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Troeung L, Sarunga Raja TL, Mann G, Wagland J, MacLeod C, Martini A. IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of the myTBI online psychoeducation platform: protocol for a mixed-methods study. BMJ Open 2024; 14:e080030. [PMID: 38508623 PMCID: PMC10953309 DOI: 10.1136/bmjopen-2023-080030] [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: 09/19/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION This protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve psychosocial adjustment to TBI across different phases of injury (acute, postacute, and chronic), and (2) undertake an evaluation of efficacy, acceptability, and feasibility. METHODS AND ANALYSIS A three-stage mixed-methods research design will be used. The study will be undertaken across four postacute community-based neurorehabilitation and disability support services in Western Australia. Stage 1 (interviews and surveys) will use consumer-driven qualitative methodology to: (1) understand the recovery experiences and psychosocial challenges of people with TBI over key stages (acute, postacute, and chronic), and (2) identify required areas of psychosocial support to inform the psychoeducation platform development. Stage 2 (development) will use a Delphi expert consensus method to: (1) determine the final psychoeducation modules, and (2) perform acceptance testing of the myTBI platform. Finally, stage 3 (evaluation) will be a randomised stepped-wedge trial to evaluate efficacy, acceptability, and feasibility. Outcomes will be measured at baseline, postintervention, follow-up, and at final discharge from services. Change in outcomes will be analysed using multilevel mixed-effects modelling. Follow-up surveys will be conducted to evaluate acceptability and feasibility. ETHICS AND DISSEMINATION Ethics approval was granted by North Metropolitan Health Service Mental Health Research Ethics and Governance Office (RGS0000005877). Study findings will be relevant to clinicians, researchers, and organisations who are seeking a cost-effective solution to deliver ongoing psychoeducation and support to individuals with TBI across the recovery journey. TRIAL REGISTRATION NUMBER ACTRN12623000990628.
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Affiliation(s)
- Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Thilaga L Sarunga Raja
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- Oats Street Rehabilitation Centre, Brightwater Care Group, East Victoria Park, Western Australia, Australia
| | - Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Janet Wagland
- Disability Services, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Colin MacLeod
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- The University of Western Australia, Crawley, Western Australia, Australia
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Penny RA, Hardiman L, Toohill J. Being connected: Exploring the needs of mothers during the postnatal period in Queensland, Australia. J Child Health Care 2024; 28:104-115. [PMID: 35638751 DOI: 10.1177/13674935221090356] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This project explored the needs of mothers beyond the immediate postnatal period in Queensland, Australia, for the development of improved models of care. Data were collected through group and individual interviews. A qualitative methodology using thematic analysis captured the experience of 58 participants. Four key themes were generated: Caring for self, Being connected, Getting direction and Having options. Being connected with care providers and peers was highly valued by participants as was having a sense of direction. Having a relationship with a carer who knew them personally throughout pregnancy and postnatal care avoided retelling stories and facilitated information sharing. Relationship-based care enabled mothers to better meet their personal needs necessary to fulfil the parenting role. Yet, many points of disconnect were identified including inconsistencies in information and gaps in care. These findings demonstrate a range of unmet needs, situated within a lack of relational continuity. Maternity and child health professionals, service managers and policy makers must reorient systems by listening, acknowledging and keeping the voice of mothers at the centre of care.
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Affiliation(s)
- Robyn A Penny
- Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia
| | - Leah Hardiman
- Mothers and Babies Queensland, Brisbane, QLD, Australia
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Morris SS, Price A, McKenzie V, Kemp L. "You do need to do the interaction": Mothers' perceptions of responsive parenting following a home-based parenting intervention. Infant Ment Health J 2023; 44:422-436. [PMID: 36867442 PMCID: PMC10946981 DOI: 10.1002/imhj.22037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/16/2022] [Indexed: 03/04/2023]
Abstract
Responsive parenting (also known as responsivity) is a dynamic and bidirectional exchange between the parent-child dyad and associated with a child's social and cognitive development. Optimal interactions require a sensitivity and understanding of a child's cues, responsiveness to the child's need, and a modification of the parent's behavior to meet this need. This qualitative study explored the impact of a home visiting program on mothers' perceptions of their responsivity to their children. This study is part of a larger body of research known as right@home, an Australian nurse home visiting program promoting children's learning and development. Preventative programs such as right@home prioritize population groups experiencing socioeconomic and psychosocial adversity. They provide opportunities to promote children's development through the enhancement of parenting skills and an increase in responsive parenting. Semi-structured interviews were conducted with 12 mothers, providing insight into their perceptions of responsive parenting. Four themes were extracted from the data using inductive thematic analysis. These indicated that: (1) mothers' perceived preparation for parenting, (2) recognition of mother and child needs, (3) response to mother and child needs, and (4) motivation to parent with responsiveness, were considered important. This research highlights the importance of interventions that focus on the parent-child relationship in increasing mother's parenting capabilities and promoting responsive parenting.
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Affiliation(s)
- Sophie Stucley Morris
- MelbourneGraduate School of EducationUniversity of MelbourneParkvilleVictoriaAustralia
| | - Anna Price
- Centre for Community Child HealthThe Royal Children's HospitalParkvilleVictoriaAustralia
- Population HealthMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
| | - Vicki McKenzie
- MelbourneGraduate School of EducationUniversity of MelbourneParkvilleVictoriaAustralia
| | - Lynn Kemp
- Ingham InstituteWestern Sydney UniversityPenrith SouthNew South WalesAustralia
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Bonakdar Tehrani M, Baird K, Trajkovski S, Kemp L. Having to manage: culturally and linguistically diverse mothers' lived experiences with sustained nurse home visiting programs. BMC Health Serv Res 2023; 23:354. [PMID: 37041620 PMCID: PMC10091528 DOI: 10.1186/s12913-023-09315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/21/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Culturally and linguistically diverse (CALD) mothers with young children with limited English proficiency (LEP) encounter multiple barriers in accessing and engaging with primary healthcare services. The aim of this study was to explore the lived experiences and perceptions of CALD mothers with LEP in receiving child and family health nursing (CFHN) services and sustained nurse home visiting (SNHV) programs. METHODS Fourteen mothers were interviewed from two large Local Health Districts in Sydney. All interviews were audio-recorded for transcription purposes. Interpretative Phenomenology Analysis (IPA) was used for analysis and the socioecological approach was applied to interpret the data. RESULTS CALD mothers with LEP experienced both challenges and facilitators in their access and engagement with CFHN services and SNHV programs that were identified in four themes: managing culture; managing the service system; managing the relationship; and strengths and weaknesses of CFHN services. CONCLUSION The integration of strategies such as building trusting relationships, using female professional interpreters and better understanding of CALD mothers' cultural practices may address CALD mothers' needs and facilitate communication. Design and development of model of support involving CALD mothers with LEP in ways that voice their ideas could meet their needs and contribute to better engagement of this vulnerable population with CFHN services and SNHV programs.
