Poster workshop
Chair: Anne E. Brady
Discussant: M. Ann Easterbrooks
In 1997, the Massachusetts legislature allocated funds for the creation of a home visiting program for primiparous teenage mothers and their infants. The services are intended to help adolescent parents (1) develop effective parenting skills to ensure optimal health and development of their children; (2) prevent repeat teen pregnancies; (3) attain maximum educational achievement; (4) develop the capability to support themselves and their children; and (5) have healthy birth outcomes. In this poster workshop, we describe the evaluation and examine several key research questions that pertain to the development of the teenage mothers as parents and individuals Data for the posters are drawn from the process study and outcome study components of the evaluation project. Central to the evaluation are issues of the ways in which teen mothers negotiate the mutual, and often competing, tasks of parenting and identity formation. The ways in which the teen mother navigates the issues in her development as an individual and as a parent are crucial to the development of her infant. Social support from family, friends, and formal programs is one significant factor in her success in reconciling her roles as a teenager and a mother.One of the implicit goals of the Massachusetts Healthy Families Program is to expand the teen mother's social support network, with both formal and informal sources of support. In their work with clients, home visitors attempt to establish positive helping relationships with the teenage mothers while also aiding the mothers to connect with other agencies, friends and community members, and family. This poster workshop investigates parental well-being and infant development as they relate to the quantity and quality of the teen mother's social supports. This workshop consists of five contributions. The first poster outlines the structure of the evaluation project and sets the stage for the others. The second poster examines the nature of the home visit, specifically investigating the relationship between the teen mother and her home visitor, since this relationship may be key to program effectiveness. This poster also will examine the teen mother's engagement in the program and her social support networks. The third poster discusses the ways in which maternal life history relates to current parenting. This poster presents data on the teen mother's childrearing history, specifically her experience of abuse, and data on the teen mother's current parenting attitudes and practices. The fourth poster describes the links between social support and parenting practice among teenage mothers, specifically investigating the extent to which social support promotes more optimal parenting attitudes and behaviors. The last poster discusses the links between social support, identity, and well-being. Data will be presented on the teen mother's perception of self, her level of well-being, and her social support network. Taken as a whole, the data from this workshop will address the process and effectiveness of a large-scale family support program aimed at adolescent mothers. The focus includes both service delivery and outcome, and addresses multiple aspects of maternal well-being and parenting. As such, the workshop has implications for policy-makers, practitioners, and researchers in the field of child development.
Details of individual items:
poster
A unique collaboration between state agencies, local programs, and universities in Massachusetts demonstrates the potential of applied work to inform the fields of child development, program practice, and policy-making. The Massachusetts Children's Trust Fund (CTF), a public-private partnership created by the state to work to prevent child abuse and neglect, received state funding to develop a statewide network of community-based home visiting providers for teen parents, the Healthy Families Newborn Home Visiting Program. The program is jointly administered by CTF and the Massachusetts Department of Public Health (MDPH). The program offers comprehensive, prevention-oriented home visiting services to all first-time Massachusetts families with mothers under the age of 20. Services can start during pregnancy and continue until the child reaches three years of age. The services are intended to help adolescent parents (1) develop effective parenting skills to ensure optimal health and development of their children; (2) prevent repeat teen pregnancies; (3) attain maximum educational achievement; (4) develop the capability to support themselves and their children; and (5) have healthy birth outcomes. MDPH monitors the program contracts with local community-based service providers and has developed a nationally-recognized MIS to gather program process and outcome data on all program families (N3D 5000 to 7000).The Massachusetts Healthy Families Evaluation has the contract to conduct an in-depth evaluation of a sample of program participants. The Tufts team is using a developmental, participatory, and utilization-focused approach to evaluation which includes quantitative and qualitative methods. The team is jointly placed in the Departments of Child Development and Urban and Environmental Policy. In partnership with MDPH, we have designed our piece of the evaluation in such a way that it will answer key policy questions, provide information to programs that will allow them to improve their practice, and inform the fields of child development and family support. 