New research has found that disadvantaged children would get a better start to life if maternal and child health nurses regularly visited their homes in the first two years to help their mothers improve parenting skills.

A team of Australian researchers has developed a new early adversity-intervention program, right@home, which puts maternal and child health nurses in children's homes on a recurring basis to support mothers as they develop their child care skills.

Research analyzing the effectiveness of right@home in Victoria and Tasmania has been published in the Official Journal of American Paediatrics.

"UNICEF and former US President Barack Obama both champion nurse home visits as a way to help disadvantaged families," said lead investigator, Professor Sharon Goldfeld from the Murdoch Children's Research Institute.

"These are families dealing with challenges like poor mental health, a lack of employment, limited education, poverty, drug and alcohol abuse, domestic violence or even just families where the parents are very young and inexperienced. Mostly it's a combination of these factors."

Prof Goldfeld said the program aims to better prepare children from at-risk families to succeed at school and in life.

"According to the Australian Early Development Census, one in five Australian children already shows some developmental vulnerabilities when they start school and the statistics show that these children are unlikely to catch up with their peers, especially those living in disadvantage," Prof Goldfeld said. "They are more likely to continue falling behind, to fail academically, and thus more likely to find themselves in low-paid jobs and suffering poor health.

"We do not want babies born in adversity to be destined to live a life of hardship. Studies have shown that early intervention is effective so we worked with researchers from the Western Sydney University to design the right@home* sustained nurse visiting program, consisting of 25 regular visits from a nurse from before birth and during a child's first two years."

Prof Goldfeld said maternal and child health nurses had been helping new mothers in Australia for more than 100 years, and were best placed to support them as they developed their parenting skills.

"This program is essentially about using an existing service – maternal and child health – better," Prof Goldfeld said.

The nurses visited the families frequently in the first few months of the program, but as the mothers' parenting skills increased the visits became less frequent. 722 women and babies joined the right@home study and half received the program while half had the standard maternal and child health program in Victoria (nine visits to two years) and Tasmania (six visits). The nurses focused on mothers' child-care skills (feeding, sleeping and safety) responsivity as parents (bonding with the baby) and creating a better home learning environment (to foster language and literacy).

"This definitely contributes to healthy child development – raising happy, thriving children who are more likely to do better in school, have good relationships in the community, and lead healthier lives," Prof Goldfeld said.

The trial took place in Victoria and Tasmania and the researchers recruited pregnant women attending antenatal clinics at ten hospitals.

"After two years both the intervention and control groups were assessed across 13 outcomes by a researcher and through the mother's feedback," Prof Goldfeld said.

"There was strong evidence of benefit, with right@home resulting in more regular child bedtimes, safer homes, warmer and less hostile parenting, and a more nurturing home learning environment.

"The program was also extremely well-received by mothers, who said it improved their capacity tocare for their children and themselves."

CEO of the Australian Research Alliance for Children and Youth (ARACY), Penny Dakin, said right@home is further proof of the importance of early and evidence-based investment in the future of vulnerable Australian children.

"As the evidence mounts, and governments around the globe start to act on it, the pressure mounts on all Australian governments to bring their investment forward, into areas such as quality early childhood education, more effective school funding, and sustained nurse home visiting programs like right@home that ensure families know how to set their child on the best possible pathway for life."

"The program is easily incorporated into Australia's existing nurse home visiting programs. We want to see Governments across Australia, making it available to the nation's most vulnerable kids and their families," Ms Dakin said.

Prof Goldfeld is also a professor with the Department of Paediatrics, University of Melbourne and the Melbourne Royal Children's Hospital.

*right@home is a research collaboration between the Australian Research Alliance for Children and Youth (ARACY); the Translational Research and Social Innovation (TReSI) Group at Western Sydney University; and the Centre for Community Child Health (CCCH), which is a department of The Royal Children's Hospital and a research group of Murdoch Children's Research Institute. right@home is supported by: Victorian Department of Education and Training, Tasmanian Department of Health and Human Services, The Ian Potter Foundation, Sabemo Trust, Sidney Myer Fund, Vincent Fairfax Family Foundation, and the National Health and Medical Research Council (NHMRC, 1079418).

Prof Goldfeld spoke to Jon Faine on ABC Radio Melbourne about the right@home program. You can listen to the interview below:

Available for interview:
· Professor Sharon Goldfeld MCRI
· Penny Dakin, Australian Research Alliance for Children and Youth
· Professor Lynn Kemp, Western Sydney University

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