Academic journal article Family Relations

Assessing Change in Families Following the Home-Start Parenting Program: Clinical Significance and Predictors of Change

Academic journal article Family Relations

Assessing Change in Families Following the Home-Start Parenting Program: Clinical Significance and Predictors of Change

Article excerpt


The aim of the present study was to examine whether improvements obtained after a home-based parenting intervention reflected meaningful and significant changes for a sample of Dutch mothers. The results showed that Home-Start mothers demonstrated reliable changes in well-being and enhanced parenting behaviors compared to both a comparison and a norm group of mothers. At posttest, a substantial number (39 - 84%) of the Home-Start mothers functioned at a level equivalent to that of a community group. The most reliable improvement was found with mothers experiencing the most severe problems at pretest, whereas the most recovery was reported for mothers with the fewest problems at pretest.

Key Words: clinically significant change, Home-Start, mothers, parenting behavior, parenting support program, reliable change.

Background and Significance

The first 5 years of life are of crucial importance for the development of both a sense of emotional security and the acquisition of self-regulation skills later in life (Repetti, Taylor, & seeman, 2002). Parenting behavior has been treated as a theoretical and empirical determinant of emotional well-being in early childhood and beyond (Papp, Cummings, & Schermerhorn, 2004). In general, parenting styles that encompass unpredictable parental behavior, lack of responsiveness and warmth, harsh discipline, and a lack of supervision of the child's activities have been linked to a host of negative outcomes for the child (Olson, Ceballo, & Park, 2002). These negative child outcomes include the development of antisocial behavior, social rejection, academic failure, and membership in deviant peer groups later on in life (Ehrensaft et al., 2003).

Given the well-documented association between parenting competence and child outcomes (see, e.g., Belsky, 1984), numerous early intervention and parenting support programs have been developed and implemented to counter potential negative outcomes and to support healthy developmental progress in families with young children. The long-term goal of many clinical interventions conducted by (mental health) professionals has been to ameliorate family dysfunction and behavioral problems of the child (Osofsky, 1998). In addition to clinical programs, a large number of home-visiting parenting support programs have been developed. These home-based parenting support programs show particular promise in that the method of delivering services to families in their own homes offers opportunities for more personalized service, which not only aids families but also increases program-retention rates (see reviews by Bilukha et al., 2005; Diamond & Josephson, 2005). Moreover, it is hypothesized that parents feel more at ease in their own homes (McGuigan, Katzev, & Pratt, 2003) and that these programs offer the opportunity to reach socially or geographically isolated people.

According to Thompson, Kropenske, Heinicke, Gomby, and Halfon (2001), another important feature of many home-based programs is their reliance on volunteers for staffing. There are several reasons why volunteers are used in this form of parenting intervention. First, volunteers are typically perceived by clients as more accessible and less threatening than professionals (Kelleher & Johnson, 2004), which may result in people feeling more at ease, leading to increased responsiveness to the intervention and less dropout. A second reason is the relatively low cost of programs staffed by volunteers, allowing for the provision of this service for many families. As a result, volunteer-based family support programs are widespread; for example, the HomeStart program is active in 17 countries on five continents and in the Netherlands has 52 locations (Home-Start international website: Given the fact that many families are served by volunteer-based family support programs, it is of great importance to evaluate the effectiveness of these programs. …

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