Addressing Maternal Depression, Substance Use, and Intimate Partner Violence in Home Visiting: a Quasi-Experimental Pilot Test of a Screen-and-Refer Approach
Open accessAbstract
This quasi-experimental pilot study describes preliminary impacts of the "Home Visitation Enhancing Linkages Project (HELP)," a pragmatic screen-and-refer approach for promoting identification of and linkage to treatment for maternal depression (MD), substance use (SU), and intimate partner violence (IPV) within early childhood home visiting. HELP includes screening for MD, SU, and IPV followed by a menu of motivational interviewing and case management interventions aimed at linking clients to treatment, designed for delivery within routine home visiting. HELP was piloted within four counties of a statewide home visiting system that were implementing Healthy Families America. HELP clients (N = 394) were compared to clients in five demographically matched counties that received usual Healthy Families services (N = 771) on whether their home visitors (1) identified MD, SU, and IPV risk; (2) discussed MD, SU, and IPV during home visits; and (3) made referrals for MD, SU, and IPV. All data were extracted from the program's management information system. A significant impact of HELP was found on discussion of risk in home visits for all three risk domains with large effect sizes (MD OR = 4.08; SU OR = 15.94; IPV OR = 9.35). HELP had no impact on risk identification and minimal impact on referral. Findings provide preliminary support for HELP as a way of improving discussion of client behavioral health risks during home visits, an important first step toward better meeting these needs within home visiting. However, more intensive intervention is likely needed to impact risk identification and referral outcomes.
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There is literature to support the potential efficacy of home visiting programs for pregnant and parenting individuals misusing substances.
“There is also literature to support the potential efficacy of home visiting programs for pregnant and parenting individuals misusing substances (Barlow et al., 2015; Dauber et al., 2019)”
From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Dauber et al., 2019
The Discussion (page unavailable) reports that the HELP home-visiting approach increased discussions of substance use with clients, which offers limited support for its potential. It also reports no impact on risk identification and minimal impact on referrals. The paper does not establish that home visiting improves outcomes for pregnant or parenting individuals misusing substances. (LLM, conf=0.85)
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- Authors
- Dauber, S., Hogue, A., Henderson, C. E., Nugent, J., & Hernandez, G.
- Affiliations
- Sam Houston State University (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Dauber, Sarah
- Venue
- Prevention Science
- Published
- 2019-08-20
- Volume
- 20
- Issue
- 8
- Pages
- 1233-1243
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC6883152
- OpenAlex
- W2969876078
- Cited by
- 27
- References
- 36
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 2
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (1R21DA034108)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Health › Intimate Partner and Family Violence
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- maternal depression, substance use, intimate partner violence, home visiting, Healthy Families America, motivational interviewing, case management, referral to treatment, early childhood, behavioral health screening, risk identification
- MeSH terms
- Intimate Partner Violence, Adult, Community Health Nursing, Female, House Calls, Humans, Maternal Welfare, Pilot Projects, Postnatal Care, Pregnancy, Professional-Family Relations, Program Evaluation, Depression, Postpartum
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