Positively Moms Program

The Foundation's Positively Moms Initiative (PMI) seeks to reduce the incidence of and negative family outcomes from perinatal maternal distress.  The three-year, $1.5mm initiative will begin by engaging experienced home visiting service providers in Cuyahoga County, Ohio and in Hawaii (along with their research/evaluation partners) to assess the prevalence of perinatal maternal distress in high-risk families, and to design and implement new interventions in order to help those mothers and their children thrive.

Since its inception in 1985, the William J. and Dorothy K. O'Neill Foundation (ONF), a private family foundation, has emphasized the importance of family.  The O'Neills come together as philanthropists and as a family, to support work that strengthens family structure to assure children reach their full potential.

Why Focus on Maternal Distress?

During pregnancy and early parenting (the perinatal period) maternal trauma, anxiety, depression and especially stress can create an environment for the developing fetus and, later, for the very young child that will have negative developmental and educational impacts over the course of the child's life.  Recent research in neuropsychology, maternal health and other fields has consistently implicated distress* in this period (traumatic stress, anxiety and everyday stressors of poverty) as a major contributor to premature birth, low birthweight and later developmental delays that can lead to educational deficits.  Even with this emerging consensus around its importance, however, reducing maternal distress has not become a focus of maternal health practice or policy, even while treatment of maternal clinical depression--requiring clinical assessment and high-cost treatment--has received more and more attention.

(*The term "distress" is often used interchangeably with "stress", but "distress" is the more comprehensive of the two, denoting a combination of stress, anxiety and/or mild depression.)

How PMI Works with Home Visiting Services

Home visiting has been called "the flagship program through which many states and local communities are reaching out to new parents," and a number of home visiting programs are now proven to have significant positive impact on at-risk families, contributing to better cognitive development in children and reduction of risk for abuse and neglect.  While many home visiting programs have added components to address certain aspects of maternal stress, anxiety and depression, neither screening nor curriculum in home visiting has been systematically updated to reflect the new understanding about the effects on child development of perinatal maternal distress, particularly in the pre-natal period.

ONF believes that because of its proven success reaching at-risk families with valuable interventions, home visiting provides an ideal delivery mechanism for a newly-informed and carefully designed intervention/curriculum to reduce maternal distress in at-risk women.  If successful, such an intervention could dramatically expand the percentage of at-risk women receiving services vital to the future wellbeing of their children. 

Putting It Together: The Positively Moms Initiative

To demonstrate the potential of a focus on perinatal distress reduction for improving child and family outcomes, the ONF will work with established providers of research-based home visiting programs to develop, deliver and evaluate new interventions to reduce distress in pregnant women and mothers of young children.  ONF grants will allow teams of experienced providers and their evaluation partners to design, deliver and evaluate services in the home that help identify and reduce maternal distress and test whether these targeted strategies can, in fact, improve the lives of families with children living in poverty.

An expert Advisory Committee helped ONF identify experienced home visiting providers that have the interest in and potential to develop and implement a curriculum targeting maternal distress.  Our first year grantees were already working with established evaluators to track and assess their home visiting programs, and these evaluators will run a parallel assessment of the PMI enhancement developed by the home visiting grantees.

In this first year of Positively Moms, grantees will establish the scope of service (who will be served), implement a distress assessment and devise a culturally appropriate intervention/curriculum enhancement for their home visiting program.  In years two and three, grantees will implement the new intervention/curriculum and monitor, assess and report on evaluation outcomes.

How Does this Relate to the Federal Home Visiting Grants?

Although ONF funding will not replace government funds under any circumstnces, the initiative has been timed to parallel the Maternal, Infant and Early Childhood Home Visiting Program (MIECHVP) in the hope of leveraging some of that effort and funding.  ONF will also seek to attract other funders to the initiative in order to expand the number of program sites and/or increase funding for research and evaluation.