Multilevel Interaction Effects of Family and Community Factors on Mothers' Engagement in Evidence-Based Home Visiting.

Informed by ecological and family system frameworks, our study investigated the relationship between family- and community-level factors, and their cross-level interactions, with evidence-based home visiting program participation in a sample of 2409 mothers (mean age: 24.15 years). Using 2-level hierarchical linear modeling, we observed that mothers living in disadvantaged communities demonstrated less active engagement in evidence-based home visiting. Cross-level interaction effects revealed that mothers' unstable living conditions and psychiatric problems amplified the negative influence of disadvantaged communities on program engagement. Conversely, mothers who were first-time parents showed higher levels of participation in family support programs when they resided in disadvantaged communities.