Community-engaged research (CEnR) has potential to advance early home visiting and improve health outcomes for all families by ensuring that research aligns with the needs of the community, methods and procedures are acceptable and accessible, and findings are interpreted accurately and disseminated effectively. We conducted a scoping review to characterize the extent and nature of CEnR in peer-reviewed literature relevant to early home visiting. We searched five scholarly databases for literature published since 2010 describing engagement of community members in research involving evidence-based early home visiting programs. We extracted data on each study’s characteristics, community collaborators, and factors, outcomes, and measures of community engagement. We then coded each study for 16 community engagement components and characterized each study along an established continuum of CEnR. Fourteen articles met all eligibility criteria and were characterized as involving community consultation, community participation, or community-based participatory research. No articles were characterized as community initiated or driven. No studies assessed the impact of community engagement, and only two described barriers or facilitators to engagement. CEnR may be underutilized and underreported in peer-reviewed home visiting research. Findings highlight opportunities to build motivation and capacity for CEnR, transparency in CEnR reporting, and evaluation of CEnR process and impacts.

Many randomized controlled trials have investigated the role of school-based prevention interventions to reduce symptoms of anxiety and depression in young people. Systematic reviews have subsequently demonstrated a small, beneficial effect of these interventions when compared to a combined control group including usual care, no intervention, or waiting list controls. However, evidence from behavioral science and clinical psychology suggests control group choice may influence the relative effectiveness of non-pharmacological interventions. Here we explored whether separating this combined control group into distinct categories might influence the apparent effectiveness of preventive interventions. After updating an earlier review and network meta-analysis of preventive interventions for anxiety and depression in young people, we considered the impact of alternative control groups on estimates of effectiveness. This analysis was restricted to comparisons with cognitive-behavioral interventions only—the most common intervention used in the included studies. In targeted populations, for both anxiety and depression outcomes, the effect of a cognitive-behavioral intervention was larger when compared to waiting list controls than to usual curriculum, no intervention, or attention controls. For anxiety, the effect of no intervention was also considerably larger than waiting list control (standardized mean difference -0.37 [95% credible interval − 0.66, − 0.11], favoring no intervention). These results suggest that the beneficial effect of preventive school-based interventions previously observed in standard meta-analyses may be an artifact of combining control groups. Although exploratory, these findings indicate the impact of different control groups may vary considerably and should be taken into account when interpreting the effectiveness of interventions.

Home visiting programs for new parents have a broad range of goals, including improvements in maternal and child health, reductions in child maltreatment, and improvements in child development. Before 2020, few home visits were conducted through phone or video encounters, i.e., telehealth home visiting (teleHV). However, rapid adoption of teleHV was required by the coronavirus disease 2019 (COVID-19) pandemic. To understand how conducting initial visits via teleHV was associated with outcomes, we performed a secondary data analysis to make use of the natural experiment created by COVID-19. Utilizing data from the Nurse-Family Partnership, a US national evidence-based model, we compared outcomes for families whose initial home visits were in person (enrolled 10/2019 to 1/2020; n = 7066) to those whose first visits were through teleHV (enrolled 4/2020 to 12/2020; n = 14,587). TeleHV at intake was associated with a higher likelihood of elevated depressive symptoms at 12 months (OR = 1.37; 95% CI 1.07, 1.76), a lower likelihood of retention to child’s age 12 months (OR = 0.67; 95% CI 0.58, 0.78), a higher likelihood of early drop from the program (OR = 1.77; 95% CI 1.48, 2.12), and fewer screening assessments completed (b = − 0.06; 95% CI − 0.07, − 0.04). No differences were detected between groups for the likelihood of breastfeeding at child’s age 6 months, elevated intimate partner violence (IPV) risk, 90% of attempted visits completed, or time to attrition. COVID-19 may have led families in different groups to have different experiences during key points of child development; however, as both groups’ involvement in the program occurred primarily during the pandemic, they were both subject to comparable influences. These findings suggest that in-person visits have some advantages in the first months of program involvement.

