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Study Detail

Kemp, L., Harris, E., McMahon, C., Matthey, S., Vimpani, G., Anderson, T., Schmied, V., & Aslam, H. (2012). 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. DOI: 10.1111/jan.12052

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:

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 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 (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 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, 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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