Self-efficacy as a mediator between maternal depression and child hospitalizations in low-income urban families

Margaret L. Holland, Byung Kwang Yoo, Harriet Kitzman, Linda Chaudron, Peter G. Szilagyi, Helena Temkin-Greener

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The objective of this study is to examine therole of maternal self-efficacy as a potential mediatorbetween maternal depression and child hospitalizations inlow-income families. We analyzed data from 432 mother-child pairs who were part of the control-group for theNurse-Family Partnership trial in Memphis, TN. Lowincomeurban, mostly minority women were interviewed12 and 24 months after their first child's birth and theirchild's medical records were collected from birth to24 months. We fit linear and ordered logistic regressionmodels to test for mediation. We also tested non-linearrelationships between the dependent variable (childhospitalization) and covariates (depressive symptoms andself-efficacy). Elevated depressive symptoms (OR: 1.70;90% CI: 1.05, 2.74) and lower maternal self-efficacy (OR:0.674; 90% CI: 0.469, 0.970) were each associated withincreased child hospitalizations. When both maternal selfefficacyand depressive symptoms were included in a singlemodel, the depressive symptoms coefficient decreasedsignificantly (OR decreased by 0.13, P = 0.069), supportingthe hypothesis that self-efficacy serves as a mediator. Anon-linear, inverse-U shaped relationship between maternalself-efficacy and child hospitalizations was supported:lower compared to higher self-efficacy was associated withmore child hospitalizations (P = 0.039), but very low selfefficacywas associated with fewer hospitalizations thanlow self-efficacy (P = 0.028). In this study, maternal selfefficacyappears to be a mediator between maternaldepression and child hospitalizations. Further research isneeded to determine if interventions specifically targetingself-efficacy in depressed mothers might decrease childhospitalizations.

Original languageEnglish (US)
Pages (from-to)1011-1019
Number of pages9
JournalMaternal and Child Health Journal
Issue number7
StatePublished - Oct 2011
Externally publishedYes


  • Child health
  • Healthcare utilization
  • Low income
  • Maternal depression
  • Self-efficacy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health


Dive into the research topics of 'Self-efficacy as a mediator between maternal depression and child hospitalizations in low-income urban families'. Together they form a unique fingerprint.

Cite this