The content and effectiveness of home-based nursing interventions to promote health and well-being in families with small children: a systematic review

Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children

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.

Relations Among Maternal Life Satisfaction, Shared Activities, and Child Well-Being

Maternal well-being is assumed to be associated with well-being of individual family members, optimal parenting practices, and positive developmental outcomes for children. The objective of this study was to examine the interplay between maternal well-being, parent-child activities, and the well-being of 5- to 7-year-old children. In a sample of N = 291 mother-child dyads, maternal life satisfaction, the frequency of shared parent-child activities, as well as children's self-regulation, prosocial behavior, and receptive vocabulary were assessed using several methods. Data were collected in a special study of the Socio-Economic Panel Study (SOEP), a representative longitudinal survey of private households in Germany. Using structural equation modeling, significant positive direct and indirect relations between maternal life satisfaction, frequency of shared parent-child activities, children's self-regulation, prosocial behavior, and receptive vocabulary were found. The more satisfied the mother was, the more she shared activities with her child and the more the child acted prosocially. Furthermore, the higher the frequency of shared parent-child activities, the higher the child scored in all three analyzed indicators of children's well-being: self-regulation, prosocial behavior, and receptive vocabulary. The current study supports the assumption of maternal well-being as the basis of positive parenting practices and child well-being.

Family-Based Maternal Sensitivity Model as a Strategy to Optimize Family Perception on the Role of Parents and the Growth of Infants

Introduction: Family perceptions on the role of parents and the growth of infants must be seriously considered by healthcare workers since they can affect the role of family development in taking care of the babies. A family that has optimally understood the role of their development as a parent will be able to give the appropriate care for the babies.Methods: The study aimed to find out the effects of a family-based Maternal Sensitivity Models (MSM) strategy for family perception optimization on the role of parents and the growth of infants. It used a quasi-experimental design with the samples of 50 families. The samples were obtained using purposive sampling technique. The data were analyzed using dependent t-test.Results: It confirmed that the Family-Based Maternal Sensitivity Models (MSM) strategy significantly affects family perceptions on the role of parents with t-value 5.915 and p-value 0.000. MSM also significantly affects family perceptions on the growth infants with the t-value -11.257 and p-value 0.000.Conclusions: Maternal Sensitivity Models (MSM) can be well applied as one of the health models provided by healthcare workers to optimize parents’ perceptions and infants’ growth as well as to develop a competent family in giving care for their babies.