OUTCOMES OF A HOME VISITATION TRIAL FOR PREGNANT AND POSTPARTUM WOMENAT-RISK FOR CHILD PLACEMENT

This study is a randomized clinical trial designed to test the psychos ocial efficacy of a pre- and postpartum home visitation model for wome n at-risk for out-of-home placement of their newborns. Two hundred twe nty-five pregnant women with high risk pregnancies for psychosocial re asons were recruited into the study and randomly assigned to an experi mental (n = 125) or control condition (n = 100) when they presented fo r prenatal care at a large urban clinic. After an average of 16 months of exposure to the intervention, women in the experimental group repo rted significantly greater access to services and there was a trend fo r the experimental group to show a decrease in psychological distress. At 10 months, there was a trend for experimental group women to exper ience an increase in social support, but this was not sustained at 16 months. Although the difference was not statistically significant, a h igher percentage of women in the experimental group had children in ou t-of-home living arrangements. There was also a trend among those with children in placement, for children of experimental group women to be placed in extended family care rather than foster care more frequentl y than controls. The implications of the findings for interventions wi th at-risk families are discussed.