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Affiliation(s)
- Mehrnoush Bonakdar Tehrani
- Translational Research and Social Innovation (TReSI), Ingham Institute for Applied Medical Research, Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia.
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Kelly Baird
- Translational Research and Social Innovation (TReSI), Ingham Institute for Applied Medical Research, Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Suza Trajkovski
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Lynn Kemp
- Translational Research and Social Innovation (TReSI), Ingham Institute for Applied Medical Research, Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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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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Creating coherent perinatal care journeys: An ethnographic study of the role of continuity of care for Danish parents in a vulnerable position. Women Birth 2023; 36:117-126. [PMID: 35430187 DOI: 10.1016/j.wombi.2022.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/04/2022] [Accepted: 03/20/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND While continuity of care is a core element of high-quality maternity care, it is potentially even more important for pregnant women and their partners who are at risk of adverse health outcomes because of psychosocial vulnerability. However, little is known about how a coherent care journey can be ensured for women and families who may require interdisciplinary and inter-sectoral services during pregnancy and the postnatal period. AIM To explore the role of continuity of care in creating a coherent care journey for vulnerable parents during pregnancy and the postnatal period. METHODS An ethnographic study conducted in Denmark based on interviews with, and field observations, of 26 mothers and 13 fathers receiving services due to mental health problems, young age, past substance abuse and/or adverse childhood experiences. FINDINGS Three key findings emerged: 1). Developing relationships allowed parents to know and feel known by care providers, which helped them feel secure and reach out for support. 2). Handover of information allowed parents to feel secure as their need for support was recognised by care providers; some parents, however, felt exposed when information was shared 3). Receiving relevant services allowed parents to have their needs for support addressed, which requires easy referral pathways and coordination of services. CONCLUSION All forms of continuity of care should be prioritised in the organisation of maternity care services for women and families in vulnerable positions. While relational continuity is important, continuity of care must also reach across providers, sectors and services to ensure coherent care journeys.
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Kanda K, Blythe S, Grace R, Elcombe E, Kemp L. Does customised care improve satisfaction and positively enable parents in sustained home visiting for mothers and children experiencing adversity? BMC Health Serv Res 2022; 22:1361. [DOI: 10.1186/s12913-022-08759-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
The Maternal Early Childhood Sustained Home-visiting program (MECSH) is a structured nurse-delivered program designed to address health inequities experienced by families experiencing significant adversity. There is strong evidence for the effectiveness of this program, but limited research exploring the practice and process elements that are core to positive parent outcomes. This study aimed to examine the relationship between customised care related to the mother’s risk factors and parent satisfaction and enablement in the delivery of a MECSH-based program.
Methods
A cross-sectional study design was used. Program delivery data collected as part of a large randomised controlled trial of a MECSH-based sustained nurse home visiting program in Australia (right@home) were analysed. This study used the data collected from the intervention arm in the trial (n = 352 women). Parent satisfaction was measured at child age 24 months using the modified short-form Patient Satisfaction Questionnaire. Parent enablement was measured at child age 24 months by a modified Parent Enablement Index. Customised care was defined as appropriate provision of care content in response to four maternal risks: smoking, mental health, domestic violence and alcohol and drugs. Logistic analysis was performed to assess the impact of customised care on parent satisfaction and enablement while adjusting for covariates such as sociodemographic factors. A significance level of 95% was applied for analysis.
Results
Our results indicated high levels of satisfaction with the care provided and positive enablement. There were several sociodemographic factors associated with satisfaction and enablement, such as language spoken at home and employment experience. The mothers who received customised care in response to mental health risk and domestic violence had significantly greater satisfaction with the care provided and experienced an increase in enablement compared to those who did not receive such care.
Conclusion
This study contributes to the existing body of empirical research that examines the relationship between care processes and client outcomes in the delivery of home visiting services. It is essential for the sustained nurse home visiting service model to be flexible enough to cater for variations according to family circumstances and needs while maintaining a core of evidence-based practice.
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Chichester M, Tepner L, Côté-Arsenault D. Nursing Care of Childbearing Families After Previous Perinatal Loss. Nurs Womens Health 2022; 26:379-388. [PMID: 36065093 DOI: 10.1016/j.nwh.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/12/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
Nurses who care for childbearing families facilitate the family's adaptation to the arrival of a newborn through assessment of physical, emotional, and psychological needs. After experiencing a perinatal loss, such as miscarriage, stillbirth, or neonatal death, a woman's perception of pregnancy and of her sense of control in becoming a mother can include fear and anxiety, and she may have significantly different needs than a pregnant woman who has not experienced perinatal loss. In this article, we provide evidence-based information and recommendations for maternal-child nurses caring for childbearing families who are preparing to welcome a new baby (sometimes called a "rainbow baby") after a previous perinatal loss.
