Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial
<p>Individual, social, and economic circumstances faced by teenage mothers can challenge a successful start for children and interrupt mothers' long-term socioeconomic stability. The Family-Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the United...
| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , , |
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| Médium: | Journal article |
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Wolters Kluwer Health, Inc.
2016
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| _version_ | 1826290693924978688 |
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| author | Robling, M Bekkers, M Bell, K Butler, C Cannings-John, R Channon, S Corbacho Martin, B Gregory, J Hood, K Kemp, A Kenkre, J Montgomery, A Moody, G Owen-Jones, E Pickett, K Richardson, G Roberts, Z Ronaldson, S Sanders, J Stamuli, E Torgerson, D |
| author_facet | Robling, M Bekkers, M Bell, K Butler, C Cannings-John, R Channon, S Corbacho Martin, B Gregory, J Hood, K Kemp, A Kenkre, J Montgomery, A Moody, G Owen-Jones, E Pickett, K Richardson, G Roberts, Z Ronaldson, S Sanders, J Stamuli, E Torgerson, D |
| author_sort | Robling, M |
| collection | OXFORD |
| description | <p>Individual, social, and economic circumstances faced by teenage mothers can challenge a successful start for children and interrupt mothers' long-term socioeconomic stability. The Family-Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the United States and introduced into practice in England. Family-Nurse Partnership involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. This study aimed to assess the effectiveness of providing the program to teenage first-time mothers on infant and maternal outcomes up to 24 months after birth.</p> <p>A pragmatic, nonblinded, randomized controlled, parallel-group trial was conducted in community midwifery settings at 18 partnerships between local authorities and primary and secondary care organizations in England. Eligible participants were nulliparous, aged 19 years or younger, living within the catchment area of a local FNP team, of less than 25 weeks' gestation, and able to provide consent and speak English. Field-based researchers randomly allocated mothers (1:1) via remote randomisation (telephone and Web) to FNP plus usual care (publicly funded health and social care) or to usual care alone. Allocation was stratified by site and minimized by gestation (<16 weeks vs >=16 weeks), smoking status (yes vs no), and preferred language of data collection (English vs non-English). Primary outcomes were tobacco use at late pregnancy (34–36 weeks' gestation), birth weight, emergency attendances, and hospital admissions for the infant within 24 months of birth, as well as the proportion of women with a second pregnancy within 24 months postpartum.</p> <p>Between 2009, and 2010, 3251 women were screened. After enrolment, 823 women were randomly assigned to receive FNP and 822 to usual care. The mean (SD) birth weight of 742 babies with mothers assigned to FNP was 3217.4 (618.0) g, whereas birth weight of 768 babies assigned to usual care was 3197.5 (581.5) g (adjusted mean difference, 20.75 g; 97.5% confidence interval [CI], -47.73 to 89.23). It was found that 587 (81%) of 725 assessed children with mothers assigned to FNP and 577 (77%) of 753 assessed children assigned to usual care attended an emergency department or were admitted to hospital at least once before their second birthday (adjusted odds ratio, 1.32; 97.5% CI, 0.99-1.76). The results of the study indicate that adding FNP to the usually provided health and social care provided no additional short-term benefit to our primary outcomes. The continuation of the program is not justified on the basis of available evidence, but could be reconsidered should supportive longer-term evidence emerge.</p> |
| first_indexed | 2024-03-07T02:48:06Z |
| format | Journal article |
| id | oxford-uuid:acb66319-c811-44f8-a0bd-979f2e794813 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T02:48:06Z |
| publishDate | 2016 |
| publisher | Wolters Kluwer Health, Inc. |
| record_format | dspace |
| spelling | oxford-uuid:acb66319-c811-44f8-a0bd-979f2e7948132022-03-27T03:30:53ZEffectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:acb66319-c811-44f8-a0bd-979f2e794813Symplectic Elements at OxfordWolters Kluwer Health, Inc.2016Robling, MBekkers, MBell, KButler, CCannings-John, RChannon, SCorbacho Martin, BGregory, JHood, KKemp, AKenkre, JMontgomery, AMoody, GOwen-Jones, EPickett, KRichardson, GRoberts, ZRonaldson, SSanders, JStamuli, ETorgerson, D<p>Individual, social, and economic circumstances faced by teenage mothers can challenge a successful start for children and interrupt mothers' long-term socioeconomic stability. The Family-Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the United States and introduced into practice in England. Family-Nurse Partnership involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. This study aimed to assess the effectiveness of providing the program to teenage first-time mothers on infant and maternal outcomes up to 24 months after birth.</p> <p>A pragmatic, nonblinded, randomized controlled, parallel-group trial was conducted in community midwifery settings at 18 partnerships between local authorities and primary and secondary care organizations in England. Eligible participants were nulliparous, aged 19 years or younger, living within the catchment area of a local FNP team, of less than 25 weeks' gestation, and able to provide consent and speak English. Field-based researchers randomly allocated mothers (1:1) via remote randomisation (telephone and Web) to FNP plus usual care (publicly funded health and social care) or to usual care alone. Allocation was stratified by site and minimized by gestation (<16 weeks vs >=16 weeks), smoking status (yes vs no), and preferred language of data collection (English vs non-English). Primary outcomes were tobacco use at late pregnancy (34–36 weeks' gestation), birth weight, emergency attendances, and hospital admissions for the infant within 24 months of birth, as well as the proportion of women with a second pregnancy within 24 months postpartum.</p> <p>Between 2009, and 2010, 3251 women were screened. After enrolment, 823 women were randomly assigned to receive FNP and 822 to usual care. The mean (SD) birth weight of 742 babies with mothers assigned to FNP was 3217.4 (618.0) g, whereas birth weight of 768 babies assigned to usual care was 3197.5 (581.5) g (adjusted mean difference, 20.75 g; 97.5% confidence interval [CI], -47.73 to 89.23). It was found that 587 (81%) of 725 assessed children with mothers assigned to FNP and 577 (77%) of 753 assessed children assigned to usual care attended an emergency department or were admitted to hospital at least once before their second birthday (adjusted odds ratio, 1.32; 97.5% CI, 0.99-1.76). The results of the study indicate that adding FNP to the usually provided health and social care provided no additional short-term benefit to our primary outcomes. The continuation of the program is not justified on the basis of available evidence, but could be reconsidered should supportive longer-term evidence emerge.</p> |
| spellingShingle | Robling, M Bekkers, M Bell, K Butler, C Cannings-John, R Channon, S Corbacho Martin, B Gregory, J Hood, K Kemp, A Kenkre, J Montgomery, A Moody, G Owen-Jones, E Pickett, K Richardson, G Roberts, Z Ronaldson, S Sanders, J Stamuli, E Torgerson, D Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial |
| title | Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial |
| title_full | Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial |
| title_fullStr | Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial |
| title_full_unstemmed | Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial |
| title_short | Effectiveness of a nurse-led intensive home-visitation program for first-time teenage mothers (building blocks): a pragmatic randomized controlled trial |
| title_sort | effectiveness of a nurse led intensive home visitation program for first time teenage mothers building blocks a pragmatic randomized controlled trial |
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