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Data on father visit participation

Data on father visit participation

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  • 1. Thinking About Fathers in the Nurse Family Partnership Program John Holmberg, Psy.D. & David Olds, Ph.D. Prevention Research Center for Family and Child Health
  • 2. Nearly 4 in 10 U.S. babies born out of wedlock • 24.3 million children under age 18 living without a biological father in this country – Rates are highest in ethnically diverse and poor populations Census Bureau – Current Population Reports Table 1, pp.70-104
  • 3. Growing Evidence on Father Involvement • Children who grow-up with a healthy and involved father, generally, fair better in childhood and young adulthood. • Not all fathers are good parents • Not all fathering is good for children
  • 4. Nurse Family Partnership Basics • Evidence based nurse home visitation program for low-income first-time mothers and their families • Tested in three randomized trials • Elmira, NY; Memphis, TN; Denver, CO • Major Findings – Improved maternal health and later life course development – Child functioning and reduced behavior problems – Marriage, cohabitation, and continuing romantic partnership • Economic analyses show potential cost savings to communities by providing the program • National Community-Based Replication
  • 5. Father involvement in the NFP “Special emphasis is placed on involving the father.”
  • 6. NFP and Fathers in National Replication • Fathers are welcome to join but they are not always invited/encouraged – Gate-keeping significant issue • Dad’s Days handouts
  • 7. What Do We Know About Father Involvement in the NFP? This talk is organized around the following questions: 1. To what degree are fathers involved with visits during the program? 2. What maternal or partner socio-demographic , risk and protective factors predict father visit participation? 3. What are the relationships between father visit participation and quantity of the NFP program delivered? 4. Are there any relationships between father visit participation (FVP) and later child functioning? 5. Is father visit participation uniquely related to child functioning?
  • 8. What Do We Know About Father Involvement in the NFP? This talk is organized around the following questions: 1. To what degree are fathers involved with visits during the program? 2. What maternal or partner socio-demographic , risk and protective factors predict father visit participation? 3. Are there any relationships between father visit participation and program implementation? 4. Are there any relationships between father visit participation (FVP) and later child functioning? 5. If any relationships exist, are they uniquely related to father visit participation?
  • 9. How often are fathers involved in home visits? Socio-demographic Characteristics of Women in NFP (N=41,448 National NFP; N=235 Denver Trial; N= 228 Memphis Trial) At Least Median Not White/ Non- Median Annual Intake Partner is One Visit Median Age Hispanic Black Education Married Income Father of Child Hispanic with Child’s Father Memphis 18 yrs. 10 yrs. 99% < 2% 90% 9% $1,140 89% 40% Denver 19 yrs. 12 yrs. 86% 44% 16% 37% $10,500 74% 58% National 18 yrs. 10 yrs. 88% 26% 23% 36% $13,500 93% 36%
  • 10. Socio-Demographic Characteristics and Father Visit Participation (FVP) FVP: At Least One Visit Intake: Median with Partner is Median Age Not Married Cohabitation Education Child’s Father Father of Child Denver 58% n=235 44% 19 yrs. 12 yrs. 86% 74%
  • 11. Distribution Father Visit Participation: Denver Father Visit Participation: Denver 45 40 35 Freq. FVP 30 25 20 15 10 5 0 0 1 2 3 4 5 6 7 8 9 10 11
  • 12. What Do We Know About Father Involvement in the NFP? This talk is organized around the following questions: 1. To what degree are fathers involved with visits during the program? 2. What maternal and partner socio-demographic , risk and protective factors predict father visit participation? 3. What are the relationships between father visit participation and quantity of the NFP program delivered? 4. Are there any relationships between father visit participation (FVP) and later child functioning? 5. If any relationships exist, are they uniquely related to father visit participation?
  • 13. Living Arrangements at Intake and FVP 90 80 Percent with a father visit 70 60 Lives with 50 Other 40 Lives with partner 30 20 10 0 Odds Ratio 4.57 (2.50- 8.36) p<.0001
  • 14. Ethnicity and Father Visit Participation 80 70 Percent with a father visit 60 African American 50 Latina 40 30 White 20 10 0 Father Visit W > L, p = .03; W>AA, p=<.0001; L>AA, p=<.01; Model R2 = .08
  • 15. Maternal Psycho-Social Characteristics and FVP Simple Standardized Regression Coefficients β Intake Variable p= Age .23 .0006 Martial Status .19 .004 Education level .17 .01 Mastery .19 .005 Mental Health .19 .005 Maltreatment Attitudes -.24 .0003 Working Currently -.15 .03
  • 16. Father Attributes and Father Visits Simple Standardized Regression Coefficients β p= variable Father excited .32 <.0001 about the baby Hours worked per week* .15 .05 * only available from those with partner at intake
  • 17. What Do We Know About Father Involvement in the NFP? This talk is organized around the following questions: 1. To what degree are fathers involved with visits during the program? 2. What maternal socio-demographic , risk and protective factors predict father visit participation? 3. What are the relationships between father visit participation and quantity of the NFP program delivered? 4. Are there any relationships between father visit participation (FVP) and later child functioning? 5. If any relationships exist, are they uniquely related to father visit participation?
  • 18. FVP and Home Visits Completed Simple Standardized Regression Coefficients variable β p= Total completed visits .42 <.0001
  • 19. Participant Attrition 60 50 40 No FVP 30 1+ FVP 20 10 0 Odds Ratio 0.79 (0.70 - 0.89) p=<.0001
  • 20. What Do We Know About Father Involvement in the NFP? This talk is organized around the following questions: 1. To what degree are fathers involved with visits during the program? 2. What maternal socio-demographic , risk and protective factors predict father visit participation? 3. What are the relationships between father visit participation and quantity of the NFP program delivered? 4. Are there any relationships between father visit participation (FVP) and later child functioning? 5. If any relationships exist, are they uniquely related to father visit participation?
  • 21. FVP and Child Functioning Child Functioning Time Point β p= Bayley Mental Development Index 24-months .15 .05 Maternal Report of Emergency 0-24 months -.10 .15 Room Visits
  • 22. What Do We Know About Father Involvement in the NFP? This talk is organized around the following questions: 1. To what degree are fathers involved with visits during the program? 2. What maternal socio-demographic , risk and protective factors predict father visit participation? 3. What are the relationships between father visit participation and quantity of the NFP program delivered? 4. Are there any relationships between father visit participation (FVP) and later child functioning? 5. If any relationships exist, are they uniquely related to father visit participation?
  • 23. FVP and Bayley Mental Development Index at Age24-Months Multiple Regression Time β p= Point Intake Maternal Education .30 .0002 Intake Household Income -.16 .05 Preg. to Father Visit .11 .16 24-month Participation
  • 24. FVP and Childhood Injuries Birth to 24-Months Multiple Regression Time β p= Point Maternal Psychological Intake .13 .07 Resources Household Income Intake -.12 .10 Father Visit Preg. to 24- -.14 .05 month Participation
  • 25. Discussion Results: • Mothers with more risk factors were less likely to have fathers attend visits • Relationships between these variables are complex, considerable co-variation (e.g., selection) • Additional information is needed to better understand the amenable factors related to healthy father visit participation • While far from conclusive, these analyses were encouraging to us. – e.g., some suggestion that FVP uniquely related to child functioning
  • 26. quot;What a child doesn't receive, he can seldom later give.quot; -P.D. James ITALIAN PAINTER RENATO GUTTUSO (1912-1987)
  • 27. And every little bit helps… Working Together For a Better Tomorrow