Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project)
Objective To evaluate the impact of Nurse-Family Partnership (NFP), a home-visiting programme, on exploratory maternal outcomes in British Columbia (BC), Canada.Design Pragmatic, parallel arm, randomised controlled trial conducted October 2013–November 2019. Random allocation of participants (1:1) t...
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BMJ Publishing Group
2025-01-01
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| author | Susan Jack Charlotte Waddell Michael Boyle Harriet MacMillan Yufei Zheng Hui Xie Colleen Varcoe Amiram Gafni Andrea Gonzalez Debbie Sheehan Lil Tonmyr Ronald Barr Lenora Marcellus Nicole L A Catherine |
| author_facet | Susan Jack Charlotte Waddell Michael Boyle Harriet MacMillan Yufei Zheng Hui Xie Colleen Varcoe Amiram Gafni Andrea Gonzalez Debbie Sheehan Lil Tonmyr Ronald Barr Lenora Marcellus Nicole L A Catherine |
| author_sort | Susan Jack |
| collection | DOAJ |
| description | Objective To evaluate the impact of Nurse-Family Partnership (NFP), a home-visiting programme, on exploratory maternal outcomes in British Columbia (BC), Canada.Design Pragmatic, parallel arm, randomised controlled trial conducted October 2013–November 2019. Random allocation of participants (1:1) to comparison (existing services) or NFP (plus existing services). Researchers were naïve to allocation.Setting 26 local health areas across four of five BC regional health authorities.Participants 739 young (<25 years), first-time mothers (enrolled <28 weeks gestation), experiencing socioeconomic disadvantage.Intervention Public health nurses with NFP education offered home visits (up to 64) during pregnancy and until children’s second birthday plus existing services on offer in BC.Outcome measures Prespecified exploratory outcomes included exposure to intimate partner violence (IPV), income (annual from employment) and not in education, employment or training (NEET) by 24 months postpartum, and psychological distress and self-efficacy across five time points (34–36 weeks gestation, 2, 10, 18 and 24 months postpartum).Results A total of 739 participants were randomised (368 NFP, 371 comparison) and analysed via an intention-to-treat analysis. At 24 months postpartum, for participants receiving NFP, a lower percentage reported IPV (group difference −7.14; 95% CI: –14.17, –0.10); incomes were larger ($1629.74, 95% CI: $5.20, $3254.28) after adjusting for baseline differences and no difference in percentage of NEET (−2.41, 95% CI: −10.11, 5.30). For participants receiving NFP, psychological distress was lower across time points (−1.59, 95% CI: −2.35 to –0.84); self-efficacy was greater at 34–36 weeks gestation (0.78, 95% CI: 0.34, 1.22), then decreasing and becoming insignificant by 24 months postpartum (0.29, 95% CI: −0.18, 0.75). No unanticipated serious adverse events were reported.Conclusion Relying on the maternal report, at 24 months postpartum, the NFP group had reduced IPV exposure and increased incomes. Benefits observed in late pregnancy were sustained to study end for psychological distress, but not self-efficacy. Longer-term follow-up is recommended.Trial registration NCT01672060. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-bb7588c0a7e44be29ba6b139e2c467902025-01-07T05:10:10ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2023-083147Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project)Susan Jack0Charlotte Waddell1Michael Boyle2Harriet MacMillan3Yufei Zheng4Hui Xie5Colleen Varcoe6Amiram Gafni7Andrea Gonzalez8Debbie Sheehan9Lil Tonmyr10Ronald Barr11Lenora Marcellus12Nicole L A Catherine134 School of Nursing, McMaster University, Hamilton, Ontario, Canada1 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada2 Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada2 Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada1 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada1 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada7 The University of British Columbia, Vancouver, British Columbia, Canada5 Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada2 Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada1 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada6 Public Health Agency of Canada, Ottawa, Ontario, Canada7 The University of British Columbia, Vancouver, British Columbia, Canada8 University of Victoria, Victoria, British Columbia, Canada1 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, CanadaObjective To evaluate the impact of Nurse-Family Partnership (NFP), a home-visiting programme, on exploratory maternal outcomes in British Columbia (BC), Canada.Design Pragmatic, parallel arm, randomised controlled trial conducted October 2013–November 2019. Random allocation of participants (1:1) to comparison (existing services) or NFP (plus existing services). Researchers were naïve to allocation.Setting 26 local health areas across four of five BC regional health authorities.Participants 739 young (<25 years), first-time mothers (enrolled <28 weeks gestation), experiencing socioeconomic disadvantage.Intervention Public health nurses with NFP education offered home visits (up to 64) during pregnancy and until children’s second birthday plus existing services on offer in BC.Outcome measures Prespecified exploratory outcomes included exposure to intimate partner violence (IPV), income (annual from employment) and not in education, employment or training (NEET) by 24 months postpartum, and psychological distress and self-efficacy across five time points (34–36 weeks gestation, 2, 10, 18 and 24 months postpartum).Results A total of 739 participants were randomised (368 NFP, 371 comparison) and analysed via an intention-to-treat analysis. At 24 months postpartum, for participants receiving NFP, a lower percentage reported IPV (group difference −7.14; 95% CI: –14.17, –0.10); incomes were larger ($1629.74, 95% CI: $5.20, $3254.28) after adjusting for baseline differences and no difference in percentage of NEET (−2.41, 95% CI: −10.11, 5.30). For participants receiving NFP, psychological distress was lower across time points (−1.59, 95% CI: −2.35 to –0.84); self-efficacy was greater at 34–36 weeks gestation (0.78, 95% CI: 0.34, 1.22), then decreasing and becoming insignificant by 24 months postpartum (0.29, 95% CI: −0.18, 0.75). No unanticipated serious adverse events were reported.Conclusion Relying on the maternal report, at 24 months postpartum, the NFP group had reduced IPV exposure and increased incomes. Benefits observed in late pregnancy were sustained to study end for psychological distress, but not self-efficacy. Longer-term follow-up is recommended.Trial registration NCT01672060.https://bmjopen.bmj.com/content/15/1/e083147.full |
| spellingShingle | Susan Jack Charlotte Waddell Michael Boyle Harriet MacMillan Yufei Zheng Hui Xie Colleen Varcoe Amiram Gafni Andrea Gonzalez Debbie Sheehan Lil Tonmyr Ronald Barr Lenora Marcellus Nicole L A Catherine Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project) BMJ Open |
| title | Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project) |
| title_full | Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project) |
| title_fullStr | Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project) |
| title_full_unstemmed | Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project) |
| title_short | Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project) |
| title_sort | effects of nurse home visiting on intimate partner violence and maternal income mental health and self efficacy by 24 months postpartum a randomised controlled trial british columbia healthy connections project |
| url | https://bmjopen.bmj.com/content/15/1/e083147.full |
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