Program

Mar 11, 2013

OVERVIEW


This home visiting program for working-class mothers and their infants provides information and advice to the mothers to improve their relationship with their child. No significant impacts were found on the number of emergency room visits for the child or the mother’s behavior concerning the child, but treatment group mothers had higher numbers of up-to-date immunizations than the control group, as well as fewer accidents.

DESCRIPTION OF PROGRAM


Target population: Mothers and their infants in working-class families.

The treatment group receives home visits starting during the child’s sixth week. Most of the home visits take place between six weeks and six months of life, seven total visits, and three take place from six to 15 months. The home visitor gives advice on four areas: general caretaking, mother-infant interaction, social status, and child development. General caretaking information includes feeding, sleeping, scheduling, bathing, clothing, preventing accidents, and encouraging the mother to follow her child’s recommended well-care visit schedule. Mother-infant interaction advice aims to facilitate the establishment of a positive, emotionally satisfying relationship between the mother and the infant, and encouragement of frequent reciprocal interaction, such as talking to the baby while feeding and responding to the baby’s vocalizations. Social status involves the family atmosphere, the mother’s relationship with her father, support systems available, and any area of great stress or concern. Child development counseling is reviewing the child’s developmental abilities and suggesting activities to the mother to promote the child’s capability. The order and detail of each part of the lesson is up to the visitor.

EVALUATION(S)OF PROGRAM

Larson, C. P. (1980). Efficacy of prenatal and postpartum home visits on child health and development. Pediatrics, 66, 191-197.

Evaluated population:
Mothers were recruited from the private offices of obstetricians who deliver at a certain hospital in urban Montreal. All the respondents were white, between 18 and 35, with an income less than the poverty line plus $10,000 a year. The mothers had a high school diploma (or equivalent) or less education. Other inclusion criteria included: no significant illness during pregnancy, no prior psychiatric hospitalization, normal delivery of a full-term, healthy baby with no major congenital defects, and the baby had to have been discharged within five days of birth. This resulted in a sample of 115 mother-infant pairs.

Approach: Mothers were randomly assigned to two groups until there were 80 pairs in those groups, and the rest of the pairs were not randomly assigned, but placed in a third group as they came to the obstetrician’s office. The treatment group had home visits beginning at the child’s sixth week after birth, and the control group had no visits. The third group had home visits beginning during pregnancy. At six weeks, six months, 12 months and 18 months of the child’s age, data on maternal behavior and an assessment of cognitive stimuli available in the home were collected. Maternal behavior included significant feeding problems, sleep problems, disorganized noise in the house, mother-infant interaction problems, financial problems, and a nonparticipant father. At six, 12, and 18 months of the child’s age, the researchers measured adequate well-child care visits, up-to-date immunizations, number of emergency room visits, and accident rates. Adequate well-child visits meant four visits before six months of age, two between six and 12 months, and one between 12 and 18 months. Up-to-date immunization referred to the diphtheria and oral polio vaccines by six months, the same vaccination plus a tuberculosis skin test at 12 months, and diphtheria, oral polio booster, and measles vaccines at 18 months of the child’s age.

Results: The post-partum home visits had significant, positive impacts on the treatment group mothers for immunizations and accident rates, compared with the no-visit control group. Compared with the control group, no impacts were found for the treatment group on maternal behavior, adequate well-child care visits, emergency room visits, or amount of cognitive stimulation in the home.

SOURCES FOR MORE INFORMATION

References:

Larson, C. P. (1980). Efficacy of prenatal and postpartum home visits on child health and development. Pediatrics, 66, 191-197.

KEYWORDS: Infants (0-12 Months), Toddlers (12-36 Months), Males and Females (co-ed), White/Caucasian, Urban, Home-based, Parent Training/Education, Home Visitation, Parent/Family Component, Other Social/Emotional Health, Health Status/Conditions, Other Safety, Parent-Child Relationship, Other Education.

Last Updated on 9/29/10

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