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Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review.
JBI Database System Rev Implement Rep. 2016 10; 14(10):167-208.JD

Abstract

BACKGROUND

Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support.

OBJECTIVES

The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors.

INTERVENTION AND PHENOMENON OF INTEREST

Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program.

TYPES OF STUDIES

Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies.

OUTCOMES

Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors.

SEARCH STRATEGY

The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered.

METHODOLOGICAL QUALITY

Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate.

DATA EXTRACTION

Both quantitative and qualitative data were independently extracted by two reviewers using standardized data extraction tools from the JBI-MAStARI and the JBI-QARI, respectively, including qualitative and quantitative details about setting of interventions, phenomena of interest, participants, study methods and outcomes or findings.

DATA SYNTHESIS

For quantitative findings, statistical pooling was not possible due to differences in interventions and outcome measures. Findings were presented in narrative form. Qualitative findings were aggregated into categories based on similarity of meaning from which synthesized findings were generated.

RESULTS

Quantitative results from two RCTs demonstrated positive impacts of peer-led home visiting parent support programs including more positive parenting attitudes and beliefs, and more child preventative health care visits.Fifteen qualitative findings from two studies were aggregated into five categories from which two synthesized findings emerged. Parents and home visitors identified similar components as contributing to their program's success, these being quality of relationships between parents and home visitors with elements being mutual respect, trust and being valued within the partnership. In addition, home visitors identified importance of enabling strategies to develop relationships. They also needed supportive working environments with clinical staff and management.

CONCLUSION

The current review indicates a positive impact of peer-led home visiting parent support programs, incorporating a framework of partnership between parents and home visitors, on mother-infant dyads. Positive changes in parenting attitudes and beliefs, and increased number of child preventative healthcare visits are supported by the quality of the relationship between parent and home visitor, and home visitors' working environments.

IMPLICATIONS FOR PRACTICE

The essential characteristics of an effective parent support program are strategies for relationship building between parents and home visitors; ongoing staff and home visitor education to enhance communication, collaboration and working in partnership; supervision by team leaders; and continuous quality improvement.

IMPLICATIONS FOR RESEARCH

The focus of further research should be on confirmatory studies using an action research methodology and the cost-effectiveness of these models.

Authors+Show Affiliations

1The Western Australian Group for Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence, School of Nursing Midwifery and Paramedicine, Curtin University, Australia 2School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia 3School of Nursing, University of Adelaide, Adelaide, South Australia, Australia 4Professorial Research Fellow, Central Queensland University, Brisbane Campus, Australia 5Centre for Research Excellence in Aboriginal Health and Wellbeing, Telethon Kids Institute, Subiaco, Western Australia, Australia 6University of Western Australia, Crawley, Western Australia, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Review
Systematic Review

Language

eng

PubMed ID

27846124

Citation

Munns, Ailsa, et al. "Effectiveness and Experiences of Families and Support Workers Participating in Peer-led Parenting Support Programs Delivered as Home Visiting Programs: a Comprehensive Systematic Review." JBI Database of Systematic Reviews and Implementation Reports, vol. 14, no. 10, 2016, pp. 167-208.
Munns A, Watts R, Hegney D, et al. Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review. JBI Database System Rev Implement Rep. 2016;14(10):167-208.
Munns, A., Watts, R., Hegney, D., & Walker, R. (2016). Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review. JBI Database of Systematic Reviews and Implementation Reports, 14(10), 167-208.
Munns A, et al. Effectiveness and Experiences of Families and Support Workers Participating in Peer-led Parenting Support Programs Delivered as Home Visiting Programs: a Comprehensive Systematic Review. JBI Database System Rev Implement Rep. 2016;14(10):167-208. PubMed PMID: 27846124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review. AU - Munns,Ailsa, AU - Watts,Robin, AU - Hegney,Desley, AU - Walker,Roz, PY - 2016/11/16/entrez PY - 2016/11/16/pubmed PY - 2018/2/13/medline SP - 167 EP - 208 JF - JBI database of systematic reviews and implementation reports JO - JBI Database System Rev Implement Rep VL - 14 IS - 10 N2 - BACKGROUND: Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support. OBJECTIVES: The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors. INTERVENTION AND PHENOMENON OF INTEREST: Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program. TYPES OF STUDIES: Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies. OUTCOMES: Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors. SEARCH STRATEGY: The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered. METHODOLOGICAL QUALITY: Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate. DATA EXTRACTION: Both quantitative and qualitative data were independently extracted by two reviewers using standardized data extraction tools from the JBI-MAStARI and the JBI-QARI, respectively, including qualitative and quantitative details about setting of interventions, phenomena of interest, participants, study methods and outcomes or findings. DATA SYNTHESIS: For quantitative findings, statistical pooling was not possible due to differences in interventions and outcome measures. Findings were presented in narrative form. Qualitative findings were aggregated into categories based on similarity of meaning from which synthesized findings were generated. RESULTS: Quantitative results from two RCTs demonstrated positive impacts of peer-led home visiting parent support programs including more positive parenting attitudes and beliefs, and more child preventative health care visits.Fifteen qualitative findings from two studies were aggregated into five categories from which two synthesized findings emerged. Parents and home visitors identified similar components as contributing to their program's success, these being quality of relationships between parents and home visitors with elements being mutual respect, trust and being valued within the partnership. In addition, home visitors identified importance of enabling strategies to develop relationships. They also needed supportive working environments with clinical staff and management. CONCLUSION: The current review indicates a positive impact of peer-led home visiting parent support programs, incorporating a framework of partnership between parents and home visitors, on mother-infant dyads. Positive changes in parenting attitudes and beliefs, and increased number of child preventative healthcare visits are supported by the quality of the relationship between parent and home visitor, and home visitors' working environments. IMPLICATIONS FOR PRACTICE: The essential characteristics of an effective parent support program are strategies for relationship building between parents and home visitors; ongoing staff and home visitor education to enhance communication, collaboration and working in partnership; supervision by team leaders; and continuous quality improvement. IMPLICATIONS FOR RESEARCH: The focus of further research should be on confirmatory studies using an action research methodology and the cost-effectiveness of these models. SN - 2202-4433 UR - https://www.unboundmedicine.com/medline/citation/27846124/Effectiveness_and_experiences_of_families_and_support_workers_participating_in_peer_led_parenting_support_programs_delivered_as_home_visiting_programs:_a_comprehensive_systematic_review_ L2 - https://doi.org/10.11124/JBISRIR-2016-003166 DB - PRIME DP - Unbound Medicine ER -