Effectiveness of home visiting programs on child outcomes: a systematic review

Abstract

BackgroundThe effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families.MethodsA comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE) from 1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years) from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies.ResultsStudies that scored 13 or greater out of a total of 15 on the validity tool (n = 21) are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a) prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b) developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c) reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families.ConclusionsHome visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the intervention prenatally and increasing the number of visits improves development and health outcomes for particular groups of children. Future studies should consider what dose of the intervention is most beneficial and address retention issues.

Nurturing care: promoting early childhood development

“…The RMNCH and nutrition reviews relied primarily on six recent overviews of reviews, including the Lancet 2014 Every Newborn series, (16) the Lancet 2013 Maternal and Child Nutrition series, (17) the Lancet 2013 Child Pneumonia and Diarrhoea series, (18) the Reproductive Health 2014 supplement on essential MNCH interventions, (19) and the WHO/RMNCH/AKU 2011 Essential Interventions for RMNCH report, (20) and the Lancet 2016 Breastfeeding series. (21) The education review was based on four recent reviews, including the Lancet 2011 ECD series, (22) a 2015 Annual Review of Psychology systematic review of parenting interventions,(23) a DFID literature review of parenting and early childhood programmes, (24) and a UNICEF systematic review of parenting programmes. (25) A meta-analysis of education programmes was conducted to determine non-cognitive developmental benefits of parenting and early childhood education programmes, as this information was not available in existing systematic reviews.…”

Sundhedsplejens indsatser og betydning i arbejdet med små udsatte børn og familier

“…Effektiviteten af brugen af paraprofessionelle ved hjemmebesøg i udsatte familier er uklar, hvorfor dette review (Peacock et al, 2013) har netop det fokusområde. Alle de involverede studier er randomiserede, kontrollerede forsøg, primaert udført i USA.…”

“…Der er endvidere taget udgangspunkt i eksisterende forskning på området, hvilket i dansk sammenhaeng er staerkt begraenset, men som i international er behaeftet med en raekke forskningsprojekter, der blandt andet retter sig mod etnicitet (Martin et al, 2012) og effekter af hjemmebesøg (Peacock et al, 2013;Duggan et al, 2007), om end disse studier ikke kan sammenlignes direkte med naervaerende projekt af forskellige årsager.…”

“…Saerligt de ekstra hjemmebesøg beskriver sundhedsplejerskerne som effektive: Effektiviteten af hjemmebesøg har laenge vaeret den internationale forsknings interessefelt, hvori hovedparten stiller sig kritisk overfor, hvorvidt besøgene har den ønskede effekt overfor de allermest udsatte familier (Peacock et al, 2013). Duggan et al (2007) stiller spørgsmålstegn ved effektiviteten af hjemmebesøg, når disse udføres i de allermest udsatte familier, og Olds et al (1995) fremhaever en positiv betydning, saerligt hvis hjemmebesøgene ivaerksaettes praenatalt.…”

Parental Expectations of Maternal and Child Health Services

“…However, "the voices, perspectives, and experiences of pregnant and parenting women are […] often overlooked or not understood by professionals" (Humbert & Roberts, 2009, p. 588). In addition, studies on maternal and child health care tend to focus on specific programs for specific target groups such as home visiting programs which are generally considered a promising strategy for at-risk families, such as single parents, low-income families, teenage mothers or parents from ethnic minorities (McCabe, Potash, Omohundro, & Taylor, 2012;McNaughton, 2004;Meghea, Zhu, Lindsay, Moore, & Roman, 2012;Peacock, Konrad, Watson, Nickel, & Muhajarine, 2013;Sheppard, Williams, & 3 Richardson, 2005). Studies that go beyond targeted at-risk groups seem to be rather scarce.…”