Family risk as a predictor of initial engagement and follow-through in a universal nurse home visiting program to prevent child maltreatment

Objective

As nurse home visiting to prevent child maltreatment grows in popularity with both program administrators and legislators, it is important to understand engagement in such programs in order to improve their community-wide effects. This report examines family demographic and infant health risk factors that predict engagement and follow-through in a universal home-based maltreatment prevention program for new mothers in Durham County, North Carolina.

Methods

Trained staff members attempted to schedule home visits for all new mothers during the birthing hospital stay, and then nurses completed scheduled visits three to five weeks later. Medical record data was used to identify family demographic and infant health risk factors for maltreatment. These variables were used to predict program engagement (scheduling a visit) and follow-through (completing a scheduled visit).

Results

Program staff members were successful in scheduling 78% of eligible families for a visit and completing 85% of scheduled visits. Overall, 66% of eligible families completed at least one visit. Structural equation modeling (SEM) analyses indicated that high demographic risk and low infant health risk were predictive of scheduling a visit. Both low demographic and infant health risk were predictive of visit completion.

Conclusions

Findings suggest that while higher demographic risk increases families’ initial engagement, it might also inhibit their follow-through. Additionally, parents of medically at-risk infants may be particularly difficult to engage in universal home visiting interventions. Implications for recruitment strategies of home visiting programs are discussed.     

A Comparison of Dropouts and Nondropouts on Participation in School Activities

Abstract

This study investigated the relationship of participation in the extraclass activities and dropouts in Kansas high schools of varying enrollments. Schools were chosen at random in each enrollment category with approximately equal number of students. A questionnaire was used to secure data on the dropouts and an equal number of nondropouts. The t ratio and analysis of variance were used with a .01 level of confidence.

The results show that lack of participation in school activities is a characteristic of the dropout in each enrollment category with 68 percent of the total being nonparticipators as opposed to only 4 percent of the nondropouts. Participation by dropouts was similar in all sizes of schools except in the smallest enrollment where a larger participation was noted.     

Multi-level determinants of retention in a home-visiting child abuse prevention program

OBJECTIVE: This exploratory study investigated how attributes from multiple domains influence retention in a voluntary home-visiting child abuse prevention program. METHOD: A sample of 1093 "at-risk" families participated in a home-visiting child abuse prevention program. A total of 71 Family Support Workers (FSWs) provided home visitation services in 12 different communities. Hierarchical general linear modeling (HGLM) was used to examine the community, home visitor, and maternal attributes that predicted retention in the program beyond 1 year. RESULTS: Multi-level analyses (HGLM) revealed significant community, home visitor, and maternal level effects. Families were less likely to remain in a home-visiting child abuse prevention program for at least 1 year if they lived in an area with high community violence. Families were more likely to remain when the home visitor received more hours of direct supervision. Older mothers were more likely to remain for at least 1 year than were younger mothers. Hispanic mothers were more likely to remain than were White non-Hispanic mothers. CONCLUSIONS: These findings demonstrate the utility of looking across multiple levels of influence when examining retention in home-visiting child abuse prevention programs. To increase retention rates home visitors will need to be adaptable to fit the needs of families in violent communities. Supervisors can influence retention rates by providing more hours of direct supervision. Other strategies that may contribute to program retention include meeting the scheduling needs of younger mothers and involving the families of younger mothers more effectively.     

Changes in depressive symptoms in first time mothers in home visitation

ObjectiveThe expansion of Home Visitation Programs for at-risk, first-time mothers and their young children has drawn attention to the potential impact of depression on program outcomes, yet little research has examined depression in the context of home visitation. The purpose of this study was to determine the prevalence of and changes in depressive symptoms in mothers enrolled in home visitation and identify predictors of change in symptoms over the first 9 months of service.MethodsSubjects consisted of 806 at-risk, first-time mothers enrolled in a Home Visitation Program. Self-reported depression was measured at enrollment and again 9 months later. Established clinical cutoffs were used to identify clinically elevated levels of depression. Additional measures were taken of interpersonal trauma history, concurrent intimate partner violence, and social support.ResultsResults indicated that: (1) 45.3% of mothers had clinically elevated symptoms of depression at some point during the first 9 months of service, (2) 25.9% of mothers had elevated symptoms at both time points or at the 9-month assessment, and (3) 74.1% experienced an interpersonal trauma prior to enrollment. Lack of improvement or worsening of depressive symptoms from enrollment to 9 months was best predicted by pre-enrollment interpersonal trauma history, young maternal age, being African American, and symptoms severe enough to have led to mental health treatment.ConclusionsFindings suggest that maternal depressive symptoms are a significant problem in home visitation. The role of interpersonal trauma in depressive symptoms, and how to best address these clinical issues in home visitation, warrants further examination.Practice implicationsMaternal depression is prevalent in Home Visitation Programs, and many mothers exhibit elevated symptoms at multiple time points over the first year of service. Interpersonal trauma history is also prevalent, and is predictive of increased depressive symptoms over time. Home Visitation Programs should note that mothers with interpersonal trauma history, young maternal age, and being African American have an increased likelihood of persistent depressive symptoms, which may in turn pose significant challenges to providing services.     

