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Khang YH, Kim YM, Kim JH, Yu J, Oh R, June KJ, Cho SH, Lee JY, Cho HJ. Impact of the Korea Early Childhood Home-visiting Intervention (KECHI) on child health and development and maternal health: a randomised controlled trial protocol. BMJ Open 2024; 14:e082434. [PMID: 39122404 PMCID: PMC11404167 DOI: 10.1136/bmjopen-2023-082434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Randomised controlled trials (RCTs) of early childhood home-visiting interventions led by nurses have been conducted mainly in Western countries, whereas such trials have been limited in non-Western cultures, including Asia. In South Korea, a national nurse home visit programme (Korea Early Childhood Home-visiting Intervention (KECHI)) was developed in 2020 and launched throughout the country. We designed a pragmatic RCT to evaluate the effectiveness of KECHI on child health and development and maternal health. METHODS AND ANALYSIS Eligible participants will be pregnant women at <37 weeks of gestation with risk factor scores of 2 or over, who are sufficiently fluent in Korean to read and answer the questionnaire written in Korean and live in districts where the KECHI services are available. Eight hundred participants will be recruited from the general community and through the District Public Health Centres. The participants will be randomised 1:1 to KECHI plus usual care or usual care. KECHI encompasses 25-29 home visits, group activities and community service linkage. Participants will complete assessments at baseline (<37 weeks gestation), 6 weeks, 6 months, 12 months, 18 months and 24 months post partum. The six primary outcomes will be (1) home environment (assessed by Infant/Toddler Home Observation for Measurement of the Environment), (2) emergency department visits due to injuries, (3) child development (assessed using Korean Bayley Scales of Infant and Toddler Development-III), (4) breastfeeding duration, (5) maternal self-rated health and (6) community service linkage. ETHICS AND DISSEMINATION This trial has received full ethical approval from the Institutional Review Board of the Seoul National University Hospital. Written consent will be obtained from the participants. The results will be reported at conferences, disseminated through peer-reviewed publications and used by the Korean government to expand the KECHI services. TRIAL REGISTRATION NUMBER NCT04749888.
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Affiliation(s)
- Young-Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea
- The Support Team for the Early Life Health Management Program, Seoul, Republic of Korea
- The Support Team for the Seoul Healthy First Step Project, Seoul, Republic of Korea
| | - Yu-Mi Kim
- The Support Team for the Early Life Health Management Program, Seoul, Republic of Korea
- The Support Team for the Seoul Healthy First Step Project, Seoul, Republic of Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Joo Hyun Kim
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jungok Yu
- Department of Nursing, Dong-A University, Busan, Republic of Korea
| | - Rora Oh
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Kyung Ja June
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea
- The Support Team for the Early Life Health Management Program, Seoul, Republic of Korea
- The Support Team for the Seoul Healthy First Step Project, Seoul, Republic of Korea
- Department of Nursing, Soonchunhyang University, Cheonan, Republic of Korea
| | - Sung-Hyun Cho
- The Support Team for the Early Life Health Management Program, Seoul, Republic of Korea
- The Support Team for the Seoul Healthy First Step Project, Seoul, Republic of Korea
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Ji Yun Lee
- The Support Team for the Early Life Health Management Program, Seoul, Republic of Korea
- The Support Team for the Seoul Healthy First Step Project, Seoul, Republic of Korea
- Department of Nursing, Kangwon National University, Chuncheon, Republic of Korea
| | - Hong-Jun Cho
- The Support Team for the Early Life Health Management Program, Seoul, Republic of Korea
- The Support Team for the Seoul Healthy First Step Project, Seoul, Republic of Korea
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Rinne GR, Podosin M, Mahrer NE, Shalowitz MU, Ramey SL, Dunkel Schetter C. Prospective associations of prenatal stress with child behavior: Moderation by the early childhood caregiving environment. Dev Psychopathol 2024:1-12. [PMID: 38738363 DOI: 10.1017/s0954579424000920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Fetal exposure to prenatal stress can increase risk for psychopathology but postnatal caregiving may offset risk. This study tests whether maternal sensitivity and the home environment during early childhood modify associations of prenatal stress with offspring behavior in a sample of 127 mother-child pairs (n = 127). Mothers reported on perceived stress during pregnancy. Maternal sensitivity was rated by coders during a parent-child free play task when children were 4 years old. One year later, mothers reported on the home environment, child internalizing and externalizing behaviors, and children completed an assessment of inhibitory control. As hypothesized, the early childhood caregiving environment modified associations of prenatal stress with child behavior. Specifically, prenatal stress was associated with more internalizing behaviors at lower levels of maternal sensitivity and in home environments that were lower in emotional support and cognitive stimulation, but not at mean or higher levels. Furthermore, prenatal stress was associated with lower inhibitory control only at lower levels of maternal sensitivity, but not at higher levels. Maternal sensitivity and an emotionally supportive and cognitively stimulating home environment in early childhood may be important factors that mitigate risk for mental health problems among children exposed to prenatal stress.
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Catherine NLA, MacMillan H, Cullen A, Zheng Y, Xie H, Boyle M, Sheehan D, Lever R, Jack SM, Gonzalez A, Gafni A, Tonmyr L, Barr R, Marcellus L, Varcoe C, Waddell C. Effectiveness of nurse-home visiting in improving child and maternal outcomes prenatally to age two years: a randomised controlled trial (British Columbia Healthy Connections Project). J Child Psychol Psychiatry 2024; 65:644-655. [PMID: 37464862 DOI: 10.1111/jcpp.13846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND We investigated the effectiveness of Nurse-Family Partnership (NFP), a prenatal-to-age-two-years home-visiting programme, in British Columbia (BC), Canada. METHODS For this randomised controlled trial, we recruited participants from 26 public health settings who were: <25 years, nulliparous, <28 weeks gestation and experiencing socioeconomic disadvantage. We randomly allocated participants (one-to-one; computer-generated) to intervention (NFP plus existing services) or comparison (existing services) groups. Prespecified outcomes were prenatal substance exposure (reported previously); child injuries (primary), language, cognition and mental health (problem behaviour) by age two years; and subsequent pregnancies by 24 months postpartum. Research interviewers were masked. We used intention-to-treat analyses. (ClinicalTrials.gov, NCT01672060.) RESULTS: From 2013 to 2016 we enrolled 739 participants (368 NFP, 371 comparison) who had 737 children. Counts for child injury healthcare encounters [rate per 1,000 person-years or RPY] were similar for NFP (223 [RPY 316.17]) and comparison (223 [RPY 305.43]; rate difference 10.74, 95% CI -46.96, 68.44; rate ratio 1.03, 95% CI 0.78, 1.38). Maternal-reported language scores (mean, M [SD]) were statistically significantly higher for NFP (313.46 [195.96]) than comparison (282.77 [188.15]; mean difference [MD] 31.33, 95% CI 0.96, 61.71). Maternal-reported problem-behaviour scores (M [SD]) were statistically significantly lower for NFP (52.18 [9.19]) than comparison (54.42 [9.02]; MD -2.19, 95% CI -3.62, -0.75). Subsequent pregnancy counts were similar (NFP 115 [RPY 230.69] and comparison 117 [RPY 227.29]; rate difference 3.40, 95% CI -55.54, 62.34; hazard ratio 1.01, 95% CI 0.79, 1.29). We observed no unanticipated adverse events. CONCLUSIONS NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal-reported child language and mental health (problem behaviour) at age two years. Follow-up of long-term outcomes is warranted given that further benefits may emerge across childhood and adolescence.
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Affiliation(s)
| | | | - Ange Cullen
- Simon Fraser University, Vancouver, BC, Canada
| | - Yufei Zheng
- Simon Fraser University, Vancouver, BC, Canada
| | - Hui Xie
- Simon Fraser University, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | | | | | | | | | | | | | - Lil Tonmyr
- Public Health Agency of Canada, Ottawa, ON, Canada
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Cavallaro F, Clery A, Gilbert R, van der Meulen J, Kendall S, Kennedy E, Phillips C, Harron K. Evaluating the real-world implementation of the Family Nurse Partnership in England: a data linkage study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-223. [PMID: 38784984 DOI: 10.3310/bvdw6447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Background/objectives The Family Nurse Partnership is an intensive home visiting programme for adolescent mothers. We aimed to evaluate the effectiveness of the Family Nurse Partnership on outcomes up to age 7 using national administrative data. Design We created a linked cohort of all mothers aged 13-19 using data from health, educational and children's social care and defined mothers enrolled in the Family Nurse Partnership or not using Family Nurse Partnership system data. Propensity scores were used to create matched groups for analysis. Setting One hundred and thirty-six local authorities in England with active Family Nurse Partnership sites between 2010 and 2017. Participants Mothers aged 13-19 at last menstrual period with live births between April 2010 and March 2019, living in a Family Nurse Partnership catchment area and their firstborn child(ren). Interventions The Family Nurse Partnership includes up to 64 home visits by a family nurse from early pregnancy until the child's second birthday and is combined with usual health and social care. Controls received usual health and social care. Main outcome measures Indicators of child maltreatment (hospital admissions for injury/maltreatment, referral to social care services); child health and development (hospital utilisation and education) outcomes and maternal hospital utilisation and educational outcomes up to 7 years following birth. Data sources Family Nurse Partnership Information System, Hospital Episode Statistics, National Pupil Database. Results Of 110,520 eligible mothers, 25,680 (23.2%) were enrolled in the Family Nurse Partnership. Enrolment rates varied across 122 sites (range: 11-68%). Areas with more eligible mothers had lower enrolment rates. Enrolment was higher among mothers aged 13-15 (52%), than 18-19 year-olds (21%). Indicators of child maltreatment: we found no evidence of an association between the Family Nurse Partnership and indicators of child maltreatment, except for an increased rate of unplanned admissions for maltreatment/injury-related diagnoses up to age 2 for children born to Family Nurse Partnership mothers (6.6% vs. 5.7%, relative risk 1.15; 95% confidence interval 1.07 to 1.24). Child health and developmental outcomes: there was weak evidence that children born to Family Nurse Partnership mothers were more likely to achieve a Good Level of Development at age 5 (57.5% vs. 55.4%, relative risk 1.05; 95% confidence interval 1.00 to 1.09). Maternal outcomes: There was some evidence that Family Nurse Partnership mothers were less likely to have a subsequent delivery within 18 months of the index birth (8.4% vs. 9.3%, relative risk 0.92; 95% confidence interval 0.88 to 0.97). Younger and more vulnerable mothers received higher numbers of visits and were more likely to achieve fidelity targets. Meeting the fidelity targets was associated with some outcomes. Limitations Bias by indication and variation in the intervention and usual care over time and between areas may have limited our ability to detect effects. Multiple testing may have led to spurious, significant results. Conclusions This study supports findings from evaluations of the Family Nurse Partnership showing no evidence of benefit for maltreatment outcomes measured in administrative data. Amongst all the outcomes measured, we found weak evidence that the Family Nurse Partnership was associated with improvements in child development at school entry, a reduction in rapid repeat pregnancies and evidence of increased healthcare-seeking in the mother and child. Future work Future evaluations should capture better measures of Family Nurse Partnership interventions and usual care, more information on maternal risk factors and additional outcomes relating to maternal well-being. Study registration The study is registered as NIHR CRN Portfolio (42900). Funding This award was funded by the National Institute of Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/99/19) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 11. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
| | - Amanda Clery
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Ruth Gilbert
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jan van der Meulen
- UCL Great Ormond Street Institute of Child Health, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Sally Kendall
- UCL Great Ormond Street Institute of Child Health, London, UK
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Eilis Kennedy
- UCL Great Ormond Street Institute of Child Health, London, UK
- Eilis Kennedy, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Catherine Phillips
- UCL Great Ormond Street Institute of Child Health, London, UK
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Katie Harron
- UCL Great Ormond Street Institute of Child Health, London, UK
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Rusanen E, Lahikainen AR, Vierikko E, Pölkki P, Paavonen EJ. A Longitudinal Study of Maternal Postnatal Bonding and Psychosocial Factors that Contribute to Social-Emotional Development. Child Psychiatry Hum Dev 2024; 55:274-286. [PMID: 35870058 PMCID: PMC10796530 DOI: 10.1007/s10578-022-01398-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/23/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022]
Abstract
In this longitudinal study, we examined how maternal bonding and psycho-social factors are associated with social-emotional problems in two-year-old children. Our data came from a birth cohort from which data were collected at four timepoints: prenatally during the third trimester, and postnatally at 3, 8 and 24 months. The participants were 1,667 mothers, of which 943 (56.6%) returned the questionnaire at each timepoint of the longitudinal study. The Children's social-emotional problems were examined using the Brief Infant-Toddler Social and Emotional Assessment. According to linear regression analysis, maternal bonding difficulties at three and eight months, maternal expectations of the unborn baby during pregnancy, and maternal relationships within and outside the family were related to social-emotional problems in children of two years of age. The results highlight the importance of screening mothers who already prenatally have bonding problems or mothers who have bonding problems postnatally to provide effective and targeted intervention support.
