Expanding developmental and Behavioral services for Newborns in primary care - Effects on parental well-being, practice, and satisfaction
Expanding developmental and Behavioral services for Newborns in primary care - Effects on parental well-being, practice, and satisfaction
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DOI：
10.1016/j.amepre.2003.12.018
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发表时间：
2004-05-01
影响因子：
5.5
通讯作者：
Thompson, RS
中科院分区：
文献类型：
--
作者：
Johnston, BD;Huebner, CE;Thompson, RS
背景资料：健康的步骤（HS）的目的是解决，前瞻性地，在儿科临床护理环境中的年轻家庭的行为和发展的支持需求。PrePare（PP）在产前开始提供这些服务，而HS在产后开始提供服务。这两种干预措施都具有普遍性和针对风险的组成部分。干预效果在出生后的前3个月herewart.Methods：一个准实验设计被用来分配439名参与者干预或通常的护理条件。在干预组中，登记者被随机分配接受HS或PP+HS服务。早期的结果进行了评估，在1周和3个月postparty.Results的电话调查：在任何干预条件的母亲不太可能报告抑郁症状，更有可能描述自己作为父母的角色感到高兴。干预家庭更有可能继续母乳喂养，更有可能给3个月大的孩子读书。干预接受者对婴儿发育的了解和对适当纪律的认识更高。干预接受者对儿科护理的满意度更高，参加产前干预的人在3个月时的健康计划退出率降低了75%。HS和PP+HS enrollees.Conclusions之间没有其他结果差异出现：收到任何干预措施与健康，安全和发育适当的养育，在婴儿早期评估的积极影响。对健康计划退出有积极影响。产前服务机构不能带来额外的好处。建议对初为人父母者提供普遍和基于风险的支助相结合，而不是仅仅提供基于风险的服务。
Background: Healthy Steps (HS) was designed to address, prospectively, behavioral and developmental support needs of young families in pediatric clinical care settings. PrePare (PP) initiates these services prenatally, whereas HS begins services in the postnatal period. Both interventions have universal and risk-directed components. Intervention effects in the first 3 months after birth are reported here.Methods: A quasi-experimental design was used to allocate 439 participants to intervention or usual care conditions. Within the intervention group, enrollees were randomly assigned to receive HS or PP+HS services. Early outcomes were assessed by telephone survey at 1 week and 3 months postpartum.Results: Mothers in either intervention condition were less likely to report depressive symptoms and more likely to describe themselves as pleased in their role as parents. Intervention families were more likely to continue breastfeeding and more likely to read to their 3-month-old. Knowledge of infant development and recognition of appropriate discipline was greater among intervention recipients. Satisfaction with pediatric care was higher among intervention recipients and the rate of health plan disenrollment was 75% lower at 3 months among those enrolled in the prenatal intervention. No other outcome difference emerged between HS and PP+HS enrollees.Conclusions: Receipt of either intervention was associated with positive effects on health, safety, and developmentally appropriate parenting, as assessed in early infancy. There were positive effects on health plan disenrollment. No additional benefit could be ascribed to prenatal institution of services. A combination of universal and risk-based support for new parents is recommended, rather than the provision of risk-based services alone.