Effectiveness of home visiting programs on child outcomes: a systematic review

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• 作者：Shelley Peacock (1)
  Stephanie Konrad (2)
  Erin Watson (3)
  Darren Nickel (4)
  Nazeem Muhajarine (2) (5)
  
• 关键词：Systematic review ; Paraprofessionals ; Young children ; Home visits ; Socially high ; risk families
• 刊名：BMC Public Health
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：256KB
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  34. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/13/17/prepub
  
• 作者单位：Shelley Peacock (1)
  Stephanie Konrad (2)
  Erin Watson (3)
  Darren Nickel (4)
  Nazeem Muhajarine (2) (5)
  
  1. College of Nursing, University of Saskatchewan, 414 St. Andrew’s College, 1121 College Drive, Saskatoon, SK, S7N 0W3, Canada
  2. Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
  3. Health Sciences Library, University of Saskatchewan, Saskatoon, SK, Canada
  4. Physical Medicine & Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
  5. Saskatchewan Population Health and Evaluation Research Unit, Saskatoon, SK, Canada
  
• ISSN：1471-2458

文摘

Background The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families. Methods A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE) from 1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6?years) from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies. Results Studies that scored 13 or greater out of a total of 15 on the validity tool (n--1) are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a) prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b) developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c) reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families. Conclusions Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the intervention prenatally and increasing the number of visits improves development and health outcomes for particular groups of children. Future studies should consider what dose of the intervention is most beneficial and address retention issues.