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Affiliation(s)
- E Rusanen
- Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.
- Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - A R Lahikainen
- Faculty of Social Sciences, University of Tampere, FI-33014, Tampere, Finland
| | - E Vierikko
- Faculty of Social Sciences, Tampere University, FI-33014, Tampere, Finland
| | - P Pölkki
- Department of Social Sciences, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - E J Paavonen
- Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 400, 00029, HUS, Finland
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Schepan ML, Jungmann T, Kliem S, Siegert C, Sandner M, Brand T. What contributes to the long-term implementation of an evidence-based early childhood intervention: a qualitative study from Germany. FRONTIERS IN HEALTH SERVICES 2024; 3:1159976. [PMID: 38313330 PMCID: PMC10834770 DOI: 10.3389/frhs.2023.1159976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024]
Abstract
Background Rigorous research trials have demonstrated that early childhood interventions can reach socially disadvantaged families and can have a lasting impact on the healthy development of their children. However, little is known about the internal and contextual factors that contribute to the long-term implementation of such interventions. In this study, we investigated the development of the home visiting program Pro Kind. The program was adapted from the evidence-based US-American Nurse-Family Partnership program and was implemented in Germany in 2006. Using an exploratory approach, we examined factors contributing to the long-term implementation of this program. Methods Qualitative interviews with program implementers (midwives, social workers, program managers) of the Pro Kind program and key stakeholders in two cities in Germany were conducted. Interview guides were developed to assess participants' perceptions and experiences on how the program had developed over time internally and in the interaction with its environment. Data were collected between March and September 2021. Drawing on the Consolidated Framework for Implementation Research (CFIR), data was coded according to the principles of thematic analysis. Results A total of 25 individuals (11 program implementers, 14 key stakeholders) were interviewed. The identified factors related to three out of five domains of the CFIR model in our analysis. First, regarding the intervention characteristics, the evidence of effectiveness and the relative advantage of the implementation of the program compared to similar interventions were viewed as contributors to long-term implementation. However, the program's adaptability was discussed as a constraining factor for reaching the target group. Second, concerning the inner setting, stakeholders and program implementers perceived the implementation climate, the leadership engagement and the program's size as relevant factors for networking strategies and program visibility. Third, as part of the outer setting, the degree of networking with external stakeholders was highlighted of great importance for the program. Conclusions We identified several factors of particular importance for the long-term implementation and sustainability of an early childhood intervention at the practice level, particularly in the local context in Germany. These findings should inform the design of impactful, scalable, and sustainable early childhood interventions targeting disadvantaged families.
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Affiliation(s)
- Marie Lisanne Schepan
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
- Department of Public Health, University of Bremen, Bremen, Germany
| | - Tanja Jungmann
- Department of Special Needs Education and Rehabilitation, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Sören Kliem
- Department of Social Work, Ernst-Abbe-Hochschule Jena, University of Applied Sciences, Jena, Germany
| | - Carolin Siegert
- Department of Social Work, Ernst-Abbe-Hochschule Jena, University of Applied Sciences, Jena, Germany
| | - Malte Sandner
- Department of Business Administration, Nuremberg Institute of Technology, Nuremberg, Germany
| | - Tilman Brand
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
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Costantini I, López-López JA, Caldwell D, Campbell A, Hadjipanayi V, Cantrell SJ, Thomas T, Badmann N, Paul E, James DM, Cordero M, Jewell T, Evans J, Pearson RM. Early parenting interventions to prevent internalising problems in children and adolescents: a global systematic review and network meta-analysis. BMJ MENTAL HEALTH 2023; 26:e300811. [PMID: 37907332 PMCID: PMC10619111 DOI: 10.1136/bmjment-2023-300811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/14/2023] [Indexed: 11/02/2023]
Abstract
QUESTION We compared the effectiveness of different types of parenting interventions based on an a priori taxonomy, and the impact of waitlists versus treatment as usual (TAU), in reducing child internalising problems. STUDY SELECTION AND ANALYSIS We conducted a systematic review and network meta-analysis of published and unpublished randomised controlled trials (RCTs) until 1 October 2022 that investigated parenting interventions with children younger than 4 years. EXCLUSION CRITERIA studies with children born preterm, with intellectual disabilities, or families receiving support for current abuse, neglect, and substance misuse. We assessed the certainty of evidence using the Confidence in Network Meta-Analysis framework. We used random-effects network meta-analysis to estimate standardised mean differences (SMDs) with 95% credible intervals (CrIs). FINDINGS Of 20 520 citations identified, 59 RCTs (18 349 participants) were eligible for the network meta-analysis. Parenting interventions focusing on the dyadic relationship (SMD: -0.26, 95% CrI: -0.43 to -0.08) and those with mixed focus (-0.09, -0.17 to -0.02) were more effective in reducing internalising problems than TAU at the first time point available. All interventions were more effective than waitlist, which increased the risk of internalising problems compared with TAU (0.36, 0.19 to 0.52). All effects attenuated at later follow-ups. Most studies were rated as with 'high risk' or 'some concerns' using the Risk of Bias Assessment Tool V.2. There was no strong evidence of effect modification by theoretically informed components or modifiers. CONCLUSIONS We found preliminary evidence that relationship-focused and mixed parenting interventions were effective in reducing child internalising problems, and the waitlist comparator increased internalising problems with implications for waiting times between referral and support. Considering the high risk of bias of most studies included, the findings from this meta-analysis should be interpreted with caution. PROSPERO registration number CRD42020172251.
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Affiliation(s)
- Ilaria Costantini
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
- Division of Psychiatry, University College London, London, UK
| | - José A López-López
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Department of Basic Psychology and Methodology, University of Murcia, Murcia, Spain
| | - Deborah Caldwell
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Amy Campbell
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | | | - Sarah J Cantrell
- Department of Paediatrics, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa
| | | | | | - Elise Paul
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Deborah M James
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Miguel Cordero
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Tom Jewell
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Jonathan Evans
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Rebecca M Pearson
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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de Oliveira RC, Altafim ERP, Gaspardo CM, Linhares MBM. Strengthening mother-child interactions among mothers and children with behavior problems at early development. CURRENT PSYCHOLOGY 2023; 43:1-13. [PMID: 37359573 PMCID: PMC10234235 DOI: 10.1007/s12144-023-04786-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/28/2023]
Abstract
The present study examined the effectiveness of a personalized remote video feedback parenting program to improve mother-child interactions and child behavior outcomes among mothers of children with behavior problems in comparison to counterparts with no behavior problems. The sample comprised 60 mothers and their 2-to-6-year-old children, including children with behavior problems (BP = 19) and children without behavior problems (NoBP = 41). The Strengthening Bonds program included one in-person group session and remote personalized video feedback about their mother-child interactions in a play situation via smartphone for six weeks. Mother-child interactions were the primary outcome, and children's behaviors were the secondary outcome. Pre- and post-intervention assessments were performed. The mother-child interactions were recorded during free- and structured-play situations and were then analyzed by the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) and the Dynamics of the dyad activity coding system. Additionally, the mothers answered the Strengths and Difficulties Questionnaire. The results showed that, in the post-intervention, the mother-child interaction pattern improved in the BP group, especially in the teaching dimension of the PICCOLO. Also, after the program, more children with normal classification were in the BP group.
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Affiliation(s)
- Rebeca Cristina de Oliveira
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Maria Beatriz Martins Linhares
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Prédio da Saúde Mental, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Campus Universitário Monte Alegre - USP, Av. Tenente Catão Roxo, 2650, Ribeirão Preto, SP CEP 14048-900 Brazil
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Hirve R, Adams C, Kelly CB, McAullay D, Hurt L, Edmond KM, Strobel N. Effect of early childhood development interventions delivered by healthcare providers to improve cognitive outcomes in children at 0-36 months: a systematic review and meta-analysis. Arch Dis Child 2023; 108:247-257. [PMID: 36732037 DOI: 10.1136/archdischild-2022-324506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/07/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the effect of early childhood development interventions delivered by healthcare providers (HCP-ECD) on child cognition and maternal mental health. DESIGN Systematic review, meta-analysis. SETTING Healthcare setting or home. PARTICIPANTS Infants under 1 month of age. INTERVENTIONS HCP-ECD interventions that supported responsive caregiving, early learning and motor stimulation. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews were searched until 15 November 2021. Studies reporting prespecified outcomes were pooled using standard meta-analytical methods. MAIN OUTCOME MEASURES Cognitive development in children at 0-36 months. RESULTS Forty-two randomised controlled trials with 15 557 infants were included in the narrative synthesis. Twenty-seven trials were included in the meta-analyses. Pooled data from 13 trials suggest that HCP-ECD interventions may improve cognitive outcomes in children between 0 and 36 months (Bayley Scales of Infant Development version IIII (BSID-III) mean difference (MD) 2.65; 95% CI 0.61 to 4.70; 2482 participants; low certainty of evidence). Pooled data from nine trials suggest improvements in motor development (BSID-III MD 4.01; 95% CI 1.54 to 6.48; 1437 participants; low certainty of evidence). There was no evidence of improvement in maternal mental health (standardised MD -0.13; 95% CI -0.28 to 0.03; 2806 participants; 11 trials; low certainty of evidence). CONCLUSIONS We report promising evidence, particularly for cognitive and motor outcomes, of the effect of HCP-ECD interventions. However, effect sizes were small, and the certainty of evidence ranged from very low to moderate. Additional high-quality research is required. PROSPERO REGISTRATION NUMBER CRD42019122021.
