Several studies looked at different types of
home visiting interventions to promote well - being and reduce the risk of depression, with mixed results.
We identified eight systematic reviews which covered the effectiveness of
home visiting interventions on outcomes relevant to this review (Benasich et al., 1992; Ciliska et al., 1996; Roberts et al., 1996; Guterman, 1997; Elkan et al., 2000; MacLeod and Nelson, 2000; MacMillan, 2000; Bernazzini, 2001).
Social support and
home visiting interventions have been successful in improving depressed mothers» moods and attitudes [71], [72], as well as their infants» attachment security and psychomotor development [46], [73].
The Department of Health and Human Services (HHS) should work with states to innovate and support promising program models that add to the evidence base for
home visiting interventions.
Effective Early Childhood Development Programs for Low - Income Families:
Home Visiting Interventions During Pregnancy and Early Childhood.
See also J. A. Fraser and others,
Home Visiting Interventions for Vulnerable Families with Newborns: Follow - Up Results of a Randomized Controlled Trial, Child Abuse and Neglect, 24 (2000) pp. 1399 — 1429.
Fraser and others,
Home Visiting Interventions for Vulnerable Families with Newborns: Follow - Up Results of a Randomized Controlled Trial (see note 45).
Harding and others, Healthy Families America Effectiveness: A Comprehensive Review of Outcomes (see note 34); Fraser and others,
Home Visiting Interventions for Vulnerable Families with Newborns: Follow - Up Results of a Randomized Controlled Trial (see note 45).
▶ The effectiveness of sustained nurse
home visiting interventions for vulnerable mothers delivered within a universal child and family heath service has been little studied.
Recent findings suggest that, regardless of parity, the group benefitting most from nurse
home visiting interventions are mothers living in impoverished areas who have lower psychosocial resources during pregnancy (despite the indices used to measure this).1 14 Trials that have had a broader client base, in terms of parity and risk, for example, the New Zealand Early Start programme, 8 15 however, have not yet reported subgroup analyses.
Effective Early Childhood Development Programs for Low - Income Families:
Home Visiting Interventions During Pregnancy and Early Childhood.
Intervention 2 -
home visits intervention: same schedule as phone support group with visits at home by the maternity nurse
We report the results of the first Australian randomised trial of a sustained nurse
home visiting intervention commencing antenatally and continuing to child - age 2 years for families living in a multicultural, socioeconomically disadvantaged urban community.
NFP
home visit intervention for high - risk first - time mothers.
Family Spirit Program Replication (PDF) Johns Hopkins University (2012) Provides an overview of the Family Spirit Program, an evidence - based and culturally tailored
home visiting intervention delivered by Native American paraprofessionals as a core strategy to support young, vulnerable Native parents.
The evidence reveals that intrapartum stressors and poor parenting can have lifelong impacts on infants with regard to their health, their development, and their ability to learn.6 The biological basis for
the home visiting intervention is discussed in more detail in this issue in Andrew Garner's article, «Home Visiting and the Biology of Toxic Stress: Opportunities to Address Childhood Adversity.»
This program involves the family or other support systems in the individual's treatment: Being
a home visiting intervention, the case managers observe interactions with the children and teach the parents and caregivers necessary skills for providing the best care to their child and how to eliminate health risks and make the house safer.
Family Spirit, an evidence - based, culturally - tailored
home visiting intervention for Native American mothers and children, and Together on Diabetes, a family - based diabetes prevention and management program for Native American youth, will lead this workshop.
Promoting First Relationships (PFR) is a manualized
home visiting intervention / prevention program which includes parent training components based on strengths - based practice, practical, and in - depth strategies for promoting secure and healthy relationships between caregivers and young children (birth to 3 years).
This study examined to what extent immigrant status and other factors play a role in determining measures of their children's health and well - being, and finally to investigate whether
a home visiting intervention modified any of these factors.
Not exact matches
And, indeed, the most effective attachment - focused
home -
visiting interventions offer parents not just parenting tips but psychological and emotional support: The
home visitors, through empathy and encouragement, literally make them feel better about their relationship with their infant and more secure in their identity as parents.
The Jamaica experiment makes a strong economic case for the potential effectiveness of some kind of
home -
visiting intervention with disadvantaged parents.
The most effective
intervention we have is a focus on parental attachment, through a public policy of
home visit programs, starting in the first days of a child's life.
