Primary studies included in this systematic review

loading
89 articles (95 References) Revert Studify

Primary study

Unclassified

Treatment of depressed mothers in home visiting: impact on psychological distress and social functioning.

blocked
Journal Child abuse & neglect
Year 2013
Links Pubmed DOI PubMed Central

This article is included in 1 Broad synthesis Broad syntheses (1 reference) 1 Systematic review Systematic reviews (1 reference)

Loading references information
OBJECTIVES: Depression is prevalent in mothers receiving home visiting. Little is known about the impact of treatment on associated features of maternal depression in this population. The purpose of this study was to examine the impact of a novel, adapted treatment for depressed mothers in home visiting on psychological distress and social functioning. METHODS: In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat depressed mothers in home visiting. A randomized clinical trial design was used in which subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visiting (n = 47) or standard home visiting (SHV; n = 46) in which they received home visitation alone and could obtain treatment in the community. Measures of psychological distress, social support, and social network were measured at pre-treatment, post-treatment, and three-month follow-up. Clinical features of depression and home visiting parameters were examined as potential moderators. RESULTS: Subjects receiving IH-CBT reported decreased psychological distress at post-treatment (ES = 0.77) and follow-up (ES = 0.73). Examination of types of psychological distress indicated broad improvements at both time points. Those receiving IH-CBT reported increased social support over time relative to those in the SHV condition. Effect sizes were modest at post-treatment (ES = 0.38) but increased at follow-up (ES = 0.65). Improvements were seen in affiliative and belonginess aspects of social support, in contrast to tangible support which was statistically non-significant. Findings were not moderated by clinical features of depression or home visiting parameters. No group differences were found in size of and involvement with social networks. CONCLUSIONS: IH-CBT is effective in reducing psychological distress and improving perceived social support in depressed mothers receiving home visiting. To the extent that mothers are better adjusted and feel socially supported, they are more available to their children and more amenable to home visiting services. IH-CBT is a feasible, readily adopted treatment that is compatible with multiple home visiting models. As a result it is a promising approach to help depressed mothers in home visiting. Additional interventions may be needed to support depressed mothers in building sizable and stable social networks.

Primary study

Unclassified

Infant health effects of a nurse-community health worker home visitation programme: a randomized controlled trial.

blocked
Journal Child: care, health and development
Year 2013
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference) 1 Systematic review Systematic reviews (1 reference)

Loading references information
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.

Primary study

Unclassified

Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program.

blocked
Journal Journal of the Academy of Nutrition and Dietetics
Year 2013
Links Pubmed DOI PubMed Central

This article is included in 1 Broad synthesis Broad syntheses (1 reference)

Loading references information
BACKGROUND: Postpartum weight retention is a risk factor for long-term weight gain. Encouraging new mothers to consume a healthy diet may result in weight loss. OBJECTIVE: To assess predictors of diet quality during the early postpartum period; to determine whether diet quality, energy intake, and lactation status predicted weight change from 5 to 15 months postpartum; and to determine whether an intervention improved diet quality, reduced energy intake, and achieved greater weight loss compared with usual care. DESIGN: Randomized clinical trial (KAN-DO: Kids and Adults Now-Defeat Obesity), a family- and home-based, 10-month, behavioral intervention to prevent childhood obesity, with secondary aims to improve diet and physical activity habits of mothers to promote postpartum weight loss. PARTICIPANTS: Overweight/obese, postpartum women (n=400), recruited from 14 counties in the Piedmont region of North Carolina. INTERVENTION: Eight education kits, each mailed monthly; motivational counseling; and one group class. METHODS: Anthropometric measurements and 24-hour dietary recalls collected at baseline (approximately 5 months postpartum) and follow-up (approximately 10 months later). Diet quality was determined using the Healthy Eating Index-2005 (HEI-2005). STATISTICAL ANALYSES: Descriptive statistics, χ(2), analysis of variance, bi- and multivariate analyses were used. RESULTS: At baseline, mothers consumed a low-quality diet (HEI-2005 score=64.4 ± 11.4). Breastfeeding and income were positive, significant predictors of diet quality, whereas body mass index was a negative predictor. Diet quality did not predict weight change. However, total energy intake, not working outside of the home, and breastfeeding duration/intensity were negative predictors of weight loss. There were no significant differences in changes in diet quality, decreases in energy intake, or weight loss between the intervention (2.3 ± 5.4 kg) and control (1.5 ± 4.7 kg) arms. CONCLUSIONS: The family-based intervention did not promote postpartum weight loss. Reducing energy intake, rather than improving diet quality, should be the focus of weight-loss interventions for overweight/obese postpartum women.