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Affiliation(s)
- Raeena Hirve
- Women and Children's Health, King's College London, London, UK
| | - Claire Adams
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Clare B Kelly
- Women and Children's Health, King's College London, London, UK
| | - Daniel McAullay
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lisa Hurt
- Population Medicine, Cardiff University, Cardiff, UK
| | - Karen M Edmond
- Women and Children's Health, King's College London, London, UK
| | - Natalie Strobel
- Edith Cowan University, Joondalup, Western Australia, Australia
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Shin J, Kim GS. Patterns of change and factors associated with IADL function decline in community-dwelling older adults with arthritis. Sci Rep 2022; 12:16840. [PMID: 36207328 PMCID: PMC9546837 DOI: 10.1038/s41598-022-19791-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 09/05/2022] [Indexed: 11/23/2022] Open
Abstract
Arthritis is a major cause of functional decline, which affects the quality of life (QoL) of older adults. This study analyzed instrumental activities of daily living (IADL) patterns in older adults with arthritis and the risk factors of functional decline. Data from the Korean Longitudinal Study of Aging (KLoSA), in which the participants were community-dwelling older adults aged ≥ 65 years and conducted every two years, were used to examine patterns in IADL performance between 2006 and 2016. The participants comprised 1,822 older adults, divided into an arthritis group and a non-arthritis group. A Generalized Estimating Equations (GEE) model and Kaplan–Meier analysis was used for the data analysis. The arthritis groups showed a statistically significant decrease in IADL function in 2012 (β = 1.283, p = 0.026), 2014 (β = 1.323, p = 0.028), and 2016 (β = 1.484, p = 0.014). The GEE model identified psychological conditions (depressive symptoms, cognitive function) and number of chronic diseases in the arthritis group as risk factors for increased IADL dependence. Healthcare providers should develop strategies to manage long-term functional decline, including programs to manage and prevent chronic diseases, cognitive function decline, and keep depressive symptoms under control, beginning within six years of arthritis diagnosis.
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Affiliation(s)
- Jinhee Shin
- College of Nursing, Woosuk University, Wanju, Jeollabuk-do, 55338, Republic of Korea
| | - Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea.
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11
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Waters CS, Cannings-John R, Channon S, Lugg-Widger F, Robling M, Paine AL. The impact of a specialist home-visiting intervention on the language outcomes of young mothers and their children: a pragmatic randomised controlled trial. BMC Psychol 2022; 10:224. [PMID: 36151554 PMCID: PMC9508755 DOI: 10.1186/s40359-022-00926-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young mothers are more likely to provide a suboptimal early language environment for their children who in turn show impairments in their language development, yet few studies have used observational methods to assess the effectiveness of home-visiting programmes in improving the language outcomes of young mothers and their children. The Family Nurse Partnership (FNP) is a licensed home-visiting intervention developed in the USA and introduced into practice in England. The intervention involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained Family Nurses. We assessed the effectiveness of FNP in improving the language outcomes of first-time teenage mothers and their infants. METHOD We conducted a pragmatic, non-blinded, randomised controlled trial to test whether the FNP programme improved mothers' and children's language production at 24 months postpartum. Eligible participants were nulliparous, aged 19 years or younger, and were recruited at less than 25 weeks' gestation from community midwifery settings (Country). Pregnant young mothers were randomly assigned to FNP plus usual care (n = 243) or usual care alone (n = 233). At 24 months postpartum, mother-child dyads were observed during a standardised free-play task with their first-born child and features of their language production was coded. Data was analysed using multi-level modelling; linear or poisson/negative binomial regression models were used as appropriate. RESULTS A small effect of FNP on mothers' productive language was detected, where mothers in the FNP group demonstrated higher mean length of utterances than mothers who received usual care alone, mean difference (adjusted by minimisation variables and by site, linear regression) = 0.10, p < .05, 95% CI (0.004-0.20), d = .18. No differences were detected between groups regarding other characteristics of maternal language or children's language outcomes. CONCLUSION This observational study conducted within the context of a randomised-controlled trial suggests that the FNP home-visiting programme may have a small, but potentially important impact on young mothers' speech to their toddlers. Exploratory analyses identified family environment, maternal, and child related predictors of the language outcomes of young mothers and their offspring. Trial registration This trial is registered with ISRCTN, number ISRCTN23019866, 20/04/2009.
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Affiliation(s)
- Cerith S Waters
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT, Wales, UK.
| | - Rebecca Cannings-John
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, Wales, UK
| | - Susan Channon
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, Wales, UK
| | - Fiona Lugg-Widger
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, Wales, UK
| | - Mike Robling
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, Wales, UK
| | - Amy L Paine
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT, Wales, UK
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Le Bas G, Youssef G, Macdonald JA, Teague S, Mattick R, Honan I, McIntosh JE, Khor S, Rossen L, Elliott EJ, Allsop S, Burns L, Olsson CA, Hutchinson D. The Role of Antenatal and Postnatal Maternal Bonding in Infant Development. J Am Acad Child Adolesc Psychiatry 2022; 61:820-829.e1. [PMID: 34555489 DOI: 10.1016/j.jaac.2021.08.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 08/09/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The affectional bond experienced by a mother toward her developing fetus/infant has been theorized to be a critical factor in determining infant developmental outcomes; yet there remains a paucity of research in this area, and a lack of high-quality longitudinal studies. This study aimed to examine the extent to which mother-to-infant bonding predicted infant development in a multi-wave longitudinal pregnancy cohort study (N = 1,347). METHOD Self-reported bonding was assessed using the Maternal Antenatal Attachment Scale at each trimester, and the Maternal Postnatal Attachment Scale at 8 weeks and 12 months postpartum. Infant development was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 12 months. RESULTS Bonding predicted indicators of infant social-affective development, including social-emotional, behavioral, and temperamental outcomes. Effect sizes ranged from small to moderate, increasing over the perinatal period (β = 0.11-0.27). Very small effects were also identified in the relationship between bonding and cognitive, language, and motor development (β = 0.06-0.08). CONCLUSION Findings suggest that a mother's perceived emotional connection with her child plays a role in predicting social-affective outcomes; prediction may not extend to other domains of infant development. Maternal bonding may therefore be a potentially modifiable predictor of infant social-affective outcomes, offering important considerations for preventive intervention.
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Affiliation(s)
- Genevieve Le Bas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - George Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Samantha Teague
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ingrid Honan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jennifer E McIntosh
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia; The Bouverie Centre, La Trobe University, Bundoora, Australia
| | - Sarah Khor
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Larissa Rossen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; The British Columbia Children's Hospital Research Institute, The University of British Columbia, Canada
| | - Elizabeth J Elliott
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia; The Sydney Children's Hospitals Network at Westmead, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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The Impact of Nurse Home Visiting on the Use, Dose and Quality of Formal Childcare: 3-Year Follow-Up of a Randomized Trial. Acad Pediatr 2022; 22:233-243. [PMID: 34365030 DOI: 10.1016/j.acap.2021.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We investigated whether nurse home visiting (NHV) affects the uptake and quality of formal early childhood education and care (ECEC) at child ages 2 and 3 years, and reasons for using ECEC at 3 years. METHODS Design: Secondary analysis of the "right@home" randomized trial of NHV. PARTICIPANTS 722 pregnant Australian, English-speaking women experiencing adversity recruited from antenatal clinics across 2 states. INTERVENTION 25 nurse home visits to 2 years; Control: universal well-child nursing service. MEASURES Parents reported formal ECEC use (government approved and subsidized), comprising long or family day care (LDC), and reasons for use. ECEC quality was classified using the Australian government's national ratings. Eighty-three percent of parents provided data at 2 years (306 intervention/290 control); and 69% at 3 years (255 intervention/240 control). ANALYSIS Intention-to-treat analyses were conducted using adjusted regression models, addressing missing data using multiple imputation and inverse probability weighting. RESULTS There was no evidence of group differences in ECEC uptake or quality, although control families may have used more LDC at 3 years (mean difference 2.8 hours, 95% confidence interval, -0.2 to 5.8 hours). Intervention parents reported using ECEC to support their children's social development more frequently than controls (48% vs 33%) but less for work/study (39% vs 46%). CONCLUSIONS The right@home NHV program did not impact ECEC uptake or quality, although it may influence parents' reasons for using ECEC. If supported by policy and provision, there is an opportunity for NHV programs to promote the transition to high-quality ECEC and evaluate the synergistic benefit on children's development.
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Solís-Cordero K, Duarte LS, Jeong J, Fujimori E. Effectiveness of different health delivery agents of parenting stimulation interventions on child development outcomes among children aged 0 to 36 months: a systematic review protocol. JBI Evid Synth 2022; 20:874-881. [PMID: 34768255 DOI: 10.11124/jbies-21-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This review will evaluate the effectiveness of different health delivery agents of parenting stimulation interventions versus usual care, no intervention, or a different type of delivery agent on child development outcomes among children aged 0 to 36 months. INTRODUCTION Stimulation interventions vary in terms of implementation. While some interventions are delivered by professionals, most are delivered by non-professionals. Several prior systematic reviews on this topic have been conducted; however, no known study has evaluated the effectiveness of stimulation interventions on child development by type of delivery agent. INCLUSION CRITERIA This review will consider randomized controlled trials assessing parenting stimulation interventions delivered by different health delivery agents. These will be compared to usual care, no intervention, or a different delivery agent, targeted at caregiver-child dyads of children aged 0 to 36 months. The outcomes will include motor, language, cognitive, and socio-emotional development. The review will exclude studies including children with specific characteristics, interventions that do not focus on parenting, and protocols of randomized clinical trials. METHODS The review will include both published and unpublished studies. The key information sources to be searched are: MEDLINE, APA (PsycNet), Embase, Scopus, Web of Science Core Collection, CINAHL, VHL Regional Portal, Google Scholar, Science Direct, Theses Canada Portal, and Library and Archives Canada. Studies in English, Spanish, and Portuguese will be included. Critical appraisal and data extraction will be conducted using standardized tools. Quantitative data, where possible, will be pooled in statistical meta-analysis, or if statistical pooling is not possible, the findings will be reported narratively. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021245245.
