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Addressing Maternal Depression, Substance Use, and Intimate Partner Violence in Home Visiting: a Quasi-Experimental Pilot Test of a Screen-and-Refer Approach

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Abstract

This quasi-experimental pilot study describes preliminary impacts of the “Home Visitation Enhancing Linkages Project (HELP),” a pragmatic screen-and-refer approach for promoting identification of and linkage to treatment for maternal depression (MD), substance use (SU), and intimate partner violence (IPV) within early childhood home visiting. HELP includes screening for MD, SU, and IPV followed by a menu of motivational interviewing and case management interventions aimed at linking clients to treatment, designed for delivery within routine home visiting. HELP was piloted within four counties of a statewide home visiting system that were implementing Healthy Families America. HELP clients (N = 394) were compared to clients in five demographically matched counties that received usual Healthy Families services (N = 771) on whether their home visitors (1) identified MD, SU, and IPV risk; (2) discussed MD, SU, and IPV during home visits; and (3) made referrals for MD, SU, and IPV. All data were extracted from the program’s management information system. A significant impact of HELP was found on discussion of risk in home visits for all three risk domains with large effect sizes (MD OR = 4.08; SU OR = 15.94; IPV OR = 9.35). HELP had no impact on risk identification and minimal impact on referral. Findings provide preliminary support for HELP as a way of improving discussion of client behavioral health risks during home visits, an important first step toward better meeting these needs within home visiting. However, more intensive intervention is likely needed to impact risk identification and referral outcomes.

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Acknowledgments

Preparation of this article was supported by grant 1R01DA034108 from the National Institute on Drug Abuse. Additional Support was received from the New Jersey Department of Children and Families; the New Jersey Division of Family Development; and the New Jersey Department of Health. We gratefully acknowledge the home visitors and supervisors who generously devoted their time to participate in this study in the hopes of advancing the clinical science in their field.

Funding

Funding for this study was received from the National Institute on Drug Abuse (1R21DA034108). The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health. Additional support for this project was provided by the New Jersey Department of Children and Families, the New Jersey Department of Human Services: Division of Family Development, and the New Jersey Department of Health.

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Authors and Affiliations

  1. Center on Addiction, 633 Third Avenue, New York, NY, 10017, USA

    Sarah Dauber & Aaron Hogue

  2. Department of Psychology, Sam Houston State University, Huntsville, TX, USA

    Craig E. Henderson

  3. Prevent Child Abuse New Jersey, 103 Church Street, New Brunswick, NJ, USA

    Jessica Nugent & Gina Hernandez

Authors
  1. Sarah Dauber
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  2. Aaron Hogue
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  3. Craig E. Henderson
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  4. Jessica Nugent
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  5. Gina Hernandez
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Corresponding author

Correspondence to Sarah Dauber.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the institutional review board of The Center on Addiction. All procedures performed in studies involving human participants were in accordance with the ethical standards of The Center on Addiction and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

This study used administrative data collected by the Healthy Families New Jersey program. All program participants provide consent for their administrative data to be used for research purposes.

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Dauber, S., Hogue, A., Henderson, C.E. et al. Addressing Maternal Depression, Substance Use, and Intimate Partner Violence in Home Visiting: a Quasi-Experimental Pilot Test of a Screen-and-Refer Approach. Prev Sci 20, 1233–1243 (2019). https://doi.org/10.1007/s11121-019-01045-x

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