.09 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High POSIT Mental Health
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 2.77 Adjusted mean = 2.91 Mean difference = -0.14 Study reported = -0.04 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High POSIT Substance Abuse
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted mean = 0.56 Adjusted mean = 0.61 Mean difference = -0.05 Study reported = -0.03 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High POSIT Substance Abuse
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 0.39 Adjusted mean = 0.55 Mean difference = -0.16 Study reported = -0.08 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High POSIT Substance Abuse
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 0.13 Adjusted mean = 0.45 Mean difference = -0.32 Study reported = -0.13 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Alcohol - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted &#37 = 16.88 Adjusted mean % = 20.02 OR = 0.71 HomeVEE calculated = -0.13 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Alcohol - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted &#37 = 25.77 Adjusted mean % = 21.55 OR = 1.14 HomeVEE calculated = 0.14 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Alcohol - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted &#37 = 17.92 Adjusted mean % = 17.81 OR = 0.80 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Any alcohol or illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted &#37 = 27.74 Adjusted mean % = 30.78 OR = 0.76 HomeVEE calculated = -0.09 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Any alcohol or illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted &#37 = 38.93 Adjusted mean % = 34.64 OR = 1.07 HomeVEE calculated = 0.11 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Any alcohol or illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted &#37 = 32.91 Adjusted mean % = 29.11 OR = 1.04 HomeVEE calculated = 0.11 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Any illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted &#37 = 22.89 Adjusted mean % = 21.92 OR = 0.93 HomeVEE calculated = 0.03 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Any illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted &#37 = 21.34 Adjusted mean % = 21.90 OR = 0.83 HomeVEE calculated = -0.02 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Marijuana - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 2 months 322 mothers Adjusted &#37 = 20.63 Adjusted mean % = 21.02 OR = 0.87 HomeVEE calculated = -0.01 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Marijuana - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted &#37 = 12.39 Adjusted mean % = 18.83 OR = 0.57 HomeVEE calculated = -0.30 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Marijuana - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted &#37 = 18.91 Adjusted mean % = 19.65 OR = 0.83 HomeVEE calculated = -0.03 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Outcome Domain: Child Development and School Readiness
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type Notes
High ITSEA - Competence domain
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted mean = 1.07 Adjusted mean = 1.02 Mean difference = 0.05 Study reported = 0.12 Not statistically significant,
p > 0.05
Primary
High ITSEA - Competence domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted &#37 = 20.27 Adjusted mean % = 17.66 OR = 0.86 HomeVEE calculated = 0.10 Not statistically significant,
p > 0.05
Primary
High ITSEA - Dysregulation domain
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted mean = 0.54 Adjusted mean = 0.59 Mean difference = -0.06 Study reported = -0.15 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ITSEA - Dysregulation domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted &#37 = 15.80 Adjusted mean % = 18.67 OR = 1.37 HomeVEE calculated = -0.12 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ITSEA - Externalizing domain
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted mean = 0.62 Adjusted mean = 0.71 Mean difference = -0.09 Study reported = -0.19 Statistically significant,
p = 0.03
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ITSEA - Externalizing domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted &#37 = 13.69 Adjusted mean % = 20.62 OR = 1.88 HomeVEE calculated = -0.30 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ITSEA - Internalizing domain
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted mean = 0.57 Adjusted mean = 0.62 Mean difference = -0.05 Study reported = -0.10 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High ITSEA - Internalizing domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 319 mothers Adjusted &#37 = 20.27 Adjusted mean % = 27.16 OR = 1.61 HomeVEE calculated = -0.23 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Outcome Domain: Positive Parenting Practices
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type Notes
High HOME inventory - 12 months
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 25.92 Adjusted mean = 25.41 Mean difference = 0.51 Study reported = 0.08 Not statistically significant,
p > 0.05
Primary
High HOME inventory - 6 months
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 22.79 Adjusted mean = 22.75 Mean difference = 0.04 Study reported = 0.01 Not statistically significant,
p > 0.05
Primary
High PLOC Parental self-efficacy - 12 months
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 23.21 Adjusted mean = 24.71 Mean difference = -1.51 Study reported = -0.23 Statistically significant,
p = 0.01
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High PLOC Parental self-efficacy - 6 months
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 6 months 322 mothers Adjusted mean = 22.98 Adjusted mean = 23.83 Mean difference = -0.85 Study reported = -0.13 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Home safety attitudes
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 29.54 Adjusted mean = 28.61 Mean difference = 0.94 Study reported = 0.19 Statistically significant,
p = 0.03
Secondary
High Home safety practices
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 1.56 Adjusted mean = 1.30 Mean difference = 0.26 Study reported = 0.16 Not statistically significant,
p > 0.05
Secondary
High Parenting knowledge
FavorableUnfavorable or ambiguousNo Effect
Family Spirit RCT, 2006-2008 sample 12 months 322 mothers Adjusted mean = 15.43 Adjusted mean = 14.08 Mean difference = 1.35 Study reported = 0.33 Statistically significant,
p = 0.001
Secondary

Outcome Measure Summary

Outcome Domain: Maternal Health
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
High

ASEBA - Externalizing

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

α range = 0.69-0.79 across scales

Primary
High

ASEBA - Internalizing

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

α range = 0.69-0.79 across scales

Primary
High

ASEBA - Total Problems

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

α range = 0.69-0.79 across scales

Primary
High

POSIT Mental Health

Problem Oriented Screening Instrument for Teens is a 139 item assessment containing 6 subscales, which include mental health and substance abuse. Maternal self-report

α range = 0.60-0.83 across scales

Secondary
High

POSIT Substance Abuse

Problem Oriented Screening Instrument for Teens is a 139 item assessment containing 6 subscales, which include mental health and substance abuse. Maternal self-report

α range = 0.60-0.83 across scales

Secondary
High

Alcohol - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary
High

Any alcohol or illegal drug - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary
High

Any illegal drug - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary
High

CES-D

Center for Epidemiological Studies Depression is a 20-item assessment of depressive symptoms Maternal self-report

α = 0.88

Secondary
High

Marijuana - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary
Outcome Domain: Child Development and School Readiness
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
High

ITSEA - Competence domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Competence domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Dysregulation domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Dysregulation domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Externalizing domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Externalizing domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Internalizing domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
High

ITSEA - Internalizing domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary
Outcome Domain: Positive Parenting Practices
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
High

HOME Inventory - 12 months

45-item assessment of parental behavior, parent-child interaction, and home environment Researcher observation

α = 0.75

Primary
High

HOME Inventory - 6 months

45-item assessment of parental behavior, parent-child interaction, and home environment Researcher observation

α = 0.75

Primary
High

PLOC Parental self-efficacy - 12 months

Self-efficacy subscale from Parental Locus of Control assessment

Maternal self-report

α = 0.67

Secondary
High

PLOC Parental self-efficacy - 6 months

Self-efficacy subscale from Parental Locus of Control assessment

Maternal self-report

α = 0.67

Secondary
High

Home safety attitudes

8-item assessment of attitudes towards home safety for children Maternal self-report

α = 0.57 for attitudinal component

Secondary
High

Home safety practices

8-item assessment of attitudes towards home safety for children Maternal self-report

α = 0.57 for attitudinal component

Secondary
High

Parenting knowledge

30-item assessment created by the investigator team to measure knowledge gains Maternal self-report

α = 0.65

Secondary