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Affiliation(s)
- Katherine Solís-Cordero
- School of Nursing, University of São Paulo, São Paulo, Brazil
- Costa Rican Evidence-Based Nursing Research Collaboration Program (CIEBE-CR): A JBI Affiliated Group, San José, Costa Rica
| | - Luciane Simões Duarte
- Chronic Noncommunicable Diseases Division, Disease Control Coordination, São Paulo State Health Department, São Paulo, Brazil
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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Kaminski JW, Robinson LR, Hutchins HJ, Newsome KB, Barry CM. Evidence base review of couple- and family-based psychosocial interventions to promote infant and early childhood mental health, 2010-2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:23-55. [PMID: 34783041 PMCID: PMC10995740 DOI: 10.1111/jmft.12570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
Infant and early childhood mental health (IECMH) has been defined as the capacity of infants and young children to regulate their emotions, form secure relationships, and explore their environments. For this special issue, we conducted a review of IECMH outcomes from evaluations of couple- and family-based psychosocial interventions not explicitly designed for trauma exposure published from 2010 through 2019, following Evidence Base Update criteria and the current convention of classifying general categories of intervention approaches rather than the former practice of evaluating specific brand-name packaged programs. Full-text review of 695 articles resulted in 39 articles eligible for categorization into intervention approaches, taking into consideration the theoretical orientation of the treatment, the population served, the intervention participants, the target outcomes, the treatment theory of change, and the degree to which the intervention was standardized across participants. Four intervention approaches were identified in this review as Probably Efficacious: Behavioral Interventions to Support Parents of Toddlers, Interventions to Support Adolescent Mothers, Tiered Interventions to Provide Support Based on Assessed Risk, and Home Visiting Interventions to Provide Individualized Support to Parents. Other intervention approaches were classified as Possibly Efficacious, Experimental, or did not have sufficient evidence in this time period to classify under these criteria. Further research could explore how to ensure that all families who need support can receive it, such as by increasing the reach of effective programs and by decreasing the number of families needing additional support.
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Affiliation(s)
- Jennifer W. Kaminski
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
| | - Lara R. Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
| | - Helena J. Hutchins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, Tennessee, USA
| | - Kimberly B. Newsome
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
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Bohingamu Mudiyanselage S, Price AMH, Mensah FK, Bryson HE, Perlen S, Orsini F, Hiscock H, Dakin P, Harris D, Noble K, Bruce T, Kemp L, Goldfeld S, Gold L. Economic evaluation of an Australian nurse home visiting programme: a randomised trial at 3 years. BMJ Open 2021; 11:e052156. [PMID: 34873002 PMCID: PMC8650480 DOI: 10.1136/bmjopen-2021-052156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To investigate the additional programme cost and cost-effectiveness of 'right@home' Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care. DESIGN A cost-utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%. Analysis used an intention-to-treat approach with multiple imputation. SETTING The right@home was implemented from 2013 in Victoria and Tasmania states of Australia, as a primary care service for pregnant women, delivered until child age 2 years. PARTICIPANTS 722 pregnant Australian women experiencing adversity received NHV (n=363) or usual care (clinic visits) (n=359). PRIMARY AND SECONDARY OUTCOME MEASURES First, a cost-consequences analysis to compare the additional costs of NHV over usual care, accounting for any reduced costs of service use, and impacts on all maternal and child outcomes assessed at 3 years. Second, cost-utility analysis from a government-as-payer perspective compared additional costs to maternal QALYs to express cost-effectiveness in terms of additional cost per additional QALY gained. RESULTS When compared with usual care at child age 3 years, the right@home intervention cost $A7685 extra per woman (95% CI $A7006 to $A8364) and generated 0.01 more QALYs (95% CI -0.01 to 0.02). The probability of right@home being cost-effective by child age 3 years is less than 20%, at a willingness-to-pay threshold of $A50 000 per QALY. CONCLUSIONS Benefits of NHV to parenting at 2 years and maternal health and well-being at 3 years translate into marginal maternal QALY gains. Like previous cost-effectiveness results for NHV programmes, right@home is not cost-effective at 3 years. Given the relatively high up-front costs of NHV, long-term follow-up is needed to assess the accrual of health and economic benefits over time. TRIAL REGISTRATION NUMBER ISRCTN89962120.
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Affiliation(s)
| | - Anna M H Price
- Population Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Fiona K Mensah
- Population Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Hannah E Bryson
- Population Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Susan Perlen
- Population Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Francesca Orsini
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC, 3052, Australia
- Melbourne Children's Trials Centre, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Harriet Hiscock
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Penelope Dakin
- Australian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia
| | - Diana Harris
- Australian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia
| | - Kristy Noble
- Australian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia
| | - Tracey Bruce
- Ingham Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Lynn Kemp
- Ingham Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Sharon Goldfeld
- Population Health, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia
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Bryson H, Perlen S, Price A, Mensah F, Gold L, Dakin P, Goldfeld S. Patterns of maternal depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum in an Australian cohort experiencing adversity. Arch Womens Ment Health 2021; 24:987-997. [PMID: 34036464 PMCID: PMC8148407 DOI: 10.1007/s00737-021-01145-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/11/2021] [Indexed: 12/17/2022]
Abstract
The objective of this study is to describe the longitudinal patterns of depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum, in a cohort of Australian mothers experiencing adversity. Longitudinal data were drawn from the control group of a trial of nurse home visiting. Pregnant women experiencing adversity (≥ 2 of 10 adversity risk factors) were recruited from antenatal clinics across 2 Australian states (30 April 2013-29 August 2014). Women completed the Depression Anxiety and Stress Scales short-form (DASS-21) at 11 time-points from pregnancy to 5 years postpartum. DASS-21 scores were summarized at each time-point for all women and by level of adversity risk. Three hundred fifty-nine women (100%) completed the DASS-21 in pregnancy and 343 (96%) provided subsequent data. Mental health symptoms were highest in pregnancy and at 4 and 5 years postpartum. While this pattern was comparable across levels of antenatal adversity risk, women with greatest adversity risk had consistently higher mental health symptoms. In a cohort of mothers experiencing adversity, depression, anxiety, and stress symptoms were highest in pregnancy and at 4 to 5 years postpartum. The striking patterns of persistent, high, mental health symptoms, beyond the first year postpartum, can inform a more equitable and responsive health system.
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Affiliation(s)
- Hannah Bryson
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Vic, 3052, Australia.
- Population Health, Murdoch Children's Research Institute, Parkville, Vic, 3052, Australia.
| | - Susan Perlen
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Vic, 3052, Australia
- Population Health, Murdoch Children's Research Institute, Parkville, Vic, 3052, Australia
| | - Anna Price
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Vic, 3052, Australia
- Population Health, Murdoch Children's Research Institute, Parkville, Vic, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Vic, 3052, Australia
| | - Fiona Mensah
- Population Health, Murdoch Children's Research Institute, Parkville, Vic, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Vic, 3052, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Burwood, Vic, 3125, Australia
| | - Penelope Dakin
- Australian Research Alliance for Children and Youth, Canberra City, ACT, 2601, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Vic, 3052, Australia
- Population Health, Murdoch Children's Research Institute, Parkville, Vic, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Vic, 3052, Australia
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Donelan-McCall NS, Knudtson MD, Olds DL. Maternal and Child Mortality: Analysis of Nurse Home Visiting in 3 RCTs. Am J Prev Med 2021; 61:483-491. [PMID: 34420828 DOI: 10.1016/j.amepre.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The impact of intensive prenatal and infant/toddler nurse home visiting on low-income mothers' and children's survival was examined in 3 RCTs following participants over 2-decade periods after trial registration during pregnancy (data gathered between 1978 and 2015 and analyzed between 2016 and 2020). METHODS All-cause and external-cause maternal mortality and preventable-cause child mortality were examined using National Death Index data. Survival rates were calculated for all the 1,138 mothers randomized and 1,076 live-born children in the second RCT (conducted in Memphis, TN) and for all the 1,135 mothers randomized and 1,087 live-born children in the first and third RCTs combined (conducted in Elmira, NY and Denver, CO). RESULTS There were no significant nurse home visiting-control differences in maternal mortality in Memphis or Elmira and Denver. Posthoc analysis, combining all 3 trials, suggested a reduction in external-cause maternal mortality among nurse-visited mothers (p=0.054). There was a marginally significant nurse home visiting-control difference in preventable-cause child mortality (p=0.09) in Memphis. CONCLUSIONS These results support examining maternal and child mortality in additional nurse home visiting trials with larger samples living in disadvantaged contexts. Intensive prenatal and infant/toddler home visiting by nurses for mothers and children living in poverty may decrease premature death.
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Affiliation(s)
- Nancy S Donelan-McCall
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael D Knudtson
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David L Olds
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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Kliem S, Sandner M. Prenatal and Infancy Home Visiting in Germany: 7-Year Outcomes of a Randomized Trial. Pediatrics 2021; 148:peds.2020-049610. [PMID: 34326178 DOI: 10.1542/peds.2020-049610] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Given the lasting positive effects of prenatal and infancy home visiting in the United States on disadvantaged mothers and children at school age, we analyzed the follow-up effects of a German home visiting program (ProKind). We hypothesized improvements in 3 domains at child age 7 years: (1) child development and life satisfaction, (2) maternal mental health and life satisfaction, and (3) adverse parenting, abusive parenting, and neglectful parenting. METHODS We conducted a randomized controlled trial of home visiting, enrolling 755 pregnant, low-income women with no previous live births. The intervention comprised 32.7 home visits by family midwives and/or social pedagogues until child age 2 years. Assessments were completed on 533 7-year-old firstborn offspring to evaluate 8 primary hypotheses. RESULTS We found significant positive effects for 4 of the 8 primary hypotheses. Mothers in the intervention group reported fewer behavioral problems among their children in the Child Behavior Checklist (effect size [ES] = 0.21; 95% confidence interval [CI]: 0.03 to 0.38), less child abusive parenting (ES = 0.19; 95% CI: 0.00 to 0.37), fewer maternal mental health problems (ES = 0.25; 95% CI: 0.07 to 0.43), and higher maternal life satisfaction (ES = 0.25; 95% CI: 0.07 to 0.43). Additional preregistered subgroup analyses regarding child sex revealed larger effects for boys and mothers of boys. CONCLUSIONS The results suggest that in a western European welfare state, home visiting targeting disadvantaged mothers has lasting effects in important outcome domains. Therefore, home visits also appear to be an effective and efficient public health intervention in European settings.
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Affiliation(s)
- Sören Kliem
- Department of Social Work, Ernst-Abbe-Hochschule Jena, University of Applied Science, Jena, Germany
| | - Malte Sandner
- Institute for Employment Research, Federal Employment Agency, Nuremberg, Germany
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Mortaji N, Krzeczkowski JE, Boylan K, Booij L, Perreault M, Van Lieshout RJ. Maternal pregnancy diet, postnatal home environment and executive function and behavior in 3- to 4-y-olds. Am J Clin Nutr 2021; 114:1418-1427. [PMID: 34159358 PMCID: PMC8491573 DOI: 10.1093/ajcn/nqab202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Optimal maternal nutrition during pregnancy has been linked to better cognitive and behavioral development in children. However, its influence on the effects of suboptimal postnatal exposures like reduced stimulation and support in the home is not known. OBJECTIVES To examine the effect of maternal pregnancy diet on executive function and/or behavioral development in children raised in suboptimal home environments. METHODS Data were provided by 808 mother-infant dyads from the Canadian Maternal-Infant Research on Environmental Chemicals-Child Development study. Maternal pregnancy diet was self-reported using the Healthy Eating Index 2010 questionnaire. Stimulation and support in the home was assessed using the Home Observation for Measurement of the Environment (HOME) when children were 3-4 y old. Child executive function was reported by mothers at this age using the Behavior Rating Inventory of Executive Functioning-Preschool Edition, and child behavior was assessed using the Behavior Assessment System for Children-2nd Edition. We examined the interaction of maternal pregnancy diet and postnatal HOME scores on child executive function and behavior using linear regression adjusted for maternal education, postpartum depression, prepregnancy BMI, and smoking. RESULTS Maternal pregnancy diet was associated with an increasingly positive association with child working memory (β: 0.21; 95% CI: 0.82, 3.41; P = 0.001), planning (β: 0.17; 95% CI: 0.38, 2.84; P = 0.007), and adaptability (β: -0.13; 95% CI: -1.72, -0.08; P = 0.032) as levels of postnatal stimulation decreased. CONCLUSIONS The positive association of maternal pregnancy diet quality and executive function and adaptability in 3- to 4-y-olds appeared to increase with decreasing levels of postnatal stimulation and support. These results suggest that overall maternal pregnancy diet could be linked to better child neurodevelopment in families experiencing barriers to providing stimulation and support to children in their home.
