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Published in: BMC Health Services Research 1/2009

Open Access 01-12-2009 | Research article

The effects of an area-based intervention on the uptake of maternal and child health assessments in Australia: A community trial

Authors: Margaret Kelaher, David Dunt, Peter Feldman, Andrea Nolan, Bridie Raban

Published in: BMC Health Services Research | Issue 1/2009

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Abstract

Background

Recognition of the importance of the early years in determining health and educational attainment and promotion of the World Health Organization Health for All (HFA) principles has led to an international trend towards community-based initiatives to improve developmental outcomes among socio-economically disadvantaged children. In this study we examine whether, Best Start, an Australian area-based initiative to improve child health was effective in improving access to Maternal and Child Health (MCH) services.

Methods

The study compares access to information, parental confidence and annual 3.5 year Ages and Stages visiting rates before (2001/02) and after (2004/05) the introduction of Best Start. Access to information and parental confidence were measured in surveys of parents with 3 year old children. There were 1666 surveys in the first wave and 1838 surveys in the second wave. The analysis of visiting rates for the 3.5 year Ages and Stages visit included all eligible Victorian children. Best Start sites included 1,739 eligible children in 2001/02 and 1437 eligible children in 2004/05. The comparable figures in the rest of the state were and 45, 497 and 45, 953 respectively.

Results

There was a significant increase in attendance at the 3.5 year Ages and Stages visit in 2004/05 compared to 2001/02 in all areas. However the increase in attendance was significantly greater at Best Start sites than the rest of the state. Access to information and parental confidence improved over the course of the intervention in Best Start sites with MCH projects compared to other Best Start sites.

