Infant health effects of a nurse-community health worker home visitation programme: a randomized controlled trial
Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse–CHW team approach over nurse prenatal and postnatal home visiting...
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| Published in | Child : care, health & development Vol. 39; no. 1; pp. 27 - 35 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.01.2013
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse–CHW team approach over nurse prenatal and postnatal home visiting.
Methods A randomized trial was conducted with Medicaid‐insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse–CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother.
Results There were no differences in overall child health between the nurse–CHW intervention and the CC arm over the first year of life. There were fewer mother‐reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections.
Conclusions There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. |
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| AbstractList | Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse-CHW team approach over nurse prenatal and postnatal home visiting. Methods A randomized trial was conducted with Medicaid-insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse-CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother. Results There were no differences in overall child health between the nurse-CHW intervention and the CC arm over the first year of life. There were fewer mother-reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P=0.01; adjusted OR=0.4, P=0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections. Conclusions There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. Adapted from the source document. Abstract Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse–CHW team approach over nurse prenatal and postnatal home visiting. Methods A randomized trial was conducted with Medicaid‐insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse–CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother. Results There were no differences in overall child health between the nurse–CHW intervention and the CC arm over the first year of life. There were fewer mother‐reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections. Conclusions There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. BACKGROUND Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse-CHW team approach over nurse prenatal and postnatal home visiting.METHODS A randomized trial was conducted with Medicaid-insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse-CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother.RESULTS There were no differences in overall child health between the nurse-CHW intervention and the CC arm over the first year of life. There were fewer mother-reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections.CONCLUSIONS There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse-CHW team approach over nurse prenatal and postnatal home visiting. A randomized trial was conducted with Medicaid-insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse-CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother. There were no differences in overall child health between the nurse-CHW intervention and the CC arm over the first year of life. There were fewer mother-reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections. There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse–CHW team approach over nurse prenatal and postnatal home visiting. Methods A randomized trial was conducted with Medicaid‐insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse–CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother. Results There were no differences in overall child health between the nurse–CHW intervention and the CC arm over the first year of life. There were fewer mother‐reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections. Conclusions There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse-CHW team approach over nurse prenatal and postnatal home visiting. A randomized trial was conducted with Medicaid-insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse-CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother. There were no differences in overall child health between the nurse-CHW intervention and the CC arm over the first year of life. There were fewer mother-reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections. There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers (CHWs). Few studies compared the child health advantages of a nurse-CHW team approach over nurse prenatal and postnatal home visiting. Methods A randomized trial was conducted with Medicaid-insured pregnant women in Kent County, Michigan. Pregnant women were assigned to a team intervention including nurse-CHW home visitation, or standard community care (CC) including nurse home visitation. Morbidity was assessed in 530 infants over their first 12 months of life from medical claims and reported by the mother. Results There were no differences in overall child health between the nurse-CHW intervention and the CC arm over the first year of life. There were fewer mother-reported asthma/wheezing/croup diagnostics in the team intervention group among infants whose mothers have low psychosocial resources (13% vs. 27%, P = 0.01; adjusted OR = 0.4, P = 0.01). There were no differences in diagnosed asthma/wheezing/croup documented by medical claims. There were no differences in immunizations, hospitalizations and ear infections. Conclusions There was no strong evidence that infant health was improved by the addition of CHWs to a programme of CC that included nurse home visitation. Targeting such interventions at common health problems of infancy and childhood or at diagnosed chronic conditions may prove more successful. 16 references |
| Author | Li, B. Zhu, Q. Moore, J. S. Meghea, C. I. Raffo, J. E. Lindsay, J. K. Roman, L. A. |
