Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial

24

Manuscripts

Released in 1989 through 2018

1

Manuscript

Impact studies rated high or moderate quality

Services intended at ages
Prenatal
0-6 months
7-11 months
12-23 months
Favorable results from well-defined research
No favorable effects found

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The Parental Skills and Attachment in Early Childhood: Reduction of Risks Linked to Mental Health Problems and Promotion of Resilience Project (CAPEDP) was a demonstration project in France, implemented from 2006 to 2011. CAPEDP enrolled pregnant women who were younger than 26 years old and had one or more of the following risk factors: had less than 12 years of education, qualified for free health care based on low-income status, or intended to raise the child in the absence of the father. The model was designed to promote infant mental health by addressing postnatal maternal depression, improving parenting skills, and promoting healthy mother-child attachment. Psychologists provided home visits that were guided by a series of six DVDs, brochures covering a variety of health and mental health topics, and video recordings of the mother-child interactions. CAPEDP offered families 44 home visits from the third trimester of the mother’s pregnancy to the child’s second birthday.

Effectiveness

Does not meet criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.

Does not meet criteria for an evidence-based home visiting model for Indigenous peoples and communities.

Extent of Evidence

For more information about manuscripts, search the research database.

For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.

24

Manuscripts

Released in 1989 through 2018

3

Manuscripts

Eligible for review

1

Manuscript

Impact studies rated high or moderate quality

Note: When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

Summary of Findings

To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.

Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.

No effect:
Findings are not statistically significant.

Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.

Outcomes Manuscripts Favorable Findings No Effects Findings Unfavorable Findings
Child development and school readiness Not measured - - -
Child health Not measured - - -
Family economic self-sufficiency Not measured - - -
Linkages and referrals Not measured - - -
Maternal health View 1 Manuscript 0 1 0
Positive parenting practices Not measured - - -
Reductions in child maltreatment Not measured - - -
Reductions in juvenile delinquency, family violence, and crime Not measured - - -

Research Characteristics

Well-designed impact studies about this model included participants with the following characteristics. The evidence for effectiveness for the model may include additional studies that did not report this participant information.

Race/Ethnicity

Data not available

Maternal Education

Less than a high school diploma
83.90%
Unknown
16.10%

Other Characteristics

This data is only reported if known for at least 50 percent of participants in well-designed impact studies of the model.

Enrollment in means-tested programs
46.80%

Well-designed impact studies about this model were conducted in the following locations:

International Locations
International (other)

Implementation

In this section:

Overview

Theoretical approach, intended population, and targeted outcomes.

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Support Availability

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Service Delivery

Model services, adaptions and enhancements, model intensity and length.

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Requirements

Staffing and organizational requirements.

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Overview

Theoretical approach

In response to an increased number of children living in disadvantaged environments being referred for mental health care, the Parental Skills and Attachment in Early Childhood: Reduction of Risks Linked to Mental Health Problems and Promotion of Resilience Project (CAPEDP) was developed to promote infant mental health and reduce the incidence of infant mental health problems. CAPEDP drew on the framework from the Nurse-Family Partnership (NFP) model and Integrated Services for Perinatal Health and Early Childhood, a Canadian adaptation of the NFP. The model was based on Bandura’s self-efficacy theory, Bronfenbrenner’s ecological model of human development, and Bowlby’s attachment theory. CAPEDP was implemented within and designed to supplement the French system of free public mother-child support and prevention services.

Intended population

The intended population included mothers who were younger than 26 years old, were less than 27 weeks pregnant, and spoke French fluently enough to actively participate in CAPEDP. Eligible participants also had to meet one or more of the following risk factors: had less than 12 years of education, qualified for free health care based on low-income status, or intended to raise the child in the absence of the father.

Targeted outcomes

The model was designed to promote infant mental health by addressing postpartum maternal depression, improving parenting skills, and promoting healthy mother-child attachment.

Highlights

Services intended at ages
Prenatal
0-6 months
7-11 months
12-23 months

Support Availability

Implementation support availability

CAPEDP was a demonstration project* funded by the French National Ministry of Health, the French National Institute for Prevention and Health Education, the French National Institute for Health and Medical Research, and the French Public Health Research Institute. It was implemented from 2006 to 2011 by Assistance Publique - Hôpitaux de Paris, the main public university hospital in Paris. No ongoing technical assistance is available.

*The information in this profile represents how the model was implemented during the demonstration trial.

Service Delivery

Model services

Psychologists provided home visits that focused on four themes: (1) the family and its social and cultural network, (2) the mother’s needs and health, (3) creating a safe and stimulating environment for the baby, and (4) the baby’s development. The specific content of the visits varied over the course of the intervention period (with different content offered in the prenatal, 0 to 6 months, 6 to 15 months, and 15 to 24 months periods). Home visitors tailored the visits to the varying needs of each family.

The home visitor recorded a video of the mother and child interacting during daily routines, such as bath and meal time. During the following visit, the home visitor and mother discussed the video together and the home visitor helped the mother reflect on her parenting practices.

To guide the visits, the home visitors used (1) a series of six DVDs on topics such as pregnancy, child care, and child development; and (2) a set of 39 brochures covering a variety of health and mental health topics related to promoting parent-child relationships.

Model intensity and length

CAPEDP offered families 44 home visits from the third trimester of the mother’s pregnancy to the child’s second birthday. That span of visits was organized into four periods: 6 visits during the prenatal period, 8 visits during the child’s first three months, 15 visits between 4 and 12 months of age, and 15 visits between 13 and 24 months.

The length of each home visit was at least 1.5 hours.

Adaptations and enhancements

No information was available on any adaptations or enhancements made to CAPEDP.

Requirements

Staffing requirements

The following staff were involved in implementing the model: home visitors, a clinical supervisor, a project manager who monitored implementation fidelity, and the principal investigator.

The home visitors were clinical psychologists. The supervisor was a child psychiatrist with perinatal and home visiting experience. The supervisor had knowledge of attachment theory, early development, and early psychopathology; and clinical expertise in postpartum depression and parental mental health disorders.

A senior clinician provided weekly individual supervision. The principal investigator met with the home visitors as a group every two weeks. The principal investigator also established a hotline for questions. The project manager monitored home visitors’ fidelity to the intervention manual.

CAPEDP required home visitors to participate in a six-day pre-service training. No information was available on the pre-service training requirements for supervisors. Ongoing training and support on how to use the video recordings of parent-child interactions was provided.

Organizational requirements

CAPEDP was implemented by home visitors from well-baby clinics.

No information was available about ongoing fidelity guidelines that implementing programs or home visitors were required to meet.

Highlights

Professional certification required for home visitors
No

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