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Li T, Yoon J, Luck J, Bui LN, Harvey M. The Impact of Continuity of Care on Cervical Cancer Screening: How Visit Pattern Affects Guideline Concordance. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:30-36. [PMID: 32542438 DOI: 10.1007/s13187-020-01777-3] [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] [Indexed: 06/11/2023]
Abstract
Cervical cancer can be prevented and highly curable if detected early. Current guidelines recommend women to receive cervical cancer screening starting at age 21. Our study aims to investigate how improving continuity of care (COC) may influence guideline concordance of cervical cancer screening. Using the eligibility and claims data, we created a person-month panel data set for women who were enrolled in Oregon Medicaid for at least 80% of the period from 2008 to 2015. We then selected our study cohort following the cervical cancer screening guidelines. Our dependent variable is whether a woman received cervical cancer screening concordant with guidelines in a given month, when she did not receive Pap test in the past 36 months and did not receive co-testing of HPV test plus Pap test in the past 60 months. We used both population-averaged logit model and conditional fixed-effect logit model to estimate the association between the guideline concordance and the COC index, after controlling for high risk, pregnancy, age, race, and ethnicity. A total of 466,526 person-month observations were included in our main models. A 0.1 unit increase of the COC score was significantly associated with a decrease in the odds of receiving guideline-concordant cervical cancer screening (population-averaged logit model: OR = 0.988, p < .001; conditional fixed-effect logit model: OR = 0.966, p < .001). Our findings remain robust to a series of sensitivity analyses. A better COC may not be necessarily beneficial to improving cervical cancer prevention. Educations for both physicians and patients should be supplemented to assure quality of preventive care.
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Affiliation(s)
- Tao Li
- Health Management and Policy Program, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 458 Waldo Hall, 2250 SW Jefferson Way, Corvallis, OR, USA.
| | - Jangho Yoon
- Health Management and Policy Program, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 458 Waldo Hall, 2250 SW Jefferson Way, Corvallis, OR, USA
| | - Jeff Luck
- Health Management and Policy Program, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 458 Waldo Hall, 2250 SW Jefferson Way, Corvallis, OR, USA
| | - Linh N Bui
- Health Management and Policy Program, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 458 Waldo Hall, 2250 SW Jefferson Way, Corvallis, OR, USA
- School of Pubic Health, University of California, Berkeley & Sutter Health Center for Health Systems Research, Berkeley, CA, USA
| | - Marie Harvey
- Health Management and Policy Program, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 458 Waldo Hall, 2250 SW Jefferson Way, Corvallis, OR, USA
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Ellis C, Pease A, Garstang J, Watson D, Blair PS, Fleming PJ. Interventions to Improve Safer Sleep Practices in Families With Children Considered to Be at Increased Risk for Sudden Unexpected Death in Infancy: A Systematic Review. Front Pediatr 2022; 9:778186. [PMID: 35047461 PMCID: PMC8762353 DOI: 10.3389/fped.2021.778186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Advice to families to follow infant care practices known to reduce the risks of Sudden Unexpected Death in Infancy (SUDI) has led to a reduction in deaths across the world. This reduction has slowed in the last decade with most deaths now occurring in families experiencing social and economic deprivation. A systematic review of the literature was commissioned by the National Child Safeguarding Practice Review Panel in England. The review covered three areas: interventions to improve engagement with support services, parental decision-making for the infant sleep environment, and interventions to improve safer sleep practices in families with infants considered to be at risk of SUDI. Aim: To describe the safer sleep interventions tested with families with infants at risk of SUDI and investigate what this literature can tell us about what works to reduce risk and embed safer sleep practices in this group. Methods: Eight online databases were systematically searched in December 2019. Intervention studies that targeted families with infants (0-1 year) at increased risk of SUDI were included. Studies were limited to those from Western Europe, North America or Australasia, published in the last 15 years. The Quality Assessment Tool for Studies with Diverse Designs was applied to assess quality. Data from included studies were extracted for narrative synthesis, including mode of delivery using Michie et al.'s Mode of Delivery Taxonomy. Results: The wider review returned 3,367 papers, with 23 intervention papers. Five types of intervention were identified: (1) infant sleep space and safer sleep education programs, (2) intensive or targeted home visiting services, (3) peer educators/ambassadors, (4) health education/raising awareness interventions, (5) targeted health education messages using digital media. Conclusion: Influencing behavior in families with infants at risk of SUDI has traditionally focused on "getting messages across," with interventions predominantly using education and awareness raising mechanisms. This review found evidence of interventions moving from "information giving" to "information exchange" models using personalized, longer term relationship-building models. This shift may represent an improvement in how safer sleep advice is implemented in families with infants at risk, but more robust evidence of effectiveness is required. Systematic Review Registration: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/901091/DfE_Death_in_infancy_review.pdf, identifier: CRD42020165302.
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Affiliation(s)
- Catherine Ellis
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Anna Pease
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Joanna Garstang
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, United Kingdom
| | - Debbie Watson
- Children and Families Research Centre, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Peter S. Blair
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Peter J. Fleming
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Bonakdar Tehrani M, Kemp L, Baird K. Sustained nurse home-visiting with culturally and linguistically diverse families: Australian nurses' perspectives. Public Health Nurs 2021; 39:40-47. [PMID: 34687070 DOI: 10.1111/phn.12996] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Australia, sustained nurse home-visiting (SNHV) programs are designed and implemented to promote positive outcomes for mothers with young children experiencing complex life challenges. Despite the crucial role of trained public health nurses, there is a dearth of research about their experiences delivering these programs to culturally and linguistically diverse (CALD) families with limited English proficiency (LEP). AIM This study aimed to explore the experiences of public health nurses in providing services to CALD families with LEP. METHOD Two focus groups were conducted with 13 public health nurses in two major local health districts in Sydney. The focus groups were audio recorded for transcription purposes, and thematically analyzed. A socioecological framework was applied during the analysis process. RESULT Five major themes were identified: (1) program issues; (2) service system issues in understanding and responding to diverse women; (3) issues working with interpreters; (4) trusting relationships; and (5) mother-related facilitators. DISCUSSION To achieve better access and engagement for CALD families, it is crucial that public health nurses increase their knowledge and awareness about potential challenges, such as female interpreter availability, and facilitators, such as engaging the broader family, in order to effectively deliver healthcare services to diverse populations.
