right@home is a
nurse home visiting program designed
to promote family wellbeing and child development. The program places nurses in children’s homes from
birth to two years old, on a regular basis, to support mothers to develop
parenting skills.
Background
Research suggests one in five Australian children are born into disadvantage and by the time they start school are already behind their peers.
The early years present a unique opportunity for early intervention to prevent disadvantage for children.
A team of Australian researchers have developed right@home, an early intervention program that increases the number of visits
women facing adversity receive from maternal child health nurses, from birth until their babies’ turn two.
Mothers were offered the extra nurse home visits via the Maternal and Child Health Service – an existing universal service available to all Australian parents – to support parenting and children’s health and development.
What researchers found
Researchers followed up with mothers after their babies turned two and found there is strong evidence of program benefit, particularly for mother’s parenting skills and their capacity to care for themselves and their children.
The research was led by the Centre for Community Child Health, a department of the Royal Children's Hospital and a research group of Murdoch Children’s Research Institute.
right@home
The right@home nurse home visiting program is based on the Maternal Early Childhood Sustained Home-visiting (MECSH) program and incorporates additional modules to help parents care for and respond to their children, and create a supportive home learning environment.
right@home began in 2012 and was the largest
randomised-control trial of nurse home visiting to be delivered through the
existing Australian universal health service.
The program ran at four locations in Victoria - Ballarat, Dandenong, Frankston and Whittlesea - and in three regions of Tasmania - Hobart, North and North West.
722 mothers experiencing adversity participated in right@home, with 363 in the intervention group receiving the extra nurse home visits and 359 in the control group receiving usual care via the Maternal and Child Health service.
right@home aims to find out how the universal child and family health nursing service might be improved to better meet the needs of all families.
Research
There are three phases to this research:
Phase 1: birth-2 years
Now that the children have turned 2, the study has evaluated the impact of the nurse home visiting program on:
- parent care skills (e.g. feeding, sleeping and safety)
- responsivity as parents (bonding with baby)
- the home learning environment (to foster language and literacy)
Findings
After two years researchers followed up both the intervention group and the control group and found strong evidence of program benefit, particularly on mothers parenting skills, maternal mental health and children’s literacy.
Mothers receiving extra nurse home visits had more regular child bedtimes, safer homes, warmer and less hostile parenting, and a more nurturing home learning environment.
Mothers also said it improved their capacity to care for their children and themselves.
There is also the likelihood that this program will help children at risk of disadvantage to be more school ready, although the next phases of the research will examine these links.
Listen
to Prof Sharon Goldfeld’s ABC interview to hear more about the findings
Read an article published in Pursuit by the
University of Melbourne, February 15 2019
Access our findings from Phase 1 published in Pediatrics, the Official Journal of American Paediatrics.
Next research steps
Phase
2seeks to identify any long-lasting effects of the extra visits on children's early learning and development by the time they start school.
In phase 2 we are continuing to follow up these families and children until child age 5 years.
In phase 3 we plan to continue to follow up these families and children until child age 8 years (funding dependent).
The right@home research partnership
right@home is a research collaboration between the Australian Research Alliance for Children and Youth
(ARACY); the Translational Research and Social Innovation (TReSI) Group at Western Sydney University; and the Centre for Community Child Health (CCCH), which is a department of The Royal Children's Hospital and a research group of Murdoch Children’s Research Institute. The research lead
investigator is Professor Sharon Goldfeld.
What makes right@home different?
The nurses who participated in right@home are specifically trained and supported to work with parents and carers facing adversity. This enabled them to establish relationships with parents, and in turn, promote children’s development in the home. This training and support is the
cornerstone of right@home.
Who funded the study?
Phase 1 of right@home is funded by a combination of financial and ‘in-kind’ support from the following institutions and departments:
Phase 2 is funded by:
Publications
Research overview
Literature reviews
Peer-reviewed journal articles
- Research findings at 2 years from the right@home Australian randomised controlled trial of nurse home visiting:
Goldfeld, S., et.al. (2019). "Nurse home visiting for families experiencing adversity: A randomized controlled trial". Pediatrics.
- This paper assesses the quality of the delivery of the right@home program.
Kemp L, Bruce T, Elcombe EL, Anderson T, Vimpani G, Price A, et al. (2019) Quality of delivery of“right@home”: Implementation evaluation of an Australian sustained nurse home visiting intervention to improve parenting and the home learning environment. PLoS ONE
- A case study of the design, testing, and implementation of the right@home program:
Goldfeld S, Price A, Kemp L. (2018). Designing, testing, and implementing a sustainable nurse home visiting program: right@ home. ANNALS of The New York Academy of Sciences
- This study explores whether the brief risk factor survey identified women experiencing increased psychosocial and socio-economic risk in pregnancy:
Price, A, Bryson H, Mensah H,et al. (2018). "A brief survey to identify pregnant women experiencing increased psychosocial and socioeconomic risk." Women and Birth.
- This study describes the first, large, prospective, population-based survey of risk factors in pregnant Australian women:
Goldfeld S, D'Abaco E, Bryson H, et al. (2018). “Surveying social adversity in pregnancy: The antenatal risk burden experienced by Australian women”. Journal of Paediatrics and Child Health
- Details of a pilot, simple, risk factor survey in pregnancy that can be collected at the population level:
Price, A. M., et al. (2017). "The feasibility and acceptability of a population-level antenatal risk factor survey: Cross-sectional pilot study" Journal of Paediatrics and Child Health
- This study describes the roadmap to carrying out the right@home trial:
Goldfeld S, Price A, Bryson H, et al. (2017) ”right@home’: a randomised controlled trial of sustained nurse home visiting from pregnancy to child age2 years, versus usual care, to improve parent care, parent responsivity and the home learning environment at 2 years” BMJ Open
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