Variations in sustained home visiting care for mothers and children experiencing adversity.
Kie Kanda, Stacy Blythe, Rebekah Grace and 2 others
PMID 34862813WHAT IT FOUND
Nurses delivered most scheduled home-visiting content on time or within an acceptable window, except antenatal sleep content.
Mothers reporting smoking, mental health, domestic violence, or drugs and alcohol were more likely to receive matching content than mothers without those risks.
Key findings
01Most scheduled home-visiting content was delivered on time or within an acceptable time range, except the antenatal sleep program module.
02Women who reported smoking, mental health, domestic violence, or drugs and alcohol were more likely to receive risk-related content than women without those risks, with odds ratios of 15.4, 15.0, 4.1, and 1.8.
03The most frequently provided content changed over time: mental health was most frequent antenatal to 6 months, and infant health and development were most frequent from 7 months to 2 years.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was limited to the right@home program in two Australian states, so it may not apply to other home-visiting services or countries. The women were those who initially agreed to take part, so families with very high levels of adversity may not be represented. Visit content came from nurses' own checklist records, not direct observation, so delivery may be over-reported or misclassified. The study describes what content was delivered; it does not test whether the content improved maternal or child outcomes. Some women did not commence or complete the program, so the findings mainly describe those who did. Risk factors and program needs may differ by geography, socioeconomic status, and culture, so local adaptation and local risk assessment are needed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that nurse home visiting improves maternal or child outcomes. The paper reports what nurses recorded delivering and how often content matched scheduled modules or reported risks, not whether families got better.