Research Findings

Minding the Baby ™ Home Visiting (MTB-HV) bridges primary care and mental health approaches to enhancing the parent-infant relationship. From 2002-2021, MTB-HV clinicians provided direct clinical service for young families in New Haven, Connecticut. These families also participated in voluntary evaluation research, and many continued to participate in longitudinal follow-up.

Through initial pilot and later efficacy testing with young adult and teen parents, positive outcomes were demonstrated in reflective functioning, parent-child relationship, infant attachment, high retention rates, lower rates of rapid subsequent childbearing (a second birth within 2 years of the first child), lower rates of child obesity, and fewer DCF referrals. These outcomes are fully described below.

MTB-HV clinicians served over 200 families in Connecticut between 2002 and 2021, with more than 470 additional families served through program implementation in Florida, England, Scotland, with an on-going independent multi-year RCT underway as part of a multi-site implementation in Denmark.

Findings

The MTB-HV intervention was tested in two NICHD-funded randomized controlled trials (RCTs) in the U.S. A total of 237 New Haven families were recruited through prenatal providers at two local Federally Qualified Health Centers (FQHCs), beginning in 2002. Of these, 133 received MTB-HV, and 104 were enrolled in the control group. Participants in the control group received “treatment as usual” at the FQHC, along with intermittent newsletters mailed from MTB staff.

Health, mental health, developmental and relationship assessments were collected at baseline (pregnancy), and then 4, 14, 18, and 24 months postpartum. Comparisons with control families revealed impacts on a number of public health variables: lower rates of obesity and significantly higher rates of normal weight in MTB toddlers , significantly higher rates of on-time pediatric immunization, lower rates of rapid subsequent childbearing, and lower rates of child protection referrals in MTB families.

MTB parents also became more reflective over the course of the intervention, and MTB infants were significantly more likely to be securely attached and less likely to be disorganized than control group infants. Parent-child interactions were less disrupted in MTB teen mothers. At 1–3-year follow-up, MTB preschoolers had significantly lower rates of maternally reported externalizing (acting out) behaviors.

MTB families were recruited for a longer-term follow-up study when the children were between 4 and 9 years of age. Analyses revealed that – years after graduation – MTB parents were more likely to parent reflectively and had lower levels of hostile or coercive parenting than controls; and their children had fewer behavior problems than children in the control group (Londono-Tobon, 2020). In addition, children of mothers in MTB had lower levels of a salivary marker for elevated stress (Condon et al., 2021) than controls.

Finally, whereas control mothers who reported childhood emotional abuse had difficulty reflecting on their child’s experience, MTB mothers did not. Positive mother-child interactions, maternal reflectiveness, secure infant attachment, and lower rates of child behavior disorders all contribute to non-cognitive, socio-emotional development, a key ingredient in school success as well as future wellness.

References

Sadler, L.S., Slade, A., Close, N., Webb, D.L., Simpson, T., Fennie, K., & Mayes, L.C. (2013). Minding the Baby™: Improving Early Health and Relationship Outcomes in Vulnerable Young Families in an Interdisciplinary Reflective Parenting Home Visiting Program._
_Infant Mental Health Journal, 34(5), 391-405.
Ordway, M.R., Sadler, L.S, Slade, A, Dixon, J, Close, N, Mayes, L. (2013). Lasting effects of an interdisciplinary home visiting program on child behavior: Preliminary follow-up results of a randomized trial. Journal of Pediatric Nursing, 29, 3-13.
Slade, A, Holland, M.L., Ordway, M.R., Carlson, E.A., Jeon, S., Close, N., Mayes, L.C., & Sadler, L.S. (2019). Minding the Baby™: Enhancing Parental Reflective Functioning and Infant Attachment in an Attachment-based, Interdisciplinary Home Visiting Program. Development and Psychopathology, 1-15.
Ordway, M., Sadler, L. S., Holland, M., Slade, A., Close, N., Mayes, L. (2018). A Home Visiting Parenting Program and Child Obesity: A Randomized Trial. Pediatrics, 141(2); e20171076.
Londono Tobon, A.L., Condon, E.M., Holland, M.L., Sadler, L.S., Mayes, L.C. & Slade, I. (2020). School Age Effects of Minding the Baby—an Attachment-Based Home Visiting Intervention—on Parenting and Child Behaviors. Development and Psychopathology, 1-13. Doi: 10.1017/S0954579420000905
Condon, E.M., Londono Tobon, A., Jackson, B., Holland, M.L., Slade, A., Mayes, L., & Sadler, L.S. (2021). Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby® Early Home Visiting Intervention. Nursing Research.
Condon, E. M., Holland, M.L., Slade, A., Redeker, N., Mayes, L. & Sadler, L. S. (2021). Examining mothers’ childhood maltreatment history, parental reflective functioning, and the long-term effects of the Minding the Baby® home visiting intervention. Child Maltreatment.

Presentations & Publications

The MTB-HV clinical model, MTB approaches, and related work out of the MTB National Office have been presented numerous times, via lectures and trainings around the world as well as in manuscripts and publications. This abbreviated reference list provides a sampling of MTB dissemination efforts and includes articles published in recent years.