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Affiliation(s)
- Mehrnoush Bonakdar Tehrani
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Lynn Kemp
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Kelly Baird
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
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D'haenens F, Van Rompaey B, Swinnen E, Dilles T, Beeckman K. The effects of continuity of care on the health of mother and child in the postnatal period: a systematic review. Eur J Public Health 2021; 30:749-760. [PMID: 31121019 DOI: 10.1093/eurpub/ckz082] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Continuity of care (COC) is essential for high-quality patient care in the perinatal period. Insights in the effects of COC models on patient outcomes are important to direct perinatal healthcare organization. To our knowledge, no previous review has listed the effects of COC on the physical and mental health of mother and child in the postnatal period. METHODS A search was conducted in four databases (PubMed, Web of Knowledge, CENTRAL and CINAHL), from 2000 to 2018. Studies were included if: participants were healthy mothers or newborns with a gestational age between 37-42 weeks; they covered the perinatal period and aimed to measure breastfeeding or any outcome related to the maternal/newborn physical or mental health. At least one of the three COC types (management, informational and relationship) was identified in the intervention. The methodological quality was assessed. RESULTS Ten articles were included. COC is mostly present in the identified care models. The effects of COC on the outcomes of mother and child in the postnatal period seem mostly to be positive, although not always significant. The relation between COC and the outcomes can be influenced by confounding factors, like the socio-economic status of the included population. Interventions with COC during pregnancy appear to be more effective for all the studied outcome factors. CONCLUSION COC as management, relational and informational continuity starting antenatal has the most impact on the postnatal outcomes of mother and child.
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Affiliation(s)
- Florence D'haenens
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Bart Van Rompaey
- Department of Nursing and Midwifery Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium
| | - Eva Swinnen
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tinne Dilles
- Department of Nursing and Midwifery Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium
| | - Katrien Beeckman
- Nursing and Midwifery Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel and University Hospital Brussel, Brussels, Belgium
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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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Fan X, Kumar MB, Zhou Z, Lee CH, Wang D, Liu H, Dang S, Gao J. Influence of China's 2009 healthcare reform on the utilisation of continuum of care for maternal health services: evidence from two cross-sectional household surveys in Shaanxi Province. Int J Equity Health 2020; 19:100. [PMID: 32560727 PMCID: PMC7304157 DOI: 10.1186/s12939-020-01179-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/24/2020] [Indexed: 11/25/2022] Open
Abstract
Background Continuum of care for maternal health services (CMHS) is a proven approach to improve health and safety for mothers and newborns. This study aims to explore the influence of China’s 2009 healthcare reform on improving the CMHS utilisation. Methods This population-based cross-sectional quantitative study included 2332 women drawn from the fourth and fifth National Health Service Surveys of Shaanxi Province, conducted in 2008 and 2013 respectively, before and after China’s 2009 healthcare reform. A generalised linear mixed model (GLMM) was applied to analyse the influence of this healthcare reform on utilisation of CMHS. Concentration curves, concentration indexes and its decomposition method were used to analyse the equity of changes in utilisation. Results This study showed post-reform CMHS utilisation was higher in both rural and urban women than the CMHS utilisation pre-reform (according to China’s policy defining CMHS). The rate of CMHS utilisation increased from 24.66 to 41.55% for urban women and from 18.31 to 50.49% for rural women (urban: χ2 = 20.64, P < 0.001; rural: χ2 = 131.38, P < 0.001). This finding is consistent when the WHO’s definition of CMHS is applied for rural women after reform (12.13% vs 19.26%; χ2 = 10.99, P = 0.001); for urban women, CMHS utilisation increased from 15.70 to 20.56% (χ2 = 2.57, P = 0.109). The GLMM showed that the rate of CMHS utilisation for urban women post-reform was five times higher than pre-reform rates (OR = 5.02, 95%CL: 1.90, 13.31); it was close to 15 times higher for rural women (OR = 14.70, 95%CL: 5.43, 39.76). The concentration index for urban women decreased from 0.130 pre-reform (95%CI: − 0.026, 0.411) to − 0.041 post-reform (95%CI: − 0.096, 0.007); it decreased from 0.104 (95%CI: − 0.012, 0.222) to 0.019 (95%CI: − 0.014, 0.060) for rural women. The horizontal inequity index for both groups of women also decreased (0.136 to − 0.047 urban and 0.111 to 0.019 for rural). Conclusions China’s 2009 healthcare reform has positively influenced utilisation rates and equity of CMHS’s utilisation among both urban and rural women in Shaanxi Province. Addressing economic and educational attainment gaps between the rich and the poor may be effective ways to improve the persistent health inequities for rural women.
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Affiliation(s)
- Xiaojing Fan
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Meghan Bruce Kumar
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK.,MARCH Centre, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China.
| | - Ching-Hung Lee
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
| | - Haixia Liu
- School of Public Health and Management, Binzhou Medical University, Shandong, Yantai, 264003, China
| | - Shaonong Dang
- Department of Epidemiology and Health Statistics, School of Public Health, Center of Medical Science, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, 710061, China
| | - Jianmin Gao
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
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16
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Olander EK, Aquino MRJ(R, Chhoa C, Harris E, Lee S, Bryar R. Women's views on contact with a health visitor during pregnancy: an interview study. Prim Health Care Res Dev 2019; 20:e105. [PMID: 32800003 PMCID: PMC6609970 DOI: 10.1017/s146342361900046x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 04/06/2019] [Accepted: 04/30/2019] [Indexed: 11/17/2022] Open
Abstract
AIM To explore recent mothers' views of the health visiting antenatal contact in England. BACKGROUND English health visitors are mandated to be in contact with all women in the third trimester of pregnancy. The aim of this antenatal contact is to assess the needs of the family before the birth and support preparation for parenthood. Recent data show that this contact is provided fragmentarily and not always face-to-face. More information on how women view this contact could inform service provision. METHODS Twenty-nine mothers with a baby less than 1 year old were recruited via social media and word of mouth. Having had antenatal contact with a health visitor was not a requirement to participate in the study. Women took part in face-to-face or phone interviews and all recordings were transcribed verbatim. Data were analysed using systematic thematic analysis. FINDINGS Eleven women had contact with a health visitor during pregnancy: nine through a home visit, one via a letter and one via a phone call. The remaining 18 women were asked about what they would have wanted from an antenatal contact. Three themes were identified: relationship building, information provision, and mode and time of contact. Some participants who had experienced a home visit reported building rapport with their health visitor before the postnatal period, but not everyone had this experience. Women reported requesting and receiving information about the health visiting service and the role of the health visitor. Finally, women suggested different modes of contact, suggesting a letter or that the information about health visiting could be provided by a midwife. A few women preferred a home visit. These study findings show women were unclear regarding the aim of the health visitor antenatal contact. As such, the contact is unlikely to reach its full potential in supporting parents-to-be.