The effects of the Webster-Stratton parenting program on maltreating families: fostering strengths

OBJECTIVE: This study examined the effects of the Webster-Stratton parenting program on the parenting skills of maltreating mothers and on the autonomy of their children (3-8 years). METHOD: A randomized controlled trial was used. Twenty-six maltreating families were randomly assigned to one of two conditions: the 16-hour weekly intervention group, or the 4-month wait list control group. Pre- and post-intervention independent assessments included a 2-hour home visit involving videotaped mother-child interactions during two prescribed, 10-minute play activities. RESULTS: Compared to the control group, treatment mothers demonstrated significant improvement in involvement and marginally significant improvement in autonomy-support, but no improvement in structure. Treatment group children showed no significant improvement in autonomy when compared to control group children. CONCLUSIONS: This parenting program proved effective with maltreating parents. The lack of demonstrated effect on children may reflect the need for a larger and more sustained treatment dose and/or the need to include parent-child interaction opportunities in the program. At the same time, while treatment gains were limited to the parent, the high treatment adherence rate (92% attended six or more of the eight program sessions) and low attrition rate (n=1) indicate that the treatment gains may hold potential for more thorough examination.     

The impact of teacher preparation on student achievement in algebra in a “hard-to-staff” urban PreK-12-university partnership

Debate about teacher supply, demand, retention, and attrition has been renewed in recent years by an increased concern about the reduced numbers of prospective teachers entering teacher education programs, the high attrition rate of beginning teachers, and the resulting teacher shortages. U.S. schools are experiencing teacher shortages, especially in low-income urban areas, because of increased school enrollment, teacher retirement, reduction in class size, teacher attrition, and turnover related to low salaries, job dissatisfaction, and lack of administrative support and influence over decision-making. Recently, the increased interest in teacher quality has been the topic of debate for policy-makers, the public, and the educational community. The purpose of this study was to determine if a nontraditional teacher preparation program, the Transition To Teaching program, was a viable way to ease the teacher shortages in a high poverty, urban U.S. school district, and at the same time, to evaluate the impact of teacher training on students' academic achievement. The results of this study afford evidence that the students taught by 1st-year, alternatively prepared teachers achieved as well as or better than their peers taught by traditionally certified 1st-year teachers, according to student achievement in mathematics, specifically Algebra I.     

PREDICTING THE RETENTION OF UNIVERSITY STUDENTS

Survival analysis was used to model theretention of 8,867 undergraduate students at OregonState University between 1991 and 1996. Attrition wasfound to increase with age, and decrease with increasing high school GPA and first-quarter GPA.Non-residents had higher attrition rates than didresident and international students, and students takingthe Freshman Orientation Course appeared to be atreduced risk of dropping out. Statistically significantassociations of retention with ethnicity/race andcollege at first enrollment were also noted. Aproportional hazards regression model was developed topredict a student's probability of leaving school basedon these demographic and academic variables. Theseanalyses are helping to guide the university's effortsto improve retention through marketing, recruitment, and the development of orientation and otherprograms.     

Factors influencing the recruitment and retention of literacy learners in Oman

The study investigates factors influencing the recruitment and retention of learners in the national adult literacy programme in Oman. Personal interviews were conducted in the interior and Capital regions of Oman (N=102). Respondents included 46 randomly selected enrolled learners, 26 randomly selected dropouts and 30 unenrolled adults. Results of the interviews were content-analyzed and frequencies, cross tabulations and Chi-square were calculated. Findings indicated regional differences in the adults' motivation for enrolling, but the spiritual motive was over all the most significant. Men and women reported different patterns of conflict and obstacles in completing their literacy studies: Men indicated work demands as their biggest obstacle while women complained about family responsibilities. Programme attrition was mainly attributed to structural characteristics of the programme.     

