Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden

Barboza, Madelene; Marttila, Anneli; Burström, Bo; Kulane, Asli

doi:10.1186/s12889-022-13492-3

Cited by 6 publications

(3 citation statements)

References 69 publications

(83 reference statements)

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“…Instead of seeing flexibility and individualization of the content as a challenge to rigorous implementation, it can be seen as a core component in itself. This is in line with how core components of parental support programs have been defined in previous studies in Sweden (37). The literature on scaling and transfer of social innovations has described how innovations can be scaled and replicated either with absolute fidelity to a specified plan and program integrity in mind, or with an overall aim of disseminating principles or methods (38).…”

Section: Fidelity Adaptations and Flexibility With Respect To The Log...supporting

confidence: 66%

Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation

Kåks,

Stansert Katzen,

Målqvist

et al. 2024

Front. Public Health

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IntroductionA South African social innovation based on peer support for mothers was contextualized in southern Sweden. The objective of the project was to support expectant women and mothers of young children in immigrant communities to access public services that would benefit maternal and child health. This study aimed to assess how the intervention was implemented, what the contextual barriers and facilitators were, and how the implementation was perceived by those who delivered and received it.MethodsThe study used mixed methods with a convergent parallel design and followed the Medical Research Council guidance on process evaluations of complex interventions. Semi-structured interviews (n = 19) were conducted with peer supporters, client mothers, and key stakeholders involved in the intervention. The qualitative data were analyzed using content analysis. Quantitative data on peer supporters' activities were collected during contacts with client mothers and were presented descriptively.ResultsThe five peer supporters had 1,294 contacts with client mothers, of which 507 were first-time contacts. The reach was perceived as wide, and the dose of the intervention was tailored to individual needs. Barriers to implementation included community mistrust of social services, norms on gender roles and parenting, and funding challenges. The implementation was facilitated by the organization's reputation, network, experience, and third-sector affiliation. Peer supporters tended to prioritize linking clients to other services over the educational components of the intervention, sometimes doing more than what was originally planned. Implementation strategies used included building trust, using multiple outreach venues, using internal support structures, and providing practical assistance as an entry point to comprehensive psychosocial support. The personal connection between peer supporters and clients was highly valued, and the building of relationships enabled them to address sensitive topics. Peer supporters sometimes experienced a blurred line between professional and personal roles.ConclusionsPeer supporters used a variety of strategies to navigate identified barriers and facilitators. Trust was central both as a contextual factor and a strategy for implementation. It is valuable to maintain a balance between flexibility and adherence to the function of peer supporters. Further research is needed to evaluate the effects of the intervention.

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Section: Fidelity Adaptations and Flexibility With Respect To The Log...supporting

confidence: 66%

Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation

Kåks,

Stansert Katzen,

Målqvist

et al. 2024

Front. Public Health

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“…The program is an extension of the national universal healthcare program offered at CHCs, in which two home visits delivered by nurses are offered as part of usual care. The core REHV program components correspond both with those shown in previous research to be effective and with the Nurturing Care framework for social sustainability proposed by the World Health Organization ( 9 , 10 ). Evaluations have demonstrated good effects on both child and parental well-being compared with families receiving standard care ( 11 – 13 ).…”

Section: Introductionsupporting

confidence: 64%

Perceptions of facilitators, barriers and solutions when preparing to implement a home visiting program in Sweden: a mixed-methods study

Lundgren,

Nilses,

Eckerdal

et al. 2024

Front. Health Serv.

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BackgroundAlthough there is growing awareness that early childhood development programs are important for a sustainable society, there is a knowledge gap about how to implement such programs. Successful implementation requires attention to implementation drivers (competency, organization, and leadership) during all phases of the implementation. The purpose of this study was to describe cross-sectoral operational workgroups’ perceptions of facilitators, barriers and solutions related to implementation drivers in the preparationphase of implementing an evidence-based early childhood home visiting program.MethodsQuantitative and qualitative data were collected from twenty-four participants, divided into 5 groups, during implementation planning workshops. The workshops were guided by a structured method informed by the principles of Motivational Interviewing and within a framework of implementation drivers. Groups sorted cards with statements representing implementation drivers according to perceptions of facilitators and barriers, and percentages were calculated for each type of implementation determinant, for each type of driver. The groups discussed their card sorting and wrote action plans to address barriers, yielding documentation that was analyzed using deductive qualitative content analysis.ResultsA mixed-methods analysis resulted identification of facilitators, barriers, unknowns and solutions in two to three subcategories under each main category of implementation driver. A competent and confident workforce, and enthusiasm and commitment were key facilitators. Key barriers were unclear roles and responsibilities, and insufficient articulation of local vision and goals. Many factors were described as yet unknown. Specific solutions were generated to support the implementation.ConclusionsOur study furthers the scientific understanding of how to take evidence-based early childhood programs from research to practice within an implementation drivers framework. Facilitators, barriers and solutions in key areas during the preparation phase were identified with the help of a novel tool. The results provide useful knowledge for decision makers and organizations preparing similar initiatives in communities striving to attain sustainable development goals.

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“…BHVQ enables regions to follow the frequency of home visits, allowing for resource allocation. Several projects are ongoing regarding extended home visiting programmes in Sweden 15–17. The data structure for the home visits in the BHVQ can be used for collecting data on additional home visits.…”

Section: Methodsmentioning

confidence: 99%

Swedish Child Health Services Register: a quality register for child health services and children’s well-being

Wennergren

Berg

Cavefors

et al. 2023

bmjpo

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BackgroundSwedish child health services (CHS) is a free-of-charge healthcare system that reaches almost all children under the age of 6. The aim for the CHS is to improve children’s physical, psychological and social health by promoting health and development, preventing illness and detecting emerging problems early in the child’s life. The services are defined in a national programme divided into three parts: universal interventions, targeted interventions and indicated interventions.The Swedish Child Health Services Register (BHVQ) is a national Quality Register developed in 2013. The register extracts data from the child’s health record and automatically presents current data in real time. At present, the register includes 21 variables.AimWe aim to describe data available in the BHVQ and the completeness of data in BHVQ across variables.MethodsChild-specific data were exported from the register, and data for children born in the regions were retrieved from Statistics Sweden to calculate coverage.ResultsThe register includes over 110 000 children born between 2011 and 2022 from 221 child healthcare centres in eight of Sweden’s 21 regions. In seven of the eight regions, 100% of centres report data.The completeness of data differs between participating regions and birth cohorts. The average coverage for children born in 2021 is 71%.ConclusionsThe BHVQ is a valuable resource for evaluating Child Health Services nationally, with high coverage for the youngest children. As a result of continuous improvement of the services, the possibility to follow the development of children’s health in Sweden is possible through the register. When fully expanded, the register will be a natural and essential part of developing preventive services, improving healthcare for children below 6 years of age and a tool for developing evidence-based child health interventions.

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Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden

Cited by 6 publications

References 69 publications

Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation

Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation

Perceptions of facilitators, barriers and solutions when preparing to implement a home visiting program in Sweden: a mixed-methods study

Swedish Child Health Services Register: a quality register for child health services and children’s well-being

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