Evaluation of the Fussy Baby Network Advanced Training: Final Report Julie Spielberger Tiffany Burkhardt Carolyn Winje Marcia Gouvêa Elizabeth Barisik 2016 Evaluation of the Fussy Baby Network Advanced Training: Final Report Julie Spielberger Tiffany Burkhardt Carolyn Winje Marcia Gouvea Elizabeth Barisik Recommended Citation Spielberger, J., Burkhardt, T., Winje, C., Gouvea, M., & Barisik, E. (2016). Evaluation of the Fussy Baby Network advanced training: Final report. Chicago, IL: Chapin Hall at the University of Chicago. ISSN: 1097-3125 © 2017 Chapin Hall at the University of Chicago Chapin Hall at the University of Chicago 1313 East 60th Street Chicago, IL 60637 773-753-5900 (phone) 773-753-5940 (fax) www.chapinhall.org Acknowledgments We would like to acknowledge several individuals and organizations that made this report possible. We would like to thank the 251 mothers who allowed us into their homes and shared their experiences with us. We appreciate the time and contributions of the staff of the ten home visitation programs who participated in this study. At Chapin Hall, we are grateful to Allen Harden, Elissa Gitlow, Jennifer Tobin, and Deborah Daro who contributed in various ways to data collection, research analysis, or advice on study design. Others who provided early guidance that informed the study design were Sydney Hans (School of Social Service Administration, University of Chicago) and Jon Korfmacher (Erikson Institute). In addition, we are grateful to the Erikson Institute, especially Linda Gilkerson, the founding director of the Fussy Baby Network, and other members of the FBN training project, Hannah Jones-Lewis and Dhara Thakar. They have been important partners throughout the development and implementation of the evaluation, and a valuable resource in the development of protocols for data collection and in the analysis and interpretation of data. We also appreciate the assistance of Theresa Kelly and Andrea Palmer from the State of Illinois in selecting the study programs and establishing policies and processes for working with the staff of these programs. Funding for this study was provided by a grant from the federal Maternal Infant Early Childhood Home Visiting program through the Illinois Department of Human Services to the Erikson Institute, which contracted with Chapin Hall to conduct the evaluation. Chapin Hall at the University of Chicago i Table of Contents Executive Summary ................................................................................................................................... viii Introduction ................................................................................................................................................... 1 FAN Training (The Intervention) ............................................................................................................. 2 Research Questions and Study Design ..................................................................................................... 3 Context for the Evaluation ........................................................................................................................ 7 Overview of this Report ........................................................................................................................... 8 Sample Characteristics at Baseline ............................................................................................................... 9 Characteristics of Program Staff............................................................................................................... 9 Home Visitors .................................................................................................................................... 10 Supervisors ......................................................................................................................................... 17 Characteristics of Program Participants ................................................................................................. 22 Time 1 to Time 2 Attrition ................................................................................................................. 23 Mother and Infant Health and Well-being at Baseline ....................................................................... 26 Baseline Relationships with Home Visitor......................................................................................... 29 Summary of Findings ............................................................................................................................. 30 Learning and Implementing the FAN: The Views of Home Visitors ......................................................... 32 Home Visitors’ Attitudes, Knowledge, and Practices: Quantitative Results .......................................... 33 Experiences with Training .................................................................................................................. 33 Learning and Use of the FAN Approach ............................................................................................ 36 Home Visitor and Supervisor Relationships ...................................................................................... 39 Experiences with Infant Mental Health Consultant and Developmental Specialist ........................... 41 Home Visitors’ Mindfulness Self-Assessment ................................................................................... 42 Home Visitors’ Job Satisfaction ......................................................................................................... 45 Qualitative Results from Home Visitor Focus Groups ........................................................................... 45 Changes in Attitudes and Practices .................................................................................................... 46 Factors Influencing Learning and Application of the FAN Approach ............................................... 51 Summary................................................................................................................................................. 63 Learning and Implementing the FAN: The Views of Supervisors and Consultants ................................... 65 Supervisors’ Attitudes, Knowledge, and Practices: Quantitative Results .............................................. 65 Views of FAN Training ...................................................................................................................... 65 Chapin Hall at the University of Chicago ii Learning and Use of the FAN Processes ............................................................................................ 66 Supervision and Relationships with Home Visitors ........................................................................... 69 Experiences with Infant Mental Health Consultant and Developmental Specialist ........................... 71 Mindfulness ........................................................................................................................................ 73 Job Satisfaction .................................................................................................................................. 73 Qualitative Results from Supervisor Interviews ..................................................................................... 75 Change in Supervisors’ Knowledge and Practices ............................................................................. 76 Changes in Home Visitors’ Practices ................................................................................................. 79 Benefits for Staff: Reducing Staff Emotional Burden ........................................................................ 83 Benefits for Families .......................................................................................................................... 83 Factors Influencing the Learning and Application of the FAN Approach ......................................... 84 Qualitative Results from Consultant Interviews ..................................................................................... 91 Changes in Home Visitors’ Attitudes and Practices ........................................................................... 91 Factors Influencing Learning and Use of the FAN ............................................................................ 92 Summary................................................................................................................................................. 95 Parents’ Experiences and Early Outcomes ................................................................................................. 96 Home Visiting Experiences before and after Training ........................................................................... 96 Home Visit Dynamics: Use of FAN Approach .................................................................................. 97 Use of FAN Core Processes Pre- and Posttraining ............................................................................ 99 Relationships with Home Visitor before and after Training ................................................................ 114 The Working Alliance Inventory ..................................................................................................... 114 Changes in Maternal Functioning......................................................................................................... 116 Parenting Stress ...............................................................................................................................