A randomized, controlled trial of nurse home visiting to vulnerable families with newborns

Objective: This project aimed to evaluate the impact of a home visiting pro gramme that targeted families where the child, for environmental reasons, w as at great risk of poor health and developmental outcomes. Methodology: Women in the immediate postpartum period were recruited to a r andomized double-blind controlled trial on the basis of self-reported vulne rability factors and were randomly assigned to receive either a structured programme of nurse home visiting, supported by a social worker and paediatr ician (n = 90), or assigned to a comparison group receiving standard commun ity child health services (n = 91). Parenting stress and maternal depressio n were measured at enrolment and at 6 weeks. Preventive health behaviour, s ervice satisfaction and home environment outcomes were tested at 6 weeks, a s were child health outcomes. Results: At six weeks, women receiving the home-based programme had signifi cant reductions in postnatal depression screening scores as well as improve ments in their experience of the parental role and improvement in the abili ty to maintain their own identity. Maternal-infant interactions were more l ikely to be positive, with significantly higher (better) scores in aspects of the home environment related to optimal development in children, particu larly maternal-infant secure attachment. intervention group mothers were si gnificantly more satisfied with the community child health service. Conclusions: This form of intervention for families is effective in promoti ng secure maternal-infant attachment, preventing maternal mood disorder and is welcomed by the families receiving it. These findings may predict long- term benefits for the healthy development of children otherwise at risk of a range of poor health and development outcomes.