Primary study

Unclassified

Women's experience with early labour management at home vs. in hospital: A randomised controlled trial.

blocked
Authors Janssen PA , Desmarais SL
Journal Midwifery
Year 2013
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference)

Loading references information
Abstract: OBJECTIVE: to compare experiences with early labour assessment and support at home vs. by telephone. DESIGN: a randomised controlled trial of nurse home visits vs. telephone support for assessment and support of women in early labour. SETTING: hospitals serving obstetrical populations in metropolitan and suburban Vancouver, British Columbia, Canada. Participants: healthy nulliparous women in labour at term with uncomplicated pregnancies participating in the third and fourth year of the trial. Intervention: women were randomised to receive early labour assessment and support at home (n=241) and or to receive assessment and support by telephone (n=182). Measurement: the Early Labour Experience Questionnaire (ELEQ), a 26-item self-administered questionnaire that measures women''s experience with early labour care across three domains: emotional well-being, emotional distress and perceptions of nursing care. FINDINGS: women who received home visits rated their early labour experience more positively overall compared to women who received telephone support (103.14±12.45 vs. 99.67±13.11, p<.01)including perceptions of nursing care that they received (38.64±2.90 vs. 36.82±4.09, p<.001). However, women''s affective experiences did not differ. Key conclusions: early labour nursing care provided at home is associated with a more positive experience of early labour compared to telephone support.

Primary study

Unclassified

APN telephone follow up to low-income first time mothers.

blocked
Authors Hannan J
Journal Journal of clinical nursing
Year 2013
Links Pubmed Health Technology Assessment (HTA) DOI crd.york.ac.uk

This article is included in 1 Broad synthesis Broad syntheses (1 reference)

Loading references information
Aims and objectives. To examine the effects of a low cost advanced practice nurse telephone intervention for 2 months postbirth in low-income first time mothers with healthy full term infants. Background. Currently women with non-complicated, healthy full term newborn deliveries receive little to no routine postpartum support. This is problematic if mothers are first time mothers, poor, have problems accessing health care, have language barriers and sparse social support. Design. A two group randomised clinical trial. This study was conducted in an inner city South Florida county hospital. Methods. A control group ( n = 69) received routine hospital discharge care. An intervention group ( n = 70) received routine hospital discharge care plus APN follow up telephone calls for week 8 postdischarge. Comparison of outcomes included maternal health (stress, social support, physical health), infant health (routine medical visits, immunisations, weight gain), morbidity (urgent care visits, emergency room visits, re-hospitalisations), and health care charges (urgent care visits, emergency room visits, re-hospitalisations). Data were analysed using descriptive statistics and two-sample t-tests. Results. Intervention group mothers had significantly lower perceived stress, significantly greater perceived maternal health and social support; infants had healthier weight gain, fewer emergency room visits; significantly lower total health care charges ($14,333 vs. $70,834) compared to controls. Conclusion. Study results indicate that APN follow up telephone calls to low-income first time mothers with healthy full term infants is an effective, safe, low cost, easy to apply intervention that improved mothers' and infants' health outcomes and reduced healthcare charges. Relevance to clinical practice. APNs are uniquely positioned to conduct follow up interventions aimed at providing continuity of care including APN telephone follow up. This is imperative for vulnerable populations especially during times of major budget cuts that affect health care services.

Primary study

Unclassified

Effect of the healthy MOMs lifestyle intervention on reducing depressive symptoms among pregnant Latinas.

blocked
Journal American journal of community psychology
Year 2013
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference) 1 Systematic review Systematic reviews (1 reference)

Loading references information
Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants ("intervention effect"). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.

Primary study

Unclassified

Pilot study of an individualised early postpartum intervention to increase physical activity in women with previous gestational diabetes

Journal International journal of endocrinology
Year 2012
Links Pubmed DOI PubMed Central

This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

Loading references information
Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined. We report a pilot study of a convenient, home based exercise program with telephone support, suited to the early post-partum period. Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week randomised controlled trial of Usual Care (n = 13) versus Supported Care (individualised exercise program with regular telephone support; n = 15). Baseline characteristics (Mean SD) were: Age 33 4 years; Weight 80 20kg and Body Mass Index (BMI) 30.0 9.7 kg/m2. The primary outcome, planned physical activity Median (Range), increased by 60 (0540) mins/week in the SC group versus 0 (0580) mins/week in the UC group (P = 0.234). Walking was the predominant physical activity. Body weight, BMI, waist circumference, % body fat, fasting glucose and insulin did not change significantly over time in either group. This intervention designed to increase physical activity in post-partum women with previous gestational diabetes proved feasible. However, no measurable improvement in metabolic or biometric parameters was observed over a three month period. Copyright © 2012 Harold David McIntyre et al.

