Home-based support for disadvantaged teenage mothers. 2007

G Macdonald, and C Bennett, and J Dennis, and E Coren, and J Patterson, and M Astin, and J Abbott
School of Sociology, Social Policy and Social Work, Director of Education, Queen's University Belfast, 6 College Park, Belfast, Northern Ireland, UK, BT7 1LP. Geraldine.Macdonald@qub.ac.uk

BACKGROUND Babies born to socio-economically disadvantaged mothers are at higher risk of injury, abuse or neglect and health problems than babies born to more affluent mothers; disadvantaged teenage mothers are at particular risk of adverse outcomes. Home-visiting programs are thought to improve outcomes for both mothers and children, largely through advice and support. OBJECTIVE To assess the effectiveness of home-visiting programmes for women who have recently given birth and who are socially or economically disadvantaged. METHODS The following electronic databases were searched: CENTRAL (2006, Issue 3); MEDLINE (1966 to March 2006); EMBASE (1980 to week 12 2006); CINAHL (1982 to March week 4 2006); PsycINFO (1872 to March week 4 2006); ASSIA (1987 to March 2006); LILACS (1982 to March 2006); and Sociological Abstracts (1963 to March 2006). Grey literature was also be searched using ZETOC (1993 to March 2006); Dissertation Abstracts International (late 1960s to 2006); and SIGLE (1980 to March 2006). Communication with published authors about ongoing or unpublished research was also undertaken. METHODS Included studies were randomised controlled trials investigating the efficacy of home visiting directed at teenage mothers. METHODS Titles and abstracts identified in the search were independently assessed for eligibility by two review authors (EC and JP or CB). Data were extracted and entered into RevMan (EC, JP and CB), synthesised and presented in both written and graphical form (forest plots). Outcomes included in this review were established at the protocol stage by an international steering group. The review did not report on all outcomes reported in included studies. RESULTS Five studies with 1838 participants were included in this review. Data from single studies provided support for the effectiveness of home visiting on some outcomes, but the evidence overall provided only limited support for the effectiveness of home visiting as a means of improving the range of maternal and child outcomes considered in this review. CONCLUSIONS This review suggests there is only limited evidence that home-visiting programmes of the kind described in this review can impact positively on the quality of parenting of teenage mothers or on child development outcomes for their offspring. For reasons discussed in the review, this does not amount to a conclusion that home-visiting programmes are ineffective but indicates a need to think carefully about the problems that home visiting might influence and about improvements in the conduct and reporting of outcome studies in this area.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008425 Maternal Behavior The behavior patterns associated with or characteristic of a mother. Maternal Patterns of Care,Maternal Care Patterns,Behavior, Maternal,Behaviors, Maternal,Care Pattern, Maternal,Care Patterns, Maternal,Maternal Behaviors,Maternal Care Pattern,Pattern, Maternal Care,Patterns, Maternal Care
D008427 Maternal Health Services Organized services to provide health care to expectant and nursing mothers. Health Services, Maternal,Services, Maternal Health,Health Service, Maternal,Maternal Health Service
D008429 Maternal Welfare Organized efforts by communities or organizations to improve the health and well-being of the mother. Welfare, Maternal
D009034 Mother-Child Relations Interaction between a mother and child. Mother-Child Interaction,Mother-Child Relationship,Mother-Infant Interaction,Mother-Infant Relations,Interaction, Mother-Child,Interaction, Mother-Infant,Interactions, Mother-Child,Interactions, Mother-Infant,Mother Child Interaction,Mother Child Relations,Mother Child Relationship,Mother Infant Interaction,Mother Infant Relations,Mother-Child Interactions,Mother-Child Relation,Mother-Child Relationships,Mother-Infant Interactions,Mother-Infant Relation,Relation, Mother-Child,Relation, Mother-Infant,Relations, Mother-Child,Relations, Mother-Infant,Relationship, Mother-Child,Relationships, Mother-Child
D009035 Mothers Female parents, human or animal. Mothers' Clubs,Club, Mothers',Clubs, Mothers',Mother,Mother Clubs,Mother's Clubs,Mothers Clubs,Mothers' Club
D002657 Child Development The continuous sequential physiological and psychological maturing of an individual from birth up to but not including ADOLESCENCE. Infant Development,Development, Child,Development, Infant
D005260 Female Females
D006699 Home Care Services Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals. Domiciliary Care,Home Health Care,Care Services, Home,Home Care,Services, Home Care,Care, Domiciliary,Care, Home,Home Care Service,Service, Home Care
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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