Less than a high school diploma
23.82%
Source
Peer reviewed?
Yes
Goldfeld, S., Bryson, H., Mensah, F., Gold, L., Orsini, F., Perlen, S., Price, A., Hiscock, H., Grobler, A., Dakin, P., Bruce, T., Harris, D., & Kemp, L. (2021). Nurse home visiting and maternal mental health: 3-year follow-up of a randomized trial. Pediatrics, 147(2), 1–11.
Model(s) Reviewed
Funding Sources
This research was supported by the state governments of Victoria and Tasmania, the Ian Potter Foundation, Sabemo Trust, the Sidney Myer Fund, the Vincent Fairfax Family Foundation, and the National Health and Medical Research Council by Award Number 1079418.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No |
Yes |
Notes
Information to demonstrate equivalence of the intervention and comparison groups was based on correspondence with the author. Several findings received a low rating because they do not satisfy HomVEE’s baseline equivalence requirement: the Personal Wellbeing Index; the Depression Anxiety Stress Scales (DASS), Stress scale score; and the self-efficacy scale score. The authors present findings using multiple imputation as well as findings using complete case analysis. The complete case findings were used in HomVEE’s review because the findings using imputation did not meet all requirements under HomVEE standards.
Study Participants
Study participants were pregnant women recruited from prenatal clinics in public maternity hospitals across two states in Australia. To be eligible, women had to be at no more than 36 weeks of gestation, have sufficient knowledge of English to complete interviews, have 2 or more risk factors from a list of 10 identified at screening for poor child outcomes, and have home addresses within travel boundaries of the participating areas. A total of 722 pregnant women were randomly assigned to either the home visiting intervention (363 women) or the comparison condition (359 women); 528 women were included in the analyses in this manuscript (255 in the intervention group and 240 in the comparison group). Outcomes were measured when children were 3 years old. In the study, 24 percent of mothers did not complete high school, 65 percent completed high school or vocational training, and 11 percent had a university degree.
Setting
The study took place in Victoria and Tasmania in Australia.
Home Visiting Services
The Maternal Early Childhood Sustained Home-Visiting (MECSH) intervention—as implemented in this study called Right@Home—consisted of about 25 home visits with a nurse that lasted 60 to 90 minutes each. The visits began before the child was born and lasted until the child reached 24 months. Mothers typically worked with the same trained nurse throughout the intervention. During visits, nurses focused on parent education around sleep routines, safety practices, nutrition, and emotional regulation, as well as the home learning environment. Nurses also provided guidance and instruction in bonding and the parent-child relationship, as well as maternal health and well-being. Nurses used video feedback and motivational interviewing strategies as primary modes of interaction. The intervention also included one or more visits by a program social care practitioner who assisted the nurse with delivering services and provided counseling and case management.
Comparison Conditions
Mothers in the comparison group received six to nine consultations with a nurse until the child reached 24 months. The first consultation occurred in families’ homes and other occurred at local centers. The consultations focused on broad-ranging supports for child health and development as well as parental well-being.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Depression Anxiety Stress Scales (DASS): Total Score (reverse coded) |
3 years old |
High | 0.25 | Statistically significant, p= <.01 |
487 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
||
Depression Anxiety Stress Scales (DASS): Depression Scale (reverse coded) |
3 years old |
High | 0.20 | Statistically significant, p= <.01 |
488 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
||
Depression Anxiety Stress Scales (DASS): Anxiety Scale (reverse coded) |
3 years old |
High | 0.17 | Statistically significant, p= 0.01 |
488 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
||
Depression Anxiety Stress Scales (DASS): Depression Scale (dichotomized, reverse coded) |
3 years old |
High | 0.31 | Statistically significant, p= 0.02 |
488 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
||
Depression Anxiety Stress Scales (DASS): Anxiety Scale (dichotomized, reverse coded) |
3 years old |
High | 0.20 | Not statistically significant, p= 0.12 |
488 mothers | MECSH vs. comparison, Australia, 2013-2017, full 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