Does Supplementary Prenatal Nursing and Home Visitation Support Improve Resource Use in a Universal Health Care System? A Randomized Controlled Trial in Canada

Abstract

Additional support provided by nurses, or nurses and home visitors, can successfully address informational needs and increase the likelihood that women will use existing community-based resources. This finding was true even for high-risk women, although this intervention did not reduce the difference in resource use between high- and low-risk women.

Early childhood risk and resilience factors for behavioural and emotional problems in middle childhood

“…The participants in this study are part of the longitudinal Community Perinatal Care (CPC) cohort that had been followed since pregnancy [23]. The initial sample for the CPC study included pregnant women over 18 years of age who attended one of three family physician low-risk maternity practices in the Calgary Health Region.…”

“…Exclusion criteria consisted of the inability to complete the questionnaire in English and lack of current mailing information after exhaustive searching. Findings from the original CPC study and the first two follow-up studies are reported elsewhere [23-25]. …”

“…The first Community Perinatal Care Study, a randomized controlled trial (RCT) of three types of prenatal care, found that additional prenatal support from nurses and home visitors increased the use of community based resources and access to pregnancy-related information, but did not alter alcohol/tobacco use, post-partum depression, or birth outcomes [23]. A follow-up survey at three years of age reported that 11% of this demographically low-risk (by maternal education and family income) sample of Canadian children screened at high risk for developmental problems, with poor maternal mental health identified as the strongest predictor of a positive screen.…”

The Overlooked Burden of Food Insecurity among Asian Americans: Results from the California Health Interview Survey

“…For example, in a proof of concept assessment of the efficacy of community health workers to improve childhood health outcomes, Martin et al demonstrated the positive influence of home visitations on asthma control, emergency care utilizations, and inhaler usage [41]. While similar assessment on the efficacy of home visitation techniques on food insecurity remains limited, Tough et al noted that home visitations improved nutrition counselling attendance among at-risk mothers, including those with language barriers [42]. As such, public health efforts to pilot test the efficacy of community health workers among Asian American subgroups and to create home visitation programs in order to assess food availability and increase participation in food assistance programs may help alleviate the burden of food insecurity among the most vulnerable Asian American populations.…”

Association between prenatal care and small for gestational age birth: an ecological study in Quebec, Canada

“…[4][5][6][7][8] However, participating in multi-component programs throughout pregnancy can improve parental behaviours and use of community-based resources. 5,9 Further, reducing use of tobacco-usually included in multi-component programs-is associated with decreased risks of low birthweight and preterm birth. 10 Randomized controlled trials (RCTs) indicate that balanced energy and protein supplementation seem to reduce the This is the first observational study of Quebec's population -and one of the few worldwide -that explores the benefits of prenatal intervention along the gradient of intensity of available care.…”