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Affiliation(s)
| | - John E Krzeczkowski
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Khrista Boylan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Linda Booij
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Maude Perreault
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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21
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Conti G, Poupakis S, Sandner M, Kliem S. The effects of home visiting on mother-child interactions: Evidence from a randomized trial using dynamic micro-level data. CHILD ABUSE & NEGLECT 2021; 115:105021. [PMID: 33684828 DOI: 10.1016/j.chiabu.2021.105021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/11/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Home visiting programs constitute an important policy to support vulnerable families with young children. One of their principal aims is to improve infant-parent relationships, so a key measure of their effectiveness is based on observational measures of parent-children interactions. In the present study we provide novel evidence on the effectiveness of home visiting programs in improving mother-child interactions within a randomized controlled trial (RCT) of the Pro Kind program. A major goal of the Pro Kind program is to promote child development by strengthening the intuitive parenting skills of mothers. On this basis, the following research question is addressed in this paper: What is the impact of the Pro Kind home visitation program on the quality of mother-child interaction? METHODS A randomly chosen subsample of the original sample was selected to participate on video recordings. This subsample of 109 mother-child dyads was videotaped during a 3-min typical play situation at the participants' homes when the child was aged 25 months. We use a novel micro-coding system which allows us to examine how the intervention affected the dynamic feedback responses of both mothers and children in three key measures of behavior: orientation, positive contingency, and negative/lack of contingency. The analysis was conducted using a set of static probit models and dynamic cross-lagged panel probit models for each measure. RESULTS The intervention significantly improved the interactions between girls and their mothers, by increasing the prevalence of orientation and positive contingency (and reducing that of negative/lack of contingency). This was achieved by increasing both the persistence of positive behaviors and also the probability of switching from negative to positive behaviors in the treatment group. Mixed impacts were detected for boys. CONCLUSIONS Overall, it can be said that the Pro Kind program has a positive impact on the quality of mother-daughter interaction. However, our findings might also influence the design and delivery of home visiting programs, to the extent that they suggest that more attention has to be devoted to the interactions between boys and their mothers. Furthermore, the results show the importance of careful dynamic modelling of interactions data from videotaped observations to have a more complete understanding of the effectiveness of home visiting programs.
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Affiliation(s)
- Gabriella Conti
- Department of Economics and Social Research Institute, University College London, United Kingdom
| | - Stavros Poupakis
- Institute for Global Health, University College London, United Kingdom.
| | - Malte Sandner
- Institute for Employment Research Institute, IAB, Germany
| | - Sören Kliem
- Ernst-Abbe-Hochschule Jena - University of Applied Sciences, Germany
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Robling M, Lugg-Widger F, Cannings-John R, Sanders J, Angel L, Channon S, Fitzsimmons D, Hood K, Kenkre J, Moody G, Owen-Jones E, Pockett R, Segrott J, Slater T. The Family Nurse Partnership to reduce maltreatment and improve child health and development in young children: the BB:2–6 routine data-linkage follow-up to earlier RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The short-term effectiveness (to 24 months post partum) of a preventative home-visiting intervention, the Family Nurse Partnership, was previously assessed in the Building Blocks trial (BB:0–2).
Objectives
The objectives were to establish the medium-term effectiveness of the Family Nurse Partnership in reducing maltreatment and improving maternal health (second pregnancies) and child health, developmental and educational outcomes (e.g. early educational attendance, school readiness); to explore effect moderators and mediators; and to describe the costs of enhancing usually provided health and social care with the Family Nurse Partnership.
Design
Children and their mothers from an existing trial cohort were followed up using routine data until the child was 7 years of age.
Setting
This study was set in 18 partnerships between local authorities and health-care organisations in England.
Participants
The participants were mothers [and their firstborn child(ren)] recruited as pregnant women aged ≤ 19 years, in local authority Family Nurse Partnership catchment areas, at < 25 weeks’ gestation, able to provide consent and able to converse in English. Participants mandatorily withdrawn (e.g. owing to miscarriage) from the BB:0–2 trial were excluded.
Interventions
The intervention comprised up to a maximum of 64 home visits by specially trained family nurses from early pregnancy until the firstborn child was 2 years of age, plus usually provided health and social care support. The comparator was usual care alone.
Main outcome measures
The primary outcome measure was child-in-need status recorded at any time during follow-up. The secondary outcomes were as follows: (1) referral to social services, child protection registration (plan), child-in-need categorisation, looked-after status, recorded injuries and ingestions at any time during follow-up; (2) early child care and educational attendance, school readiness (Early Years Foundation Stage Profile score) and attainment at Key Stage 1; and (3) health-care costs.
Data sources
The following data sources were used: maternally reported baseline and follow-up data (BB:0–2), Hospital Episode Statistics data (NHS Digital), social care and educational data (National Pupil Database) and abortions data (Department of Health and Social Care).
Results
There were no differences between study arms in the rates of referral to social services, being registered as a child in need, receiving child protection plans, entering care or timing of first referral for children subsequently assessed as in need. There were no differences between study arms in rates of hospital emergency attendance, admission for injuries or ingestions, or in duration of stay for admitted children. Children in the Family Nurse Partnership arm were more likely to achieve a good level of development at reception age (school readiness), an effect strengthened when adjusting for birth month. Differences at Key Stage 1 were not statistically different, but, after adjusting for birth month, children in the Family Nurse Partnership arm were more likely to reach the expected standard in reading. Programme effects were greater for boys (Key Stage 1: writing); children of younger mothers (Key Stage 1: writing, Key Stage 1: mathematics); and children of mothers not in employment, education or training at study baseline (Key Stage 1: writing). There were no differences between families who were part of the Family Nurse Partnership and those who were not for any other outcome. The differences between study arms in resource use and costs were negligible.
Limitations
The outcomes are constrained to those available from routine sources.
Conclusions
There is no observable benefit of the programme for maltreatment or maternal outcomes, but it does generate advantages in school readiness and attainment at Key Stage 1.
Future work
The trajectory of longer-term programme benefits should be mapped using routine and participant-reported measures.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 2. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Michael Robling
- Centre for Trials Research, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | | | | | - Julia Sanders
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Lianna Angel
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Sue Channon
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Joyce Kenkre
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | | | | | - Rhys Pockett
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - Jeremy Segrott
- Centre for Trials Research, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Thomas Slater
- School of Social Sciences, Cardiff University, Cardiff, UK
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Beatson R, Molloy C, Perini N, Harrop C, Goldfeld S. Systematic review: An exploration of core componentry characterizing effective sustained nurse home visiting programs. J Adv Nurs 2021; 77:2581-2594. [PMID: 33481301 DOI: 10.1111/jan.14755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/09/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022]
Abstract
AIMS To identify the core components or potential 'active ingredients' of sustained nurse home visiting (SNHV) programs that have demonstrated positive effects on maternal or child health, psychosocial development, or self-sufficiency outcomes among disadvantaged families in high-income countries. DESIGN Systematic review with narrative summary. DATA SOURCES Programs were identified from searches of several reputable evidence clearing houses and the following bibliographic databases: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Cochrane Central Register of Controlled Trials. Year of publication was originally restricted from 2008 -2018, with additional searches conducted up to 2019. REVIEW METHODS This review of SNHV program componentry builds on a previous evaluation of program effectiveness. Programs were selected for inclusion if they had been tested in a randomized or cluster-randomized controlled trial (RCT/CRCT). Componentry characteristics related to program delivery, nurse provider, and outcome-specific intervention content were then extracted. RESULTS Comparison of the seven eligible programs showed seven common core components: antenatal commencement, support to child age 2 years, at least 19 scheduled visits and experienced or highly qualified nurses with program-specific training, caseloads of approximately 25 families, regular supervision, and multidisciplinary supports. Outcome-specific program content was generally not well reported. CONCLUSION The findings from this review have utility in guiding the development of minimum standard benchmarks and best-practice recommendations for SNHV programs and call for more detailed publication of core content componentry in the SNHV literature. IMPACT Identification of the core componentry underpinning program effectiveness should inform policy decisions on program selection, adaptation for specific populations, and quality control. Such evidence-based decision-making should in turn lead to better maternal and child outcomes among disadvantaged families in high-income countries, reducing societal and economic burdens of inequity.
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Affiliation(s)
- Ruth Beatson
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Carly Molloy
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Sharon Goldfeld
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia
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Molloy C, Beatson R, Harrop C, Perini N, Goldfeld S. Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children. J Adv Nurs 2021; 77:147-161. [PMID: 33038049 DOI: 10.1111/jan.14576] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/26/2020] [Accepted: 08/27/2020] [Indexed: 12/17/2022]
Abstract
AIMS To systematically evaluate published experimental studies of sustained nurse home visiting (SNHV) programs. This review summarizes the evidence and identifies gaps in the literature to inform practice, policy, and future research. DESIGN Restricted systematic review with narrative summary. DATA SOURCES Databases searched were Medline, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials. Year of publication was originally restricted from 2008 to the date of search (13 February 2018, with supplementary searches conducted to identify more recent publications (up to 2019). Several reputable evidence clearinghouses were also searched. REVIEW METHODS Studies were included if they used a randomized or cluster-randomized controlled trial to evaluate a home visiting program that: (a) targeted disadvantaged mothers; (b) commenced during pregnancy or prior to the child's first birthday; (c) had an intended duration of at least 12 months from the time of enrolment; and (d) was substantively delivered by nurses or midwives. Meta-analyses and reviews of studies meeting these criteria were also included. A quality appraisal was conducted for all studies. RESULTS Of 1,393 total articles, 30 met inclusion criteria. Seven specific SNHV programs were identified. Each demonstrated evidence of a positive statistical effect on at least one child or maternal outcome. CONCLUSION Sustained nurse home visiting programs benefit disadvantaged families, though effects vary across outcomes and subgroups. Further research is needed to discern the critical components of effective programs. IMPACT As SNHV programs have gained policy appeal, the need to evaluate the evidence-base supporting such interventions has become imperative. The findings of this review will assist policy-makers and practitioners in high-income countries to make evidence-informed decisions about which programs are best suited to addressing specific maternal and child outcomes for disadvantaged families. This should in turn ameliorate some of the inequalities in child development that have significant social and economic costs.
