Working in partnership: user perceptions of intensive home visiting

Abstract

The aim of this study was to explore the perceptions of vulnerable women about the value of intensive home visiting in pregnancy and the first year of life delivered by health visitors trained to work in partnership with families.Twenty in-depth interviews were conducted with women who had completed the home visiting programme and agreed to be interviewed. The data were fully transcribed and analysed thematically.Despite initial concerns and negative preconceptions about health and social service professionals, participating women greatly valued the relationships that were established with their home visitors and identified a number of ways in which they had benefited. These included increased confidence, improved mental health, better parenting, improved relationships and changes in their attitudes toward professionals.These findings demonstrate the potential of intensive home visiting delivered in partnership with mothers in reaching and helping vulnerable and 'hard-to-reach' families. They highlight the importance of establishing a trusting relationship between helper and provider, and the need for home visitors to have the necessary skills and qualities to establish such relationships.

Why health visiting? Examining the potential public health benefits from health visiting practice within a universal service: A narrative review of the literature

“…Whilst there may be some common thinking about the difficult things in parenting, the importance and priority of these difficulties can differ between health visitors and parents (Foster and Mayall, 1990;Bloomfield et al, 2005). Failure to read cues, or to purposively seek clarification of parents' understanding, risks damaging future opportunities for health promotion, as parents may feel they are being dictated to and misunderstood when presented with unsolicited advice (Bloor and McIntosh, 1990;Foster and Mayall, 1990;Kirkpatrick et al, 2007;McIntosh and Shute, 2007). This may be perceived as being judgemental (Roche, et al, 2005) or as 'negative verbal persuasion' (Bandura, 1982), which has the potential to undermine selfefficacy, whereas 'positive verbal persuasion' (praise, encouragement, support) can help it to develop.…”

“…In some instances, the health visitor may mediate between the parent and a third party (Bryans et al, 2009) and, when the parent accepts referral, the health visitor can support introductions to another source of help (Luker and Chalmers, 1989;Kirkpatrick et al, 2007). After identifying needs and resources, offering some follow-up can help the parent feel that they are valued and being kept in mind (Hanafin and Cowley, 2006;Worth and Hogg, 2000).…”

Exploring mothers’ perspectives of an intensive home visiting program in Australia: A qualitative study

“…A review of the published and grey literature indicated that while there was a heavy focus on program evaluation, the majority of evaluation reports do not include an investigation of clients' perspectives of intensive home visiting programs. There are five studies that have specifically investigated parents' perspectives of intensive nurse home visiting programs: two of these studies are from the United Kingdom (McIntosh & Shute, 2006;Kirkpatrick et al, 2007), two from Canada (Jack et al, 2005;Heaman et al, 2005) and one from the United States of America (DeMay, 2003). Five major themes were identified during the review of these studies, they included: negative preconceptions, trusting relationships, support, empowerment, and change.…”

Exploring mothers' perspectives of an intensive home visiting program in Australia: A qualitative study.

“…For participants, engaging in the program was an ongoing cyclical process that included When difficult messages are communicated with respect, they are likely to be accepted with respect (Kirkpatrick et al, 2007). Lack of respect and adversity especially in early childhood can result is low self-esteem or not valuing one's self, depression and abusive relationships in adulthood (Saunders, 2002).…”