An Overview of the An Overview of the Family Life ProjectFamily Life Project

Lynne Vernon-FeagansLynne Vernon-FeagansMartha CoxMartha Cox

22

The Family Life Project Community MeetingApril 27th, 2006 Goldsboro, NC

33

Research InvestigatorsResearch Investigators Lynne Vernon-FeagansLynne Vernon-Feagans PI PI Martha Cox Co-PIMartha Cox Co-PI

Patricia Garrett-PetersPatricia Garrett-Peters Research Director Research Director Roger Mills-KoonceRoger Mills-Koonce Research Director Research Director

Nan CrouterNan Crouter PI of Penn State Core PI of Penn State Core Peg BurchinalPeg Burchinal Data management and Data management and Statistical coreStatistical core Clancy BlairClancy Blair Project 1: Emotion Regulation Project 1: Emotion Regulation ( Mark Greenberg) and Temperament( Mark Greenberg) and Temperament Lynne Vernon-Feagans Lynne Vernon-Feagans Project 2: Competence and Project 2: Competence and

Pre-Readiness Skills Pre-Readiness Skills Martha Cox Martha Cox Project 3: Family Processes Project 3: Family Processes Nan CrouterNan Crouter Project 4: Work and Family Project 4: Work and Family Linda Burton Project 5: Community and Linda Burton Project 5: Community and (Debra Skinner)(Debra Skinner) Family Ethnography Family Ethnography

44

RationaleRationale Most of the research about children is based on studies Most of the research about children is based on studies

of urban childrenof urban children

Nearly half of all children live in non-urban (rural) settingsNearly half of all children live in non-urban (rural) settings

Children in non-urban areas are on average poorer than Children in non-urban areas are on average poorer than children in urban areaschildren in urban areas

There is some evidence that there may be different risk There is some evidence that there may be different risk and protective factors in urban versus rural areas and protective factors in urban versus rural areas

55

Poverty Rates in Urban and Rural Poverty Rates in Urban and Rural AreasAreas

66

Percent of Children living in Percent of Children living in Poverty by metro/nonmetroPoverty by metro/nonmetro

77

Risk Factors Associated with Risk Factors Associated with Non-Urban LifeNon-Urban Life

More maternal depressionMore maternal depression More tobacco useMore tobacco use More alcohol and prescription drug abuseMore alcohol and prescription drug abuse Less access to health and mental health servicesLess access to health and mental health services Less access and availability to childcareLess access and availability to childcare Longer distances to work and childcareLonger distances to work and childcare Less access to public transportationLess access to public transportation Fewer good jobs Fewer good jobs

88

Protective Factors Associated Protective Factors Associated with Non-Urban Lifewith Non-Urban Life

Less exposure to random violent crimeLess exposure to random violent crime More single family homes More single family homes More homes and land owned by familiesMore homes and land owned by families More access to extended familyMore access to extended family Stronger connections to religious institutionsStronger connections to religious institutions Greater sense of communityGreater sense of community

99

The Family Life ProjectThe Family Life Project

Recruit every baby born to a mother Recruit every baby born to a mother who resided in three non-urban who resided in three non-urban counties in Pennsylvania and three counties in Pennsylvania and three non-urban counties in North Carolina non-urban counties in North Carolina between September 2003 and between September 2003 and September 2004.September 2004.

1010

Recruitment – Overall SummaryRecruitment – Overall Summary

0

10

20

30

40

50

60

70

80

90

100

Contact rate Agreementrate

Enrollmentrate

NCPAStudy

1111

Study SampleStudy Sample

We recruited 1292 families in North We recruited 1292 families in North Carolina and Pennsylvania in 6 Carolina and Pennsylvania in 6 countiescounties

Families were representative of all Families were representative of all babies born to mothers in these babies born to mothers in these counties.counties.

