Nurse Home Visit Program to Promote Parenting In Brazil: Premises And Planning

Abstract

BackgroundPromoting good parenting has been a challenge for public policies since child development became part of the Sustainable Development Goals until 2030. Home visitation programs have been proved to be effective in supporting the most vulnerable families, especially the vulnerable, first time pregnant’s teenagers, in acquiring skills and incorporating parenting practices that promote integral child development. The Young Mothers Caregivers is an innovative, experimental program, implemented in the context of a RCT. This paper aims to analyze the fidelity of the HVs, regarding the planning and the operative framework of the young Mothers Cargivers’ protocol.MethodsThis qualitative study was conducted by content analysis from nurse’s records of 390 HVs delivered for 39 teenagers, attended by YMCP. The software Wordart was used to visualize the frequency of themes. The analysis examined, 1) which priority areas were most focused on in HV records, and 2) which themes were prominent in each content priority area, according to the five axes that compose the bases of the interventions. ResultsThe first trimester of HV focused on “Care with Health” axis (specially “Nutrition”); along with “Life Course” axis, “Familiar&Social Network”, “Environment” and “Parenting”. In the second trimester of HV, again “Care with Health” axis (primarily focused on “Nutrition” and “Birth”) was identified in records, as was the concept of “Parenting” (“Praise”, “Attachment”, and “Expressing Feelings”). In the third trimester of HV, “Care with Health” axis (primarily through Breastfeeding and Birth) and “Parenting” axis(through Praise, Attachment, and Readiness to Address Concerns) were prominent. ConclusionsThe content priorities raised in each HV trimester, with different themes within each category, indicating the capacity to adjust the protocol according to the youth interest. At different times, some categories were more highlighted than others. The study found recurring emphasis on praise and the nurse’s ability to address concerns, underscoring the importance of a strong relationship among the nurse visitor and the young mother. Relevance to PracticeData highlights the role of responsive communication and participant’s centered needs as skills for nurses that delivers HV. This is a crucial aspect to structure the monitoring and supervision axes of the Program, for further scaling up.

A Nurse Home Visiting Program for Pregnant Adolescents: A Randomized Controlled Trial

“…Nurses were supervised weekly by senior nurses (A.C., L.F.) and a child psychologist. More details about the intervention can be found elsewhere [65][66][67] .…”

Comparação de redes de microRNAs placentários de primigestas submetidas a intervenção psicossocial

“…Foram realizadas avaliações sobre exposição a estressores com 8-16 semanas de gestação, com 30 semanas de gestação, aos 12 e 24 meses do bebê após o nascimento, além da coleta de amostras biológicas dessas mães e bebês para a busca de evidências biológicas desta intervenção psicossocial realizada nestes períodos. Mais informações sobre o "Primeiros laços" e as intervenções podem ser encontradas em Sadler et al, 2013, Pinheiro et al, 2018, Francolli et al, 2018, Siqueira et al, 2020 1.2. A placenta e mecanismos epigenéticos como os responsáveis pela mediação da resposta à exposição ao estresse ambiental: foco em miRNAs.…”