Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children. (10th October 2020)

• Record Type: Journal Article
• Authors: Molloy, Carly; Beatson, Ruth; Harrop, Christopher; Perini, Nicholas; Goldfeld, Sharon
• Is Part Of: Journal of advanced nursing. Volume 77:Number 1(2021)
• Page Start: 147
• Page End: 161
• Publication Date: 2020-10-10
• Subjects: adverse childhood experiences -- child health -- home visiting -- maternal health -- midwives -- nurses -- parenting behaviour -- psychosocial development -- systematic review; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.14576
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aims: To systematically evaluate published experimental studies of sustained nurse home visiting (SNHV) programs. This review summarizes the evidence and identifies gaps in the literature to inform practice, policy, and future research. Design: Restricted systematic review with narrative summary. Data Sources: Databases searched were Medline, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials. Year of publication was originally restricted from 2008 to the date of search (13 February 2018, with supplementary searches conducted to identify more recent publications (up to 2019). Several reputable evidence clearinghouses were also searched. Review Methods: Studies were included if they used a randomized or cluster‐randomized controlled trial to evaluate a home visiting program that: (a) targeted disadvantaged mothers; (b) commenced during pregnancy or prior to the child's first birthday; (c) had an intended duration of at least 12 months from the time of enrolment; and (d) was substantively delivered by nurses or midwives. Meta‐analyses and reviews of studies meeting these criteria were also included. A quality appraisal was conducted for all studies. Results: Of 1, 393 total articles, 30 met inclusion criteria. Seven specific SNHV programs were identified. Each demonstrated evidence of a positive statistical effect on at least one child or maternal outcome. Conclusion: Sustained nurse home visiting programs benefit disadvantaged families, though effects vary across outcomes and subgroups. Further research is needed to discern the critical components of effective programs. Impact: As SNHV programs have gained policy appeal, the need to evaluate the evidence‐base supporting such interventions has become imperative. The findings of this review will assist policy‐makers and practitioners in high‐income countries to make evidence‐informed decisions about which programs are best suited to addressing specific maternal and child outcomes for disadvantaged families. This should in turn ameliorate some of the inequalities in child development that have significant social and economic costs. 摘要: 目标: 对已发表的持续护士家访(SNHV)项目实验研究进行系统性评价。这篇评价文章对相关证据进行概述, 确定文献中存在的差距, 供实践、政策和未来研究作参考。 设计: 有限的系统性回顾和叙述性总结。 数据来源: 进行检索的数据库包括联机医学文献分析和检索系统(MEDLINE)、护理学数据库(CINAHL)、心理学文摘(PsycINFO)和Cochrane对照试验中央寄存器。出版年份起止日期为2008年至检索当日(2018年2月13日, 进行补充检索以确定较新的发表文章(截至2019年)。此外, 也搜索了几个著名的证据资料库。 评价方法: 将采用随机对照试验或群随机对照试验评估家访项目的研究纳入在内:(a)目标弱势母亲;(b)在怀孕期间或孩子一岁前开始;(c)从登记之日起至少12个月的计划时间;(d)实质上由护士或助产士接生。此外, 将符合这些标准的研究荟萃分析和评价纳入在内。对所有研究进行质量评估。 结果: 在共计1393篇文章中, 有30篇符合入选标准。确定了7个特定的持续护士家访项目。每一个项目均有证据表明至少对一个孩子或母亲具有积极统计影响的成果。 结论: 持续护士家访项目有益于弱势家庭, 尽管其有益的效果会因成果和不同子组而有所不同。需要开展进一步的研究, 觉察到有效项目的关键组成部分。 影响: 随着持续护士家访项目获得政策倾向, 评估支持此类干预措施的循证需求变得势在必行。这篇评价文章的结果将有助于高收入国家的政策制定者和实施人员就哪些项目最为适合解决弱势家庭中母亲和儿童具体问题做出循证决策, 进而改善会造成社会和经济代价的儿童发展中的一些不平等现象。