Conclusion

These results suggest that community-based initiatives in disadvantaged areas may improve parents' access to child health information, improve their confidence and increase MCH service use. These outcomes suggest such programmes could potentially contribute to strategies to reduce child health inequalities.
Literature
1.
go back to reference Melhuish E, Belsky J, Leyland AH, Barnes J, National Evaluation of Sure Start Research Team: Effects of fully-established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study. Lancet. 2008, 372: 1641-1647. 10.1016/S0140-6736(08)61687-6.CrossRefPubMed Melhuish E, Belsky J, Leyland AH, Barnes J, National Evaluation of Sure Start Research Team: Effects of fully-established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study. Lancet. 2008, 372: 1641-1647. 10.1016/S0140-6736(08)61687-6.CrossRefPubMed
2.
go back to reference Love JM, Kisker EE, Ross C, Raikes H, Constantine J, Boller K, Brooks-Gunn J, Chazan-Cohen R, Tarullo LB, Brady-Smith C, et al: The effectiveness of early head start for 3-year-old children and their parents: lessons for policy and programs. Dev Psychol. 2005, 41 (6): 885-901.CrossRefPubMed Love JM, Kisker EE, Ross C, Raikes H, Constantine J, Boller K, Brooks-Gunn J, Chazan-Cohen R, Tarullo LB, Brady-Smith C, et al: The effectiveness of early head start for 3-year-old children and their parents: lessons for policy and programs. Dev Psychol. 2005, 41 (6): 885-901.CrossRefPubMed
3.
go back to reference World Health Organisation: Health21- Health for All in the 21st Century. 1998, Geneva: World Health Organisation World Health Organisation: Health21- Health for All in the 21st Century. 1998, Geneva: World Health Organisation
5.
go back to reference Stafford M, Nazroo J, Popay JM, Whitehead M: Tackling inequalities in health: evaluating the New Deal for Communities initiative. J Epidemiol Community Health. 2008, 62 (4): 298-304. 10.1136/jech.2006.058628.CrossRefPubMed Stafford M, Nazroo J, Popay JM, Whitehead M: Tackling inequalities in health: evaluating the New Deal for Communities initiative. J Epidemiol Community Health. 2008, 62 (4): 298-304. 10.1136/jech.2006.058628.CrossRefPubMed
6.
go back to reference Olds DL, Sadler L, Kitzman H: Programs for parents of infants and toddlers: recent evidence from randomized trials. J Child Psychol Psychiatry. 2007, 48 (3–4): 355-391. 10.1111/j.1469-7610.2006.01702.x.CrossRefPubMed Olds DL, Sadler L, Kitzman H: Programs for parents of infants and toddlers: recent evidence from randomized trials. J Child Psychol Psychiatry. 2007, 48 (3–4): 355-391. 10.1111/j.1469-7610.2006.01702.x.CrossRefPubMed
7.
go back to reference Tugwell P, Petticrew M, Robinson V, et al: Cochrane and Campbell Collaborations, and health equity. Lancet. 2006, 367: 1128-1130. 10.1016/S0140-6736(06)68490-0.CrossRefPubMed Tugwell P, Petticrew M, Robinson V, et al: Cochrane and Campbell Collaborations, and health equity. Lancet. 2006, 367: 1128-1130. 10.1016/S0140-6736(06)68490-0.CrossRefPubMed
8.
go back to reference Thomson H, Atkinson R, Petticrew M, Kearns A: Do urban regeneration programmes improve public health and reduce health inequalities? A synthesis of the evidence from UK policy and practice (1980–2004). Journal of Epidemiology and Community Health. 2006, 60: 108-115. 10.1136/jech.2005.038885.CrossRefPubMedPubMedCentral Thomson H, Atkinson R, Petticrew M, Kearns A: Do urban regeneration programmes improve public health and reduce health inequalities? A synthesis of the evidence from UK policy and practice (1980–2004). Journal of Epidemiology and Community Health. 2006, 60: 108-115. 10.1136/jech.2005.038885.CrossRefPubMedPubMedCentral
11.
go back to reference Bricker D, Squires J: The Ages & Stages Questionnaires (Asq) – a Parent-completed, Child-monitoring System (English Version – Complete Asq System) 2 Rev Ed edition. 1999, Baltimore: Brookes Publishing Company Bricker D, Squires J: The Ages & Stages Questionnaires (Asq) – a Parent-completed, Child-monitoring System (English Version – Complete Asq System) 2 Rev Ed edition. 1999, Baltimore: Brookes Publishing Company
12.
go back to reference Kendrick D, Elkan R, Hewitt M, Dewey M, Blair M, Robinson J, Williams D, Brummell K: Does home visiting improve parenting and the quality of the home environment? A systematic review and meta analysis. Arch Dis Child. 2000, 82 (6): 443-451. 10.1136/adc.82.6.443.CrossRefPubMedPubMedCentral Kendrick D, Elkan R, Hewitt M, Dewey M, Blair M, Robinson J, Williams D, Brummell K: Does home visiting improve parenting and the quality of the home environment? A systematic review and meta analysis. Arch Dis Child. 2000, 82 (6): 443-451. 10.1136/adc.82.6.443.CrossRefPubMedPubMedCentral
13.
go back to reference Olds DL, Kitzman H: Can home visitation improve the health of women and children at environmental risk?. Pediatrics. 1990, 86 (1): 108-116.PubMed Olds DL, Kitzman H: Can home visitation improve the health of women and children at environmental risk?. Pediatrics. 1990, 86 (1): 108-116.PubMed
14.
go back to reference Centre for Community Child Health: A review of the Early Childhood literature. 2000, Canberra: Department of Family and Community Services Centre for Community Child Health: A review of the Early Childhood literature. 2000, Canberra: Department of Family and Community Services
15.
go back to reference Barnett WS, Belfield CR: Early childhood development and social mobility. Future Child. 2006, 16 (2): 73-98. 10.1353/foc.2006.0011.CrossRefPubMed Barnett WS, Belfield CR: Early childhood development and social mobility. Future Child. 2006, 16 (2): 73-98. 10.1353/foc.2006.0011.CrossRefPubMed
16.
go back to reference Jacobson VJC, Szilagyi P: Patient reminder and patient recall systems to improve immunization rates. Cochrane Database Syst Rev. 2005, CD003941-3 Jacobson VJC, Szilagyi P: Patient reminder and patient recall systems to improve immunization rates. Cochrane Database Syst Rev. 2005, CD003941-3
17.
