Prediction of Early Engagement and Completion of a Home Visitation Parenting Intervention for Preventing Child Maltreatment

Objective: We examined predictors of engagement and completion in a randomized trial comparing the effectiveness of two interventions for preventing child maltreatment and promoting positive parenting. Methods: Participants in this study were 255 mother-child dyads, most of whom were enrolled in Head Start programs, were randomly assigned to a 5-session home visitation intervention (Planned Activities Training-PAT) or to a similar parenting intervention enhanced by the addition of cell phone calls and text messages (CPAT). Results: (1) Early engagement and participation in the cellular phone enhanced program predicted intervention completion, and (2) the quality of parenting prior to entrance in the program predicted engagement. Conclusions: The results have important implications for engagement and completion in home visitation programs aimed at promoting positive parenting among high- risk mothers.  Implications for practitioners are also discussed

Enhancing Parent Engagement and Program Completion in a Home Visiting Parenting Intervention Through the Use of Cellular Phones

We examined factors that predict parent engagement and intervention completion in a home visiting parenting intervention. In this randomized trial, we compared the effectiveness of a parenting intervention to a cellular phone enhanced parenting intervention for preventing child maltreatment and promoting positive parenting. We randomly assigned 219 mother-child dyads, most of whom were enrolled in Head Start programs to a 5-session home visitation intervention (Planned Activities Training-PAT) or to cellular phone enhanced PAT (CPAT). We found that (1) early parent engagement predicted completion of the parenting intervention, (2) parents in the cellular phone enhanced PAT were twice as likely to complete the intervention than those in traditional PAT, and (3) the quality of parenting prior to entrance in either intervention predicted parent engagement. The implications of this study focus on the importance of early identification of parents who are higher-risk for drop-out in order to provide them additional supports to promote retention

Child Abuse and Neglect: Behavioral Research, Treatment, and Theory

Described here is behavioral theory, research, and treatment of physical child abuse. A brief history is presented, along with incidence data. Some research has shown successful behavioral assessment and treatment in child abuse; many more issues remain open for additional success with this treatment refractory societal problem. These issues are explored, along with speculation as to why there has not been more research in an area of such vital social importance

Route of myomectomy and fertility: a prospective cohort study

OBJECTIVE: To assess prospectively the association between the myomectomy route and fertility. DESIGN: Prospective cohort study. SETTING: The Comparing Treatments Options for Uterine Fibroids (COMPARE-UF) Study is a multisite national registry of eight clinic centers across the United States. PATIENT(S): Reproductive-aged women undergoing surgery for symptomatic uterine fibroids. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): We used life-table methods to estimate cumulative probabilities and 95% confidence intervals (CI) of pregnancy and live birth by the myomectomy route during 12, 24, and 36 months of follow-up (2015-2019). We also conducted 12-month interval-based analyses that used logistic regression to estimate odds ratios and 95% CIs for associations of interest. In all analyses, we used propensity score weighting to adjust for differences across surgical routes. RESULT(S): Among 1,095 women who underwent myomectomy (abdominal = 388, hysteroscopic = 273, and laparoscopic = 434), 202 reported pregnancy and 91 reported live birth during 36 months of follow-up. There was little difference in the 12-month probability of pregnancy or live birth by route of myomectomy overall or among women intending pregnancy. In interval-based analyses, adjusted ORs for pregnancy were 1.28 (95% CI, 0.76-2.14) for hysteroscopic myomectomy and 1.19 (95% CI, 0.76-1.85) for laparoscopic myomectomy compared with abdominal myomectomy. Among women intending pregnancy, adjusted ORs were 1.27 (95% CI, 0.72-2.23) for hysteroscopic myomectomy and 1.26 (95% CI, 0.77-2.04) for laparoscopic myomectomy compared with abdominal myomectomy. Associations were slightly stronger but less precise for live birth. CONCLUSION(S): The probability of conception or live birth did not differ appreciably by the myomectomy route among women observed for 36 months postoperatively. CLINICAL TRIALS REGISTRATION NUMBER: (NCT02260752, clinicaltrials.gov)

Route of myomectomy and fertility: a prospective cohort study

OBJECTIVE: To assess prospectively the association between the myomectomy route and fertility. DESIGN: Prospective cohort study. SETTING: The Comparing Treatments Options for Uterine Fibroids (COMPARE-UF) Study is a multisite national registry of eight clinic centers across the United States. PATIENT(S): Reproductive-aged women undergoing surgery for symptomatic uterine fibroids. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): We used life-table methods to estimate cumulative probabilities and 95% confidence intervals (CI) of pregnancy and live birth by the myomectomy route during 12, 24, and 36 months of follow-up (2015-2019). We also conducted 12-month interval-based analyses that used logistic regression to estimate odds ratios and 95% CIs for associations of interest. In all analyses, we used propensity score weighting to adjust for differences across surgical routes. RESULT(S): Among 1,095 women who underwent myomectomy (abdominal = 388, hysteroscopic = 273, and laparoscopic = 434), 202 reported pregnancy and 91 reported live birth during 36 months of follow-up. There was little difference in the 12-month probability of pregnancy or live birth by route of myomectomy overall or among women intending pregnancy. In interval-based analyses, adjusted ORs for pregnancy were 1.28 (95% CI, 0.76-2.14) for hysteroscopic myomectomy and 1.19 (95% CI, 0.76-1.85) for laparoscopic myomectomy compared with abdominal myomectomy. Among women intending pregnancy, adjusted ORs were 1.27 (95% CI, 0.72-2.23) for hysteroscopic myomectomy and 1.26 (95% CI, 0.77-2.04) for laparoscopic myomectomy compared with abdominal myomectomy. Associations were slightly stronger but less precise for live birth. CONCLUSION(S): The probability of conception or live birth did not differ appreciably by the myomectomy route among women observed for 36 months postoperatively. CLINICAL TRIALS REGISTRATION NUMBER: (NCT02260752, clinicaltrials.gov)