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Affiliation(s)
- Ellinor K. Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | | | - Celine Chhoa
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
| | - Erica Harris
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Suzanne Lee
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Ros Bryar
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
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17
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Wainaina CW, Wanjohi M, Wekesah F, Woolhead G, Kimani-Murage E. Exploring the Experiences of Middle Income Mothers in Practicing Exclusive Breastfeeding in Nairobi, Kenya. Matern Child Health J 2019; 22:608-616. [PMID: 29349653 DOI: 10.1007/s10995-018-2430-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives To establish exclusive breastfeeding (EBF) practice, women are encouraged to initiate breastfeeding of their newborns within one hour of delivery and breastfeed exclusively for the first 6 months of the infant's life. Research in Kenya has shown evidence of a reduced rate of EBF with an increase in socio-economic class (SES). This study explores the experiences of middle-income women so as to understand their attitudes and practices of EBF and to contribute toward the Baby Friendly Hospital (BFHI) and Baby Friendly Community Initiatives (BFCI) programs in Kenya. Methods A qualitative study using nine in-depth interviews and two focus group discussions were conducted with middle-income women with a child < 2 years. Thematic content analysis was used to analyze the data. Results The majority of the women interviewed did not achieve EBF and this was attributed to many challenges that they encountered such as; inadequate workplace support including short maternity leave, lack of designated breast feeding facilities flexible hours and breastfeeding breaks. Support structures were highlighted as either inadequate or lacking while the internet was preferred by most of the women for breastfeeding information. Mass media was seen as more credible, though some women indicated that there was lack of depth in the information it provided. Conclusion The study showed that majority of women were unable to EBF for the first 6 months. Women experienced inadequate social, healthcare and workplace support and preferred online sites for information on breastfeeding than the healthcare professionals or mass media. Recommendation There is need to implement policies at the workplace that promote a breastfeeding friendly environment. There is also a need for more research on role of mass media in promotion of optimal breastfeeding practices, especially how to reach this population. There is a need for continued advocacy on social support including spousal, relatives, and other community members at the community level.
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Affiliation(s)
- Caroline W Wainaina
- School of Public Health, Laureate Online Education, University of Liverpool, Liverpool, UK.
- African Population Health Research Center (APHRC), Nairobi, Kenya.
| | - Milka Wanjohi
- African Population Health Research Center (APHRC), Nairobi, Kenya
| | | | - Gillian Woolhead
- School of Public Health, Laureate Online Education, University of Liverpool, Liverpool, UK
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Hans SL, Edwards RC, Zhang Y. Randomized Controlled Trial of Doula-Home-Visiting Services: Impact on Maternal and Infant Health. Matern Child Health J 2018; 22:105-113. [PMID: 29855838 PMCID: PMC6153776 DOI: 10.1007/s10995-018-2537-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction Although home-visiting programs typically engage families during pregnancy, few studies have examined maternal and child health outcomes during the antenatal and newborn period and fewer have demonstrated intervention impacts. Illinois has developed an innovative model in which programs utilizing evidence-based home-visiting models incorporate community doulas who focus on childbirth education, breastfeeding, pregnancy health, and newborn care. This randomized controlled trial (RCT) examines the impact of doula-home-visiting on birth outcomes, postpartum maternal and infant health, and newborn care practices. Methods 312 young (M = 18.4 years), pregnant women across four communities were randomly assigned to receive doula-home-visiting services or case management. Women were African American (45%), Latina (38%), white (8%), and multiracial/other (9%). They were interviewed during pregnancy and at 3-weeks and 3-months postpartum. Results Intervention-group mothers were more likely to attend childbirth-preparation classes (50 vs. 10%, OR = 9.82, p < .01), but there were no differences on Caesarean delivery, birthweight, prematurity, or postpartum depression. Intervention-group mothers were less likely to use epidural/pain medication during labor (72 vs. 83%; OR = 0.49, p < .01) and more likely to initiate breastfeeding (81 vs. 74%; OR = 1.72, p < .05), although the breastfeeding impact was not sustained over time. Intervention-group mothers were more likely to put infants on their backs to sleep (70 vs. 61%; OR = 1.64, p < .05) and utilize car-seats at three weeks (97 vs. 93%; OR = 3.16, p < .05). Conclusions for practices The doula-home-visiting intervention was associated with positive infant-care behaviors. Since few evidence-based home-visiting programs have shown health impacts in the postpartum months after birth, incorporating doula services may confer additional health benefits to families.
