Effectiveness of a 2‐year post‐natal nurse home‐visiting programme when children are aged 5 years: Results from a natural experiment

• Published in: Journal of paediatrics and child health 2019-09, Vol.55 (9), p.1091-1098
• Main Authors: Sawyer, Alyssa CP, Kaim, Amy LE, Mittinity, Murthy N, Jeffs, Debra, Lynch, John W, Sawyer, Michael G
• Format: Article
• Language: English
• Subjects: Adult; Australia; Checklist; Child Behavior; Child, Preschool; Childrens health; early childhood; Female; Health visiting; Humans; Low income groups; Male; mother; Neonatal nursing; nurse home visiting; Nurses, Community Health; Parent-Child Relations; Postnatal Care; Preschool children; Program Evaluation; programme evaluation; Surveys and Questionnaires
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/jpc.14348

Aim To evaluate the effect of a 2‐year post‐natal nurse home visiting (NHV) programme delivered in routine clinical practice to socially disadvantaged mothers on children's development at 5 years. Methods The study was a natural experiment resulting from progressive rollout of NHV (2008–2012). Children of three groups of mothers, all eligible for NHV, were compared: (i) mothers receiving NHV in a metropolitan region (n = 197); (ii) mothers in a rural region prior to NHV being available (n = 94); and (iii) mothers receiving NHV in the rural region after it became available (n = 84). Outcomes were evaluated using the Child Behaviour Checklist, Child–Parent Relationships Scale, Behaviour Inventory of Executive Functioning and Australian Early Development Index. Results Analyses were conducted using augmented inverse probability weighting accounting for differences in the groups' baseline characteristics. While some differences were observed in the range of 8–12% between the intervention and comparison groups (albeit with wide confidence intervals, e.g. 31% less likely to 4% more likely to be experiencing poor outcomes). For the majority of outcomes, however, there were no differences observed between the intervention and comparison groups. Conclusions Post‐natal NHV provided as a part of routine service delivery did not improve children's outcomes at 5 years. It may be that in the Australian context a NHV intervention, as offered in this study, does not provide additional benefits over standard care.