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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]

Background Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Methods Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule ( DB- DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment ( PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale ( FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Results Observed disruptive behavior on the DB- DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. Conclusions The DB- DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research. [ABSTRACT FROM AUTHOR]

Background: The juvenile justice system's interventions are expected to help reduce recidivism. However, previous studies suggest that official processing in juvenile court fails to reduce adolescents' criminal behavior in the following year. Longer term effects have not yet been investigated with a rigorous method. This study used propensity score matching to assess the impact of juvenile court processing into young adulthood. Method: Participants were part of a prospective longitudinal study of 1,037 boys from low- socioeconomic areas of Montreal, followed from ages 6-25 years. During their adolescence, 176 participants were processed in juvenile court, whereas 225 were arrested, but not sent to court. Propensity score matching was used to balance the group of participants exposed to juvenile court and the unexposed comparison group on 14 preadolescent child, family and peer characteristics. The two groups were compared on their official adult criminal outcomes. Results: The risk of conviction for an adult offence was 50.0% for court-processed participants compared with 24.3% for their matched counterparts, OR = 3.13, 95% CI = 1.80-5.44. Court-processed participants committed an average of 0.39 violent crimes, compared with 0.15 for their matched counterparts; Poisson model IRR = 2.60, 95% CI = 1.39-4.87. They also committed an average of 2.38 nonviolent crimes, compared to 1.30 for their matched counterparts, IRR = 1.87, 95% CI = 1.19-2.93. Conclusions: Rather than decreasing recidivism, juvenile court intervention increased both violent and nonviolent future crimes. Along with previous studies, this study highlights a pressing need for more research and knowledge transfer about effective interventions to reduce recidivism among youths who commit crime. [ABSTRACT FROM AUTHOR]