Using quality improvement to promote implementation and increase well child visits in home visiting

A key goal of home visiting is to connect children with medical homes through anticipatory guidance regarding recommended well child care (WCC). Substantial barriers to WCC among low socioeconomic families can limit achievement of this outcome. Quality improvement strategies have been widely adopted in healthcare but only recently implemented in home visiting to achieve program outcomes. The objective of this initiative was to increase the percentage of infants enrolled in home visiting who completed at least 3 recommended WCC visits in the first 6 months of life within a large, multi-model program comprised of 11 sites. A series of 33 quality improvement cycles were conducted at 3 sites involving 18 home visitors and 139 families with infants in the target age range. These were deployed sequentially, and changes within and across sites were monitored using trend charts over time. Adopted strategies were then implemented program-wide. Initiatives focused on staff training in WCC recommendations, data collection processes, monthly family tracking reports, and enhanced communication with primary care offices. Data were shared in iterative sessions to identify methods for improving adherence. Wide baseline variability across sites was observed, with the percentage of infants with recommended care ranging from 35% to 83%. Over the project timeline, the percentage of infants receiving at least 3 WCC visits in the first 6 months increased from 58% to 86%. Quality improvement within home visiting can be used to improve WCC adherence and provides an example of maximizing implementation of home visiting interventions.     

Where have all the students gone? Participation of doctoral students in authentic mathematical activity as a necessary condition for persistence toward the PH.D.

The mathematics community in the U.S. has become concerned about the state of doctoral education, including concerns about high attrition rates and the small numbers of women and students from some racial and ethnic groups. This paper proposes a model of doctoral student persistence and attrition, in which student participation in the life of the department and discipline lead to increased student integration, which is crucial for students' success. Ten faculty members and eighteen graduate students were interviewed about their interests,conceptions, and experiences within mathematics, in a case study of one mathematics department. In this department, students experienced four types of obstacles to their participation: obstacles stemming from the program structure, obstacles to participation in class, obstacles to participating with faculty outside of class, and obstacles stemming from faculty beliefs about teaching and learning. Implications for the retention of mathematics doctoral students are discussed. This revised version was published online in July 2006 with corrections to the Cover Date.     

Pupils Helping other Pupils with their Learning: Cross-age tutoring in a primary and secondary school

Doctoral students leave their programs early due to lack of mentoring relationships needed to support degree completion and success. However, how mentoring contributes to Ed.D degree completion is not widely studied. In this qualitative narrative study, we sought to explore how multiple mentoring relationships reduced attrition in an Ed.D program. Study participants shared their experiences with mentors across their life domains (academic, personal, and professional) to seek support needed to promote progression and or completion of the program. Each mentoring relationship served a specific purpose. For instance, family members and friends supported participants with home duties, childcare, encouragement, and praise during their doctoral journey. Supervisors supported the participant’s success both academically and professionally. Fellow doctoral students enhanced the learning experience by sharing different perspectives and providing academic and career advice/strategies. Faculty mentoring support was critical to the academic and dissertation process as well as to scholarly development.     

Learning Communities,Academic Performance,Attrition, and Retention: A Four-Year Study

This study extends and makes unique methodological contributions to research on the impact of learning communities (LCs) on community college students. Much of the previous research was short-term, lacked adequate comparison groups, and focused on four-year college students. This four-year study controlled for instructor-related variables by comparing academic outcomes of LC students with those of non-LC students taught by the same instructor during the same semester. Differences in grades, attrition, and retention were compared between students enrolled in two pairs of linked English 101 and Psychology 101 LC classes and students enrolled in non-LC courses with the same professor. Student enrollment in the LC courses was associated with higher grade point averages, lower course attrition rates, and higher fall-to-spring semester retention rates. Reasons for the relative scarcity of LCs in community colleges is discussed, along with recommendations as to how institutions can encourage the growth of LCs on their campuses.     