go back to reference Pritchard MA, Colditz PB, Beller EM: Parental experiences and preferences which influence subsequent use of post-discharge health services for children born very preterm. J Paediatr Child Health. 2008, 44 (5): 281-284. 10.1111/j.1440-1754.2007.01256.x.CrossRefPubMed Pritchard MA, Colditz PB, Beller EM: Parental experiences and preferences which influence subsequent use of post-discharge health services for children born very preterm. J Paediatr Child Health. 2008, 44 (5): 281-284. 10.1111/j.1440-1754.2007.01256.x.CrossRefPubMed
18.
go back to reference Fagot B, Leve LD: Teacher ratings of externalizing behavior at school entry for boys and girls: similar early predictors and different correlates. J Child Psychol Psychiatry. 1998, 39 (4): 555-566. 10.1017/S002196309800225X.CrossRefPubMed Fagot B, Leve LD: Teacher ratings of externalizing behavior at school entry for boys and girls: similar early predictors and different correlates. J Child Psychol Psychiatry. 1998, 39 (4): 555-566. 10.1017/S002196309800225X.CrossRefPubMed
19.
go back to reference Shaw DS, Owens EB, Giovannelli J, et al: Infant and toddler pathways leading to earlyI externalizing disorders. J Am Acad Child Adolesc Psychiatry. 2001, 40 (1): 36-43. 10.1097/00004583-200101000-00014.CrossRefPubMed Shaw DS, Owens EB, Giovannelli J, et al: Infant and toddler pathways leading to earlyI externalizing disorders. J Am Acad Child Adolesc Psychiatry. 2001, 40 (1): 36-43. 10.1097/00004583-200101000-00014.CrossRefPubMed
20.
go back to reference Belsky J, Bell B, Bradley RH, et al: Socioeconomic risk, parenting during the preschool years and child health age 6 years. Eur J Public Health 17(5) (2007) 508-13. 2007, 17 (5): 508-513. 10.1093/eurpub/ckl261.CrossRef Belsky J, Bell B, Bradley RH, et al: Socioeconomic risk, parenting during the preschool years and child health age 6 years. Eur J Public Health 17(5) (2007) 508-13. 2007, 17 (5): 508-513. 10.1093/eurpub/ckl261.CrossRef
21.
go back to reference Caldwell B, Bradley R: Home observation for measurement of the environment. 1984, Little Rock, Arkansas: University of Arkansas Caldwell B, Bradley R: Home observation for measurement of the environment. 1984, Little Rock, Arkansas: University of Arkansas
22.
go back to reference Glascoe F: Parents' Evaluation of Developmental Status (PEDS). 1997, Nashville, TN: Ellsworth & Vandermeer Press Glascoe F: Parents' Evaluation of Developmental Status (PEDS). 1997, Nashville, TN: Ellsworth & Vandermeer Press
23.
go back to reference Offord Centre for Child Studies: Early Development Instrument (EDI). Offord Centre for Child Studies, McMaster University McMaster Children's Hospital Offord Centre for Child Studies: Early Development Instrument (EDI). Offord Centre for Child Studies, McMaster University McMaster Children's Hospital
24.
go back to reference Victorian Auditor-general: Giving Victorian children the best start in life. 2007, Melbourne: Victorian Government Printer Victorian Auditor-general: Giving Victorian children the best start in life. 2007, Melbourne: Victorian Government Printer
25.
go back to reference Hawe P, Shiell A, Riley T: Complex interventions: How "out of control" can a randomised community trial be?. BMJ. 2004, 328: 1561-1563. 10.1136/bmj.328.7455.1561.CrossRefPubMedPubMedCentral Hawe P, Shiell A, Riley T: Complex interventions: How "out of control" can a randomised community trial be?. BMJ. 2004, 328: 1561-1563. 10.1136/bmj.328.7455.1561.CrossRefPubMedPubMedCentral
26.
go back to reference Bethell C, Peck C, Schor E: Assessing health system provision of well-child care: The Promoting Healthy Development Survey. Pediatrics. 2001, 107 (5): 1084-1094. 10.1542/peds.107.5.1084.CrossRefPubMed Bethell C, Peck C, Schor E: Assessing health system provision of well-child care: The Promoting Healthy Development Survey. Pediatrics. 2001, 107 (5): 1084-1094. 10.1542/peds.107.5.1084.CrossRefPubMed
27.
go back to reference Perry CD, Kenney GM: Preventive care for children in low-income families: How well do Medicaid and State Children's Health Insurance Programs do?. Pediatrics. 2007, 120 (6): E1393-E1401. 10.1542/peds.2006-3520.CrossRefPubMed Perry CD, Kenney GM: Preventive care for children in low-income families: How well do Medicaid and State Children's Health Insurance Programs do?. Pediatrics. 2007, 120 (6): E1393-E1401. 10.1542/peds.2006-3520.CrossRefPubMed
28.
go back to reference Hiscock H, Bayer JK, Price A, et al: Universal parenting programme to prevent early childhood behavioural problems: cluster randomised trial. BMJ. 2008, 336 (7639): 318-321. 10.1136/bmj.39451.609676.AE.CrossRefPubMedPubMedCentral Hiscock H, Bayer JK, Price A, et al: Universal parenting programme to prevent early childhood behavioural problems: cluster randomised trial. BMJ. 2008, 336 (7639): 318-321. 10.1136/bmj.39451.609676.AE.CrossRefPubMedPubMedCentral
29.
go back to reference Olds DL, Sadler L, Kitzman H: Programs for parents of infants and toddlers: recent evidence from randomized trials. Journal of Child Psychology and Psychiatry. 2007, 48 (3–4): 355-391. 10.1111/j.1469-7610.2006.01702.x.CrossRefPubMed Olds DL, Sadler L, Kitzman H: Programs for parents of infants and toddlers: recent evidence from randomized trials. Journal of Child Psychology and Psychiatry. 2007, 48 (3–4): 355-391. 10.1111/j.1469-7610.2006.01702.x.CrossRefPubMed
30.
go back to reference Diez-Roux AV: Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am J Public Health. 1998, 88 (2): 216-222. 10.2105/AJPH.88.2.216.CrossRefPubMedPubMedCentral Diez-Roux AV: Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am J Public Health. 1998, 88 (2): 216-222. 10.2105/AJPH.88.2.216.CrossRefPubMedPubMedCentral
Metadata
Title
The effects of an area-based intervention on the uptake of maternal and child health assessments in Australia: A community trial
Authors
Margaret Kelaher
David Dunt
Peter Feldman
Andrea Nolan
Bridie Raban
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2009
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-9-53

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