Association of Maternal and Community Factors with Enrollment in Home Visiting Among At-Risk, First-Time Mothers




Neera K. Goyal, Eric S. Hall, David E. Jones, Jareen K. Meinzen-Derr, Jodie A. Short, Robert T. Ammerman, and Judith B. Van Ginkel

Brief Type

Journal publication


  • Healthy Families America (HFA)
  • Other Models


Objectives: We identified individual and contextual factors associated with referral and enrollment in home visiting among at-risk, first-time mothers. Methods: We retrospectively studied referral and enrollment in a regional home visiting program from 2007 to 2009 in Hamilton County, Ohio. Using linked vital statistics and census tract data, we obtained individual and community measures on first-time mothers meeting eligibility criteria for home visiting (low income, unmarried, or age < 18 years). Generalized linear modeling was performed to determine factors associated with relative risk (RR) of (1) referral to home visiting among eligible mothers and (2) enrollment after referral. Results: Of 8187 first-time mothers eligible for home visiting, 2775 were referred and 1543 were enrolled. Among referred women, high school completion (RR = 1.10) and any college (RR = 1.17) compared with no high school completion were associated with increased enrollment, and enrollment was less likely for those living in communities with higher socioeconomic deprivation (RR = 0.71; P< .05). Conclusions: Barriers to enrollment in home visiting persisted at multiple ecological levels. Ongoing evaluation of enrollment in at-risk populations is critical as home visiting programs are implemented and expanded. (author abstract)

Data Collection Methods

  • Program administrative record reviews



For More Information

Goyal, N. K., Hall, E. S., Jones, D. E., Meinzen-Derr, J. K., Short, J. A., Ammerman, R. T., & Van Ginkel, J. B. (2014). Association of maternal and community factors with enrollment in home visiting among at-risk, first-time mothers. American Journal of Public Health, 104(S1), S144-S151. doi: 10.2105/AJPH.2013.301488
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4011104


  • Participant Characteristics
  • Program Quality, Continuous Quality Improvement, and Fidelity