A home-visitation program to prevent postpartum parental distress and enhance wellbeing in both parents and infants.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness from this review. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Early help
- Targeted and specialist
Australian Study
Risk of Bias
Cost
Target Age Group
About
Psychoeducational Parenting Intervention (PPI) involves home visitations by nurses to reduce the maternal psychological parenting stress of mothers with a history of child maltreatment. The included studies supported nurse visitations to the homes of low-income, teenage mothers with newborns. The model focuses on providing mothers with didactic skills in child development, parenting and coping strategies for managing stresses, as well as assistance in developing social support networks.
Aims
- Improve infant wellbeing
- Improve infant development
- Increase infant security attachment
- Improve parenting skills
- Improve parent mental health
- Develop social support networks.
Impact
Results are mixed and inconclusive for the two child and parent mental health behaviour outcomes measured in the included studies.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| Child | Mental health/behaviour | Yes | Yes | Yes |
| Parent/caregiver | Mental health/functioning | Yes | Not found | Yes |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
PPI has an evidence rating of Supported+.
This means that PPI has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, long-term impact on at least one child and family outcome.
This assessment is based on 4 research outputs from one primary study. PPI has not received a Well-supported rating as it has not yet replicated its results in another RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | 4 |
| Quasi-experiment | Not identified or included |
The evidence has low concerns with risk of bias.
We can be confident about the results and quality of evidence from the included study.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- The RCT was conducted in the United States.
Sample
- A total of 189 infants and their biological mothers (49 intervention one and 53 intervention 2, 35 control one and 52 control 2) identified through the inspection of Child Protective Service and preventive service records participated in the evaluation.
- Families in the sample were characterised by poverty, relatively large family size and frequent unstable marriages. 65% of the maltreated infants were identified as the targets of abuse and/or neglect.
- In the trial, nurses visited the homes of low-income mothers to provide education about infant physical and psychological development. In addition, therapists utilised a variety of cognitive and behavioural techniques to help parents develop parenting skills, problem solving skills, relaxation strategies and social support resources.
- Almost three quarters of the mothers were of minority race or ethnicity.
Implementation
Delivery model, mode and setting
- This PPI model is delivered in-person, to the parent/caregiver only.
- The program is typically conducted in the clients’ homes.
Target cohort
- Parents and caregivers of children aged up to 5, who are at risk of or have experienced trauma and/or maltreatment
- Children from birth to age 5.
Program delivery
- The PPI delivered is designed to provide mothers with education about child development and parenting skills to reduce parenting stress and increase life satisfaction.
- Time spent on each area is individually tailored to meet each mother’s primary needs.
Duration and intensity
- PPI in this study was delivered by nurses and therapists who visit client’s homes weekly over a 12-month period.
Guides and manuals
- We were unable to locate any manuals or guides to implement PPI.
Staffing
- At a minimum, therapists are required to have a bachelor's degree and good interpersonal skills.
- Supervisors are required to have a master’s degree or equivalent.
Training
- We were unable to locate any information on training requirements to implement PPI.
To our knowledge, PPI is not available and has not been implemented in Australia.
Cost
We were unable to locate any information on the cost of PPI.
References
Studies identified and included in the review
- Cicchetti D, Rogosch FA and Toth SL (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development & Psychopathology 18(3): 623-649.
- Stronach EP (2013). Preventive interventions and sustained attachment security in maltreated children: A 12-month follow-up of a randomized controlled trial. Dissertation Abstracts International: Section B: The Sciences and Engineering 74(3): No Pagination Specified.
- Stronach EP, Toth SL, Rogosch F and Cicchetti D (2013). Preventive interventions and sustained attachment security in maltreated children. Development & Psychopathology 25(4 Pt 1): 919-930.
- Toth SL, Sturge-Apple ML, Rogosch FA and Cicchetti D (2015). Mechanisms of change: Testing how preventative interventions impact psychological and physiological stress functioning in mothers in neglectful families. Development & Psychopathology 27(4 Pt 2): 1661-1674.
Studies identified but not counted towards the evidence rating due to study quality
No studies that were identified were excluded due to study quality.