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Study Detail

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.

Program(s) Reviewed: Maternal Early Childhood Sustained Home-Visiting Program (MECSH)

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
ModerateRandomized controlled trialLowEquivalent on SES, information on race/ethnicity not availableNoneNone
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 Characteristics

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 Condition

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.

Staff Characteristics and Training

Child and family health nurses provided all intervention home visits.

Funding Source

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.

Author Affiliation

Lynn Kemp, a study author, is a developer of this program model.


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