Improved Parental Self-Efficacy Reduces Stress in Women Receiving Home Visitation in a Longitudinal Study
Background: A plethora of studies evaluated home-visiting programs like Nurse-Family Partnership (NFP) broadly. Still, the mechanisms behind changes in mothers and children are scarcely considered. Aim: Pro Kind, the German NFP adaption, investigated the process of change in effective program variables, which are maternal perceived social support and parental self-efficacy (PSE) as coping resources for dealing with general stress within an ecological framework. Design: Longitudinal randomized controlled trial. Methods: Between 2006 and 2012 Pro Kind’s effectiveness was evaluated in mothers and children from pregnancy until the children’s second birthday. Altogether N=755 at-risk first-time mothers referred to the project. The treatment group (TG, n=394) received home visitation, while the control group (CG, n=361) solely had access to standard community services. Results: Structural equation modeling revealed a protective effect of social support as an environmental resource on general stress in the TG before birth and in the CG until two years postpartum. PSE as a personal resource also showed a protective effect on general stress which was more stable, and also present longitudinally, in the TG compared to the CG. PSE functioned as a mediator between social support and stress, again with a stronger, prolonging effect in the TG. Conclusion: Pro Kind strengthened mothers’ personal competencies (PSE) in regard of handling general stress. Mothers from the CG relied more on their social support network which can be hard to retrieve or in detrimental condition in socially disadvantaged environments. Home visitors should focus more intensely on building stable maternal PSE during the first year postpartum within an ecological perspective.
Dähne Verena*, Klein Annette, Jungmann Tanja, Kliem Soren and Sierau Susan
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