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Affiliation(s)
- Sydney L Hans
- School of Social Service Administration, University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA.
| | - Renee C Edwards
- School of Social Service Administration, University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA
| | - Yudong Zhang
- School of Social Service Administration, University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA
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Lines L, Grant J, Hutton A. How Do Nurses Keep Children Safe From Abuse and Neglect, and Does it Make a Difference? A Scoping Review. J Pediatr Nurs 2018; 43:e75-e84. [PMID: 30064706 DOI: 10.1016/j.pedn.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the extent of child protection work performed by nurses and identify which interventions hold the strongest evidence for future practice. DESIGN This scoping review was guided by Arksey and O'Malley's framework for scoping reviews. DATA SOURCES Electronic databases (CINAHL, Medline, Scopus, Web of Science) and grey literature were searched in August 2017. Further studies were identified through manual literature searching. RESULTS Forty-one studies from seven countries met the inclusion criteria. The studies showed nurses keep children safe primarily through the prevention of abuse (n = 32), but also through detection of abuse (n = 1) and interventions to mitigate the effects of abuse (n = 8). Nurses' specific interventions most frequently involved post-natal home visiting (n = 20), parent education (n = 10) and assessment and care of children or adolescents following sexual abuse (n = 4). The main findings showed that although nurses did have positive impacts upon some measures of abuse and neglect, results were not consistent across studies. In addition, some studies used indirect measures of abuse and neglect, which may not impact children's experiences of abuse. It is difficult to extrapolate these findings to the broader nursing profession as literature did not accurately represent the range of ways that nurses keep children safe from abuse and neglect. CONCLUSIONS This review demonstrated nurses prevent, detect and respond to abuse and neglect in many ways. However, given mixed evidence and absence of some nurse interventions in the literature, further research is needed to represent the range of ways that nurses keep children safe and determine their effectiveness.
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Affiliation(s)
- Lauren Lines
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Julian Grant
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Alison Hutton
- School of Nursing and Midwifery, University of Newcastle, New South Wales, Australia.
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Goldfeld S, Price A, Kemp L. Designing, testing, and implementing a sustainable nurse home visiting program: right@home. Ann N Y Acad Sci 2018; 1419:141-159. [DOI: 10.1111/nyas.13688] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/16/2018] [Accepted: 02/28/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute; The Royal Children's Hospital; Parkville Victoria Australia
- Population Health; Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; The University of Melbourne; Parkville Victoria Australia
| | - Anna Price
- Centre for Community Child Health, Murdoch Children's Research Institute; The Royal Children's Hospital; Parkville Victoria Australia
- Population Health; Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; The University of Melbourne; Parkville Victoria Australia
| | - Lynn Kemp
- Ingham Institute; Western Sydney University; Sydney Victoria Australia
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Kemp L, Cowley S, Byrne F. Maternal Early Childhood Sustained Home-visiting (MECSH): A UK update. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/johv.2017.5.8.392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lynn Kemp
- Director, Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University; member of the Ingham Institute for Applied Medical Research
| | - Sarah Cowley
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London
| | - Fiona Byrne
- MECSH Project Officer, Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University; member of the Ingham Institute for Applied Medical Research
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Kemp L. Adaptation and Fidelity: a Recipe Analogy for Achieving Both in Population Scale Implementation. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:429-38. [PMID: 26969173 DOI: 10.1007/s11121-016-0642-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Balancing adherence to fidelity of evidence-based programs and adaptation to local context is one of the key debates in the adoption and implementation of effective programs. Concern about maintaining fidelity to achieve outcomes can result in replication of research-based models that can be a poor fit with the real world. Equally, unplanned adaptation can result in program drift away from the core elements needed to achieve outcomes. To support implementation of the Maternal Early Childhood Sustained Home-visiting (MECSH) program in multiple sites in three countries, an analogy was developed to identify how both fidelity and adaptation can be managed and successfully achieved. This article presents the Commonsense Cookery Book Basic Plain Cake with Variations recipe analogy to articulate the dual requirements of both fidelity and adaptation to achieve quality implementation of the MECSH program. Components classified by the analogy include identification of core ingredients, methods, and equipment that contribute to fundamental outcomes and fidelity to the evidence-based program, and a planned, collaborative approach to identification of needed variations to suit locally sourced capacity, needs, and tastes. Quality is achieved by identifying and measuring the core ingredients and the variations. Sourcing local ingredients and honoring of context support sustainability of quality practice. Using this analogy has assisted adopters of the MECSH program to understand that effective implementation requires uncompromised commitment to expectations of fidelity to the core components and methods; planned, proactive adaptation; systematic monitoring of both core program and agreed variations; and local ownership and sustainability.
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Affiliation(s)
- Lynn Kemp
- Centre for Health Equity Training Research and Evaluation (CHETRE), part of the Centre for Primary Health Care and Equity, Faculty of Medicine, UNSW Australia, Liverpool Hospital Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. .,Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia.
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Schmied V, Langdon R, Matthey S, Kemp L, Austin MP, Johnson M. Antenatal psychosocial risk status and Australian women's use of primary care and specialist mental health services in the year after birth: a prospective study. BMC Womens Health 2016; 16:69. [PMID: 27782825 PMCID: PMC5078921 DOI: 10.1186/s12905-016-0344-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 09/16/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Poor mental health in the perinatal period can impact negatively on women, their infants and families. Australian State and Territory governments are investing in routine psychosocial assessment and depression screening with referral to services and support, however, little is known about how well these services are used. The aim of this paper is to report on the health services used by women for their physical and mental health needs from pregnancy to 12 months after birth and to compare service use for women who have been identified in pregnancy as having moderate-high psychosocial risk with those with low psychosocial risk. METHODS One hundred and six women were recruited to a prospective longitudinal study with five points of data collection (2-4 weeks after prenatal booking, 36 weeks gestation, 6 weeks postpartum, 6 months postpartum and 12 months postpartum) was undertaken. Data were collected via face-to-face and telephone interviews, relating to psychosocial risk factors, mental health and service use. The prenatal psychosocial risk status of women (data available for 83 of 106 women) was determined using the Antenatal Risk Questionnaire (ANRQ) and was used to compare socio-demographic characteristics and service use of women with 'low' and 'moderate to high' risk of perinatal mental health problems. RESULTS The findings indicate high use of postnatal universal health services (child and family health nurses, general practitioners) by both groups of women, with limited use of specialist mental health services by women identified with moderate to high risk of mental health problems. While almost all respondents indicated that they would seek help for mental health concerns most had a preference to seek help from partners and family before accessing health professionals. CONCLUSION These preliminary data support local and international studies that highlight the poor uptake of specialist services for mental health problems in postnatal women, where this may be required. Further research comparing larger samples of women (with low and psychosocial high risk) are needed to explore the extent of any differences and the reasons why women do not access these specialist services.
