High school diploma or GED
78%
Source
Kemp, L., Harris, E., McMahon, C., Matthey, S., Vimpani, G., Anderson, T., Schmied, V., Aslam, H., & Zapart, S. (2011). Child and family outcomes of a long-term nurse home visitation programme: A randomised controlled trial. Archives of Disease in Childhood, 96, 533-540.
Model(s) Reviewed
Funding Sources
The trial was funded by the Australian Research Council (LP0560285), Sydney South West Area Health Service, the New South Wales (NSW) Department of Community Services, and the NSW Department of Health.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Equivalent on SES, information on race/ethnicity not available | None |
Notes
Moderate rating applies to outcomes (birthweight and preterm birth) measured at the one-month post partum follow-up, which had low attrition. Outcomes measured after one month postpartum had high attrition. Because of missing data on race and ethnicity, baseline equivalence could not be established and all other outcomes receive a low rating.
Study Participants
Pregnant women were eligible to participate if they did not require the use of an interpreter and reported at least one risk factor for poor maternal or child outcomes during routine psychosocial and domestic violence screenings conducted by midwives in a local hospital. After consenting to participate in the study, 208 eligible mothers were randomly assigned to the program (MECSH) or comparison group before baseline data were collected, assigning 111 to MECSH and 97 to the comparison group. There were no significant differences between the two groups on age, marital status, educational attainment, source of income, or number of risk factors. The study did not report baseline information on race or ethnicity, so equivalence could not be established on this factor. Participants were followed for 24 months.
Setting
The study was conducted in a socioeconomically disadvantaged suburb of Sydney, Australia.
Home Visiting Services
Women in the intervention group received an average of 16.3 visits (range 0–52), each of 60 to 90 minutes duration, by a child health nurse. Visits began, on average, at 26 weeks gestation and continued up to the child’s second birthday. Home visits included information and activities to encourage child development and linkages to community activities (such as parenting groups).
Comparison Conditions
Women in both study conditions received usual antenatal midwifery, obstetric, and birthing services. Comparison group women were expected to receive a home visit by a child health nurse within two weeks of giving birth, in accordance with standard practice in New South Wales.
Study Participants
Pregnant women were eligible to participate if they did not require the use of an interpreter and reported at least one risk factor for poor maternal or child outcomes during routine psychosocial and domestic violence screenings conducted by midwives in a local hospital. After consenting to participate in the study, 208 eligible mothers were randomly assigned to the program (MECSH) or comparison group before baseline data were collected, assigning 111 to MECSH and 97 to the comparison group. There were no significant differences between the two groups on age, marital status, educational attainment, source of income, or number of risk factors. The study did not report baseline information on race or ethnicity, so equivalence could not be established on this factor. Participants were followed for 24 months.
Setting
The study was conducted in a socioeconomically disadvantaged suburb of Sydney, Australia.
Home Visiting Services
Women in the intervention group received an average of 16.3 visits (range 0–52), each of 60 to 90 minutes duration, by a child health nurse. Visits began, on average, at 26 weeks gestation and continued up to the child’s second birthday. Home visits included information and activities to encourage child development and linkages to community activities (such as parenting groups).
Comparison Conditions
Women in both study conditions received usual antenatal midwifery, obstetric, and birthing services. Comparison group women were expected to receive a home visit by a child health nurse within two weeks of giving birth, in accordance with standard practice in New South Wales.
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Low birth weight (< 2500 g) | 1 month | Moderate | 0.79 | Not Statistically significant, p = 0.15 | 201 mothers | Sydney sample | ||
| Preterm (< 37 weeks) | 1 month | Moderate | 0.33 | Not Statistically significant, p = 0.32 | 203 mothers | Sydney sample | ||
| Respiratory infection | 24 months | Moderate | 0.06 | Not Statistically significant, p = 0.76 | 166 children | Sydney sample | ||
| Gastroenteritis | 24 months | Moderate | 0.05 | Not Statistically significant, p = 0.76 | 166 children | Sydney sample | ||
| Immunization up to date | 24 months | Moderate | Not statistically significant, p ≥ 0.05 | 166 children | Sydney sample | |||
| Transition to solids (weeks) | 12 months | Moderate | Not statistically significant, p ≥ 0.05 | 162 children | Sydney sample | |||
| Breastfeeding duration (weeks) | 12 months | Moderate | 0.52 | Statistically significant, p = 0.002 | 139 children | Sydney sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Home Observation for Measurement of the Environment (HOME), Responsivity | 24 months | Moderate | 0.26 | Statistically significant, p = 0.02 | 174 mothers | Sydney sample | ||
| Home Observation for Measurement of the Environment (HOME), Avoidance of restriction and punishment | 24 months | Moderate | Not Statistically significant, p = 0.18 | 174 mothers | Sydney sample | |||
| Home Observation for Measurement of the Environment (HOME), Organization of environment | 24 months | Moderate | Not Statistically significant, p = 0.43 | 174 mothers | Sydney sample | |||
| Home Observation for Measurement of the Environment (HOME), Provision of appropriate play materials | 24 months | Moderate | Not Statistically significant, p = 0.21 | 174 mothers | Sydney sample | |||
| Home Observation for Measurement of the Environment (HOME), Maternal involvement with child | 24 months | Moderate | Not Statistically significant, p = 0.76 | 174 mothers | Sydney sample | |||
| Home Observation for Measurement of the Environment (HOME), Variety in daily stimulation | 24 months | Moderate | Not Statistically significant, p = 0.49 | 174 mothers | Sydney sample | |||
| Household always smoke free | 24 months | Moderate | 0.00 | Not Statistically significant, p = 0.99 | 208 mothers | Sydney sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Mother never smoked | 24 months | Moderate | 0.00 | Not Statistically significant, p = 0.38 | 208 mothers | Sydney sample | ||
| Maternal general health | 24 months | Moderate | Not Statistically significant, p = 0.33 | 208 mothers | Sydney sample | |||
| Maternal physical health | 24 months | Moderate | Not Statistically significant, p = 0.84 | 208 mothers | Sydney sample | |||
| Maternal mental health | 24 months | Moderate | Not Statistically significant, p = 0.69 | 208 mothers | Sydney sample | |||
| Maternal depression | 24 months | Moderate | Not Statistically significant, p = 0.55 | 208 mothers | Sydney sample | |||
| Maternal social support | 24 months | Moderate | Not Statistically significant, p = 0.26 | 208 mothers | Sydney sample | |||
| Family functioning | 24 months | Moderate | Not Statistically significant, p = 0.21 | 208 mothers | Sydney sample | |||
| Stressful life events | 24 months | Moderate | Not Statistically significant, p = 0.98 | 208 mothers | Sydney sample | |||
| Maternal experience of being a mother | 12 months | Moderate | Not statistically significant, p ≥ 0.05 | 138 mothers | Sydney sample |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- State not reported or international
International Locations
Australia