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Open Access Study protocol

Miller Early Childhood Sustained Home-visiting (MECSH) trial: design, method and sample description

Lynn Kemp1*, Elizabeth Harris1, Catherine McMahon2, Stephen Matthey3, Graham Vimpani4, Teresa Anderson3 and Virginia Schmied5

Author Affiliations

1 Centre for Health Equity Training Research and Evaluation, part of the Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of NSW, Liverpool Hospital, Locked Bag 7103, Liverpool BC NSW 1871, Australia

2 Department of Psychology, Division of Linguistics and Psychology, Macquarie University, North Ryde NSW 2109, Australia

3 Sydney South West Area Health Service, Liverpool Hospital, Locked Bag 7103, Liverpool BC NSW 1871, Australia

4 School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle NSW 2310, Australia

5 School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797 Penrith South DC NSW 1797, Australia

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BMC Public Health 2008, 8:424  doi:10.1186/1471-2458-8-424

Published: 29 December 2008

Abstract

Background

Home visiting programs comprising intensive and sustained visits by professionals (usually nurses) over the first two years of life show promise in promoting child health and family functioning, and ameliorating disadvantage. Australian evidence of the effectiveness of sustained nurse home visiting in early childhood is limited. This paper describes the method and cohort characteristics of the first Australian study of sustained home visiting commencing antenatally and continuing to child-age two years for at-risk mothers in a disadvantaged community (the Miller Early Childhood Sustained Home-visiting trial).

Methods and design

Mothers reporting risks for poorer parenting outcomes residing in an area of socioeconomic disadvantage were recruited between February 2003 and March 2005. Mothers randomised to the intervention group received a standardised program of nurse home visiting. Interviews and observations covering child, maternal, family and environmental issues were undertaken with mothers antenatally and at 1, 12 and 24 months postpartum. Standardised tests of child development and maternal-child interaction were undertaken at 18 and 30 months postpartum. Information from hospital and community heath records was also obtained.

Discussion

A total of 338 women were identified and invited to participate, and 208 were recruited to the study. Rates of active follow-up were 86% at 12 months, 74% at 24 months and 63% at 30 months postpartum. Participation in particular data points ranged from 66% at 1 month to 51% at 24 months postpartum. Rates of active follow-up and data point participation were not significantly different for the intervention or comparison group at any data point. Mothers who presented for antenatal care prior to 20 weeks pregnant, those with household income from full-time employment and those who reported being abused themselves as a child were more likely to be retained in the study. The Miller Early Childhood Sustained Home-visiting trial will provide Australian evidence of the effectiveness of sustained nurse home visiting for children at risk of poorer health and developmental outcomes.

Trial registration

ACTRN12608000473369