Association between participation in the Families First Home Visiting programme and First Nations families’ public health outcomes in Manitoba, Canada: a retrospective cohort study using linked administrative data

Abstract

ObjectiveTo determine whether the Families First Home Visiting (FFHV) programme, which provides home visiting services to families across Manitoba, is associated with improved public health outcomes among First Nations families facing multiple parenting challenges.DesignRetrospective cohort study using population-based administrative data.SettingManitoba, Canada.ParticipantsFirst Nations children born in Manitoba in 2003–2009 (n=4010) and their parents enrolled in FFHV compared with non-enrolled families with a similar risk profile.InterventionFFHV supports public health in Manitoba by providing home visiting services to First Nations and non-First Nations families with preschool children and connecting them with resources in their communities.OutcomesPredicted probability (PP) and relative risk (RR) of childhood vaccination, parental involvement in community support programmes and children’s development at school entry.ResultsFFHV participation was associated with higher rates of complete childhood vaccination at age 1 (PP: FFHV 0.715, no FFHV 0.661, RR 1.08, 95% CI 1.03 to 1.14) and age 2 (PP: FFHV 0.465, no FFHV 0.401, RR 1.16, 95% CI 1.08 to 1.25), and with parental involvement in community support groups (PP: FFHV 0.149, no FFHV 0.097, RR 1.54, 95% CI 1.27 to 1.86). However, there was no difference between FFHV participants and non-participants in rates of children being vulnerable in at least one developmental domain at age 5 (PP: FFHV 0.551, no FFHV 0.557, RR 1.00, 95% CI 0.91 to 1.11).ConclusionsFFHV supports First Nations families in Manitoba by promoting childhood vaccination and connecting families to parenting resources in their communities, thus playing an important role in fulfilling the mandate of public health practice.

Population-Level Data on Child Development at School Entry Reflecting Social Determinants of Health: A Narrative Review of Studies Using the Early Development Instrument

“…EDI data collected in countries across the globe, such as Canada, Australia, Ireland, and Ethiopia, have been used to implement and evaluate programs meant to improve children’s developmental health at school entry [ 16 , 17 , 18 , 67 ]. One of the most important and ubiquitous programs put in place to help support early child development is preschool.…”

“…The results showed that the earlier a child exited the program, the more vulnerable they were in all five developmental domains of the EDI [ 19 ], suggesting the program was effective at improving children’s developmental health; however, a multivariate analysis found no overall difference among the study groups in terms of EDI outcomes. Many other countries have attempted to use early at-home interventions to improve developmental outcomes for marginalized communities before entering preschool [ 18 , 72 ]. A study by Enns et al [ 18 ] focused specifically on the Families First Home Visiting (FFHV) program available to indigenous populations in Manitoba.…”

“…Many other countries have attempted to use early at-home interventions to improve developmental outcomes for marginalized communities before entering preschool [ 18 , 72 ]. A study by Enns et al [ 18 ] focused specifically on the Families First Home Visiting (FFHV) program available to indigenous populations in Manitoba. An analysis of data for over 4000 families showed no significant difference in a child’s likelihood of being vulnerable in one or more domains of the EDI in comparison to non-participants.…”

“…The EDI has also enabled researchers to examine the impacts of early childhood programs and interventions meant to help improve developmental outcomes for children, for example by evaluating the effectiveness of preschools [ 16 , 17 ] or in-home interventions [ 18 , 19 ]. As the understanding of the pervasive influence of social determinants of health on children development increased, it has also become more evident that they may moderate the impacts of interventions [ 20 ].…”

A visita domiciliar na primeira infância: mapa conceitual

“…Resultados progressivos e contínuos são importantes e que quanto mais tempo as crianças ficam expostas às intervenções com VD, mais elas conseguem atingir os marcos do desenvolvimento infantil (DUFFEE et al, 2017). O sucesso no desenvolvimento infantil pode ser pertinente pela redução nos riscos de resultados psicossociais e de aprendizagem negativos (SALVY et al, 2017 (ENNS et al, 2019;GRACE et al, 2019).…”