About Us // Our Research

Research at Every Child Succeeds

Through its association with Cincinnati Children's Hospital Medical Center, Every Child Succeeds contributes to the home visitation field through programmatic scientific studies that generate new and more effective practices. All members of the ECS community are involved in research activities, including mothers, children and families; home visitors and provider agencies; and Cincinnati Children's faculty. It is through such efforts that new research findings are made and the next generation of home visitation programs will emerge, optimizing the development and well-being of children and families through improved interventions.

Every Child Succeeds has obtained several federally funded research grants to pursue studies of important areas in home visitation. Findings from these and other ongoing research efforts include:

Ongoing or recently completed studies:

Mother and Infant Depression Improvement Study (MIDIS):

Research has demonstrated that two of every five mothers who participate in Every Child Succeeds have clinically elevated levels of depression, an illness that can have a devastating impact on maternal functioning and a child's social, emotional and cognitive development Ammerman et al., 2009). The MIDIS project is funded by NIMH Grant # R34MH073867 and was completed on 5/31/10. This study consisted of refining In-Home Cognitive Behavioral Therapy (IH-CBT), an adapted form of CBT for postpartum depressed mothers in home visitation whose initial development was supported by a grant from the Health Foundation of Greater Cincinnati. In addition, a clinical trial of IH-CBT was conducted in which 91 mothers were randomly assigned to home visitation + IH-CBT or home visitation alone. Measurement focused on maternal depression, other psychiatric symptoms, social support, parenting, and child adjustment. Mothers and children were followed through post-treatment and at three month follow-up.

First Years Project (FYP):

Funded by Grant # R40MC06632 from the Maternal and Child Health Bureau, this study sought to understand why families join, remain and leave home visitation programs, and determine whether motivational interviewing helps families maintain their commitment to the program over time. This study recruited 232 mothers, and followed them from enrollment through 18 months post-enrollment. Measures included motivation for change, maternal and child outcomes, and reasons for leaving or staying in the program. This study will be completed on 12/31/11.

New studies:

Mother and Infant Depression Improvement Study-2 (MIDIS2):

The MIDIS2 project is funded by NIMH Grant # R01MH087499 and began on 8/15/10, scheduled to be completed on 6/31/15. This study expands and extends research on In-Home Cognitive Behavioral Therapy (IH-CBT), an adapted form of CBT for postpartum depressed mothers in home visitation. The study is a clinical trial of IH-CBT and Present-Centered Therapy (PCT), a supportive and pragmatic treatment. The study will enroll 220 mothers who will be randomized into IH-CBT or PCT and followed from pre-treatment through 18 months post-treatment. Measurement includes maternal depression, recovery and relapse, other psychiatric symptoms, social support, parenting, mother-child interactions, child development and emotional/social adjustment, and biomarkers of children’s stress reactivity.

Cincinnati Home Injury Prevention and Literacy Promotion Study (CHIP):

Led by Dr. Kieran Phelan (link to Phelan lab page), the CHIP study seeks to evaluate a novel injury prevention program for young children that consists of installing safety devices in the home settings, an alternative to the educational or central distribution approaches that are more typically used. Funded by NICHD Grant #R01HD066115, this study began on 9/28/10 and scheduled to be completed on 7/31/15. It seeks to recruit 1000 families in Every Child Succeeds, and follow them for two years. Families will be randomly assigned either to the injury prevention condition or a literacy enhancement arm. Measurement includes non-intentional injuries, health care utilization, supervision, and other maternal and child outcomes.

Recent Research Findings

Ammerman, R.T., Putnam, F.W., Margolis, P.A., & Van Ginkel, J.B. (2009). Quality improvement in child abuse prevention programs. In K.A. Dodge & D.L. Coleman (Eds.), Preventing child maltreatment: Community approaches (pp. 121-138). New York: Guilford.

This chapter describes the principles and practices of Quality Improvement (QI) as they are applied in prevention programs like Every Child Succeeds. Specific examples are offered, and a discussion of the distinction between QI and more traditional research approaches to evaluation are discussed.

Ammerman, R.T., Putnam, F.W., Altaye, M., Chen, L., Holleb, L.J., Stevens, J., Short, J.A., & Van Ginkel, J.B. (2009). Changes in depressive symptoms in first time mothers in home visitation. Child Abuse & Neglect, 33, 127-138.

The purpose of this study was to determine the prevalence of and changes in depressive symptoms in mothers enrolled in home visitation and identify predictors of change in symptoms over the first 9 months of service. Subjects consisted of 806 at-risk, first-time mothers enrolled in Every Child Succeeds. Self-reported depression was measured at enrollment and again 9 months later. Established clinical cutoffs were used to identify clinically elevated levels of depression. Additional measures were taken of interpersonal trauma history, concurrent intimate partner violence, and social support. Results indicated that: (1) 45.3% of mothers had clinically elevated symptoms of depression at some point during the first 9 months of service, (2) 25.9% of mothers had elevated symptoms at both time points or at the 9-month assessment, and (3) 74.1% experienced an interpersonal trauma prior to enrollment. Lack of improvement or worsening of depressive symptoms from enrollment to 9 months was best predicted by pre-enrollment interpersonal trauma history, young maternal age, being African American, and symptoms severe enough to have led to mental health treatment. Findings suggest that maternal depressive symptoms are a significant problem in home visitation and warrant attention in these programs.

Ammerman, R.T., Putnam, F.W., Stevens, J., Bosse, N.R., Short, J.A., Bodley, A.L., & Van Ginkel, J.B. (in press). An open trial of In-Home CBT for depressed mothers in home visitation. Maternal and Child Health Journal.

This study used an open trial design to evaluate In-Home Cognitive Behavior Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. Sixty-four depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. Results indicated that there was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study.

Publications and Presentations

Research Faculty

To learn more about research efforts in Every Child Succeeds, contact:

Robert T. Ammerman, PhD, ABPP, Scientific Director
Robert.Ammerman@cchmc.org

Thomas DeWitt, MD, Medical Director
Thomas.DeWitt@cchmc.org