Variations in sustained home visiting care for mothers and children experiencing adversity

Objective: This study aimed to examine the variations in care received by mothers and families within a sustained home visiting program. We sought to identify the extent to which there were variations in home visiting care in response to the program schedule and families' risk factors. Design and sample: Data collected within the right@home program, a randomized controlled trial (RCT) for a sustained nurse home visiting intervention in Australia, were analyzed. A total of 352 women comprised the intervention arm of the trial. Measurements: Visit content in the home visiting program, sociodemographic data, and families' risk factors were used for analysis. Results: Our results confirmed that the majority of women received scheduled content on time or within an acceptable timeframe, except for the sleeping program. Women with identified risks were significantly more likely to receive content related to those risks than women without those risks (smoking: Odds Ratio [OR] = 15.39 [95%CI 3.7- 64.7], mental health: OR = 15.04 [1.8-124.0], domestic violence: OR = 4.07 [2.0-8.3], and drugs and alcohol: OR = 1.81 [1.1-3.0]). Conclusions: The right@home program had high compliance with the scheduled content. Capacity development in responding to mothers with the risk of domestic violence and drugs and alcohol is recommended. Further research is required to explore the relationship between variations in care and critical outcomes.