Parenting programs aim to improve parenting quality, which may, in turn, support various aspects of child development, including behavior and mental health. However, parenting interventions show considerable heterogeneity in response patterns across different families, demonstrating that they are not one-size-fits-all programs. This variability points to a need for greater understanding of which families benefit most from these interventions and how to improve response among those who do not. Following this literature gap, this study employed a person-centered approach to identify different parenting profiles associated with heterogeneity in treatment responses to a family-based prevention interventions adapted for military families. This study used data from a randomized controlled trial of the ADAPT intervention for 336 US military families in which at least one parent had deployed to war. Latent profile analyses revealed three unobserved parenting profiles among mothers and fathers, reflecting High positive, Moderate positive, and Coercive parenting styles. Latent transition analysis (LTA) suggested that the ADAPT program led to improvements in parenting, particularly among mothers who began the program with moderate or typical levels of parenting skills, and that these positive changes in parenting may help to decrease child externalizing problems. For fathers, the ADAPT program was most effective in preventing declines in positive parenting among those with initially typical levels of positive parenting. Overall, study findings demonstrate considerable heterogeneity in parenting behavior among a sample of military families that is associated with variability in parent responses to the evidence-based parenting program.

Evidence-based home visiting services (EBHV) are available in states and localities nationwide through the federally-funded Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. Nevertheless, the anticipated benefits of EBHV, such as improved child developmental outcomes and increased positive parenting practices, may be undermined by the fact that most families withdraw from services earlier than the model developers planned. Prior studies have linked family attrition with staff turnover. The current study used a mixed methods design to investigate the conditions under which families remained active in the home visiting program after their assigned home visitor resigned. Coincidence Analysis revealed that giving families advance notice (at least 1 month) prior to the home visitors’ upcoming resignation or developing a strong positive working alliance with the inheriting home visitor appears to independently make a difference for ongoing family engagement at 3 and 6 months following a staff transition. These findings suggest that emphasizing how staff turnover is managed may mitigate the risk of family withdrawal during these transitions.

Interventions (including behavioral, biobehavioral, biomedical, and social-structural interventions) hold tremendous potential not only to improve public health overall but also to reduce health disparities and promote health equity. In this study, we introduce one way in which interventions can be optimized for health equity in a principled fashion using the multiphase optimization strategy (MOST). Specifically, we define intervention equitability as the extent to which the health benefits provided by an intervention are distributed evenly versus concentrated among those who are already advantaged, and we suggest that, if intervention equitability is acknowledged to be a priority, then equitability should be a key criterion that is balanced with other criteria (effectiveness overall, as well as affordability, scalability, and/or efficiency) in intervention optimization. Using a hypothetical case study and simulated data, we show how MOST can be applied to achieve a strategic balance that incorporates equitability. We also show how the composition of an optimized intervention can differ when equitability is considered versus when it is not. We conclude with a vision for next steps to build on this initial foray into optimizing interventions for equitability.

Homophobic bullying constitutes a serious threat to adolescent well-being and could be understood as an ecological phenomenon, influenced by diverse school, regional, and community contexts. This study examined geographic variations in the relationship between school characteristics and homophobic bullying. Data from 2244 California schools, including student surveys and administrative records, were combined and analyzed using geographically weighted regression (GWR). Results showed that the associations between school characteristics and general victimization were consistent across geographic areas. However, when it came to homophobic bullying, the relationships with school characteristics varied significantly based on location. Notably, regions with high intolerance, urbanity, large school size, and small student–teacher ratios appeared to offer protection against bullying. Additionally, student socioeconomic status influenced bullying in disadvantaged rural schools with limited Gay-Straight Alliance (GSA) presence. Ethnic diversity also played a role, with low diversity or dominance of two ethnic groups linked to higher bullying rates.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11121-024-01732-4.