Home-based support for disadvantaged teenage mothers.
BACKGROUND
Babies born to socio-economically disadvantaged mothers are at higher risk of injury, abuse or neglect and health problems than babies born to more affluent mothers; disadvantaged teenage mothers are at particular risk of adverse outcomes. Home-visiting programs are thought to improve outcomes for both mothers and children, largely through advice and support.


OBJECTIVE
To assess the effectiveness of home-visiting programmes for women who have recently given birth and who are socially or economically disadvantaged.


METHODS
The following electronic databases were searched: CENTRAL (2006, Issue 3); MEDLINE (1966 to March 2006); EMBASE (1980 to week 12 2006); CINAHL (1982 to March week 4 2006); PsycINFO (1872 to March week 4 2006); ASSIA (1987 to March 2006); LILACS (1982 to March 2006); and Sociological Abstracts (1963 to March 2006). Grey literature was also be searched using ZETOC (1993 to March 2006); Dissertation Abstracts International (late 1960s to 2006); and SIGLE (1980 to March 2006). Communication with published authors about ongoing or unpublished research was also undertaken.


METHODS
Included studies were randomised controlled trials investigating the efficacy of home visiting directed at teenage mothers.


METHODS
Titles and abstracts identified in the search were independently assessed for eligibility by two review authors (EC and JP or CB). Data were extracted and entered into RevMan (EC, JP and CB), synthesised and presented in both written and graphical form (forest plots). Outcomes included in this review were established at the protocol stage by an international steering group. The review did not report on all outcomes reported in included studies.


RESULTS
Five studies with 1838 participants were included in this review. Data from single studies provided support for the effectiveness of home visiting on some outcomes, but the evidence overall provided only limited support for the effectiveness of home visiting as a means of improving the range of maternal and child outcomes considered in this review.


CONCLUSIONS
This review suggests there is only limited evidence that home-visiting programmes of the kind described in this review can impact positively on the quality of parenting of teenage mothers or on child development outcomes for their offspring. For reasons discussed in the review, this does not amount to a conclusion that home-visiting programmes are ineffective but indicates a need to think carefully about the problems that home visiting might influence and about improvements in the conduct and reporting of outcome studies in this area.
Macdonald
G
G
School of Sociology, Social Policy and Social Work, Director of Education, Queen's University Belfast, 6 College Park, Belfast, Northern Ireland, UK, BT7 1LP. Geraldine.Macdonald@qub.ac.uk
Bennett
C
C
Dennis
J
J
Coren
E
E
Patterson
J
J
Astin
M
M
Abbott
J
J
D000293:Adolescent; D002657:Child Development; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D008425:Maternal Behavior; D008427:Maternal Health Services; D008429:Maternal Welfare; D009034:Mother-Child Relations; D009035:Mothers; D016487:Parenting; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D035862:Vulnerable Populations