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Affiliation(s)
- Carly Molloy
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
- University of Melbourne, Melbourne, Vic., Australia
| | - Ruth Beatson
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| | | | | | - Sharon Goldfeld
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
- University of Melbourne, Melbourne, Vic., Australia
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25
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Döhnert M, Wiegand-Grefe S. [Preventive and therapeutic interventions for children of mentally ill parents]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 49:51-61. [PMID: 33269950 DOI: 10.1024/1422-4917/a000771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Preventive and therapeutic interventions for children of mentally ill parents Abstract. The risk of developing mental disorders increases markedly in children of mentally ill parents. Several risk factors have been identified and become possible targets of preventive and therapeutic interventions. Numerous studies investigated the efficacy of these interventions, which are very heterogeneous regarding content and methodology. One part of these studies focuses on infants of depressed and substance-addicted mothers; the other part focuses on children and adolescents of parents suffering from various mental disorders. Today, we have several meta-analyses at our disposal which yielded small effect sizes concerning the development of psychological symptoms or disorders in these affected children. The current review reveals a lack of high-quality studies, and analyses on cost-effectiveness are also needed. The preventive and therapeutic interventions now available show inadequate efficacy to effectively improve the situation of these children and adolescents. Future research is needed to develop and implement cost-effective interventions as well as high-quality studies to investigate the efficacy of these interventions.
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Affiliation(s)
- Mirko Döhnert
- Universitätsklinikum Leipzig AöR, Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Leipzig
| | - Silke Wiegand-Grefe
- Universitätsklinikum Hamburg-Eppendorf (UKE), Zentrum für psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Hamburg
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26
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Agostini FCPDAD, Charepe ZB, Reticena KDO, Siqueira LD, Fracolli LA. Experiences of interaction between teenage mothers and visiting nurses: a phenomenological study. Rev Esc Enferm USP 2020; 54:e03635. [PMID: 33263664 DOI: 10.1590/s1980-220x2019030103635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/18/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To understand the experiences of interaction between teenage mothers and visiting nurses in the Young Mothers Caregivers Program. METHOD Qualitative research using the theoretical-methodological framework of Social Phenomenology, with phenomenological interviews with visiting nurses and teenage mothers. RESULTS Three visiting nurses and nine teenage mothers participated. The understanding of the experiences led to the elaboration of three categories of contexts of meanings related to the past and present: "Experiences of participation in the PJMC"; "The interaction experienced by visiting nurses and teenage mothers"; "Parenting and maternal role". CONCLUSION The interaction between visiting nurses and teenage mothers in the program was characterized as positive, as it provided the mother with greater security in her maternal and parental role. The attitudes of nurses and adolescent mothers were fundamental for establishing a positive interaction.
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Affiliation(s)
| | - Zaida Borges Charepe
- Universidade Católica Portuguesa, Instituto de Ciências da Saúde, Lisboa, Portugal
| | | | - Lucíola D'Emery Siqueira
- Universidade de São Paulo, Escola de Enfermagem, Departamento Saúde Coletiva, São Paulo, SP, Brasil
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27
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Henwood T, Channon S, Penny H, Robling M, Waters CS. Do home visiting programmes improve children's language development? A systematic review. Int J Nurs Stud 2020; 109:103610. [PMID: 32585448 DOI: 10.1016/j.ijnurstu.2020.103610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 02/26/2020] [Accepted: 04/12/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This review examines home visiting programmes that specifically provide home based support to vulnerable, socially disadvantaged women who are either pregnant or have recently become a new parent. Home visiting programmes often report multiple outcomes. The purpose of this review is to systematically summarise how effective home visiting programmes are at improving young children's language development. DATA SOURCES A comprehensive search of four online databases (Embase, Emcare, Psycinfo and Medline) between 1990 and 2020 was conducted, as well as a hand search of the references of relevant studies. REVIEW METHOD Studies were screened with N = 11 meeting the inclusion/exclusion criteria. The risk of bias of each study was assessed. To enable comparisons between home visiting programmes, relevant data was extracted using an adapted version of the Cochrane Public Health Group Data Extraction and Assessment Template. RESULTS Most of the home visiting programmes had been established in America. Six of the eleven studies reported positive language outcomes for children. Where statistical data was reported, the magnitude of the difference between the intervention and control groups represented small effect sizes. Nine different language measures were used, reporting on varying domains of language development rendering comparisons across programmes difficult. Most studies failed to report the duration of home visits, though studies which started prenatally showed the most promise in improving children's language development. CONCLUSION Home visiting programmes targeted at socially disadvantaged women and their children have the potential to positively influence the language development of the child. This review highlights that not all home visiting programmes measure the impact that the programme has on children's language development, and not all home visiting programmes achieve positive language outcomes. Initiating visits prenatally may help towards the improvement of children's language development. Future evaluations of home visiting programmes should explore this finding further, consider the language assessment tools selected, and improve on the reporting of their language results.
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Affiliation(s)
- Tom Henwood
- Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, United Kingdom
| | - Sue Channon
- Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, United Kingdom
| | - Helen Penny
- Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, United Kingdom
| | - Mike Robling
- Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, United Kingdom
| | - Cerith S Waters
- Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, United Kingdom.
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Cavallaro FL, Gilbert R, Wijlaars L, Kennedy E, Swarbrick A, van der Meulen J, Harron K. Evaluating the real-world implementation of the Family Nurse Partnership in England: protocol for a data linkage study. BMJ Open 2020; 10:e038530. [PMID: 32430455 PMCID: PMC7239518 DOI: 10.1136/bmjopen-2020-038530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Almost 20 000 babies are born to teenage mothers each year in England, with poorer outcomes for mothers and babies than among older mothers. A nurse home visitation programme in the USA was found to improve a wide range of outcomes for young mothers and their children. However, a randomised controlled trial in England found no effect on short-term primary outcomes, although cognitive development up to age 2 showed improvement. Our study will use linked routinely collected health, education and social care data to evaluate the real-world effects of the Family Nurse Partnership (FNP) on child outcomes up to age 7, with a focus on identifying whether the FNP works better for particular groups of families, thereby informing programme targeting and resource allocation. METHODS AND ANALYSIS We will construct a retrospective cohort of all women aged 13-24 years giving birth in English NHS hospitals between 2010 and 2017, linking information on mothers and children from FNP programme data, Hospital Episodes Statistics and the National Pupil Database. To assess the effectiveness of FNP, we will compare outcomes for eligible mothers ever and never enrolled in FNP, and their children, using two analysis strategies to adjust for measured confounding: propensity score matching and analyses adjusting for maternal characteristics up to enrolment/28 weeks gestation. Outcomes of interest include early childhood development, childhood unplanned hospital admissions for injury or maltreatment-related diagnoses and children in care. Subgroup analyses will determine whether the effect of FNP varied according to maternal characteristics (eg, age and education). ETHICS AND DISSEMINATION The Nottingham Research Ethics Committee approved this study. Mothers participating in FNP were supportive of our planned research. Results will inform policy-makers for targeting home visiting programmes. Methodological findings on the accuracy and reliability of cross-sectoral data linkage will be of interest to researchers.
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Affiliation(s)
- Francesca L Cavallaro
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ruth Gilbert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Linda Wijlaars
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Eilis Kennedy
- Children, Young Adults and Families Directorate, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Ailsa Swarbrick
- Family Nurse Partnership National Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Katie Harron
- Great Ormond Street Institute of Child Health, University College London, London, UK
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29
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Kabisch N, Alonso L, Dadvand P, van den Bosch M. Urban natural environments and motor development in early life. ENVIRONMENTAL RESEARCH 2019; 179:108774. [PMID: 31606619 DOI: 10.1016/j.envres.2019.108774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/13/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Abstract
An emerging body of evidence has associated natural environments with improved brain development in children; however, these studies have mainly focused on cognition and available evidence for motor development is still scarce. This study aimed to evaluate the protective association of neighbourhood greenspace with motor development deficits in children. We obtained data on motor development deficits (separately for fine and gross motor developments) at sub-district level from routine medical check-up of children prior to enrolment into primary schools in the city of Berlin (2015-2016). Neighbourhood natural environments across the sub-districts were measured with three different metrics: the average of satellite-based normalized difference vegetation index (NDVI), the share of public green spaces, and the share of both public blue and green spaces (composite nature) across the sub-district. We applied negative binominal models to estimate the association between neighbourhood natural environments and fine and gross motor development deficits (one at a time), controlled for relevant sociodemographic indicators. Higher neighbourhood public green space and composite nature were significantly associated with lower risk of motor development deficits; however, the association were not statistically significant when using NDVI. Our findings, if confirmed by future studies, could provide evidence for implementing targeted interventions to enhance motor development in urban children.
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Affiliation(s)
- Nadja Kabisch
- Department of Geography, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany; Department of Urban and Environmental Sociology, Helmholtz Centre for Environmental Research-UFZ, Permoserstrasse 15, 04318, Leipzig, Germany.
| | - Lucia Alonso
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Payam Dadvand
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Matilda van den Bosch
- The School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada; The Department of Forest and Conservation Sciences, The University of British Columbia, 2424 Main Mall, Vancouver, BC, V6T 1Z4, Canada.
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30
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Le Bas GA, Youssef GJ, Macdonald JA, Rossen L, Teague SJ, Kothe EJ, McIntosh JE, Olsson CA, Hutchinson DM. The role of antenatal and postnatal maternal bonding in infant development: A systematic review and meta‐analysis. SOCIAL DEVELOPMENT 2019. [DOI: 10.1111/sode.12392] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Genevieve A. Le Bas
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
| | - George J. Youssef
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
- Murdoch Children's Research Institute Royal Children's Hospital Melbourne Victoria Australia
| | - Jacqui A. Macdonald
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
- Murdoch Children's Research Institute Royal Children's Hospital Melbourne Victoria Australia
- Department of Paediatrics University of Melbourne, Royal Children's Hospital Melbourne Victoria Australia
| | - Larissa Rossen
- School of Psychiatry, Faculty of Medicine University of New South Wales Sydney Victoria Australia
- National Drug and Alcohol Research Centre University of New South Wales Sydney New South Wales Australia
| | - Samantha J. Teague
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
| | - Emily J. Kothe
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
| | - Jennifer E. McIntosh
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
- Murdoch Children's Research Institute Royal Children's Hospital Melbourne Victoria Australia
- Department of Paediatrics University of Melbourne, Royal Children's Hospital Melbourne Victoria Australia
| | - Craig A. Olsson
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
- Murdoch Children's Research Institute Royal Children's Hospital Melbourne Victoria Australia
- Department of Paediatrics University of Melbourne, Royal Children's Hospital Melbourne Victoria Australia
| | - Delyse M. Hutchinson
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development Deakin University Geelong Victoria Australia
- Murdoch Children's Research Institute Royal Children's Hospital Melbourne Victoria Australia
- Department of Paediatrics University of Melbourne, Royal Children's Hospital Melbourne Victoria Australia
- National Drug and Alcohol Research Centre University of New South Wales Sydney New South Wales Australia
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Hua J, Sun J, Cao Z, Dai X, Lin S, Guo J, Gu G, Du W. Differentiating the cognitive development of early-term births in infants and toddlers: a cross-sectional study in China. BMJ Open 2019; 9:e025275. [PMID: 30975675 PMCID: PMC6500364 DOI: 10.1136/bmjopen-2018-025275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aimed to explore the cognitive development of low-risk children during early childhood for early-term births at 37 and 38 weeks of gestation compared with full term births at 39-41 weeks of gestation. SETTING AND PARTICIPANTS We conducted a cross-sectional study in Shanghai, one of the largest cities in China. A total of 1444 children from singleton pregnancies born at term gestation were included in the study. MEASURES The cognitive outcomes of the subjects were measured using the cognitive subtest of Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) across three cities in China. We analysed the association between gestational age and cognitive development during infancy and toddler stages using multivariate linear modelling. RESULTS The cognitive development scores for infants born at 37 gestational weeks were significantly lower than those born at 39-41 gestational weeks (β=-2.257, 95% CI -4.280 to -0.235; p<0.05) after adjusting for children's and maternal characteristics, as well as socio-economic factors. However, there were no significant differences in cognitive ability between infants born at 38 gestational weeks compared with their full-term counterparts (p>0.05). Moreover, these effects were not found in toddlers (between 17 and 48 months of age) after adjusting for the possible confounders (p>0.05). CONCLUSIONS Infants born at 37 weeks of gestation exhibited weaker cognitive ability compared with those born at 39-41 weeks of gestation. Our findings provide evidences for the close monitoring of potential developmental problems in early-term children, especially those born at 37 gestational weeks.
