Universal and targeted early home visiting: perspectives of public health nurses, managers and mothers

Abstract

Early home visits provided by public health nurses (PHNs) around the world have been proven to positively impact physical, social, emotional and mental health outcomes of mothers and babies. Most of the research has focused on home visiting programs delivered by public health nurses and lay home visitors to support <em>at</em> <em>risk</em> or <em>targeted</em> mothers. Little research has been conducted to examine <em>universal</em> home visiting programs for mothers who are perceived to be lower-risk. The purpose of this research was to explore how universal and targeted early home visiting programs for mothers and babies were organized, delivered and experienced through the everyday practices of PHNs, mothers, and managers in one city in Atlantic Canada. Feminist post-structuralism was used to collect and analyze data through semi-structured face-to-face interviews with 16 PHNs, 16 mothers and 4 managers. Personal, social and institutional discourses of program delivery were examined using discourse analysis. Four main themes of the study include: i) understanding targeted and universal programming; ii) health outcomes; iii) building relationships; and iv) exploring a new surveillance. This article will discuss the first theme; understanding targeted and universal programming.

Public Health Nurses and Mothers Challenge and Shift the Meaning of Health Outcomes

“…This strong focus on primary prevention, health promotion, and protection for children and mothers continues to underpin PHN practice today. Yet, despite this long history, the work of PHNs around the world has not been well researched or evaluated and therefore continues to be misunderstood, misconstrued, unrecognized, undervalued, and seen as women’s work (Aston et al, 2014a, 2014b; Davies, 1998; Stamler & Yiu, 2011; Yiu & Horsburgh, 1989). …”

Teaching Feminist Poststructuralism: Founding Scholars Still Relevant Today

“…My colleagues and I have used and continue to use FPS in our research studies that span a variety of health issues including postpartum care of mothers, caring for intellectually disabled children and obesity management. The following is a list of articles and dissertations by faculty and students who used FPS (Abudulai, 2014;Aston et al, 2016, Aston et al, 2014a, Aston et al, 2014b, Aston et al, 2014c, Aston et al, 2014d, Aston et al, 2011Bye & Aston, 2016;Cassidy et al, 2016;Griscti, 2015, Griscti et al 2016Kirk et al, 2014;MacConnell et al, 2012;Price et al, 2015;Sheppard-Lemoine, 2015).…”

Examining the social construction of surveillance: A critical issue for health visitors and public health nurses working with mothers and children

“…Aston (), Aston () examined the importance of relationships and how PHNs attempted to shift practices of surveillance and the hierarchies of health outcomes. While mothers expressed feeling a bit nervous before meeting the PHNs and worried about being judged, they also expressed great relief after meeting the PHNs and said that the PHNs helped them to feel confident, normal and to have more self‐esteem, sometimes after only one visit.…”

“…Mildon, Betker, and Underwood () agreed with Meagher‐Stewart, Edwards, Aston and Young that although it had not yet been fully incorporated into practice, there had been increased attention to the surveillance work of PHNs particularly with the emergence of socio‐ecological surveillance and what it meant in practice. A socio‐ecological surveillance discourse incorporates strength‐based language and practices such as being present with mothers and engaging in building trusting relationships that lead to supporting mothers’ strengths and ideas (Cowley et al., ; Hartrick Doane & Varcoe, ; Aston, ).…”

“…Meagher-Stewart, Edwards, Aston, and Young (2009) relationships that lead to supporting mothers' strengths and ideas (Cowley et al, 2013;Hartrick Doane & Varcoe, 2015;Aston, 2014).…”