# Embedding Mental Health Consultation Within Prenatal Home Visiting to Prevent Child Maltreatment and Violence Exposure

> **NIH ALLCDC R01** · EMMA PENDLETON BRADLEY HOSPITAL · 2021 · $350,000

## Abstract

Abstract
Adverse childhood experiences (ACES) is a major public health problem that exacts tremendous cost to the
United States each year. Exposure to ACES during infancy, including child maltreatment and child exposure to
adult intimate partner violence, undermines health across the lifespan. Infants are at greatest risk for fatality
resulting from maltreatment in the first week of life, and nearly a third of infants who experience maltreatment
in the first year have been maltreated by one week postpartum. Thus, intervening in the postpartum period to
prevent maltreatment and exposure to intimate partner violence is too late. Furthermore, mothers with their
own history of adversity or trauma are much more likely to experience risk factors in the postpartum period for
perpetrating violence. Intervening prenatally to support mothers into the postpartum transition, particularly
mothers with their own trauma history, is critical to reducing maltreatment and violence exposure in children.
Home visiting programs, with their emphasis on maternal-child health, are an important bridge to support
mothers with a trauma history across the perinatal transition, and an ideal setting for primary prevention of
child maltreatment and violence exposure. The proposed research will focus on RFA Objective #3:
Effectiveness research to evaluate a primary prevention strategy that incorporates a dual-generation
approach. Through close collaboration with the Rhode Island Department of Health (RIDOH) and the Rhode
Island Department of Children, Youth, and Families (RI DCYF), we will capitalize on established infrastructure
to innovate and enhance a statewide short-term home visiting program. Our primary prevention program,
Enhanced First Connections, will draw upon an infant mental health perspective to provide prenatal infant and
early childhood mental health consultation in the context of the home visiting program. We will focus on a
selected high-risk population, mothers with a history of adversity or trauma, with the goal of preventing ACES
exposure among infants. Primary outcomes of the proposed randomized control trial (RCT) will include
the prevention of child maltreatment (child abuse and neglect) and exposure to adult intimate partner
violence. Secondary outcomes of the proposed RCT will include increases in family engagement in longer-
term evidence based home visiting programs, increases in family engagement in specialized support services
to address maternal adversity and trauma, reductions in maternal risk factors, and the promotion of positive
parenting and the parent-child relationship. We will use gold-standard assessments to measure our outcome
variables including review of child protection records, interview and observational assessments, and review of
home visiting records. Our focus on infant and early childhood mental health consultation is highly innovative
as no prior research has empirically tested this strategy for the primary prevention of child...

## Key facts

- **NIH application ID:** 10237847
- **Project number:** 5R01CE003103-03
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** Stephanie Hart Parade
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $350,000
- **Award type:** 5
- **Project period:** 2019-09-30 → 2022-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10237847

## Citation

> US National Institutes of Health, RePORTER application 10237847, Embedding Mental Health Consultation Within Prenatal Home Visiting to Prevent Child Maltreatment and Violence Exposure (5R01CE003103-03). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10237847. Licensed CC0.

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