| Methods |
RCT. |
| Participants |
LHW: 90 community mothers living in disadvantaged areas who were identified by a local public nurse and interviewed by regional family development nurse to assess suitability. Education level not clear. Community leaders/self promoting individuals were generally excluded.
TRAINING: Four weeks of training, during which the concepts of the programme are explained. Community mothers also meet, exchange ideas and explore ways of delivering the programme. Supervised by family nurse.
PATIENTS: First time mothers with infant <1 year old. In the control group mean age=23.1 years and in the intervention group mean age=24.1 years. 56% were single; 17% (control) to 29% (intervention) employed; 12% social class I, II, IIINM; 88% social class IIIM,IV,V; 40% live in private housing; 60% live in local authority housing; 42% of fathers employed.
TOTAL=262; INTERVENTION=141; CONTROL=121. |
| Interventions |
OBJECTIVE: to deliver a child development programme (early reading as a child, language development, cognitive development through play) to disadvantaged mothers.
INTERVENTION: non‐professional community mothers.
CONTROL: no intervention.
MODE OF DELIVERY: one volunteer mother supports 5 to 15 first time parents with guidance on health/development. After training, each community mother works under the guidance of a family development nurse, who serves as a resource person, confidante, and monitor.
RECIPIENT INVOLVEMENT IN DESIGN/DEVELOPMENT/DELIVERY: not described.
ORGANISATIONAL BASE OF THE INTERVENTION: based upon the principles inherent in the Early Childhood Development Unit in the University of Bristol.
GEOGRAPHICAL SETTING: urban Ireland.
HEALTHCARE SETTING: home. |
| Outcomes |
HEALTHCARE BEHAVIOURS: immunisations, dietry nutrition intake, number of mothers who read to their children, the extent to which mothers use nursery rhyme and song with their children.
HEALTH STATUS AND WELLBEING: mother's self esteem, relative risk of having an accident, mother's feeling in year since child was born, hospital admissions.
LENGTH OF FOLLOW UP: one year. |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Adequate sequence generation? |
Low risk |
Used table of random numbers. |
| Allocation concealment? |
Low risk |
Cards were sealed, put in marked envelopes and drawn in consecutive order. |
| Blinding?
All outcomes |
High risk |
The family development nurse who told mothers the group they were assigned to also collected data and could lead to bias in reporting. |
| Incomplete outcome data addressed?
All outcomes |
Low risk |
Outcomes stated in objectives are reported. |
| Free of selective reporting? |
Low risk |
|
| Free of other bias? |
Low risk |
|