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Affiliation(s)
- Virginia Schmied
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797 Penrith, Sydney, 2751, NSW, Australia.
| | - Rachel Langdon
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797 Penrith, Sydney, 2751, NSW, Australia
- Centre for Applied Nursing Research (a joint facility of the South Western Sydney Local Health District and Western Sydney University, Liverpool, Australia
- The Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia
| | - Stephen Matthey
- School of Psychology, University of Sydney and Research Director, Infant, Child & Adolescent Mental Health Service, South West Sydney Local Health District, Sydney, Australia
| | - Lynn Kemp
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797 Penrith, Sydney, 2751, NSW, Australia
| | - Marie-Paule Austin
- Chair, Perinatal Mental Health Unit University of New South Wales & St John of God Health Care, Burwood , Sydney, Australia
- The Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
- The Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia
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Rossiter C, Schmied V, Kemp L, Fowler C, Kruske S, Homer CSE. Responding to families with complex needs: a national survey of child and family health nurses. J Adv Nurs 2016; 73:386-398. [PMID: 27624334 DOI: 10.1111/jan.13146] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. BACKGROUND Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. DESIGN The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. METHODS Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. FINDINGS Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. CONCLUSION For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally.
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Affiliation(s)
- Chris Rossiter
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, New South Wales, Australia
| | - Lynn Kemp
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, New South Wales, Australia
| | - Cathrine Fowler
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Sue Kruske
- Maternal Child Health, Institute of Urban Indigenous Health, Bowen Hills, Queensland, Australia.,School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia
| | - Caroline S E Homer
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Broadway, New South Wales, Australia
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Breuer E, Lee L, De Silva M, Lund C. Using theory of change to design and evaluate public health interventions: a systematic review. Implement Sci 2016; 11:63. [PMID: 27153985 PMCID: PMC4859947 DOI: 10.1186/s13012-016-0422-6] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 04/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the increasing popularity of the theory of change (ToC) approach, little is known about the extent to which ToC has been used in the design and evaluation of public health interventions. This review aims to determine how ToCs have been developed and used in the development and evaluation of public health interventions globally. METHODS We searched for papers reporting the use of "theory of change" in the development or evaluation of public health interventions in databases of peer-reviewed journal articles such as Scopus, Pubmed, PsychInfo, grey literature databases, Google and websites of development funders. We included papers of any date, language or study design. Both abstracts and full text papers were double screened. Data were extracted and narratively and quantitatively summarised. RESULTS A total of 62 papers were included in the review. Forty-nine (79 %) described the development of ToC, 18 (29 %) described the use of ToC in the development of the intervention and 49 (79 %) described the use of ToC in the evaluation of the intervention. Although a large number of papers were included in the review, their descriptions of the ToC development and use in intervention design and evaluation lacked detail. CONCLUSIONS The use of the ToC approach is widespread in the public health literature. Clear reporting of the ToC process and outputs is important to strengthen the body of literature on practical application of ToC in order to develop our understanding of the benefits and advantages of using ToC. We also propose a checklist for reporting on the use of ToC to ensure transparent reporting and recommend that our checklist is used and refined by authors reporting the ToC approach.
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Affiliation(s)
- Erica Breuer
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700 Cape Town, South Africa
| | - Lucy Lee
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Mary De Silva
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Crick Lund
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700 Cape Town, South Africa
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Zapart S, Knight J, Kemp L. 'It Was Easier Because I Had Help': Mothers' Reflections on the Long-Term Impact of Sustained Nurse Home Visiting. Matern Child Health J 2015; 20:196-204. [PMID: 26497131 DOI: 10.1007/s10995-015-1819-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This qualitative descriptive study sought women's views of the Maternal Early Childhood Sustained Home-visiting (MECSH) program they received from prior to birth to child-age 2-years. MECSH is a structured nurse home visiting program for a broad range of women of all ages (both primiparous and multiparous) who experienced stressors in pregnancy that could negatively impact on maternal and child outcomes. Women were asked for their perceptions of how and why the intervention worked for them, and the impact of the intervention on their subsequent parenting to child-age 5-years. METHODS Thirty-six women participated in a semi-structured interview when their child commenced formal schooling at age 5-years. Recorded and transcribed data were analysed using qualitative content analysis. RESULTS Women described the importance of a positive relationship with the nurse, and nurses' availability and responsiveness as critical to positive impacts. The interventions they recalled receiving were consistent with the comprehensive MECSH program model. The intervention impacted on women's emotional well-being, confidence and help-seeking behaviour, and positively impacted on their parenting of their MECSH program child and their older and subsequent children. A small number of women reported feeling stressed and disconnected from services following program completion, however, most women continued to apply the learnings from the program. CONCLUSIONS Overall women reported positive impacts not just for themselves and their parenting abilities during the 2-year intervention program, but also described ongoing benefit to their subsequent parenting in the preschool period.
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Affiliation(s)
- Siggi Zapart
- Centre for Health Equity Training Research and Evaluation (CHETRE), A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia
| | - Jennifer Knight
- Centre for Health Equity Training Research and Evaluation (CHETRE), Part of the Centre for Primary Health Care and Equity, Faculty of Medicine, UNSW Australia, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia
| | - Lynn Kemp
- Centre for Health Equity Training Research and Evaluation (CHETRE), Part of the Centre for Primary Health Care and Equity, Faculty of Medicine, UNSW Australia, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. .,Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia.
