Search

The association between prenatal stress and children's socioemotional development is well established. The COVID‐19 pandemic has been a particularly stressful period, which may impact the gestational environment. However, most studies to‐date have examined prenatal stress at a single time point, potentially masking the natural variation in stress that occurs over time, especially during a time as uncertain as the pandemic. This study leveraged dense ecological momentary assessments from a prenatal randomized control trial to examine patterns of prenatal stress over a 14‐week period (up to four assessments/day) in a U.S. sample of 72 mothers and infants. We first examined whether varied features of stress exposure (lability, mean, and baseline stress) differed depending on whether mothers reported on their stress before or during the pandemic. We next examined which features of stress were associated with 3‐month‐old infants' negative affect. We did not find differences in stress patterns before and during the pandemic. However, greater stress lability, accounting for baseline and mean stress, was associated with higher infant negative affect. These findings suggest that pathways from prenatal stress exposure to infant socioemotional development are complex, and close attention to stress patterns over time will be important for explicating these pathways. [ABSTRACT FROM AUTHOR]

The Nurse‐Family Partnership® (NFP) is an evidence‐based home‐visiting program for low‐income, first‐time mothers. NFP® has demonstrated benefits for reducing child maltreatment and improving parenting, child development and families' economic self‐sufficiency. It is now implemented widely in the US where, despite the use of home visits, which generally reduce barriers to program participation, only 35% of clients nationwide complete the 2.5‐year program. This concurrent mixed‐methods study was conducted in 2013 in an urban northeastern US NFP site and included administrative program data, surveys (n = 56), in‐depth interviews (n = 14) with nurse home visitors, and focus groups with nurse supervisors (n = 13). We explored associations between nurses' attrition rates and their perspectives on client attrition and retention strategies. We further conducted an inductive thematic analysis of the qualitative data. Findings indicate that nurses' attrition rates were not significantly associated with their views and strategies to retain clients. Nurses and supervisors noted that clients' competing priorities and 'chaotic lives' primarily explained attrition. They thought that clients often left the program upon receiving enough information and skills or achieving key milestones, which may reflect reaching a saturation point, albeit prior to the full completion of the program. We offer recommendations to assess performance based on client accomplishments rather than whether they participated until the prescribed endpoint. [ABSTRACT FROM AUTHOR]