Engaging From Both Sides: Facilitating a Canadian Two-Generation Prenatal-to-Three Program for Families Experiencing Vulnerability

Can J Nurs Res. 2020 Jun;52(2):117-128. doi: 10.1177/0844562120905710. Epub 2020 Feb 11.

Abstract

Background: Young children living in families experiencing social vulnerability, including low income, mental illness, addictions, social isolation, and/or homelessness, are at risk of developmental delay. Two-generation programs can improve outcomes for preschool children, but underlying mechanisms and outcomes for younger children remain unclear.

Purpose: We explored program facilitation and identified developmental benefits of a two-generation program beginning prenatally.

Methods: In our convergent, concurrent mixed methods study, we interviewed agency staff (n = 10) and held focus groups with parents (n = 14). We compared child (N = 100) development between program intake and exit as measured by the Ages and Stages Questionnaires 3rd edition.

Results: Our core category, Engaging From Both Sides, included (a) Mitigating Adversity (focused codes Developing Trust, Letting Go of Fear, and Putting in the Effort); (b) Continual Learning (focused codes Staying Connected, and Taking it to the Community); (c) Fostering Families (focused codes Cultivating Optimism, and Happiness and Love); (d) Unravelling Cycles of Crisis (focused codes Advocating, and Helping Parents' Parent); and (e) Becoming Mainstream (focused codes Knowing Someone Has Your Back, and Managing Stress, Anxiety, and Anger). We found significant improvements in child Fine Motor, Problem-Solving, and Personal-Social domains between program intake and exit.

Conclusions: Our study adds to existing literature regarding mechanisms of two-generation programs beginning prenatally. Mitigating effects of intergenerational adversity was the primary motivation for interaction and engagement of staff and parents in two-generation programming, which improved child development.

Keywords: Infants; constructivist grounded theory; mixed methods; preschool children; social vulnerability; two-generation program.

MeSH terms

  • Adult
  • Canada
  • Child, Preschool
  • Fear
  • Female
  • Humans
  • Infant
  • Male
  • Mental Disorders*
  • Parenting
  • Pregnancy
  • Social Support
  • Trust