Background: Maternal depression can be detrimental to infant development.

This study investigated the characteristics of families with a new baby, screened to identify families with vulnerability, who did not take up the offer of home‐visiting support from a community volunteer. Using logistic regression, background factors were compared with those families receiving support. Those not receiving support, 59.1% of those referred, were more socially, educationally and economically disadvantaged, living in more disadvantaged neighbourhoods. Those who received support were more likely to have larger families, no local support network, or had family members with health or mental health problems. One in nine families referred had not been reached by the support service. In brief qualitative telephone interviews, mothers who did not take up the offer of support reported changing their mind, wanting to cope without help and in some cases feeling that the support offered did not meet their specific needs. Policy implications are suggested, in particular offering support to new parents thought to be vulnerable within a statutory framework, with sufficient infrastructure and resources to conduct outreach work. Research implications include making a concerted effort to find out about families who decide not to take part in service evaluation studies, or who drop out after initial agreement.

Mrs. Michelle Nichols was a fieldwork interviewer for the Right from the Start study.She has recently completed a PGCE at the University of Hertfordshire.Mrs. Sharon Dixon was a fieldwork interviewer for the Right from the Start study. She now works as a regional fieldwork interviewer for the National Evaluation of Sure Start. AbstractSemi-structured interviews were conducted with 55 mothers of infants. Some had received Home-Start during their infant's first year, others were offered the support but declined and the remainder were not offered Home-Start. Most of their support had come from informal sources such as family and friends with less from professionals.Mothers who received Home-Start described beneficial aspects, in particular the extent of practical support provided, preferable to calling on close relatives or friends.Difficulties related to volunteer characteristics and administrative problems. Overall volunteer support can be important to complement informal and formal support but needs careful management.

The study reported here aimed to evaluate the impact on parenting and the home environment of community volunteer home visiting offered during or soon after pregnancy to potentially vulnerable mothers. A cluster‐randomised study allocated Home‐Start schemes to intervention or comparison (existing services) conditions. Mothers were screened at routine health checks. Families in intervention and comparison areas were assessed at two and 12 months. The results showed that comparing families receiving support and those in comparison areas, there were few differences. There was a greater reduction in parent‐child relationship difficulties for supported families, but they offered their children fewer healthy foods. There was no evidence of enhanced parenting, organisation of the home environment or more appropriate use of health services. Comparing families receiving support with a second comparison group, living in intervention areas but not receiving support, no differences were found. The article concludes that a more structured approach may be required to make changes in parenting behaviour and the home environment.

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