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Effectiveness of nurse home visiting for families in rural South Australia

Authors

  • Michael G Sawyer,

    Corresponding author
    1. Discipline of Paediatrics, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
    2. Research and Evaluation Unit, Women's and Children's Health Network, North Adelaide, South Australia, Australia
    • Correspondence: Prof. Michael G Sawyer, Research and Evaluation Unit, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia. Fax: +61 8 8161 6906; email: michael.sawyer@adelaide.edu.au

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  • Sara Pfeiffer,

    1. Research and Evaluation Unit, Women's and Children's Health Network, North Adelaide, South Australia, Australia
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  • Alyssa Sawyer,

    1. Discipline of Public Health, School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
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  • Kerrie Bowering,

    1. Child and Family Health Service, Women's and Children's Health Network, Adelaide, South Australia, Australia
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  • Debra Jeffs,

    1. Child and Family Health Service, Women's and Children's Health Network, Adelaide, South Australia, Australia
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  • John Lynch

    1. Discipline of Public Health, School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
    2. School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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  • Conflict of interest/financial disclosures: The authors have no conflicts of interest or financial disclosures.

Abstract

Aim

To evaluate the effectiveness of a 2-year post-natal home-visiting programme delivered by nurses to socially disadvantaged mothers in rural regions of South Australia.

Methods

The intervention group consisted of 225 mothers who lived in rural regions and enrolled in the programme between 2010 and 2012. The comparison group consisted of 239 mothers who lived in rural areas between 2008 and 2009 when the programme was not yet available. All participants were eligible for enrolment in the home-visiting programme. Participants in both groups were assessed at baseline (mean child age = 15.2 weeks, SD = 2.4), prior to programme enrolment, and again when children were aged 9, 18 and 24 months. Outcomes were evaluated using the Parent Stress Index, Kessler Psychological Distress Scale, Ages and Stages Questionnaire, Child Behaviour Checklist, and MacArthur Communicative Developmental Inventory.

Results

During the follow-up period, there was little difference in the pattern of scores across the two groups. Mixed models adjusting for baseline differences between the groups did not identify any significant Group × Time interactions. This suggests that the linear trajectories of scores on outcomes did not differ significantly between the two groups.

Conclusions

Findings suggest that the home-visiting programme did not have a measurable effect on maternal or child outcomes. However, the programme was relatively early in its rollout, and the greater challenges of recruitment, training and support, along with rural nurses’ broader responsibilities for delivering other maternal and child health services, may explain why effects seen in the metropolitan area were not evident in rural regions.

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