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| ID | Type | Description | Link |
|---|---|---|---|
| 1P50HD096698-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | NIH |
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Home visitation by community health workers is a commonly utilized approach to support families and prevent child maltreatment. At times, however, more intensive intervention is needed to address familial trauma, depression, or other challenges. This preventive treatment evaluation study evaluates whether adding Child-Parent Psychotherapy (CPP) to a Community Health Worker (CHW) outreach model improves positive parenting and parent-child relationships above CHW alone. The efficacy of CPP has been demonstrated with maltreated and other high-risk populations. This evaluation will examine optimal timing of CPP (beginning prenatally or postnatally) and optimal duration of services (6 vs. 12 months). Additionally, how and for whom CPP is most effective and why will be examined. Assessments of parenting, maternal sensitivity, representational models, cognitions, physiological reactivity, and physical health indicators will be assessed prenatally, and at children's age of 3, 9, and 12 months.
PROMISE is integrated into the TRANSFORM Capstone Center to promote the next generation of research on child maltreatment, translate research findings into clinical and preventive interventions, and disseminate research and best practice to varied stakeholders. Informed by developmental psychopathology, the research incorporates multiple levels of analysis within a lifespan framework. Increasing knowledge of optimal methods for delivering dual mother and child preventive intervention has crucial public health significance in preventing child maltreatment. PROMISE involves a randomized control trial to evaluate whether expanding a Community Health Worker (CHW) outreach model, by adding Child-Parent Psychotherapy (CPP), an intensive intervention that focuses on parent-infant relationships for families at risk for child maltreatment, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. The efficacy of CPP has been demonstrated with maltreated and other high-risk populations. Through the use of four intervention arms, the evaluation will assess whether more intensive intervention better protects against child maltreatment compared with CHW support alone, and will determine the optimal timing of these interventions (i.e., beginning prenatally or postnatally), the optimal duration of services (i.e., 6 vs. 12 months), mechanisms of effect (mediator analyses), and which intervention strategy works best for mothers with varying risk factors (moderator analyses). Pregnant women (N = 300) and their infants after birth will participate. Longitudinal assessments will occur during the third trimester of pregnancy, at infant's ages of 3 and 9 months, and a post-intervention follow-up at 15 months old. The measurements obtained at each timepoint constitute a rich multi-level perspective of maternal and child functioning over time in response to the interventions. Maternal parenting behaviors, representational models, cognitions, and physiological reactivity, and infants' health and development will be assessed longitudinally. CPP groups are hypothesized to improve sensitive and responsive parenting and secure attachment, relative to CHW home visitation alone, thereby reducing risks for child maltreatment. Improvements in maternal attachment representations, parenting cognitions, and stress reactivity are hypothesized to mediate treatment outcomes. Moderators, including maternal histories of trauma, psychopathology, and intimate partner violence, will advance determination of differential responsiveness to CHW and CPP (what works for whom and why?) and allow for tailored preventive strategies. Identification of timing, dosage, and intensity of service delivery, along with outcome mediators and moderators is innovative and will facilitate development of targeted prevention and intervention strategies that support parenting and decrease child maltreatment for this vulnerable population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CHW+CPP brief prenatal onset | Experimental | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) |
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| CHW+CPP brief postnatal onset | Experimental | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning postnatally, in addition to services from a Community Health Worker (CHW) |
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| CHW+CPP 12 months | Experimental | Participants will receive Child-Parent Psychotherapy (CPP) for 12 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) |
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| CHW only | Experimental | Participants will receive services from a Community Health Worker (CHW) without Child-Parent Psychotherapy (CPP) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Child-Parent Psychotherapy (CPP) | Behavioral | Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. |
| Measure | Description | Time Frame |
|---|---|---|
| Parental Sensitivity (Measured With the Parental Bonding Questionnaire) | Improvements in maternal reports of positive emotional responses to their babies; Parental Bonding Questionnaire, 25 items, each item ranges 0-5 (never to always); higher scores indicate greater bonding or more mother-reports emotional bond with her baby; total score=sum score utilized, range 0-125. | Assessment at child's age of 9 months |
| Parental Acceptance (Measured With the Parental Acceptance and Rejection Questionnaire) | Improvements in maternal reports of acceptance in parent-child relationships, Parental Acceptance and Rejection Questionnaire, scale assessing parental warmth/affection, indifference/neglect, and rejection; higher scores indicate more challenge, total score=sum score utilized; scale range 1-4 (almost never true to almost always true), range 55 - 220. | Assessment at child's age of 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Parental Sensitivity (Measured With the Parental Bonding Questionnaire) | Improvements in maternal reports of positive emotional responses to their babies; Parental Bonding Questionnaire, 25 items, each item ranges 0-5 (never to always); higher scores indicate greater bonding or more mother-reports emotional bond with her baby; total score=sum score utilized, range 0-125. | Assessment at child's age of 15 months |
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Inclusion Criteria:
Exclusion Criteria:
Enrollment will include pregnant women
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mt. Hope Family Center | Rochester | New York | 14608 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | CHW+CPP Brief Prenatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| FG001 | CHW+CPP Brief Postnatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning postnatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| FG002 | CHW+CPP 12 Months | Participants will receive Child-Parent Psychotherapy (CPP) for 12 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| FG003 | CHW Only | Participants will receive services from a Community Health Worker (CHW) without Child-Parent Psychotherapy (CPP) Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | CHW+CPP Brief Prenatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Parental Sensitivity (Measured With the Parental Bonding Questionnaire) | Improvements in maternal reports of positive emotional responses to their babies; Parental Bonding Questionnaire, 25 items, each item ranges 0-5 (never to always); higher scores indicate greater bonding or more mother-reports emotional bond with her baby; total score=sum score utilized, range 0-125. | The number analyzed on the Postpartum Boding Questionnaire at baby age 9 months differs from the number recruited because of attrition or missing data at our third wave of data collection | Posted | Mean | Standard Deviation | score on a scale | Assessment at child's age of 9 months |
|
15 months postnatal
No adverse event were reported
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | CHW+CPP Brief Prenatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
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The pandemic occurred during data collection and intervention was shifted to telehealth until safety precautions allowed resumption of in-person sessions.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jody Manly | University of Rochester Mt. Hope Family Center | (585) 275-2991 | 251 | jody_manly@urmc.rochester.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 2, 2023 | Mar 30, 2026 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D003150 | Community Health Workers |
| ID | Term |
|---|---|
| D000488 | Allied Health Personnel |
| D006282 | Health Personnel |
| D005159 | Health Care Facilities Workforce and Services |
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Child-Parent Psychotherapy
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Research assistants will be blind to the arm the participant has been randomly assigned to and to study hypotheses.