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Affiliation(s)
- Jing Hua
- The Women and Children’s Health Care Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Sun
- The Women and Children’s Health Care Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhijuan Cao
- The Women and Children’s Health Care Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaotian Dai
- The Women and Children’s Health Care Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Senran Lin
- The Women and Children’s Health Care Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jialin Guo
- The Women and Children’s Health Care Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guixiong Gu
- Health Statistical Division, Pediatrics Research Institution of Soochow University, Suzhou, China
| | - Wenchong Du
- Psychology Division, Nottingham Trent University, Nottingham, UK
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[Impact of Intimate Partner Violence on Child's Cognitive Development - Results from the Evaluation of the Home Visiting Program "Pro Kind"]. Prax Kinderpsychol Kinderpsychiatr 2019; 68:63-80. [PMID: 30628871 DOI: 10.13109/prkk.2019.68.1.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Impact of Intimate Partner Violence on Child's Cognitive Development - Results from the Evaluation of the Home Visiting Program "Pro Kind" Intimate partner violence (IVP) is a socially relevant problem area of high prevalence. Direct or indirect IVP leads to well documented problems in child socioemotional development. Longitudinal studies on influences of IVP on child's cognitive development are rare. The present study adds to close this gap. We analyze data from n = 535 families living under psychosocial risk conditions. All families took part in the evaluation of the home visiting program "Pro Kind". We administered one item of a parent questionnaire to assess the occurrence of IVP. The child's cognitive development is assessed at the ages of 6, 12, and 24 months of age with the Bayley Scales-II. We test the hypothesis that IVP to the mother causally affects early cognitive development of children in a structural equation model with Cross-Lagged-Panel design. The results show a causal influence of IVP on child's cognitive development during the period from t3 (12 months of child's age) to t4 (24 months of child's age). The explanatory power of results is limited by methodological problems, e. g. the operationalization of IVP with only one item and a high panel mortality. Implications for early prevention and intervention of IVP are derived.
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Chou JL, Pierce KJ, Pennington LB, Seiler R, Michael J, Mc Namara D, Zand D. Social Support, Family Empowerment, Substance Use, and Perceived Parenting Competency during Pregnancy for Women with Substance Use Disorders. Subst Use Misuse 2018; 53:2250-2256. [PMID: 29757060 DOI: 10.1080/10826084.2018.1467456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Parenting self-efficacy has been linked to positive parent and child outcomes however, little research exists on factors that influence parenting self-efficacy among pregnant women with substance use disorders. OBJECTIVES This study explored substance use severity, social support, and family empowerment as predictors of parenting self-efficacy among pregnant women (N = 71) entering SUD treatment. METHODS The study used a quantitative cross-sectional design. RESULTS Statistically significant positive correlations emerged between social support and parenting self-efficacy as well as family empowerment and parenting self-efficacy. Family empowerment and social support were also correlated. A backward elimination regression analysis revealed family empowerment to be the strongest predictor of parenting self-efficacy. No relationships were found among substance use severity and the study variables. CONCLUSIONS When promoting parenting self-efficacy, both social support and family empowerment are important domains to consider for treatment planning and resource development among pregnant women with substance use disorders.
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Affiliation(s)
- Jessica L Chou
- a Department of Counseling and Family Therapy , Drexel University , Philadelphia , Pennsylvania , USA
| | - Katherine J Pierce
- b Saint Louis University School of Medicine , General Academic Pediatrics , Saint Louis , Missouri , USA
| | | | | | | | - Donna Mc Namara
- b Saint Louis University School of Medicine , General Academic Pediatrics , Saint Louis , Missouri , USA
| | - Debra Zand
- b Saint Louis University School of Medicine , General Academic Pediatrics , Saint Louis , Missouri , USA
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Boorman RJ, Creedy DK, Fenwick J, Muurlink O. Empathy in pregnant women and new mothers: a systematic literature review. J Reprod Infant Psychol 2018; 37:84-103. [PMID: 30269515 DOI: 10.1080/02646838.2018.1525695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This systematic review explores changes in perinatal empathy and influence on maternal behaviours and child development. BACKGROUND The well-being and development of infants are commonly linked to their mothers' capacity for empathy. However, characteristic changes during pregnancy and childbirth including sleep deprivation, mood and cognitive difficulties may disrupt empathic processing. METHODS Original research papers (n = 7413) published in English language peer-reviewed academic journals were obtained by searching four electronic databases PsycINFO, PubMed, Scopus and CINAHL. Inclusion criteria were studies reporting empathy of women in the period from pregnancy to 12 months postpartum. Empathy was operationalised as a general tendency of empathic emotional responding and cognitive perspective taking. Thirteen studies were systematically assessed using the Critical Appraisal Skills Programme criteria. RESULTS Impaired empathy in mothers, due most notably to high personal distress, was associated with risk of neglect or maltreatment of children and was partially explained by mothers' aversive response to infant crying. CONCLUSION Few studies present empathy as a central theme. There is a paucity of definitional parameters and theoretical linkages and over-reliance on brief self-report indices of empathy. Future studies need to be theory based, incorporate experimental approaches, and provide greater sampling diversity toadvance our understanding of empathy in perinatal women.
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Affiliation(s)
- Rhonda J Boorman
- a School of Nursing and Midwifery , Griffith University , Meadowbrook , Australia
| | - Debra K Creedy
- a School of Nursing and Midwifery , Griffith University , Meadowbrook , Australia
| | - Jennifer Fenwick
- a School of Nursing and Midwifery , Griffith University , Meadowbrook , Australia
| | - Olav Muurlink
- b School of Business and Law , Central Queensland University , Brisbane , Australia.,c Griffith Institute for Educational Research , Griffith University , Nathan , Australia
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Leirbakk MJ, Torper J, Engebretsen E, Opsahl JN, Zeanah P, Magnus JH. Formative research in the development of a salutogenic early intervention home visiting program integrated in public child health service in a multiethnic population in Norway. BMC Health Serv Res 2018; 18:741. [PMID: 30261872 PMCID: PMC6161435 DOI: 10.1186/s12913-018-3544-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Few early intervention programs aimed at maternal and child health have been developed to be integrated in the existing Child Health Service in a country where the service is free, voluntary and used by the majority of the eligible population. This study presents the process and the critical steps in developing the "New Mothers" program. METHODS Formative research uses a mixed method, allowing us to obtain data from multiple sources. A scoping review provided information on early intervention programs and studies, clarifying key elements when framing a new program. Key informant and focus group interviews offered insight of existing challenges, perceptions, identified power structures and offered reflections germane to the identified framework, securing user involvement at all stages. Monthly meetings with the project group enabled feedback loops for the data, securing program advancement. RESULTS The "New Mothers" program was formed based on a salutogenic theory, emphasizing resistance and strengths. Public health nurses in the existing Child Health Service were to offer universally all first-time mothers and children home visits from gestational week 28 until the child reached 2 years, with motivational interviewing and empathic communication as methods to mentor the mothers, help them identify their strengths and resources, and provide support and information. CONCLUSIONS Using formative research as mixed method ensures incorporation of detailed information from multiple resources when an early intervention program is developed. This method secured program appropriateness, both culturally and at system level, when integrating new elements in the existing service.
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Affiliation(s)
- Maria J Leirbakk
- Department of Health Sciences, University of Oslo, Harald Schjelderups hus, Forskningsveien 3a, 0373, Oslo, Norway. .,Agency for Health, City of Oslo, Storgata 51, 0182, Oslo, Norway.
| | - Johan Torper
- Department for Primary Health and Social Services, City of Oslo, City Hall, NO-0037, Oslo, Norway
| | - Eivind Engebretsen
- Department of Health Sciences, University of Oslo, Harald Schjelderups hus, Forskningsveien 3a, 0373, Oslo, Norway
| | | | - Paula Zeanah
- College of Nursing and Allied Health Professions and Cecil J. Picard Center for Child Development and Lifelong Learning, University of Louisiana at Lafayette, 200 East Devalcourt Street, Lafayette, LA, 70506, USA
| | - Jeanette H Magnus
- Faculty of Medicine, University of Oslo, Klaus Torgårds vei 3, Sogn Arena, 0372, Oslo, Norway.,Department of Global Community Health & Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA
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Lugg-Widger F, Cannings-John R, Angel L, Moody G, Segrott J, Kenkre J, Robling M. Assessing the impact of specialist home visiting upon maltreatment in England: a feasibility study of data linkage from a public health trial to routine health and social care data. Pilot Feasibility Stud 2018; 4:98. [PMID: 29988307 PMCID: PMC6022436 DOI: 10.1186/s40814-018-0294-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/09/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Follow-up for public health trials may benefit from greater use of routine data. Our trial of a home-visiting intervention for first-time teenage mothers assessed outcomes to the child's second birthday. To examine its medium-term impact, particularly upon maltreatment outcomes, we designed a study using routine records. METHODS We aimed to establish the feasibility of our study design, which combines trial data with routine health, social care and education data using a dissent-based linkage model. Trial participant identifiers were linked to routine health, social care and education data if women did not dissent. Data were forwarded to a safe haven and further linked to de-identified trial outcome data. The feasibility study aimed first to establish the acceptability of data linkage through a discussion group of young mothers and by levels of dissent received by the research team. Second, we assessed levels of accurate linkage to both health (via NHS Digital) and education and social care (both via National Pupil Database, NPD). Third, we assessed the availability of data and levels of missingness for key outcomes received for a sample of target study years. RESULTS Of 1545 mother-child dyads contacted, eight women opted out. The engagement exercise with stakeholders found support for the principle of data linkage, including in the context of maltreatment. Some contributors preferred opt-in consent. Most (99.9%) health records were matched on either three or all four identifiers. Fifty participants were not matched to any health data. Primary outcome data from NPD are derived from any one of three fields, all of which were satisfactorily returned and provided an indication of cases for analysis. Missing data for secondary outcomes varied from 0% (Child looked after status) to 70% (Anatomical Area A&E diagnosis) however when combined with other variables the levels of missingness for outcome decrease. CONCLUSIONS Through study set-up and in this pilot, we provide evidence that the main study is feasible, satisfies governance requirements and is likely to generate data of sufficient quality to address our main research questions. Observed levels of missingness or low event rates are likely to affect some secondary analysis (e.g. state transition modelling) although overall were satisfactory.