1212

North Carolina

1313

PennsylvaniaPennsylvania

1414

The Context of AppalachiaThe Context of Appalachia

1515

Steel Mills in Johnstown , Pennsylvania20 Years Ago

1616

Empty Steel Mills in Johnstown, Pennsylvania (2003)

1717

Dairy and Vegetable Farms in Blair County

1818

The Context of the SouthThe Context of the South

1919

The three counties in North Carolina werepart of a handful of counties in the country that produced the most tobacco in the U.S.

2020

Tobacco is cheap to produce, pest resistant,not dependent on rich soil, and yields large profits

2121

Shift Work

2222

Poultry Farms

2323

Hog Farms have begun to replace tobacco

2424

Highly skilled jobs

2525

2626

2727

Housing is diverseAnd affordable

In both Pa and NC

2828

2929

3030

Schedule of Data Schedule of Data CollectionCollection

Birth 2 months

Hospital Home Visit

6 months

2 Home Visits Phone Call 1 Home Visit

15 months

Child CareVisit

Child CareVisit

Phone Call 2 Home Visits Phone Calls 2 Home Visits

24 months 36 months

Child CareVisit

Child CareVisit

3131

Family Configuration for 1292 Family Configuration for 1292 familiesfamilies

0

15

30

45

60

Singleparent

Single +G'prt

Dualparent

Dual +G'prt

Other

%

3232

Life of Families in North Life of Families in North CarolinaCarolina

3333

While many of the parents in our study While many of the parents in our study were born and raised in NC, about 25% were born and raised in NC, about 25% come from other parts of the country.come from other parts of the country.

3434

Poverty DefinitionPoverty Definition Federal Poverty level for a family of 4 in Federal Poverty level for a family of 4 in

2004 is $18,850.2004 is $18,850. We placed families who made less than We placed families who made less than

twice the Federal poverty level ($37,700) twice the Federal poverty level ($37,700) as poor because most poverty programs as poor because most poverty programs allow families to be eligible up to $185% of allow families to be eligible up to $185% of the federal poverty level. the federal poverty level.

The Non-Poor made more than two times The Non-Poor made more than two times the poverty level. the poverty level.

3535

EducationEducation

0

25

50

Lessthan HS

HS SomeCollege

Collegedegree

Poor

Not-Poor

0

25

50

2 months 6 months

Poor mothers are more likely to have a high Poor mothers are more likely to have a high school degree or less, while not poor mothers school degree or less, while not poor mothers are likely to have at least some college.are likely to have at least some college.

About ¼ or our poor mothers are currently in About ¼ or our poor mothers are currently in school or some type of training course.school or some type of training course.

Educational background (%) % mothers currently in school or training program

3636

EmploymentEmployment

0

50

100

6 months2 months

PoorNot-Poor

0

50

100

Days Nights Shifts

Fewer poor mothers are working at 2 and 6 Fewer poor mothers are working at 2 and 6 monthsmonths

Poor mothers are, however, more often work Poor mothers are, however, more often work night jobs and shift work than non-poor mothersnight jobs and shift work than non-poor mothers

% of mothers working % in day, night, and shift work

3737

ChildcareChildcare

0

50

100

2 months 6 months

0

50

2 months 6 months

Poor Not-Poor

At 2 months, roughly 50% of the sample reported some At 2 months, roughly 50% of the sample reported some type of childcare arrangement outside of the hometype of childcare arrangement outside of the home

By 6 months, use of childcare had risen to over 75%By 6 months, use of childcare had risen to over 75%

Over 1/3 of childcare arrangements use center-based careOver 1/3 of childcare arrangements use center-based care

The average child spends over 30 hours per week in some The average child spends over 30 hours per week in some form of childcareform of childcare

% in some form of childcare % of center-based childcare

3838

AssetsAssets

0

50

100

Owns home Rents home Lives withextended family

Car in household

Poor Not-Poor

Most non-poor families own their home, while Most non-poor families own their home, while most poor families rent.most poor families rent.

25% of poor families do not have an automobile 25% of poor families do not have an automobile in the householdin the household

3939

Health InsuranceHealth Insurance

0

25

50

75

100

Mothers Children

% of mothers and children with health coverage

Poor Not-Poor

Although almost all children have some Although almost all children have some sort of health insurance, only 75% of poor sort of health insurance, only 75% of poor mothers have health coverage.mothers have health coverage.