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| Community Health Worker (CHW) home visitation | Behavioral | Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
|
| Parental Acceptance (Measured With the Parental Acceptance and Rejection Questionnaire) | Improvements in maternal reports of acceptance in parent-child relationships; Parental Acceptance and Rejection Questionnaire, scale assessing parental warmth/affection, indifference/neglect, and rejection; higher scores indicate more challenge, total score=sum score utilized; scale range 1-4 (almost never true to almost always true), range 55 - 220. | Assessment at child's age of 15 months |
| BG001 | CHW+CPP Brief Postnatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning postnatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| BG002 | CHW+CPP 12 Months | Participants will receive Child-Parent Psychotherapy (CPP) for 12 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| BG003 | CHW Only | Participants will receive services from a Community Health Worker (CHW) without Child-Parent Psychotherapy (CPP) Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| BG004 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| OG001 | CHW+CPP Brief Postnatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning postnatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| OG002 | CHW+CPP 12 Months | Participants will receive Child-Parent Psychotherapy (CPP) for 12 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
| OG003 | CHW Only | Participants will receive services from a Community Health Worker (CHW) without Child-Parent Psychotherapy (CPP) Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. |
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| Primary | Parental Acceptance (Measured With the Parental Acceptance and Rejection Questionnaire) | Improvements in maternal reports of acceptance in parent-child relationships, Parental Acceptance and Rejection Questionnaire, scale assessing parental warmth/affection, indifference/neglect, and rejection; higher scores indicate more challenge, total score=sum score utilized; scale range 1-4 (almost never true to almost always true), range 55 - 220. | The number of participants analyzed on the Parental Acceptance and Rejection Questionnaire at child's age of 9 months is different than the number recruited because of attrition and missing data by the third wave of data collection | Posted | Mean | Standard Deviation | score on a scale | Assessment at child's age of 9 months |
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| Secondary | Parental Sensitivity (Measured With the Parental Bonding Questionnaire) | Improvements in maternal reports of positive emotional responses to their babies; Parental Bonding Questionnaire, 25 items, each item ranges 0-5 (never to always); higher scores indicate greater bonding or more mother-reports emotional bond with her baby; total score=sum score utilized, range 0-125. | The number of participants analyzed on the Parental Bonding Questionnaire at child's age of 15 months differs from the total number recruited because of attrition and missing data by the fourth wave of data collection | Posted | Mean | Standard Deviation | score on a scale | Assessment at child's age of 15 months |
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| Secondary | Parental Acceptance (Measured With the Parental Acceptance and Rejection Questionnaire) | Improvements in maternal reports of acceptance in parent-child relationships; Parental Acceptance and Rejection Questionnaire, scale assessing parental warmth/affection, indifference/neglect, and rejection; higher scores indicate more challenge, total score=sum score utilized; scale range 1-4 (almost never true to almost always true), range 55 - 220. | The number of participants analyzed on the Parental Acceptance and Rejection Questionnaire differs from the number recruited because of attrition and missing data by the fourth wave of data collection | Posted | Mean | Standard Deviation | score on a scale | Assessment at child's age of 15 months |
|
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| 0 |
| 46 |
| 0 |
| 46 |
| 0 |
| 46 |
| EG001 | CHW+CPP Brief Postnatal Onset | Participants will receive Child-Parent Psychotherapy (CPP) for 6 months, beginning postnatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. | 0 | 56 | 0 | 56 | 0 | 56 |
| EG002 | CHW+CPP 12 Months | Participants will receive Child-Parent Psychotherapy (CPP) for 12 months, beginning prenatally, in addition to services from a Community Health Worker (CHW) Child-Parent Psychotherapy (CPP): Child-Parent Psychotherapy (CPP) focuses on parent-infant relationships, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. A primary goal is to strengthen the parent-child relationship to improve family functioning and child security of attachment. Through respect, empathic concern, and positive regard, the therapeutic relationship provides mothers with corrective emotional experiences, through which they are able to differentiate current from past relationships, form positive internal representations of themselves and of themselves in relationship to others, particularly their children. Parents are encouraged to process their experiences of trauma and restore parental roles as protective shields, improve affective regulation capacities, enhance understanding of the meaning of behavior, acknowledge the impact of trauma, and support children in a more positive developmental trajectory. Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. | 0 | 57 | 0 | 57 | 0 | 57 |
| EG003 | CHW Only | Participants will receive services from a Community Health Worker (CHW) without Child-Parent Psychotherapy (CPP) Community Health Worker (CHW) home visitation: Community Health Worker (CHW) home visitation includes assistance with concrete support needs, such as transportation to medical appointments, referrals for food, housing, and employment services, and attention to developmental needs of young children. | 0 | 63 | 0 | 63 | 0 | 63 |
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