500 program participants will participate in the evaluation. Within-cohort comparisons will examine differential program effectiveness; comparisons across extant data sets (historical comparisons and comparison standards) will assess overall effectiveness. Information will be presented on the Healthy Families program, program participants and their use of the program, and the program evaluation design, especially quantitative and qualitative work designed to address many developmental issues.Embedded in the main research questions of the evaluation are program participant-related questions of interest to developmentalists. Ethnographic methods will examine family ethnotheories of parenting, child development, and help-seeking behaviors and the way in which the program interacts with families' culture. Other analyses, using quantitative and qualitative data, will address the importance of fathers and extended family members in the life of the teen mother and for her participation in the program; and the way in which a teen's developmental level ties into her adaptation to parenting and her program participation. Preliminary data from two of four data collection points will be available for the ICIS meeting2E
poster
The relationship between a home visitor and client is believed to be the central component of home visiting programs (cf. Wasik, Bryant, & Lyons, 1990; Wasik, 1993; Roberts, 1997). Despite the acknowledged importance of this relationship, home visiting program evaluations have not effectively investigated or described this relationship. Little is known about the relation between the home visitor/client relationship and client engagement and satisfaction, for example. One goal of the MHFE is to address these questions. The evaluation research questions include queries of the teen mother's relationship with her home visitor, the quantity and quality of her social support network, and her personal functioning. One goal of the Healthy Families Program is to increase young mothers' access to and use of social supports. According to the literature (cf. Wasik, Bryant, & Lyons, 1990), the quality of the home visitor/client relationship may be a significant factor in attainment of this goal. We hypothesize a curvilinear relation between the mother's level of social support and her relationship with her home visitor; mothers with low levels of social support will demonstrate either low or high levels of engagement in the program and low or high levels of connection with their home visitor. Mothers with low levels of social support may be most in need of their home visitors' assistance since they do not have other sources of help and support, and may therefore connect with their home visitor. Alternatively, mothers with low levels of social support may be demonstrating general difficulty in engaging with other people, and may find it difficult to connect with their home visitor and to take advantage of the help and support that is offered. We predict that the presence of depression moderates this relation, so that depressed mothers will be more likely to demonstrate low engagement and connection with their home visitor.This poster presents an examination of the relationship between home visitors and their clients in the Massachusetts Healthy Families Program. We will report data on approximately 150 evaluation participants from their first six months of program involvement. Pregnant and parenting teens have described their relationships with their home visitors in open-ended interviews and through standardized questionnaires. Data on program participation collected through the Participant Data System (PDS) allows us to monitor client engagement in the Healthy Families Program. In addition, evaluation participants have completed measures of social support and depression. In the next phase of data collection, approximately 75 home visits will be videotaped and analyzed to further our understanding of this relationship. Preliminary analyses of the Home Visitor/Client Inventory (adapted from Barnard, 1998) and the Family-Centered Behavior Scale (Allen, Petr, & Brown, 1995) indicate that on average, teen mothers enrolled in the program are satisfied with their home visitors (mean 3D 1.59) and perceive the program to be family-centered (mean 3D 4.62). On the Personal Network Matrix Version 1 (Trivette & Dunst, 1988), teenage mothers report having the most contact with (mean 3D 35), and depending most upon (mean 3D 34) informal sources of social support, particularly family members. Further analyses will examine the relations between home visitor/client relationship, client engagement, social support, and depression.References Allen, R.I., Petr, C.G., & Brown, B.F.C. (1995). Family-Centered Behavior Scale and user's manual. Lawrence, KS: The Beach Center on Families and Disability, University of Kansas. Barnard, K. (1998). Developing, implementing, and documenting interventions with parents and young children. Zero to Three, February/March, 23-29.Roberts, R. (1997). Preventing child abuse and neglect through home visiting: Informing practice with research. APSAC Advisor, 10(1), 7-10.Trivette, C., & Dunst, C. (1988). Personal Network Matrix. In C. Dunst, C. Trivette, & A. Deal, Enabling and empowering families: Principles and guidelines for practice. Cambridge, MA: Brookline Books. Wasik, B. H. (1993). Staffing issues for home visiting program. The Future of Children, 3(3), 140-157.Wasik, B.H., Bryant, D..M., & Lyons, C.M. (1990). Home visiting: Procedures for helping families. Newbury Park, CA: Sage.