Primary study

Unclassified

Effect of a peer support service on breast-feeding continuation in the UK: A randomised controlled trial.

blocked
Journal Midwifery
Year 2012
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference) 2 Systematic reviews Systematic reviews (2 references)

Loading references information
Abstract: OBJECTIVE: to assess the effectiveness of a peer support worker (PSW) service on breast-feeding continuation. DESIGN: cluster randomised controlled trial (ISRCTN16126175). SETTING: Primary Care Trust, UK serving a multi-ethnic, socio-economically disadvantaged population. Participants: 2,724 women giving birth following antenatal care from 66 clinics: 33 clinics (1,267 women) randomised to the PSW service and 33 clinics (1,457 women) to usual care. 848 women consented to additional follow-up by questionnaire at 6 months. Intervention: PSW service provided in the antenatal and postnatal period. Measurements: any and exclusive breast feeding at 10–14 days obtained from routine computerised records and at 6 weeks and 6 months from a questionnaire. FINDINGS: follow-up: 94% at 10–14 days, 67.5% at 6 months. There was no difference in any breast feeding at 10–14 days between intervention and usual care, odds ratio (OR) 1.07 (95% CI 0.87–1.31, p=0.54). Proportion of women reporting any breast feeding in the intervention group at 6 weeks was 62.7% and 64.5% in the usual care group OR 0.93 (95% CI 0.64–1.35); and at 6 months was 34.3% and 38.9%, respectively, OR 1.06 (95% CI 0.71–1.58). Key conclusions: universal antenatal peer support and postnatal peer support for women who initiated breast feeding did not improve breast-feeding rates up to 6 months in this UK population. Implications for practice: with high levels of professional support part of usual maternity care it may not be possible for low intensity peer support to produce additional benefit. More intensive or targeted programmes might be effective, but should have concurrent high quality evaluation.

Primary study

Unclassified

Mentors Offering Maternal Support: A Support Intervention for Military Mothers.

blocked
Authors Weis KL , Ryan TW
Journal Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG
Year 2012
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference)

Loading references information
ABSTRACT Objective To evaluate the effectiveness of the Mentors Offering Maternal Support (MOMS) program to promote maternal fetal attachment, maternal adaptation to pregnancy, self-esteem, and perceived community support in women within a military environment. Design A randomized, controlled, repeated measured pilot study compared two groups of pregnant military wives, a control group receiving standard prenatal care and an intervention group receiving a structured eight-session MOMS program. Setting The study was conducted at two Air Force installations in Florida having joint (Air Force, Army, and Navy) operations and high deployment requirements. Participants Sixty-five military wives in their first trimester of pregnancy (control group, n = 36 and intervention group, n = 29) completed all aspects of the study. Methods Women randomized to the MOMS program received eight structured classes starting in the first trimester of pregnancy and occurring every other week until the third trimester. Outcome measures were obtained in each trimester. The women in the control group received usual prenatal care. Results No statistically significant differences were found between the two groups for any of the outcome variables. The interaction of the amount of contact the women had with their deployed husbands and group assignment was statistically different for two variables, the Relationship with Husband Scale and the Rosenberg Self-Esteem Inventory.

Primary study

Unclassified

The Family Spirit trial for American Indian teen mothers and their children: CBPR rationale, design, methods and baseline characteristics.

blocked
Journal Prevention science : the official journal of the Society for Prevention Research
Year 2012
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference)

Loading references information
The purpose of this paper is to describe the rationale, design, methods and baseline results of the Family Spirit trial. The goal of the trial is to evaluate the impact of the paraprofessional-delivered "Family Spirit" home-visiting intervention to reduce health and behavioral risks for American Indian teen mothers and their children. A community based participatory research (CBPR) process shaped the design of the current randomized controlled trial of the Family Spirit intervention. Between 2006 and 2008, 322 pregnant teens were randomized to receive the Family Spirit intervention plus Optimized Standard Care, or Optimized Standard Care alone. The Family Spirit intervention is a 43-session home-visiting curriculum administered by American Indian paraprofessionals to teen mothers from 28 weeks gestation until the baby's third birthday. A mixed methods assessment administered at nine intervals measures intervention impact on parental competence, mother's and children's social, emotional and behavioral risks for drug use, and maladaptive functioning. Participants are young (mean age = 18.1 years), predominantly primiparous, unmarried, and challenged by poverty, residential instability and low educational attainment. Lifetime and pregnancy drug use were ~2-4 times higher and ~5-6 times higher, respectively, than US All Races. Baseline characteristics were evenly distributed between groups, except for higher lifetime cigarette use and depressive symptoms among intervention mothers. If study aims are achieved, the public health field will have new evidence supporting multi-generational prevention of behavioral health disparities affecting young American Indian families and the utility of indigenous paraprofessional interventionists in under-resourced communities.