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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Nurse Home Visiting and Maternal Mental Health: 3-Year Follow-Up of a Randomized Trial

Sharon Goldfeld, Hannah Bryson, Fiona Mensah, Lisa Gold, Francesca Orsini, Susan Perlen, Anna Price, Harriet Hiscock, Anneke Grobler, Penelope Dakin, Tracey Bruce, Diana Harris and Lynn Kemp
Pediatrics February 2021, 147 (2) e2020025361; DOI: https://doi.org/10.1542/peds.2020-025361
Sharon Goldfeld
aCentre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia;
bPopulation Health and
cDepartment of Paediatrics, Melbourne Medical School, University of Melbourne, Victoria, Australia;
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Hannah Bryson
aCentre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia;
bPopulation Health and
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Fiona Mensah
bPopulation Health and
cDepartment of Paediatrics, Melbourne Medical School, University of Melbourne, Victoria, Australia;
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Lisa Gold
dSchool of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia;
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Francesca Orsini
eClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia;
fMelbourne Children’s Trials Centre, Murdoch Children’s Research Institute, Parkville, Victoria, Australia;
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Susan Perlen
aCentre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia;
bPopulation Health and
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Anna Price
aCentre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia;
bPopulation Health and
cDepartment of Paediatrics, Melbourne Medical School, University of Melbourne, Victoria, Australia;
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Harriet Hiscock
aCentre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia;
bPopulation Health and
cDepartment of Paediatrics, Melbourne Medical School, University of Melbourne, Victoria, Australia;
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Anneke Grobler
eClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia;
fMelbourne Children’s Trials Centre, Murdoch Children’s Research Institute, Parkville, Victoria, Australia;
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Penelope Dakin
gAustralian Research Alliance for Children and Youth, Canberra City, Australia; and
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Tracey Bruce
hIngham Institute for Applied Medical Research, Western Sydney University, Sydney, Australia
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Diana Harris
gAustralian Research Alliance for Children and Youth, Canberra City, Australia; and
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Lynn Kemp
hIngham Institute for Applied Medical Research, Western Sydney University, Sydney, Australia
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Abstract

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BACKGROUND: Poor mental health is recognized as one of the greatest global burdens of disease. Maternal mental health is crucial for the optimal health of mothers and their children. We examined the effects of an Australian Nurse Home Visiting (NHV) program (right@home), offered to pregnant women experiencing adversity, on maternal mental health and well-being at child age 3 years.

METHODS: A randomized controlled trial of NHV delivered via universal child and family health services (2013–2016). Pregnant women experiencing adversity (≥2 of 10 risk factors) were recruited from 10 antenatal clinics across 2 states. Intervention comprised 25 home visits until child age 2 years. The outcomes assessed 1-year postintervention completion were maternal self-report of mental health symptoms (Depression Anxiety Stress Scales) and positive aspects of mental health (personal well-being and self-efficacy).

RESULTS: Of the 722 women enrolled in the trial, 255 of 363 (70%) intervention and 240 of 359 (67%) control group women provided data at 3 years. Compared with controls, the intervention group reported better mental health (reverse Depression Anxiety Stress Scales scores): effect sizes of 0.25 (depression; 95% confidence interval [CI]: 0.08 to 0.32), 0.20 (anxiety; 95% CI: 0.05 to 0.30), 0.17 (stress; 95% CI: 0.09 to 0.37), and 0.23 (total score; 95% CI: 0.12 to 0.38); 0.16 (95% CI: 0.04 to 0.29) for personal well-being; and an odds ratio of 1.60 (95% CI: 1.19 to 2.16) for self-efficacy.

CONCLUSIONS: An NHV designed to support mothers experiencing adversity can lead to later maternal mental health benefits, even after the program ends.

  • Accepted November 16, 2020.
  • Copyright © 2021 by the American Academy of Pediatrics

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Pediatrics
Vol. 147, Issue 2
1 Feb 2021
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Nurse Home Visiting and Maternal Mental Health: 3-Year Follow-Up of a Randomized Trial
Sharon Goldfeld, Hannah Bryson, Fiona Mensah, Lisa Gold, Francesca Orsini, Susan Perlen, Anna Price, Harriet Hiscock, Anneke Grobler, Penelope Dakin, Tracey Bruce, Diana Harris, Lynn Kemp
Pediatrics Feb 2021, 147 (2) e2020025361; DOI: 10.1542/peds.2020-025361

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Nurse Home Visiting and Maternal Mental Health: 3-Year Follow-Up of a Randomized Trial
Sharon Goldfeld, Hannah Bryson, Fiona Mensah, Lisa Gold, Francesca Orsini, Susan Perlen, Anna Price, Harriet Hiscock, Anneke Grobler, Penelope Dakin, Tracey Bruce, Diana Harris, Lynn Kemp
Pediatrics Feb 2021, 147 (2) e2020025361; DOI: 10.1542/peds.2020-025361
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