Community Contextual Effects on At-Risk Mothers’ Engagement in Georgia’s Maternal, Infant, and Early Childhood Home Visiting Programme




Junhan Cho, Dayoung Bae, Darcey D. Terris, Rachael E. Glisson, and Anita Brown

Brief Type

Journal publication


  • Healthy Families America (HFA)
  • Nurse-Family Partnership (NFP)
  • Parents as Teachers (PAT)


The current study examined family and community factors related to home visiting program engagement in a sample of 1,024 mothers (primary caregivers, mean age 22.89 years) who participated in family support programs funded through Georgia's Maternal, Infant, and Early Childhood Home Visiting program. Using 2-level hierarchical linear modelling, we examined the relationships between mothers' home visiting program engagement and mothers' sociodemographic and community-level risk factors. Higher sociodemographic risks, characterized by unstable romantic relationships, employment, low educational, and economic resources, were associated with less active home visiting engagement. Mothers who lived in communities with more challenging socio-economic contexts, such as communities that had a higher proportion of divorced/separated households, poor quality housing conditions, and residential mobility, demonstrated lower program engagement. Meanwhile, mothers who lived in communities that had a higher proportion of residents that did not finish high school demonstrated relatively higher program engagement. The observed influence of community-level factors remained significant after we controlled for mothers' sociodemographic characteristics. Although community-level risks may appear outside the locus of control of home visiting, flexible programming and strategic partnerships with other community-based resources, ones that explicitly take into account community-level risks, may support improved home visiting engagement outcomes. (author abstract)

Data Collection Methods

  • Program administrative record reviews
  • Standardized assessment tools



For More Information

Cho, J., Bae, D., Terris, D. D., Glisson, R. E., & Brown, A. (2018). Community contextual effects on at-risk mothers' engagement in Georgia's Maternal, Infant, and Early Childhood Home Visiting Programme. Child & Family Social Work. Advance online publication. https://doi.org/10.1111/cfs.12448
Author Contact Information:
Dayoung Bae


  • Participant Characteristics
  • Participant Recruitment, Retention, Engagement, and Dosage