4040

HealthHealth

0

10

20

30

40

50

60

70

80

90

100

% Smoked Preg

% LBW (2500g)

% Ever breastfed

• Most mothers did not smoke during pregnancy and less than half ever tried breastfeeding. About 15% were low birthweight babies

4141

Early NutritionEarly Nutrition

0

50

100

2 monhts 6 months

Poor

Not-Poor

0

25

50

2 months 6 months

Poor mothers are less likely to breastfeed their Poor mothers are less likely to breastfeed their children at early ages, as well as less likely to children at early ages, as well as less likely to continue.continue.

By 6 months of age, 25% of children are consuming By 6 months of age, 25% of children are consuming some type of fast food on a weekly basis.some type of fast food on a weekly basis.

% of mothers breastfeeding % of children eating fast food

4242

Early Service ProvisionEarly Service Provision

0

25

50

Pregnancy home visit Breastfeeding services Early Head Start

% of families participating in local services

Poor Not-Poor

While poor mothers are more likely to participate While poor mothers are more likely to participate in pregnancy home visits and early Head Start, in pregnancy home visits and early Head Start, they are less likely to participate in breastfeeding they are less likely to participate in breastfeeding servicesservices

4343

Residential InstabilityResidential Instability

0

10

20

Moved once Moved twice or more

% of famlies that move in the first 6 months

Poor Not-Poor

During the first 6 months, over 12% of During the first 6 months, over 12% of poor families move at least once.poor families move at least once.

4444

The Constant TelevisionThe Constant Television

0

25

50

75

100

% with TV on 7+ hours per day

Poor Not-Poor

64% of poor families have the television 64% of poor families have the television on for at least 7 hours each dayon for at least 7 hours each day

4545

SummarySummary Education is linked to being poorEducation is linked to being poor Owning a home is linked to not being poorOwning a home is linked to not being poor One quarter of poor families don’t have a carOne quarter of poor families don’t have a car Most mothers are back at work by 6 monthsMost mothers are back at work by 6 months Poor mothers have more irregular work schedulesPoor mothers have more irregular work schedules

Babies are generally healthyBabies are generally healthy All babies have health insuranceAll babies have health insurance Most babies are in childcare by 6 months of ageMost babies are in childcare by 6 months of age

Less than half the mothers breastfeed their babies and Less than half the mothers breastfeed their babies and those that do generally don’t continue for longthose that do generally don’t continue for long

One quarter of children are eating fast food once a week by One quarter of children are eating fast food once a week by 6 months of age6 months of age

Most families have the TV on most of the day. Most families have the TV on most of the day.

4646

Getting the Job Getting the Job DoneDone

Collecting Data on 773 Collecting Data on 773 North Carolina FamiliesNorth Carolina Families

4747

RecruitmenRecruitmentt

August 2002-August 2003: FLP communications with August 2002-August 2003: FLP communications with pediatricians, ob/gyn, nurses, county health departments, pediatricians, ob/gyn, nurses, county health departments, and hospitals; Distribution of pamphletsand hospitals; Distribution of pamphlets

August 2003-September 2004: Recruitment at Wayne August 2003-September 2004: Recruitment at Wayne Memorial Hospital, Wilson Medical Center, and Sampson Memorial Hospital, Wilson Medical Center, and Sampson Regional Medical CenterRegional Medical Center

Nurses and other staff helped FLP recruiters identify Nurses and other staff helped FLP recruiters identify 31273127 new mothers; many mothers had already heard about the new mothers; many mothers had already heard about the project through the county agenciesproject through the county agencies

Eligibility: agree to participate, live in target counties, Eligibility: agree to participate, live in target counties, English speaking, and no plans to move for 3 yrsEnglish speaking, and no plans to move for 3 yrs

773 families enrolled across tri-county area773 families enrolled across tri-county area

4848

Data CollectionData Collection

1 home visit when child is 2 and15 1 home visit when child is 2 and15 months; 2 home visits when child months; 2 home visits when child is 6, 24, and 36 monthsis 6, 24, and 36 months

Childcare visits (except 2mo)Childcare visits (except 2mo)

Phone calls between visits at 10.5, Phone calls between visits at 10.5, 19.5, 27, and 31 months19.5, 27, and 31 months

4949

Families are visited by 2 home Families are visited by 2 home visitorsvisitors

Each home visit lasts Each home visit lasts approximately 2 to 2 ½ hours.approximately 2 to 2 ½ hours.

