Home Visiting Programs: What the Primary Care Clinician Should Know
Home Visiting Programs: What the Primary Care Clinician Should Know
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DOI：
10.1016/j.cppeds.2015.12.011
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发表时间：
2016-04-01
影响因子：
1.6
通讯作者：
Riewerts, Robert J.
中科院分区：
文献类型：
--
作者：
Finello, Karen Moran;Terteryan, Araksi;Riewerts, Robert J.
初级保健临床医生的责任正在迅速扩大，因为家庭生活的复杂性造成幼儿健康和发展结果的差异越来越大。尽管要求初级保健临床医生在复杂的家庭和社区因素的背景下促进健康，大多数初级保健临床医生是在培训有限和支持家庭的资源短缺的环境中工作。与针对幼儿及其家庭的循证家访方案建立伙伴关系，可以提供一种资源，有助于减少不良幼儿经历的影响，促进健康公平。美国的家访方案通常是自愿的，其目的是预防性的，但通常是根据重大风险标准向家庭提供服务，因为普遍做法的相关费用被认为过高。项目可以在健康（身体或行为/心理健康）、儿童福利、早期教育或早期干预系统内资助，也可以由主要集中在上述系统之一的私人基金会资助（例如，健康），方案和供资者针对广泛的成果。服务可能主要集中在孩子、父母或父母与孩子的交互上。服务包括制定有针对性的个性化干预策略，更好地指导父母，以及改进互动模式，以帮助陷入困境的家庭。本文提供了一个广泛的概述家访的历史，家访计划的理论基础，循证模型的关键组成部分，结果通常有针对性，有效性研究，成本信息，挑战和家访的好处，资金/可持续性问题。对初级保健临床医生的意义进行了具体描述，并强调了与临床医生相关的信息。
Responsibilities for primary care clinicians are rapidly expanding ascomplexities in families' lives create increased disparities in health and developmental outcomes for young children. Despite the demands on primary care clinicians to promote health in the context of complex family and community factors, most primary care clinicians are operating in an environment of limited training and a shortage of resources for supporting families. Partnerships with evidence-based home visiting programs for very young children and their families can provide a resource that will help to reduce the impact of adverse early childhood experiences and facilitate health equity. Home visiting programs in the United States are typically voluntary and designed to be preventative in nature, although families are usually offered services based on significant risk criteria since the costs associated with universal approaches have been considered prohibitive. Programs may be funded within the health (physical orbehavioral/mental health), child welfare, early education, or early intervention systems or by private foundation dollars focused primarily on oneof the above systems (e.g., health), with a wide range of outcomes targeted by the programs and funders. Services may be primarily focused on the child, the parent, or parent-child interactions. Services include the development of targeted and individualized intervention strategies, better coaching of parents, and improved modeling of interactions that may assist struggling families. This paper provides a broad overview ofthe history of home visiting, theoretical bases of home visiting programs, key components of evidence-based models, outcomes typically targeted, research on effectiveness, cost information, challenges and benefits of home visiting, and funding/sustainability concerns. Significance for primary care clinicians isdescribed specifically and information relevant for clinicians is emphasized throughout the paper.