title: Child and family outcomes of a long-term nurse home visitation programme: a randomised controlled trial.
abstract: OBJECTIVE
  To investigate the impact of a long-term nurse home visiting programme, embedded within a universal child health system, on the health, development and well-being of the child, mother and family.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  208 (111 intervention, 97 comparison) eligible at-risk mothers living in a socioeconomically disadvantaged area in Sydney, booking into the local public hospital for confinement.
  
  
  METHODS
  A sustained and structured nurse home visiting antenatal and postnatal parenting education and support programme.
  
  
  METHODS
  Usual universal care.
  
  
  METHODS
  The quality of the home environment for child development (12-24 months), parent-child interaction and child mental, psychomotor and behavioural development at 18 months.
  
  
  RESULTS
  Mothers receiving the intervention were more emotionally and verbally responsive (HOME observation) during the first 2 years of their child's life than comparison group mothers (mean difference 0.5; 95% CI 0.1 to 0.9). Duration of breastfeeding was longer for intervention mothers than comparison mothers (mean difference 7.9 weeks; 95% CI 2.9 to 12.9). There was no significant difference in parent-child interaction between the intervention and comparison groups. There were no significant overall group differences in child mental, psychomotor or behavioural development. Mothers assessed antenatally as having psychosocial distress benefitted from the intervention across a number of areas.
  
  
  CONCLUSIONS
  This sustained nurse home visiting programme showed trends to enhanced outcomes in many, but not all, areas. Specifically, it resulted in clinically enhanced outcomes in breastfeeding duration and, for some subgroups of mothers, women's experience of motherhood and children's mental development.
  
  
  BACKGROUND
  ACTRN12608000473369.
authors.affiliation: Centre for Health Equity Training Research and Evaluation, School of Public Health and Community Medicine, University of New South Wales, Liverpool Hospital, Liverpool BC, NSW 1871, Australia. l.kemp@unsw.edu.au
authors.forename: Lynn
authors.initials: L
authors.lastname: Kemp
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Harris
authors.forename: Catherine
authors.initials: C
authors.lastname: McMahon
authors.forename: Stephen
authors.initials: S
authors.lastname: Matthey
authors.forename: Graham
authors.initials: G
authors.lastname: Vimpani
authors.forename: Teresa
authors.initials: T
authors.lastname: Anderson
authors.forename: Virginia
authors.initials: V
authors.lastname: Schmied
authors.forename: Henna
authors.initials: H
authors.lastname: Aslam
authors.forename: Siggi
authors.initials: S
authors.lastname: Zapart
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D002657:Child Development; D002662:Child Health Services / Q000458:organization & administration; D002669:Child Welfare / Q000706:statistics & numerical data; D002675:Child, Preschool; D003152:Community Health Nursing / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D004812:Epidemiologic Methods; D005192:Family Health; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010287:Parent-Child Relations; D010290:Parents / Q000193:education; D011204:Poverty Areas; D012959:Socioeconomic Factors; D055815:Young Adult