Results indicated that early engagement in home visitation services was associated with being White and having increased parenting risk, such as indicators of mental health, substance abuse, low social support, lower levels of functioning, and increased stress. The findings are consistent with previous research that has shown increased adversity enhances engagement in prevention programs generally and home visitation programs in particular. Given that mothers who are engaged in home visitation programs may have increased psychosocial needs, visitation programming should be augmented to address mental health issues. Participants were 515 first-time mothers who were enrolled in the first year of a community-based home visitation program operating in southwest Ohio and northern Kentucky. Three main components were examined to assess engagement: (1) length of time active in the program during the first year of service; (2) number of home visits received; and (3) gaps in service between home visits. Participants completed semi-structured interviews that collected information about demographic information and family stress. Multivariate hierarchical linear regression models were used to analyze the data. Future research should investigate other potential predictors of home visitation engagement, such as maternal life events and the characteristics of the home visitor. Tables, references