Program

Nov 13, 2006

OVERVIEW

This program addressed high-needs families with newborn
children who were at risk for poor health and development. The program provided
home visits by child health care nurses. Results showed the visits having
no significant impact on child health after six weeks, but did indicate
increases in parent and family functioning and parental satisfaction with community
health services.

DESCRIPTION OF
PROGRAM

Target population: High-risk
families with children at risk for poor health and development were entered
into the program immediately following the birth of their child.

The program provided home
visits by child health care nurses who attend to families’ health and
social needs. The nurse home visits occurred weekly for the first six weeks and
ever other week after that until three months, and monthly until 6 months
postpartum. The goals of the nurse home visits were to first establish a relationship
of trust with the infant’s family. The program worked to enhance the
parenting self-esteem and confidence of participants as well as provide
guidance for parents on normal child development. The program also promoted
preventive child health care and helped parents access appropriate community
services.

EVALUATION(S) OF
PROGRAM

Armstrong,
K. L., Fraser, J. A., Dadd, M. R., & Morris, J. (1999). A randomized,
controlled trial of nurse home visiting to vulnerable families with newborns. Journal
of Pediatrics and Child Health, 35,
237-244.

Evaluated
population: The evaluated population consisted of 181 women in
Australia who were recruited after giving birth. Women were invited to
participate if they reported risk factors for poor health and poor development
of their child. Ninety women were randomly assigned to receive the home
visiting program and to receive support from a social worker and
pediatrician. Ninety-one women were randomly assigned to receive standard
community child health services.

Approach: Data were collected from participants in their homes at time of enrollment
and when the infant was six weeks of age. At both points, the researchers
collected data on parenting stress and maternal depression. At six weeks,
the researchers measured preventive health behavior, service satisfaction, and
home environment outcomes as well as child health outcomes.

Child
health outcomes were measured using a 30-item self-report questionnaire
developed for the study, which was completed by mothers after six weeks. Parent
and family functioning were measured using the Edinburgh Post Natal Depression
Scale and the Parent Domain subscale of the Parenting Stress Index. To measure
Home environment, the researchers used the Home Observation for Measurement of
the Environment Inventory. Finally, the researchers measured satisfaction with
community child health services using the Parent Satisfaction
Questionnaire-III.

At
enrollment, there were some differences between the intervention and control
groups. In the intervention group, there were more first-time mothers, fewer
mothers reported a past history of postnatal depression, fewer mothers had
partners with histories of psychiatric illness, and fewer mothers reported
physical forms of domestic violence.

Results: Results of the study indicated that both the intervention and control group
experienced improvements in child health related outcomes such as infant sleep
position; but there were no significant differences between the two
groups. Also, no impacts on breastfeeding were found. The
researchers note that halfway through the study, a mass media campaign designed
to affect child health outcomes was launched. The researchers acknowledge that
this may have accounted for changes in the groups.

In
addition, the researchers found there were significant impacts on parent and
family functioning. Program participants experienced a significant
reduction in scores on the Edinburgh Post Natal Depression Scale. In
addition, program participants reported being more satisfied with their
parental role. There were also significant differences found on the home
environment with program participants experiencing a positive impact. Finally,
program participants reported significantly more satisfaction with the program
than control group members did with standard community health services.

SOURCES FOR MORE
INFORMATION

References:

Armstrong, K. L., Fraser, J. A., Dadd, M. R., & Morris, J.
(1999). A randomized, controlled trial of nurse home visiting to vulnerable
families with newborns. Journal of Pediatrics and Child Health, 35,237-244.


KEYWORDS: Home-based, Infants (0-12 months), Adolescents (12-17), Young Adults (18-24), Adolescent Mothers, Co-Ed, Parent or Family Component, Urban, Home Visitation, White or Caucasian, High-Risk, Child Maltreatment, Safety (Other); Physical Health (Other); Mental Health (Other).

Program
information last updated 11/13/06

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