Evaluating Fidelity in Home-Visiting Programs a Qualitative Analysis of 1058 Home Visit Case Notes from 105 Families

Autor: Susana Tereno, Romain Dugravier, Tim Greacen, Anne Revah-Levy, Emilie Lerner, Elodie Simon-Vernier, Bruno Falissard, Eléonore Pintaux, Antoine Guedeney, Thomas Saïas, Alessandra Emer, Florence Tubach
Rok vydání: 2012
Předmět:
Program evaluation
Non-Clinical Medicine
Economics
Health Care Sector
lcsh:Medicine
Social and Behavioral Sciences
Pediatrics
Child Development
Pregnancy
Human Relations
House call
Psychology
Quality of Care
Child
lcsh:Science
Health Education
Qualitative Research
media_common
Psychiatry
Child Psychiatry
Multidisciplinary
Postpartum Period
Obstetrics and Gynecology
Prenatal Care
House Calls
Clinical Psychology
Mental Health
Medicine
Female
Health education
Family Relations
France
Research Article
medicine.medical_specialty
media_common.quotation_subject
education
Child Welfare
Fidelity
Interpersonal relationship
Health Economics
medicine
Humans
Health Care Quality
Medical education
Health Care Policy
Mood Disorders
business.industry
lcsh:R
Infant
Newborn
Infant
Social Support
Communication in Health Care
Child development
Psychotherapy
Therapies
Developmental Psychology
lcsh:Q
Postpartum Care
business
Postpartum period
Program Evaluation
Qualitative research
Zdroj: PLoS ONE, Vol 7, Iss 5, p e36915 (2012)
PLoS ONE
ISSN: 1932-6203
Popis: Objective Implementation fidelity is a key issue in home-visiting programs as it determines a program’s effectiveness in accomplishing its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health which took place in France between 2006 and 2011. Method To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses. Results During the prenatal period, home visitors focused on the social components of the program. Visitors discussed the physical changes in pregnancy, and psychological and social environment issues. Discussing immigration, unstable employment and financial related issues, family relationships and dynamics and maternity services, while not expected, were found in case notes. Conversely, health during pregnancy, early child development and postpartum mood changes were not identified as topics within the prenatal case notes. During the postnatal period, most components of the intervention were addressed: home visitors observed the mother’s adaptation to the baby; routine themes such as psychological needs and medical-social networks were evaluated; information on the importance of social support and on adapting the home environment was given; home visitors counseled on parental authority, and addressed mothers’ self-esteem issues; finally, they helped to find child care, when necessary. Some themes were not addressed or partially addressed: health education, child development, home environment, mother’s education plans and personal routine, partner support and play with the child. Other themes were not expected, but found in the case notes: social issues, mother-family relationship, relation with services, couple issues, quality of maternal behavior and child’s language development. Conclusions In this program, home visitors experienced difficulties addressing some of the objectives because they gave precedence to the families“ urgent needs. This research stresses the importance of training home visitors to adapt the intervention to the social, psychological and health needs of families.
Databáze: OpenAIRE
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