Multilevel Interaction Effects of Family and Community Factors on Mothers’ Engagement in Evidence-Based Home Visiting




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

Brief Type

Journal Publication


  • Early Head Start Home-Based Option (EHS)
  • Healthy Families America (HFA)
  • Nurse-Family Partnership (NFP)
  • Parents as Teachers (PAT)


Informed by ecological and family system frameworks, our study investigated the relationship between family- and community-level factors, and their cross-level interactions, with evidence-based home visiting program participation in a sample of 2409 mothers (mean age: 24.15 years). Using 2-level hierarchical linear modeling, we observed that mothers living in disadvantaged communities demonstrated less active engagement in evidence-based home visiting. Cross-level interaction effects revealed that mothers' unstable living conditions and psychiatric problems amplified the negative influence of disadvantaged communities on program engagement. Conversely, mothers who were first-time parents showed higher levels of participation in family support programs when they resided in disadvantaged communities. (author abstract)

Data Collection Methods

  • State administrative record reviews



For More Information

Bae, D., Cho, J., Terris, D. D., Glisson, R. E., Brown, A., & Nelson, T. (2019). Multilevel interaction effects of family and community factors on mothers' engagement in evidence-based home visiting. Family & Community Health, 42(3), 203-212. doi: 10.1097/FCH.0000000000000231
Author Contact Information:
Dayoung Bae


  • Participant Recruitment, Retention, Engagement, and Dosage