Keeping Our Eyes on the Prize: Focusing on Parenting Supports Depressed Parents’ Involvement in Home Visiting Services




Lorraine M. McKelvey, Shalese Fitzgerald, Nicola A. Conners Edge, and Leanne Whiteside-Mansell

Brief Type

Journal publication


  • Healthy Families America (HFA)
  • Parents as Teachers (PAT)


Objectives: Improving family retention and engagement is crucial to the success of home visiting programs. Little is known about retaining and engaging depressed parents in services. The purpose of the study is to examine how home visit content moderates the association between depression and retention and engagement. Methods: The sample (N=1322) was served by Healthy Families America (n=618) and Parents as Teachers (n=704) between April 1, 2012 and June 30, 2016. Parents averaged 23 years (SD=6). Nearly half of the parents were White (48%) and the majority was single (71%). Depression was screened with the Patient Health Questionnaire-2. Home visitors reported the percent of time focused on particular content and parent engagement at every home visit. Results: Multilevel regression analyses showed the amount of time that home visitors spent supporting parent–child interaction moderated the association between depression and retention at 6 (B=.08, SE=.03, p=.003) and 12 (B=.1, SE=.03, p<.001) months, such that there was a stronger positive association for depressed parents. The main effects of child development focused content and retention at 6 (B=.07, SE=.01, p<.001) and 12 (B=.08, SE=.01, p<.001) months were positive, while effects of case management focused content at 6 (B=−.06, SE=.01, p<.001) and 12 (B=−.07, SE=.01, p<.001) months were negative. Conclusions: Families were more likely to be retained when home visitors focused on child development and parent–child interaction, but less likely with more case management focus. Parents with positive depression screens were more likely to remain in services with more time spent focused on supporting parent–child interactions. (author abstract)

Data Collection Methods

  • Program administrative record reviews
  • Standardized assessment tools



For More Information

McKelvey, L. M., Fitzgerald, S., Edge, N. A. C., & Whiteside-Mansell, L. (2018). Keeping our eyes on the prize: Focusing on parenting supports depressed parents’ involvement in home visiting services. Maternal and Child Health Journal, 22(1), 33-42. https://doi.org/10.1007/s10995-018-2533-y
Author Contact Information:
Lorraine M. McKelvey


  • Participant, Family, and Program Outcomes
  • Participant Recruitment, Retention, Engagement, and Dosage