Childcare visits last Childcare visits last approximately 1 to 1 ½ hours.approximately 1 to 1 ½ hours.

5050

The Family Life Project StaffGoldsboro, NC

5151

FLP Home VisitorsFLP Home Visitors 14-18 highly trained research assistants14-18 highly trained research assistants

Rigorous training on all research protocolsRigorous training on all research protocols

Attend 2 day trainings with staff at Penn State Attend 2 day trainings with staff at Penn State before each new assessment pointbefore each new assessment point

For all tasks: Read training manuals, watch For all tasks: Read training manuals, watch training videos, practice with local families, submit training videos, practice with local families, submit videotapes for official certification, observed by videotapes for official certification, observed by Project Directors while conducting visits w/familiesProject Directors while conducting visits w/families

5252

What happens on a home visit?What happens on a home visit?

Videotaped interactions of child Videotaped interactions of child and caregiversand caregivers

Videotaped child behaviors during Videotaped child behaviors during challengechallenge

Computerized interview with many, Computerized interview with many, many questions for primary many questions for primary (mother) and secondary (father or (mother) and secondary (father or grandmother) caregiversgrandmother) caregivers

5353

Biological data collection including heart Biological data collection including heart rate and mother and child salivarate and mother and child saliva

Child assessmentsChild assessments LanguageLanguage MemoryMemory AttentionAttention

5454

Parent-Child Picture Book TaskParent-Child Picture Book Task

5555

5656

5757

5858

5959

6060

6161

6262

6363

Heart Rate Collection

6464

6565

Child Challenge TasksChild Challenge Tasks

Remove toy Remove toy MasksMasks Arm restraintArm restraint

Cortisol = Stress Hormone in Saliva

6666

To date, we’ve completed: To date, we’ve completed:

3550 home visits ($177,500)3550 home visits ($177,500)

790 childcare visits ($31,600)790 childcare visits ($31,600)

1485 phone calls 1485 phone calls

Currently midway through 24mo Currently midway through 24mo visitsvisits

Beginning 36mo visits in AugustBeginning 36mo visits in August

6767

New Research and New Research and Innovations in the Study of Innovations in the Study of

Children and FamiliesChildren and Families

6868

Biohealth ResearchBiohealth Research

CortisolCortisol

αα-Amylase -Amylase

Cotinine Cotinine

6969

Defining “Rural”Defining “Rural”

7070

Early Cognitive Early Cognitive DevelopmentDevelopment

Standardizing a Standardizing a new assessment new assessment of early executive of early executive functioningfunctioning AttentionAttention MemoryMemory Self-controlSelf-control

7171

Nutrition and HealthNutrition and Health

Early childhood Early childhood obesity and healthobesity and health

BreastfeedingBreastfeeding

Early growth and Early growth and cognitive cognitive developmentdevelopment

7272

ChildcareChildcare

TypeType RelativeRelative Home-basedHome-based Center-basedCenter-based

QualityQuality

QuanitityQuanitity

AvailabilityAvailability

7373

Family FunctioningFamily Functioning

Early Parent-Child RelationshipsEarly Parent-Child Relationships

Parent Language Parent Language InputInput

Family Work Family Work ScheduleSchedule

Multi-Generation Multi-Generation HouseholdsHouseholds

7474

Our sincerest appreciation to the Our sincerest appreciation to the families participating in this study and families participating in this study and to the counties and communities who to the counties and communities who

have supported this work over the past have supported this work over the past four years.four years.