Prenatal and Infancy Home Visiting in Germany: 7-Year Outcomes of a Randomized Trial

  • Given the lasting positive effects of prenatal and infancy home visiting in the United States on disadvantaged mothers and children at school age, we analyzed the follow-up effects of a German home visiting program (ProKind). We hypothesized improvements in 3 domains at child age 7 years: (1) child development and life satisfaction, (2) maternal mental health and life satisfaction, and (3) adverse parenting, abusive parenting, and neglectful parenting.METHODSWe conducted a randomized controlled trial of home visiting, enrolling 755 pregnant, low-income women with no previous live births. The intervention comprised 32.7 home visits by family midwives and/or social pedagogues until child age 2 years. Assessments were completed on 533 7-year-old firstborn offspring to evaluate 8 primary hypotheses. We found significant positive effects for 4 of the 8 primary hypotheses. Mothers in the intervention group reported fewer behavioral problems among their children in the Child Behavior Checklist (effect size [ES] = 0.21; 95% confidenceGiven the lasting positive effects of prenatal and infancy home visiting in the United States on disadvantaged mothers and children at school age, we analyzed the follow-up effects of a German home visiting program (ProKind). We hypothesized improvements in 3 domains at child age 7 years: (1) child development and life satisfaction, (2) maternal mental health and life satisfaction, and (3) adverse parenting, abusive parenting, and neglectful parenting.METHODSWe conducted a randomized controlled trial of home visiting, enrolling 755 pregnant, low-income women with no previous live births. The intervention comprised 32.7 home visits by family midwives and/or social pedagogues until child age 2 years. Assessments were completed on 533 7-year-old firstborn offspring to evaluate 8 primary hypotheses. We found significant positive effects for 4 of the 8 primary hypotheses. Mothers in the intervention group reported fewer behavioral problems among their children in the Child Behavior Checklist (effect size [ES] = 0.21; 95% confidence interval [CI]: 0.03 to 0.38), less child abusive parenting (ES = 0.19; 95% CI: 0.00 to 0.37), fewer maternal mental health problems (ES = 0.25; 95% CI: 0.07 to 0.43), and higher maternal life satisfaction (ES = 0.25; 95% CI: 0.07 to 0.43). Additional preregistered subgroup analyses regarding child sex revealed larger effects for boys and mothers of boys.CONCLUSIONSThe results suggest that in a western European welfare state, home visiting targeting disadvantaged mothers has lasting effects in important outcome domains. Therefore, home visits also appear to be an effective and efficient public health intervention in European settings.show moreshow less

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Metadaten
Author:Sören Kliem, Malte SandnerORCiD
DOI:https://doi.org/10.1542/peds.2020-049610
ISSN:0031-4005
Parent Title (English):Pediatrics
Publisher:American Academy of Pediatrics (AAP)
Document Type:Article
Language:English
Reviewed:Begutachtet/Reviewed
Release Date:2024/08/05
Volume:148
Issue:2
institutes:Fakultät Betriebswirtschaft
Research Themes:Soziale & ökonomische Transformation
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