Abstract
This research aimed to identify key components for a home-based, early intervention designed to optimise outcomes for preterm infants whilst meeting the perceived needs and priorities of primary caregivers and health visitors. This multi-phase study aligned with the development stage of the UK Medical Research Council Framework on developing and evaluating complex interventions (Craig et al., 2008).Phase One (Evidence synthesis) synthesised evidence from systematic reviews assessing the effectiveness of home-based, early interventions designed to improve outcomes for preterm infants. Phases Two and Three (Ascertaining the views of key stakeholders) used qualitative inquiry to understand primary caregivers’ experiences of health visitor home visits within 6 months of preterm neonatal discharge and health visitors’ perceptions, experiences and professional needs while caring for these infants and families. Findings: The systematic review of systematic reviews (Phase One) confirmed the complexity and heterogeneity of home-based interventions. Positive impacts on several child, parent-child and parental outcomes were demonstrated. Key potential intervention components were identified: i) a focus on parent-infant interactions, ii) parental debriefing sessions with on-going psycho-social support, iii) short, streamlined interventions with initial high intensity home visits, iv) complementary non-home-based components, v) targeting multiple outcome domains, and vi) an explicit theory of change.
Phases Two and Three: Thematic analysis generated six themes. The quality of the parent-infant relationship and individuality of each family was a central theme for both health visitors and parents. Positive parent-health visitor relationships facilitated: i) a positive parent – child relationship ii) health visitors to work in partnership with parents to provide individualised needs-based care and support through home visits. Essential prerequisites to delivering care and support were: i) inter-professional information sharing, ii) continuing professional development and iii) health visitor well-being.
Conclusions: Integrated evidence from the systematic review of systematic reviews and thematic analyses provided the framework for an evidence-based model which could potentially be used to underpin a home-based, early intervention.
| Date of Award | Jul 2024 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Supervisor | Fiona Alderdice (Supervisor), Jennifer McNeill (Supervisor) & Claire Kerr (Supervisor) |
Keywords
- premature infants
- home-based, early intervention
- health visitors' experiences home visits
- parents' experiences home visits
- qualitative research
- community support
- public health
- complex intervention development
- post-neonatal discharge
- child outcomes
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