Language
English (en)
Date of Award
5-9-2024
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Chair and Committee
Melissa Jonson-Reid
Abstract
This dissertation examines variations in early childhood developmental and socioemotional health as well as level of participation in home visitation among recent immigrant families according to reports of adverse experiences (including poverty, intimate partner violence (IPV), and prior history of child protective services (CPS) involvement), maternal depression, and parent–child relationship measures. The period of early childhood is dependent on positive parenting to support optimum development, but parenting may be particularly sensitive to the detrimental influences of adverse experiences. Less is known about how the relationship between parenting, adverse experiences, and child development may differ for immigrant families. Home visitation has been noted as an effective means of promoting positive parenting and child development and may act as a buffer for adverse experiences and other potential strains on parenting, like maternal depression. However, research on the impact of home visitation across developmental domains is scarce with mixed results. Child outcomes may vary by the presence of specific stressors, and there is scant research related to immigrant families. To help fill these gaps, this study uses data from a nationally available home visitation program (Parents as Teachers, PAT) to understand the relationship between family stressors (adverse experiences and maternal depression), parenting, child development, and participation in home visiting among immigrant families. A particular focus is on the potential effects of parent-reported IPV, maternal depression, and parent reports of CPS involvement. Analyses are guided by attachment theory and an ecological stress model. Data come from the PAT electronic data system, which includes data from affiliates who meet essential requirements and standards in 41 states. The sample included all families noted as recent immigrants (less than 5 years ago) according to baseline PAT assessment from 2010 to 2022 (N=6,130). The sample size for specific aims varies because of the variation in program measures reported. This three-paper dissertation included one aim for each paper: (Paper 1) to examine the association between family stressors, parent–child interaction, maternal depression, and early childhood development among immigrants to the U.S. at enrollment in home visitation; (Paper 2) to examine the risk factors associated with family CPS involvement and home visitation engagement among immigrants enrolled in home visitation; (Paper 3) to examine the association between parent IPV, other family stressors, families’ home visiting engagement, and longer term child socioemotional development among young children in immigrant families. Paper one’s research questions were answered using multinomial logistic regression, with outcomes being whether a child was in the normal, borderline, or concerning range at baseline. Mediation analyses tested the role of parent–child attachment, maternal depression and family stress. In Paper two, I used logistic regression to derive propensity scores for CPS involvement, which were then used in a multinomial regression to predict the duration of home visitation involvement. In Paper three, I present a path analysis to understand how baseline characteristics and home visitation participation may impact later socioemotional development outcomes. Immigrant families in the sample had an elevated prevalence of developmental delay compared to the national rate. Children with disability, low birth weight and male gender were at high risk for developmental delay. Additionally, the quality of the parent–child relationship and maternal depression were significantly associated with early childhood socioemotional and cognitive developmental delay but not related to motor development. IPV was a significant risk for CPS involvement, along with substance abuse, teen parenthood, and parent mental illness. CPS-involved families were more likely to remain with PAT between 90 days and 1 year than shorter or longer. My findings indicate that maternal depression is a significant mediator in the relationship between early parent IPV exposure and later child socioemotional development. The mediated effect differed based on the time participating in home visiting rather than the number of visits. The findings suggest that concerns about child developmental delay among immigrants are high although the association with IPV, maternal depression, and developmental outcomes are not dissimilar to research with nonimmigrant populations. Given other literature that suggests a higher risk of trauma experiences and related mental health difficulties within certain immigrant populations, however, my findings suggest that effective response to such screening results may be particularly salient.
Recommended Citation
Andom, Fithi, "Impact of Parent Reported Adverse Experiences and Other Family Stressors on Child Development and Home Visitation Participation Among Immigrant Families" (2024). Brown School Theses and Dissertations. 33.
https://openscholarship.wustl.edu/brown_etds/33