A randomised controlled trial of specialist health visitor intervention for failure to thrive.
OBJECTIVE
To determine whether home intervention by a specialist health visitor affects the outcome of children with failure to thrive.


METHODS
Children referred for failure to thrive were randomised to receive conventional care, or conventional care and additional specialist home visiting for 12 months. Outcomes measured were growth, diet, use of health care resources, and Bayley, HAD (hospital anxiety and depression), and behavioural scales.


RESULTS
Eighty three children, aged 4-30 months, were enrolled, 42 received specialist health visitor intervention. Children in both groups showed good weight gain (mean (SD) increase in weight SD score for the specialist health visitor intervention group 0.59 (0.63) v 0.42 (0.62) for the control group). Children < 12 months in the intervention group showed a higher mean (SD) increase in weight SD score than the control group (0.82 (0.86) v 0.42 (0.79)). Both groups improved in developmental score and energy intake. No significant differences were found for the primary outcome measures, but controls had significantly more dietary referrals, social service involvement, and hospital admissions, and were less compliant with appointments.


CONCLUSIONS
The study failed to show that specialist health visitor intervention conferred additional benefits for the child. However, the specialist health visitor did provide a more coordinated approach, with significant savings in terms of health service use. Problems inherent to health service research are discussed.
Raynor
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P
Community Paediatrics, Leeds Community and Mental Health Trust, Belmont House, 3-5 Belmont Grove, Leeds LS2 9NP, UK.
Rudolf
M C
MC
Cooper
K
K
Marchant
P
P
Cottrell
D
D
D002652:Child Behavior; D002657:Child Development; D002662:Child Health Services / Q000706:statistics & numerical data; D016241:Child of Impaired Parents; D002675:Child, Preschool; D003152:Community Health Nursing; D004032:Diet; D004739:England; D005183:Failure to Thrive / Q000451:nursing*; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers / Q000523:psychology; D010352:Patient Dropouts; D012017:Referral and Consultation; D012044:Regression Analysis; D016037:Single-Blind Method