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Tanninen HM, Häggman-Laitila A, Pietilä AM, Kangasniemi M. The content and effectiveness of home-based nursing interventions to promote health and well-being in families with small children: a systematic review. Scand J Caring Sci 2015; 30:217-33. [DOI: 10.1111/scs.12251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/07/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Arja Häggman-Laitila
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Anna-Maija Pietilä
- Social and Health Care Services; Kuopio Finland
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Mari Kangasniemi
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
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Psaila K, Fowler C, Kruske S, Schmied V. A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia. Women Birth 2014; 27:e51-60. [PMID: 25257376 DOI: 10.1016/j.wombi.2014.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/19/2014] [Accepted: 08/19/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND The transition of care (ToC) from maternity services, particularly from midwifery care to child and family health (CFH) nursing services, is a critical time in the support of women as they transition into early parenting. However significant issues in service provision exist, particularly meeting the needs of women with social and emotional health risk factors. These include insufficient resources, poor communication and information transfer, limited interface between private and public health systems and tension around role boundaries. In response some services are implementing strategies to improve the transition of care from maternity to CFH services. AIM This paper describes a range of innovations developed to improve transition of care between maternity and child and family health services and identifies the characteristics common to all innovations. METHODS Data reported were collected in phase three of a mixed methods study investigating the feasibility of implementing a national approach to child and family health services in Australia (CHoRUS study). Data were collected from 33 professionals including midwives, child and family health nurses, allied health staff and managers, at seven sites across four Australian states. Data were analysed thematically, guided by Braun and Clarke's six-step process of thematic analysis. FINDINGS The range of innovations implemented included those which addressed; information sharing, the efficient use of funding and resources, development of new roles to improve co-ordination of care, the co-location of services and working together. Four of the seven sites implemented innovations that specifically targeted families with additional needs. Successful implementation was dependent on the preliminary work undertaken which required professionals and/or organisations to work collaboratively. CONCLUSION Improving the transition of care requires co-ordination and collaboration to ensure families are adequately supported. Collaboration between professionals and services facilitated innovative practice and was core to successful change.
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Affiliation(s)
- Kim Psaila
- School of Nursing and Midwifery, Building EB Parramatta Campus, University of Western Sydney, Australia.
| | - Cathrine Fowler
- Tresillian Chair for Child & Family Health Centre for Midwifery, Child & Family Health Faculty of Nursing, Midwifery & Health University of Technology Sydney, Australia.
| | - Sue Kruske
- Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Qld 4072, Australia.
| | - Virginia Schmied
- School of Nursing and Midwifery, The Family and Community Health Research Group, Building EB Parramatta Campus, University of Western Sydney, Australia.
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Breuer E, De Silva MJ, Fekadu A, Luitel NP, Murhar V, Nakku J, Petersen I, Lund C. Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME). Int J Ment Health Syst 2014; 8:15. [PMID: 24808923 PMCID: PMC4012094 DOI: 10.1186/1752-4458-8-15] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 04/18/2014] [Indexed: 12/01/2022] Open
Abstract
Background The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way in high income countries. Little is known about its use to develop mental health care plans in low and middle income countries where mental health services remain inadequate. Aims ToC workshops were held as part of formative phase of the Programme for Improving Mental Health Care (PRIME) in order 1) to develop a structured logical and evidence-based ToC map as a basis for a mental health care plan in each district; (2) to contextualise the plans; and (3) to obtain stakeholder buy-in in Ethiopia, India, Nepal, South Africa and Uganda. This study describes the structure and facilitator’s experiences of ToC workshops. Methods The facilitators of the ToC workshops were interviewed and the interviews were recorded, transcribed and analysed together with process documentation from the workshops using a framework analysis approach. Results Thirteen workshops were held in the five PRIME countries at different levels of the health system. The ToC workshops achieved their stated goals with the contributions of different stakeholders. District health planners, mental health specialists, and researchers contributed the most to the development of the ToC while service providers provided detailed contextual information. Buy-in was achieved from all stakeholders but valued more from those in control of resources. Conclusions ToC workshops are a useful approach for developing ToCs as a basis for mental health care plans because they facilitate logical, evidence based and contextualised plans, while promoting stakeholder buy in. Because of the existing hierarchies within some health systems, strategies such as limiting the types of participants and stratifying the workshops can be used to ensure productive workshops.
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Affiliation(s)
- Erica Breuer
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch 7700, Cape Town, South Africa
| | - Mary J De Silva
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Abebaw Fekadu
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, PO Box 9086 Addis Ababa, Ethiopia ; King's College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders and Affective Disorders Research Group, London, UK
| | - Nagendra Prasad Luitel
- Transcultural Psychosocial Organization Nepal, Baluwatar, Box 8974, Kathmandu, GPO, Nepal
| | - Vaibhav Murhar
- Sangath, HN - 6, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh, India
| | - Juliet Nakku
- Butabika National Mental Hospital, Kampala, Uganda
| | - Inge Petersen
- School of Psychology, University of KwaZulu-Natal, Howard College Campus, Durban 4000, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch 7700, Cape Town, South Africa
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Maher CM, Spurling GKP, Askew DA. Health and well-being of urban Aboriginal and Torres Strait Islander women at their first antenatal visit: A cross-sectional study. Aust N Z J Obstet Gynaecol 2013; 54:88-90. [DOI: 10.1111/ajo.12159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Clare M. Maher
- Inala Indigenous Health Service; Queensland Health; Brisbane Queensland Australia
- Discipline of General Practice; School of Medicine; University of Queensland; Brisbane Queensland Australia
| | - Geoffrey K. P. Spurling
- Inala Indigenous Health Service; Queensland Health; Brisbane Queensland Australia
- Discipline of General Practice; School of Medicine; University of Queensland; Brisbane Queensland Australia
| | - Deborah A. Askew
- Inala Indigenous Health Service; Queensland Health; Brisbane Queensland Australia
- Discipline of General Practice; School of Medicine; University of Queensland; Brisbane Queensland Australia
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Schmied V, Johnson M, Naidoo N, Austin MP, Matthey S, Kemp L, Mills A, Meade T, Yeo A. Maternal mental health in Australia and New Zealand: A review of longitudinal studies. Women Birth 2013; 26:167-78. [DOI: 10.1016/j.wombi.2013.02.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 01/03/2013] [Accepted: 02/12/2013] [Indexed: 10/26/2022]
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