Community Services

A Collaboration:
Yale Child Study Center
Yale School of Nursing
Fair Haven Community Health Center
Cornell Scott Hill Health Center

Program Directors:
Lois S. Sadler, PhD, RN, PNP-BC, FAAN
Arietta Slade, PhD
Nancy Close, PhD
Linda C. Mayes, MD

Program Overview:

Minding the Baby (MTB) is an intensive home visiting program working with first-time young mothers and their families in New Haven, Connecticut. First developed in 2002, the program is interdisciplinary and brings together a home visiting team including a pediatric nurse practitioner and a licensed clinical social worker to promote positive health, mental health, life course, and attachment outcomes in babies, mothers, and their families.

Grounded in attachment theory and reflective parenting, MTB provides an integrated model of care that bridges primary care and mental health approaches to enhancing the mother-infant relationship. Clinicians receive intensive training in the unique incorporation of the physical and mental health components of the intervention as well as ongoing joint supervision. MTB provides direct clinical service for young families while simultaneously integrating ongoing research using a randomized clinical trial design.

Preliminary Results:

Initial findings in the sample have been very encouraging. To date, 155 families have been enrolled into the project. Data have been analyzed for 60 Intervention families and 40 Control families from the pilot phase of the work. Additional data analysis of the pilot study sample is currently in process. Broadly speaking, the health, mental health, public health and life course outcomes from the first stage of the pilot study have been very encouraging.

Most promising are the trends being seen in a sample that is comprised largely of teen mothers. There are higher rates of secure attachment and lower rates of disorganized attachment in the intervention children compared to the control group. Disorganized attachment is usually very high in such stressed populations. Increases in maternal reflective functioning are also being noted over the 27 months of the intervention, especially among the most vulnerable mothers. Such developments in mothers are crucial to sensitive mothering, and enhanced affective communication with the baby, and attachment outcomes.

Initial findings also point to a number of positive health outcomes, including high retention rates (90% intervention and 80% control). Additionally, no mothers in the pilot sample of intervention group families have had rapid subsequent childbearing (a second birth within 2 years of the first child), compared to16% of control group mothers reporting rapid subsequent childbearing. Perhaps most importantly, there have been no DCF referrals in the intervention group, while there have been two children removed from their families and one child and family placed under DCF supervision in the control group.  

The promising findings from the pilot study provided the preiminary data for the current efficacy study (RO1HD057947) now uderway at two community health centers in New Haven.  While the sample size is small, initial results are very encouraging, and suggest strongly that highly trained, interdisciplinary teams with a focus on the devleopment of parental reflective functioning are particularly well suited to working with high-risk mothers, babies, and their families.  Data are now being analyzed from a small follow-up study including 50 of the initial families who were in the project, and whose children are now between the ages of 3 and 5 years.  

Home Visitors:
Denise Webb, MSN, APRN, PNP
Tanika Simpson, MSW, LCSW
Bennie Finch, MSW, LCSW
Dana Hoffman, MSW, LCSW
Rosie Price, BSc, RN, RM

Research Staff:
Patricia Miller, Grad Dip Psych
Andrea Miller, BA
Monica Ordway, APRN, PhD Candidate
Stephanie Bedolla, RN

Project Director:
Crista Marchesseault, MAT, MA

Funding Support: 
The Irving B. Harris Foundation
The FAR Fund
Pritzker Early Childhood Foundation
Seedlings Foundation
The Annie E. Casey Foundation
The Patrick and Catherine Weldon Donaghue Foundation
The Edlow Family
The Schneider Family
NIH/NINR (P30NR08999)
NIH/NICHD (R21HD048591)
NIH/NICHD (RO1HD057947)
NIH/NCRR (UL1 RR024139) 

The MTB follow-up study, The effects of parenting on child behavior: The role of parental reflective functioning, would not be possible without the following support:

NIH/NINR NRSA (1F31NR011263-01)
NINR (T32NR008346)
Nurse Practitioner Healthcare Foundation – Community Innovations Award
Delta Mu, Sigma Theta Tau small grant award
Evelyn Andersen Scholarship
Dr. Lorraine G. Spranzo Foundation

Please download our Program Brochure for additional details, and visit this site again soon for a link to an expanded web site with more detail about the program, mission, clinical model, research, and training.

For more information, please contact MTB Project Director Crista Marchesseault.