At the end of chapter one I write about a variety of
interventions that provide emotional and psychological support to parents — from child - parent psychotherapy to Attachment and Biobehavioral Catch - up to attachment - based
home visiting.
Although not directly comparable, our findings are in broad agreement with those from routine data in Scotland that have indicated a positive association between Baby Friendly accreditation, but not certification, and breastfeeding at 1 week of age.17 Our findings reinforce those of Coutinho and colleagues who reported that high exclusive breastfeeding rates achieved in Brazilian hospitals implementing staff training with the course content of the Baby Friendly Hospital Initiative were short - lived and not sustained at
home unless implemented in combination with post-natal
home visits.35 Similarly in Italy, training of staff with an adapted version of the Baby Friendly course content resulted in high breastfeeding rates at discharge, with a rapid decrease in the days after leaving hospital.36 In contrast, a cluster randomized trial in Belarus (PROBIT) found an association between an
intervention modelled on the Baby Friendly Initiative with an increased duration of breastfeeding37 an association also reported from an observational study in Germany.38 Mothers in Belarus stay in hospital post-partum for 6 — 7 days, and in Germany for 5 days, with post-natal support likely to be particularly important in countries where mothers stay in the hospital for a shorter time, with early discharge likely to limit the influence of a hospital - based
intervention.
Home visitation is a type of service - delivery model that can be used to provide many different kinds of
interventions to target participants.1
Home visiting programs can vary widely in their goals, clients, providers, activities, schedules and administrative structure.
Evidence is emerging that the impact of high quality multidimensional
home visiting programs lasts long after the
intervention ends.
Home visiting programs vary in goals and content of services, but in general, they combine parenting and health care education, child abuse prevention, and early
intervention and education.
The nine national models that met the HHS evidence requirements as of October 2011 include Child FIRST, Early Head Start —
Home Visiting (EHS — HV), Early
Intervention Program for Adolescent Mothers (EIP), Family Check - Up, Healthy Families America (HFA), Healthy Steps,
Home Instruction for Parents of Preschool Youngsters (HIPPY), Nurse - Family Partnership (NFP), and Parents as Teachers (PAT).
Studies of
home visiting's effectiveness as an
intervention designed to prevent child maltreatment demonstrate some promise, but compared to the number of studies conducted that measure child maltreatment, risk for maltreatment, or protective factors, there are far more findings of no effects than reductions in maltreatment and improvements in child and family well - being.
One randomized controlled trial comparing
home -
visited families with control participants who received other community services found a statistically significant difference in mean depressive symptoms at two years post-enrollment, but this contrast was nonsignificant at three years post - enrollment.15 A second study of Early Head Start found no differences in depressive symptoms between
intervention and control group participants post-
intervention, although a difference was detected at a longer - term follow - up prior to children's enrollment in kindergarten.10 Other randomized controlled trial studies have not found effects of
home visitation on maternal depressive symptoms.12, 16,17
For example,
home visits are included with family training and counseling as part of the definition of early
intervention services under Part C and, according to the most recent data reports, approximately 87 % of all Part C services for infants and toddlers with developmental delays or disabilities are provided in
home settings.
Domestic violence, maternal depression, and addiction plague many
home visiting participants, which often makes effective
intervention with those families challenging for
home visiting professionals.
In instances when parents and children have needs beyond those addressed by the
home visiting program in which they are enrolled, they should be linked to additional resources available in their community, such as high - quality child care programs and comprehensive early childhood programs such as Early Head Start, early
intervention programs, health assistance programs, and mental health services.
Given the large number of
home visiting clients at risk for developing clinical depression, Tandon and colleagues have adapted an
intervention — the Mothers and Babies Course
Those models include: Child FIRST, Early Head Start -
Home Visiting, Early
Intervention Program for Adolescent Mothers (EIP), Early Start (New Zealand), Family Check - Up, Healthy Families America (HFA), Healthy Steps,
Home Instruction for Parents of Preschool Youngsters (HIPPY), Nurse Family Partnership (NFP), Oklahoma's Community - Based Family Resource and Support (CBFRS) Program, Parents as Teachers (PAT), Play and Learning Strategies (PALS) Infant6, and SafeCare Augmented.
Home visiting programs are generally more effective when services are provided to the neediest subgroups in a population (e.g., parents living in poverty, with psychological difficulties or children with disabilities) and when participants are fully involved in the
intervention.