poster
It is part of conventional wisdom that the way in which a mother is raised influences the way she raises her own children. In particular, there is thought to be intergenerational transmission of patterns of parenting and maltreatment (e.g., Garbarino & Eckenrode, 1997). Most studies of the topic have been conducted with adult parents. Little is known about the ways in which child-rearing history pertains to current parenting practices of teenage mothers.Embedded in the research questions of the Massachusetts Healthy Families Evaluation are inquiries pertaining to the life history of the teenage mother and her own parenting style. We expect that mothers who were well-parented and were not abused will demonstrate more optimal parenting attitudes and behaviors themselves, consistent with the knowledge base on older parents. Various mechanisms have been raised in explanation of this pattern of intergenerational transmission, including attachment, modeling of behavior patterns, and psychological availability or empathy. A second hypothesis is that level of engagement in the Healthy Families program will moderate the relation between child-rearing history and current parenting practice. Families who demonstrate high program engagement will not demonstrate as strong links between life history and parenting practices. In this poster, we will present data on approximately 150 families from the first two data collection points, through the first six months of program involvement. At the first data collection point, all mothers answered open-ended interview questions about the way in which they were raised, their family composition, and their own parenting attitudes and behaviors. In addition, mothers completed the Adult-Adolescent Parenting Inventory (Bavolek, 1984). At Time 2, mothers discussed their own parenting behavior and completed several standardized indicators of life history and parenting: the Conflict Tactics Scale -Adult Recall Version (Straus, 1999), the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Parenting Stress Index (Abidin, 1983), and the Parent Self-Efficacy Inventory (Myers-Walls, 1999). In order to assess actual parenting behaviors, at both data collection points, mothers were observed playing with their children and were rated on several scales of the Parent Child Early Relational Assessment (Clark, 1985). Preliminary analyses suggest that mothers display a wide range of attitudes about parenting. Scores for expectations about child development, empathy, belief in corporal punishment, and role reversal are normally distributed. Mean standard scores on the AAPI indicate that, as a group, mothers have attitudes that place them at risk for being abusive as parents (inappropriate expectations, m 3D 3.88; empathy, m 3D 4.65; corporeal punishment, m 3D 6.45; role reversal, m 3D 4.39). Qualitative analyses of research interview questions indicate that mothers in our evaluation experienced a range of negative events during their childhoods, such as family abuse/neglect, father absence, and substance abuse. Further analyses will explore the links between these life experiences and aspects of current parenting.ReferencesAbidin, R. (1983). Parenting Stress Index: Professional manual. Odessa, FL: Psychological Assessment Resources, Inc.Bavolek, S. (1984). Handbook for the AAPI: Adult- Adolescent Parenting Inventory. Park City, Utah: Family Development Resources, Inc. Clark, R. (1985). The Parent-Child Early Relational Assessment. Unpublished manuscript: University of Wisconsin Medical School. Garbarino, J., & Eckenrode, J. (1997). Understanding abusive families: An ecological approach to theory and practice. San Francisco: Jossey-Bass Publishers. Myers-Walls, J. (1999). Parenting self-efficacy inventory. Unpublished manuscript: Purdue University. Parker, G., Tupling, H., & Brown, L.B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1-10. Straus, Murray A. (1999). Child report and adult recall versions of the revised Conflict Tactics Scales. Durham, NH: Family Research Laboratory, University of New Hampshire.
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One of the goals of the Massachusetts Healthy Families Evaluation is to examine social support and how it relates to parenting practices. Research on social support and parenting has shown that social support can act as a buffer against stress in certain conditions (Crnic et al, 1983) and is positively related to maternal and infant functioning and maternal satisfaction with parenting (Crnic, Greenberg & Slough, 1986; Belsky, Rosenberger, & Crnic, 1995). The large body of research on parenting and intervention indicates that supporting mothers in some capacity positively influences their parenting practices, leading to better outcomes for their infants (c.f. IHDP, 1990; Spiker, Ferguson & Brooks-Gunn, 1993). In the case of teenage pregnancy, there are mixed findings about the effects of social support, and ambiguity over which types (informal or formal) influence parenting competence the most. The developmental 'tasks' of adolescence at times conflict with the responsibility of parenthood, thwarting the assumption that all forms of support are positive or significant. In this poster, we hypothesize that teens with higher levels of social support will engage in more optimal parenting practices and have more positive attitudes about childrearing. In addition, we will consider whether factors such as family structure or depression moderate how 'supported' a mother feels. We expect that mothers who are depressed will feel less supported, as will mothers with small or 'unreliable' families. We will present analyses of early project data on social support and parenting practices of teen mothers using data from teen mothers' initial enrollment in the program through the first six months of program involvement. Social support measures include: a) the Personal Network Matrix (Trivette & Dunst, 1988), which assess the frequency and extent of social contact as well as quality of support, b) the Home Visitor/Client Relationship Inventory (adapted from Barnard, 1998), which measures the quality of the relationship with their home visitor, and c) a questionnaire which indicates the quality of teen mothers' friendships. Teen mothers also are interviewed about their relationships with the baby's father and grandmothers