The Influence of Intervention Augmentation and Strength of Maternal Engagement on Community Child Health Nurse Home Visiting for New Parents: An Exploratory Study

Wednesday, 1 August 2012: 3:50 PM

Tara J. Flemington, RN, BNurs, BHlthSci, GradCertNursing
Sydney Nursing School, The University of Sydney, Sydney, Australia
Jennifer A. Fraser, PhD, RN, BN, MN
Sydney Nursing School, The University of Sydney, Sydney 2006, Australia

Learning Objective 1: The learner will be able to explain the importance of nurse home visiting programs in improving outcomes for at-risk children.

Learning Objective 2: The learner will be able to identify the need for research into engagement and its importance in achieving targeted outcomes in nurse home visiting programs.


Sustained and high quality maternal involvement in home visiting programs may be an important factor in reducing child abuse potential in at-risk families. This study aimed to examine this neglected field by investigating factors predicting program engagement and relationship to maternal outcomes in an intensive, nurse-led home visiting program in South East Queensland. Using a theoretical basis of Bronfenbrenner’s ecological theory and McCurdy and Daro’s theory of parental engagement in home visiting programs, the study aimed to examine engagement in the Australian context.


Data from a longitudinal randomised controlled trial investigating standard nurse home visiting (Family Care) and an augmented program (PUP B) were analysed. A chart audit following the trial was then conducted to elicit detailed information about duration of program participation and longer term postnatal depression status.  


A relationship between maternal engagement, postnatal depression and child abuse potential, maternal engagement and maternal-infant attachment, and enrolment in an augmented program and child abuse potential was found.


The majority of studies in this area have examined the relationship between either maternal or provider characteristics, or both, and maternal engagement. The limited and conflicting results arising from previous research may be due to a lack of depth and complexity of the variables, or potential confounders, such as community characteristics, being excluded from the analysis. There is a scarcity of research that examines complex explanatory variables and their relationship to engagement and program outcomes. This study found that maternal engagement is an important factor in success of home visiting programs in terms of outcomes achieved and program completion. Further investigation in the Australian context is needed to clarify the direction of influence of explanatory variables.