The largest randomized trial of a comprehensive early
intervention program for low - birth - weight, premature infants (birth to age three), the Infant Health and Development Program, included a
home visiting component along with an educational centre - based program.7 At age three,
intervention group children had significantly better cognitive and behavioural outcomes and improved parent - child interactions.
While
home visiting programs vary in goals and content of services, in general, they combine parenting and health care education, child abuse prevention, and early
intervention and education services for young children and their families.
Evidence is emerging that the impact of multi-dimensional
home visiting programs lasts long after the
intervention ends.
Given the large number of
home visiting clients at risk for developing clinical depression, Tandon and colleagues have adapted an
intervention — the Mothers and Babies Course24 — for use in
home visitation as a depression prevention
intervention.
A smaller number of studies have examined
home visitation programs» identification of maternal depression, 9,11 and challenges related to programs» identification and response.13, 14 In recognition of the prevalence of maternal depression and
home visiting programs» limited response to this issue,
interventions aimed at preventing and treating maternal depression have been developed.
Eight existing
home visiting programs met the minimal legislative threshold for federal funding: Early Head Start, the Early Intervention Program, Family Check - up, Healthy Families America, Healthy Steps, Home Instruction Program for Preschool Youngsters, Nurse - Family Partnership, and Parents as Teachers.40 In August 2011, the Coalition for Evidence - Based Policy built upon the government's review by evaluating the extent to which programs implemented with fidelity would produce important improvements in the lives of at - risk children and parents.41 Through this review, one program was given a strong rating (the Nurse - Family Partnership), two were given medium ratings (Early Intervention Program and Family Check - up), and all other programs were given a low rat
home visiting programs met the minimal legislative threshold for federal funding: Early Head Start, the Early
Intervention Program, Family Check - up, Healthy Families America, Healthy Steps,
Home Instruction Program for Preschool Youngsters, Nurse - Family Partnership, and Parents as Teachers.40 In August 2011, the Coalition for Evidence - Based Policy built upon the government's review by evaluating the extent to which programs implemented with fidelity would produce important improvements in the lives of at - risk children and parents.41 Through this review, one program was given a strong rating (the Nurse - Family Partnership), two were given medium ratings (Early Intervention Program and Family Check - up), and all other programs were given a low rat
Home Instruction Program for Preschool Youngsters, Nurse - Family Partnership, and Parents as Teachers.40 In August 2011, the Coalition for Evidence - Based Policy built upon the government's review by evaluating the extent to which programs implemented with fidelity would produce important improvements in the lives of at - risk children and parents.41 Through this review, one program was given a strong rating (the Nurse - Family Partnership), two were given medium ratings (Early
Intervention Program and Family Check - up), and all other programs were given a low rating.
In 20 studies the
intervention (s) involved the child at various levels of intensity, from attendance at all sessions (e.g. Barrett et al., 2000 [20]-RRB-, attendance at some sessions for parental skills rehearsal (e.g. 3/8 sessions Pfiffner et al., 1990 [21]-RRB- or observation of children in another setting with feedback to parents during
home visits (Sanders & McFarland 2000 [22]-RRB-.
Studies were excluded where the
intervention (a) was aimed at prevention rather than treatment; (b) was aimed specifically at children, the whole family as a unit or at teachers; or (c) was non-structured, such as an informal support group or unstructured
home visits.
Other community - based
intervention packages that may reduce neonatal mortality include
home - based neonatal care and treatment and education of mothers and antenatal and postnatal
visits (low - certainty evidence).
The cabinet - level state agency was responsible for early
intervention programs,
home visiting, early care and education and child care licensing programs across the state, serving more than 50,000 children each year.
The detailed examples provided in midwives» accounts may usefully assist the reader in this regard, but further research is required to explore the topic more fully and to examine the impact of the
interventions identified (e.g. management of early labour,
home visits in early labour, delayed admission to hospital, water birth, Verbena cocktail) on the progress of labour and birth outcomes.
What is different with midwives in this qualitative study is that the
home visit in early labour was not a single
intervention but one part of a comprehensive package of midwifery care in early labour.
Intervention: package including use of a new continuum of care card, continuum of care orientation for health workers, 24 - hour health facility retention of mothers and newborns after delivery, and postnatal care by
home visits.