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Affiliation(s)
- Fiona Lugg-Widger
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Rebecca Cannings-John
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Lianna Angel
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Gwenllian Moody
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Jeremy Segrott
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
- DECIPHer Centre, Cardiff University, Cardiff, UK
| | - Joyce Kenkre
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Michael Robling
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
- DECIPHer Centre, Cardiff University, Cardiff, UK
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Kliem S, Sandner M, Lohmann A, Sierau S, Dähne V, Klein AM, Jungmann T. Follow-up study regarding the medium-term effectiveness of the home-visiting program "Pro Kind" at age 7 years: study protocol for a randomized controlled trial. Trials 2018; 19:323. [PMID: 29925419 PMCID: PMC6011474 DOI: 10.1186/s13063-018-2707-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pro Kind is a German adaptation of the US Nurse Family Partnership program. It is an intervention based on home visits targeting first-time mothers from disadvantaged populations. Pro Kind was implemented as a randomized control trial from 2006 to 2012 with N = 755 first-time mothers (TG n = 394, CG n = 391). The 7-8-year follow-up aims to assess the mid-term effects of the program. METHODS/DESIGN Mid-term outcomes are being assessed by trained assessors. In a multimethod approach telephone interviews, on-site interviews, observations and developmental tests will be held in order to assess children's and mothers' life satisfaction, mental health, cognitive and social development, parenting behavior, signs of child abuse or neglect as well as the family's socio-economic status. Furthermore, administrative data will be accessed to obtain information regarding the mother's usage of pediatric health care, welfare usage and employment history. DISCUSSION Results regarding the mid-term effects of the intervention from the Pro Kind Follow-up will provide a scientific basis for future primary prevention programs as well as help stakeholders legitimizing early childhood investments. TRIAL REGISTRATION German Clinical Trial Registration DRKS-ID, ID: DRKS00007554 . Registered on 11 June 2015, updated on 6 October 2017.
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Affiliation(s)
- Sören Kliem
- Criminological Research Institute of Lower Saxony, Lützerodestr 9, 30161 Hannover, Germany
| | - Malte Sandner
- Institute for Employment Research (IAB) of the German Federal Employment Agency (BA), Regensburger Strasse 104, 90478 Nuremberg, Germany
| | - Anna Lohmann
- Criminological Research Institute of Lower Saxony, Lützerodestr 9, 30161 Hannover, Germany
| | - Susan Sierau
- Department of Medical Psychology and Medical Sociology, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Verena Dähne
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Cr, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Annette M. Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Cr, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Tanja Jungmann
- Institut für Sonderpädagogische Entwicklungsförderung und Rehabilitation (ISER), August-Bebel-Str. 28, 18055 Rostock, Germany
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Rayce SB, Rasmussen IS, Klest SK, Patras J, Pontoppidan M. Effects of parenting interventions for at-risk parents with infants: a systematic review and meta-analyses. BMJ Open 2017; 7:e015707. [PMID: 29284713 PMCID: PMC5770968 DOI: 10.1136/bmjopen-2016-015707] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Infancy is a critical stage of life, and a secure relationship with caring and responsive caregivers is crucial for healthy infant development. Early parenting interventions aim to support families in which infants are at risk of developmental harm. Our objective is to systematically review the effects of parenting interventions on child development and on parent-child relationship for at-risk families with infants aged 0-12 months. DESIGN This is a systematic review and meta-analyses. We extracted publications from 10 databases in June 2013, January 2015 and June 2016, and supplemented with grey literature and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analyses. INCLUSION CRITERIA (1) Randomised controlled trials of structured psychosocial interventions offered to at-risk families with infants aged 0-12 months in Western Organisation for Economic Co-operation and Development (OECD) countries, (2) interventions with a minimum of three sessions and at least half of these delivered postnatally and (3) outcomes reported for child development or parent-child relationship. RESULTS Sixteen studies were included. Meta-analyses were conducted on seven outcomes represented in 13 studies. Parenting interventions significantly improved child behaviour (d=0.14; 95% CI 0.03 to 0.26), parent-child relationship (d=0.44; 95% CI 0.09 to 0.80) and maternal sensitivity (d=0.46; 95% CI 0.26 to 0.65) postintervention. There were no significant effects on cognitive development (d=0.13; 95% CI -0.08 to 0.41), internalising behaviour (d=0.16; 95% CI -0.03 to 0.33) or externalising behaviour (d=0.16; 95% CI -0.01 to 0.30) post-intervention. At long-term follow-up we found no significant effect on child behaviour (d=0.15; 95% CI -0.03 to 0.31). CONCLUSIONS Interventions offered to at-risk families in the first year of the child's life appear to improve child behaviour, parent-child relationship and maternal sensitivity post-intervention, but not child cognitive development and internalising or externalising behaviour. Future studies should incorporate follow-up assessments to examine long-term effects of early interventions.
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Affiliation(s)
- Signe B Rayce
- Department for Child and Family, VIVE – The Danish Centre of Applied Social Science, Copenhagen, Denmark
| | - Ida S Rasmussen
- Department for Child and Family, VIVE – The Danish Centre of Applied Social Science, Copenhagen, Denmark
| | - Sihu K Klest
- Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway
| | - Joshua Patras
- Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway
| | - Maiken Pontoppidan
- Department for Child and Family, VIVE – The Danish Centre of Applied Social Science, Copenhagen, Denmark
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Sun J, Patel F, Rose-Jacobs R, Frank DA, Black MM, Chilton M. Mothers' Adverse Childhood Experiences and Their Young Children's Development. Am J Prev Med 2017; 53:882-891. [PMID: 28919342 DOI: 10.1016/j.amepre.2017.07.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 06/14/2017] [Accepted: 07/21/2017] [Indexed: 01/27/2023]
Abstract
INTRODUCTION This study examined how mothers' Adverse Childhood Experiences (ACEs) relate to their children's developmental risk and assessed how the association is mediated through mothers' depressive symptoms and fair/poor health. METHODS Mothers of children aged between 4 months and 4 years were recruited from the emergency department of a children's hospital between March 2012 and June 2015 and interviewed about ACEs, mothers' depressive symptoms and health status, and children's developmental risk (screened via Parents' Evaluations of Developmental Status [PEDS]). Between August and November 2016 a Cochran-Armitage test assessed trend of PEDS by ACEs. Multinomial regression models examined differences in PEDS by ACEs severity. Mediation by mothers' depressive symptoms and self-rated health was also assessed. RESULTS Of 1,293 mothers, 56.7% reported one or more ACEs. Mothers also reported developmental risk (20.4% overall): 120 (9.2%) reported one concern and 144 (11.2%) reported two or more concerns on the PEDS. Mothers who reported household substance use, mental illness, or an incarcerated household member during childhood were more likely to report at least one child developmental concern on the PEDS. After controlling for covariates, odds of one PEDS concern were 1.86 (95% CI=1.16, 3.00) for ACEs, one to three versus none, and 2.21 (95% CI=1.26, 3.87) for ACEs four or more versus none. Adjusted odds of two or more concerns were 1.70 (95% CI=1.07, 2.72) for ACEs, one to three versus none, and 1.76 (95% CI=1.02, 3.05) for ACEs, four or more versus none. Mothers' depressive symptoms and self-rated health were potential mediators. CONCLUSIONS Mothers' ACEs are significantly associated with their children's developmental risk. If replicated, findings suggest that addressing intergenerational trauma through focus on childhood adversity among young children's caregivers may promote child development.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Falguni Patel
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Ruth Rose-Jacobs
- Boston University School of Medicine and Boston Medical Center Department of Pediatrics, Boston, Massachusetts
| | - Deborah A Frank
- Boston University School of Medicine and Boston Medical Center Department of Pediatrics, Boston, Massachusetts
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland; RTI International, Research Park, North Carolina
| | - Mariana Chilton
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania.
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Caminha MDFC, Silva SLD, Lima MDC, Azevedo PTÁCCD, Figueira MCDS, Batista Filho M. VIGILÂNCIA DO DESENVOLVIMENTO INFANTIL: ANÁLISE DA SITUAÇÃO BRASILEIRA. REVISTA PAULISTA DE PEDIATRIA 2017; 35:102-109. [PMID: 28977308 PMCID: PMC5417801 DOI: 10.1590/1984-0462/;2017;35;1;00009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/20/2016] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo: Descrever o caso do Brasil sob o aspecto de antecedentes históricos e realizar revisão sistemática de estudos publicados sobre registro da vigilância do desenvolvimento infantil mediante aplicação do Cartão ou Caderneta de Saúde da Criança. Fontes de dados: Fez-se busca da literatura em abril de 2016 nas bases eletrônicas: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO) e Medical Literature Analysis and Retrieval System Online (Medline), sem restrição do idioma nem período de publicação, e em referências bibliográficas dos artigos selecionados. Descritores utilizados: desenvolvimento infantil e cartão da criança e desenvolvimento infantil e caderneta de saúde da criança. Critério de inclusão: artigos originais que mensuravam, no Brasil, o uso do instrumento de acompanhamento do desenvolvimento infantil. Critério de exclusão: outra forma de publicação que não fosse artigo original. Os artigos foram selecionados pelos títulos, seguido dos resumos e de sua leitura na íntegra. Síntese dos dados: A recomendação em apoiar a vigilância do desenvolvimento infantil ocorre desde 1984. Em 1995, incluíram-se marcos do desenvolvimento no Cartão da Criança, tornando-se tais marcos, em 2004, ato normativo para registro da vigilância por meio desse instrumento. Na revisão sistemática foram selecionados seis artigos, nos quais verificou-se a prevalência de notificação da vigilância do desenvolvimento infantil de 4,6 a 30,4%. Essa variação deve-se a critérios e tamanhos amostrais diversos e a diferentes metodologias de análise sobre a adequação do preenchimento do cartão. Conclusões: Apesar de a formalização pelo Ministério da Saúde do Brasil da vigilância do desenvolvimento infantil ter ocorrido há 32 anos, quando avaliada pelo registro no Cartão ou Caderneta de Saúde da Criança, sua realização ainda é deficitária e irregular.
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Jungmann T, Brand T, Dähne V, Herrmann P, Günay H, Sandner M, Sierau S. Comprehensive evaluation of the Pro Kind home visiting program: A summary of results. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.mhp.2015.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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