Involvement in Early Head Start home visiting services: Demographic predictors and relations to child and parent outcomes

One strand of home visiting research investigates efficacy while another investigates under what conditions programs achieve outcomes. The current study follows the latter approach. Using a within-program design in a sample of 11 home-based sites in the Early Head Start Research and Evaluation study, this study found that three components of home visits (quantity of involvement including number of home visits, duration in the program, length of visits and intensity of service; quality of engagement including global ratings of engagement by staff and ratings of engagement during each home visit; and the extent to which home visits were child focused) represented distinguishable aspects of home visit services. Demographic variables predicted components of involvement, and home visit involvement components were differentially related to outcomes at 36 months, after controlling for demographic/family factors and earlier functioning on the same measure. Only one quantity of involvement variable (duration) predicted improvements in home language and literacy environments at 36 months. Quality of involvement variables were negative predictors of maternal depressive symptoms at 36 months. Finally, the proportion of time during the visit devoted to child-focused activities predicted children's cognitive and language development scores, parent HOME scores, and parental support for language and learning when children were 36 months of age. Implications for home visiting programs and policies are discussed.     

ATTRITION AND RETENTION AMONG ACCOUNTING MAJORS IN COMMUNITY COLLEGES: PROBLEMS AND POSSIBLE REMEDIATION

Accounting programs nationwide are reporting declines in enrollment and the demand for new accountants continues unabated. Given this current crisis in accounting education, attention needs to be given to recruitment and retention issues. This study used a Delphi procedure to sample the accounting department chairpersons in one state's community college system regarding four questions: What initially attracts community college students to accounting?; What are the predictors of success for community college students who choose accounting for majors?; What are the major problems students encounter in completing accounting programs and What recommendations do these chairpersons have for reducing attrition among community college accounting majors? Conclusions and recommendations are presented for community college counselors, administrators, and accounting faculty.     

基于时间序列模型的福建省高考录取率预测

高中毕业生数和普通高等教育招生数是影响高考录取率的2个重要因素。分析福建省小学、初中、高中各阶段的毕业率和升学率以及普通高等教育招生数,用时间序列方法分别建立合适的数学模型,进而预测高中毕业生人数和普通高等教育招生人数,推测出高考录取率的短期发展趋势。预测结果表明,2014—2015年福建省高考录取率可能逼近100%。     

Student Engagement at Two-Year Institutions: Age and Generational Status Differences

This study examined the relationship between participation and location of dual-credit enrollment and the educational aspirations of high school students. A total of 304 students from 5 rural Kansas high schools were surveyed. The return rate was 80.9%. Results indicated that participation in dual-credit programs had a positive and significant relationship with educational aspirations. Other independent variables that demonstrated strong predictive importance for educational aspirations were parents’ educational levels and grades. The findings further indicated that concurrent enrollment location was a significant predictor of educational aspirations.     

Inside home visits: a collaborative look at process and quality

Home visit quality was assessed in an Early Head Start program (N = 92 families) using measures developed in collaboration with program staff. Parent ratings were high, indicating “customer satisfaction” with home visiting. Home visitors rated their relationships with parents as having a feeling of partnership and their home visits as typically going well. Researcher observations of home visits were consistent with the program’s theory of change: Home visitors attempted to facilitate parent-child interaction, parents were engaged in home visit activities, home visitors interacted mostly with both parent and child together. Families perceived by staff as improving the most had home visitors observed by researchers as most effective at engaging parents and involving parent and child together. Families seen as “success” cases showed consistently high engagement in home visits; while “nonsuccess” cases showed consistently low home visitor facilitation of parent-child interaction. Through a collaborative partnership, assessments of home visits were used to guide both program improvement and research.     

Funding at-risk compensatory programs: An urban high school case study

A Texas urban high school with a 98 percent minority student enrollment was selected to conduct a micro-finance analysis on site-based at-risk per pupil costs. A process was developed to define site-based state compensatory education (SCE) and to account for all students receiving direct and indirect state compensatory education services. Program costs data were analyzed to develop a relationship between full-time equivalent (FTE) state categorical program costs and regular education program costs. At-risk student background characteristics were defined using a parent home survey, conducted with a sample of twenty at-risk students and twenty regular education students. The data revealed that 68 percent of the students exhibited one or more of the state-defined at-risk variables; the highest program costs produced the highest achievement: and based on student backgroud characteristics, all of the students, including regular funded students, were at risk.