| Author_xml | – sequence: 1 givenname: C. I. surname: Meghea fullname: Meghea, C. I. email: cristian.meghea@hc.msu.edu organization: Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University – sequence: 2 givenname: B. surname: Li fullname: Li, B. organization: Kellogg School of Management, Northwestern University, Evanston, IL, USA – sequence: 3 givenname: Q. surname: Zhu fullname: Zhu, Q. organization: Institute for Health Care Studies, Michigan State University, East Lansing – sequence: 4 givenname: J. E. surname: Raffo fullname: Raffo, J. E. organization: Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University – sequence: 5 givenname: J. K. surname: Lindsay fullname: Lindsay, J. K. organization: Spectrum Health, Grand Rapids, MI – sequence: 6 givenname: J. S. surname: Moore fullname: Moore, J. S. organization: Spectrum Health, Grand Rapids, MI – sequence: 7 givenname: L. A. surname: Roman fullname: Roman, L. A. organization: Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22372918$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.chiabu.2006.06.011 10.1016/j.chiabu.2007.02.008 10.1542/peds.2008-3607 10.1046/j.1525-1446.2001.00225.x 10.2105/AJPH.85.8_Pt_1.1055 10.1016/j.chiabu.2007.07.007 10.1542/peds.2005-0948 10.1016/j.pcl.2009.01.002 10.1023/A:1019990432161 10.1353/jhr.2008.0003 10.1046/j.0737-1209.2003.20306.x 10.1007/s00737-009-0083-4 10.1111/j.1525-1446.2007.00630.x 10.1001/archpediatrics.2008.532 |
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| References_xml | – volume: 116 start-page: e803 year: 2005 end-page: e809 article-title: Randomized trial of the Early Start Program of home visitation publication-title: Pediatrics – year: 2009 – volume: 18 start-page: 225 year: 2001 end-page: 235 article-title: Promoting infant health through home visiting by a nurse‐managed community worker team publication-title: Public Health Nursing – volume: 31 start-page: 829 year: 2007 end-page: 852 article-title: Impact of a statewide home visiting program on parenting and on child health and development publication-title: Child Abuse & Neglect – volume: 32 start-page: 295 year: 2008 end-page: 315 article-title: Healthy Families New York (HFNY) randomized trial: effects on early child abuse and neglect publication-title: Child Abuse & Neglect – volume: 24 start-page: 239 year: 2007 end-page: 248 article-title: Addressing mental health and stress in Medicaid insured pregnant women using a nurse‐community health worker home visiting team publication-title: Public Health Nursing – volume: 43 start-page: 88 year: 2008 end-page: 138 article-title: Short, medium and long term consequences of poor infant health: an analysis using siblings and twins publication-title: The Journal of Human Resources – year: 2007 – volume: 123 start-page: 598 year: 2009 end-page: 603 article-title: The role of preschool home‐visiting programs in improving children's developmental and health outcomes publication-title: Pediatrics – volume: 12 start-page: 379 year: 2009 end-page: 391 article-title: Alleviating perinatal depressive symptoms and stress: a nurse‐community health worker randomized trial publication-title: Archives of Women's Mental Health – volume: 56 start-page: 389 year: 2009 end-page: 403 article-title: Home visiting for the prevention of child maltreatment: lessons learned during the past 20 years publication-title: Pediatric Clinics of North America – volume: 163 start-page: 141 year: 2009 end-page: 149 article-title: A randomized controlled trial of asthma self‐management support comparing clinic‐based nurses and in‐home community health workers: the Seattle‐King County Healthy Homes II Project publication-title: Archives of Pediatrics & Adolescent Medicine – volume: 31 start-page: 801 year: 2007 end-page: 827 article-title: Impact of a statewide home visiting program to prevent child abuse publication-title: Child Abuse & Neglect – volume: 3 start-page: 153 year: 2002 end-page: 172 article-title: Prenatal and infancy home visiting by nurses: from randomized trials to community replication publication-title: Prevention Science – volume: 20 start-page: 190 year: 2003 end-page: 203 article-title: Maternal and infant outcomes at one year for a nurse‐health advocate home visiting program serving African Americans and Mexican Americans publication-title: Public Health Nursing – volume: 85 start-page: 1055 year: 1995 end-page: 1058 article-title: Community health workers: integral members of the health care work force publication-title: American Journal of Public Health – ident: e_1_2_9_6_1 doi: 10.1016/j.chiabu.2006.06.011 – ident: e_1_2_9_3_1 doi: 10.1016/j.chiabu.2007.02.008 – ident: e_1_2_9_4_1 doi: 10.1542/peds.2008-3607 – ident: e_1_2_9_2_1 doi: 10.1046/j.1525-1446.2001.00225.x – ident: e_1_2_9_17_1 doi: 10.2105/AJPH.85.8_Pt_1.1055 – ident: e_1_2_9_7_1 doi: 10.1016/j.chiabu.2007.07.007 – ident: e_1_2_9_8_1 doi: 10.1542/peds.2005-0948 – ident: e_1_2_9_5_1 doi: 10.1016/j.pcl.2009.01.002 – ident: e_1_2_9_11_1 doi: 10.1023/A:1019990432161 – ident: e_1_2_9_12_1 doi: 10.1353/jhr.2008.0003 – ident: e_1_2_9_10_1 doi: 10.1046/j.0737-1209.2003.20306.x – ident: e_1_2_9_13_1 doi: 10.1007/s00737-009-0083-4 – ident: e_1_2_9_15_1 – ident: e_1_2_9_14_1 doi: 10.1111/j.1525-1446.2007.00630.x – volume-title: Outcomes of Community Health Worker Interventions year: 2009 ident: e_1_2_9_16_1 contributor: fullname: Viswanathan M. – ident: e_1_2_9_9_1 doi: 10.1001/archpediatrics.2008.532 |
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| Snippet | Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health... Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health workers... Abstract Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or... BACKGROUND Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health... Background Home visiting is supported as a way to improve child health and development. Home visiting has been usually provided by nurses or community health... |
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| SubjectTerms | Adolescent Adult Asthma - prevention & control Child Health Child Health Services - organization & administration Children Childrens health Clinical Nursing Research - methods Clinical outcomes Community health care Community Health Nursing - organization & administration Community Health Workers - organization & administration Croup - prevention & control Domiciliary visits Female Health Home Care Services - organization & administration Home health care Home Visits House Calls Humans Infant Infant Welfare - statistics & numerical data Infant, Newborn Infants interventions maternal Medical personnel Michigan morbidity Nurses Outcome Assessment (Health Care) Patient Care Team - organization & administration Pediatrics Pregnancy Prenatal Care - organization & administration prevention Program Evaluation Stress, Psychological - prevention & control Teams Young Adult Young Children |
| Title | Infant health effects of a nurse-community health worker home visitation programme: a randomized controlled trial |
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