and the type of support these figures give. The teens' parenting practices and attitudes will be measured by the Adult-Adolescent Parenting Inventory (Bavolek, 1984), assessed at enrollment and after 1 year; as well as interview questions about specific parenting activities such as play and discipline. Preliminary analyses of approximately 150 teen mothers at time of enrollment indicate that teen mothers with a higher quality of friendships had higher empathy for their children (r 3D .25, p < .002) and also had lower rates of depression (r 3D -.31, p < .00). In addition, teen mothers who are more depressed show lower empathy for their children (r 3D -.17, p < .03). Further analyses will examine whether subgroups of teen mothers with higher quality friendships differ in their degree of empathy. It is hypothesized that, for some mothers, friendships may detract from a focus on parenting. Further analyses will also examine the potential interaction between depression and empathy.References Barnard, K. (1998). Developing, implementing, and documenting interventions with parents and young children. Zero to Three, February/March, 23-29.Bavolek, S. (1984). Handbook for the AAPI: Adult-Adolescent Parenting Inventory. Park City, Utah: Family Development Resources, Inc.Belsky, J.; Rosenberger, K.; Crnic, K. (1995). The origins of attachment security:'Classical' and contextual determinants. In S. Goldberg, R. Muir (Ed) Attachment theory: Social, developmental, and clinical perspectives., pp. 153-183. Hillsdale, NJ, : Analytic Press, IncCrnic, K.A., Greenberg, M.T., Ragozin, A.S., Robinson, N.M. & Basham, R.B2E (1983). Effects of stress and social support on mothers and premature and full-term infants. Child Development, 54, 209-217. Crnic, K.A., Greenberg, M.T., & Slough, N.M (1986). Early stress and social support influences on mothers' and high-risk infants' functioning in late infancy. Spiker, D, Ferguson, J. & Brokks-Gunn Spiker, Donna; Ferguson, Joan; Brooks-Gunn, Jeanne. Enhancing maternal interactivebehavior and child social competence in low birth weight, premature infants. ChildDevelopment. Vol 64(3), Jun 1993, 754-768.Trivette, C., & Dunst, C. (1988). Personal Network Matrix. In C. Dunst, C. Trivette, & A. Deal, Enabling and empowering families: Principles and guidelines for practice. Cambridge, MA: Brookline Books.
poster
One of the goals of the Healthy Families program is to promote adaptive and positive functioning of teen mothers in their roles as parents, and in other aspects of their lives. The typical developmental tasks of adolescents are centered on developing their own identity as part of a group and as an individual and on issues of autonomy and connectedness within the family. The teen mother is in a period where she is struggling to find a balance between her independence and maintaining ties with her family and social support group. At the same time, she is dealing with the demands and the realities of being a mother. Some research suggests that pregnancy for teens causes an interruption of their normal adolescent development, resulting in the loss of coping ability, abrupt changes in relationships, and increased distress (Cartoff, 1978; Group for Advancement of Psychiatry, 1986). The hypothesis of this study is that the quality and the quantity of social support a teen perceives having is directly related to her well-being and identity. Social support from a mother's family and friends is important in her adjustment to parenthood (Unger & Wandersman, 1985). Our analysis of data from the Massachusetts Healthy Families Evaluation will address the relations between the quantity and quality of social support (from family, friends, Healthy Families program) and aspects of mothers' well-being (depression, coping, risk behaviors) and identity. Using multiple methods (interview, standardized questionnaires) we have assessed pregnant and parenting teens' relationships with their home visitors, friends, and family. As predictors of social support we have used the Personal Network Matrix, the Home Visitor/Client Relationship scale, a measure of the quality of the friendship network, and a measure of the involvement of the babies' grandmother and father. The Personal Network Matrix, for example, allows the teen mom to indicate the frequency with which she has had contact with the people who are involved in her life and on whom she depends for help of assistance when she needs it. Analyses will determine how these measures of social support can be used to predict the teen mom's view of herself. As measures of identity and well-being, teen mothers in this study have completed a project-developed instrument assessing identity, a depression scale, and measures of her optimism and hopes, coping and risk behavior. Preliminary analyses indicate negative associations between reliance on seeking professional support as a form of coping and the amount of support a teen mother feels she receives from her family (r3D -.182, p<.05), her satisfaction with her relationship with her home visitor and her perception of her home visitor's family-centeredness (r3D -.177, p<.05), and the quality of her friendships (r3D -.172, p<.05). Teen mothers with higher quality of friendships were more likely to use venting feelings (r3D .205, p<.05) and avoidance of problems (r3D .282, p<.01) as coping behaviors and were less likely to show symptoms of depression (r3D -.308, p<.01). These results may indicate that mothers with good friendships and high levels of social support rely on more positive coping mechanisms and have better mental health. Further analyses will explore the relations between social support (from friends, family, and formal sources), identity, and maternal well-being. ReferencesCartoff, V.G. (1978). Postpartum services for adolescent mothers. Child Welfare, 57, 660-666.Powell, D.R. (1983). Parent education as early childhood intervention: Emerging directions in theory, research, and practice. Advances in Applied Developmental Psychology, 3, 105-130.Unger, D.G. & Wandersman, L.P. (1988). The relation of family support and partner support to the adjustment of adolescent mothers. Child Development, 59, 1056-1060.Unger, D.G., & Wandersman, L.P. (1985). Social support and adolescent mothers: Action research contributions to theory and applications. Journal of Social Issues, 41, 29-46.