High school diploma or GED
78%
Source
Kemp, L., Harris, E., McMahon, C., Matthey, S., Vimpani, G., Anderson, T., Schmied, V., & Aslam, H. (2013). Benefits of psychosocial intervention and continuity of care by child and family health nurses in the pre‐and postnatal period: Process evaluation. Journal of Advanced Nursing, 69(8), 1850–1861.
Model(s) Reviewed
Funding Sources
The trial was funded by the Australian Research Council, 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
In order to receive a high rating, randomized controlled trials (RCTs) with low attrition must control for race/ethnicity, socioeconomic status (SES), and, if applicable, baseline outcomes if statistically significant differences exist between treatment and control groups. In this case, there were no significant differences in terms of race/ethnicity, but we had insufficient information to assess baseline equivalence on SES because the only SES measure collected at baseline was maternal education. HomVEE prefers to see equivalence on income, earnings, or poverty levels according to federal thresholds, but also considers other measures of SES (that is, maternal education, employment, and Aid to Families with Dependent Children/Temporary Assistance for Needy Families or food stamps receipt), if at least two such alternative measures of SES are provided.
Moderate rating does not apply to infant sleeping environment and mother enablement outcomes which had high attrition.
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 (Maternal Early Childhood Sustained Home Visiting Program, or MECSH) or comparison group before baseline data were collected. One hundred eleven were assigned to MECSH and 97 to the comparison group. This study reports on prenatal and birth outcomes, as well as outcomes measured at four to six weeks postpartum.
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, 60 to 90 minutes long). Visits were conducted by a child health nurse. Visits began, on average, at 26 weeks gestation and continued 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 (Maternal Early Childhood Sustained Home Visiting Program, or MECSH) or comparison group before baseline data were collected. One hundred eleven were assigned to MECSH and 97 to the comparison group. This study reports on prenatal and birth outcomes, as well as outcomes measured at four to six weeks postpartum.
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, 60 to 90 minutes long). Visits were conducted by a child health nurse. Visits began, on average, at 26 weeks gestation and continued 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 | |
|---|---|---|---|---|---|---|---|---|
| Genitourinary infection in pregnancy | Birth | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 203 mothers | Western Sydney | ||
| Gestational diabetes | Birth | Moderate | 0.20 | Not statistically significant, p ≥ 0.05 | 203 mothers | Western Sydney | ||
| Pregnancy-induced hypertension | Birth | Moderate | 0.40 | Not statistically significant, p ≥ 0.05 | 203 mothers | Western Sydney | ||
| Unassisted vaginal delivery | Birth | Moderate | 0.25 | Not statistically significant, p ≥ 0.05 | 199 mothers | Western Sydney | ||
| Assisted vaginal delivery | Birth | Moderate | 0.30 | Not statistically significant, p ≥ 0.05 | 199 mothers | Western Sydney | ||
| Caesarean section | Birth | Moderate | 0.13 | Not statistically significant, p ≥ 0.05 | 199 mothers | Western Sydney | ||
| Maternal general health, very good or excellent | 4-6 weeks | Moderate | 0.44 | Statistically significant, p = 0.03 | 141 mothers | Western Sydney |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Infant admission to special care nursery | Birth | Moderate | 0.12 | Not statistically significant, p ≥ 0.05 | 203 mothers | Western Sydney | ||
| Breastfeeding initiated | Birth | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 202 mothers | Western Sydney | ||
| Breastfeeding fully or partially at 4 weeks | 4 weeks | Moderate | 0.12 | Not statistically significant, p ≥ 0.05 | 161 mothers | Western Sydney | ||
| SIDS risk knowledge | 4 weeks | Moderate | 0.35 | Statistically significant, p = 0.04 | 137 mothers | Western Sydney |
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