Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Educational Material, Home Visits

Intervention Description: To assess the efficacy of peer counseling to promote exclusive breastfeeding (EBF) among low-income inner-city women in Hartford, Conn.

Intervention Results: Significantly more mothers in the control group had not initiated breastfeeding compared to mothers in the intervention group (RR= 2.48; 95% CI: 1.04-5.90)

Conclusion: Well-structured, intensive breastfeeding support provided by hospital and community-based peer counselors is effective in improving exclusive breastfeeding rates among low-income, inner-city women in the United States.

Study Design: RCT

Setting: 3 clinic teams providing prenatal care at the Women’s Ambulatory Health Services Clinic of Hartford Hospital (CT)

Population of Focus: First stage: Recruited mothers attending the prenatal clinic on mornings of 4 predetermined weekdays who were ≥ 18 years old, ≤ 32 weeks gestational age (GA), healthy, and did not have medical conditions likely to impair successful breastfeeding Second stage: Recruited mothers considering breastfeeding who planned to deliver at Hartford Hospital, and to stay in the area for three months after delivery, living in a household earning < 185% of the federal poverty level, and available to be contacted via telephone. Third stage (Postpartum): Recruited mothers free of any medical condition that would prevent her from exclusively breastfeeding with newborns at least 36 weeks GA, weighing ≥ 2500 gm, with no complications requiring treatment in the NICU, and Apgar scores of ≥ 6 at 1 and 5 minutes.

Data Source: Medical records and mother self-report

Sample Size: Randomized • Intervention (n=90) • Control (n=92) Stage 3 Screening After Delivery • Intervention (n=77) • Control (n=85)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To evaluate the efficacy of an early home-based intervention on the quality of maternal–infant attachment, maternal mood and child health parameters in a cohort of vulnerable families.

Intervention Results: At 4 month follow-up, 160 families (80 intervention, 80 control) were available for assessment. The intervention improved family functioning at 4 months. All aspects of the home environment, including the quality of maternal–infant attachment and mothers’ relationship with their child, were significantly enhanced. In particular, significant and positive differences were found in parenting with the intervention group feeling less restrictions imposed by the parenting role, greater sense of competence in parenting, greater acceptability of the child, and the child being more likely to provide positive reinforcement to the parent. Early differences in maternal mood were not maintained at 4 months. Various child health parameters were enhanced including immunization status, fewer parent-reported injuries and bruising, and researcher confirmed lack of smoking in the house or around the infant. The families were consistently more satisfied with their community health service.

Conclusion: This form of early home based intervention targeted to vulnerable families promotes an environment conducive for infant mental and general health and hence long-term psychological and physical well-being, and is highly valued by the families who receive it.

Study Design: RCT

Setting: Community (child health nurse home visits)

Population of Focus: Families with an infant and whose English literacy skills enabled them to complete a questionnaire

Data Source: Parent self-report and child’s personal health record book.

Sample Size: 181 families; Intervention (n=90), Control (n=91)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits,

Intervention Description: The specific intervention is known as the Rinkeby extended home visiting program, which is a multicomponent intervention aimed at addressing health inequities among children in a disadvantaged area in Sweden. The intervention is designed to decrease risk factors and increase protective factors for children's health and well-being, with a focus on strengthening parents' self-efficacy and health. It also aims to facilitate families' integration into Swedish society through language learning and the child's enrollment in public day care services . The intervention aligns with a discernible strategy based on the principles of proportionate universalism, which emphasizes the need to tailor interventions to the specific needs of individuals and communities while addressing the social determinants of health . The program content is based on the national Child Health Care (CHC) program, with a focus on creating open meetings between families and professionals where parents' needs and concerns lead the intervention. The intervention also emphasizes the importance of the participation of fathers . The study analyzes the implementation of this multicomponent intervention through a qualitative content analysis of the documentation of home visits by Child Health Care (CHC) nurses, providing insights into the content and mechanisms of the intervention .

Intervention Results: The analysis revealed that the home visits covered three main categories of content related to the health, care and development of the child; the strengthening of roles and relations within the new family unit; and the influence and support located in the broader external context around the family. The model of categories and sub-categories proved stable over all six visits. Families with extra needs received continuous attention to their additional issues during the visits, as well as the standard content described in the content model.

Conclusion: This study on home visiting implementation indicates that the participating families received programme content which covered all the domains of nurturing care as recommended by the WHO Commission on Social Determinants of Health and recent research. The content of the home visits can be understood to create enabling conditions for health equity effects. The intervention can be seen to represent a practical example of proportionate universalism.

Study Design: The study design involves a qualitative content analysis of the implementation of the Rinkeby extended home visiting program. The content analysis is based on the documentation of home visits by Child Health Care (CHC) nurses, providing insights into the content and mechanisms of the intervention . This approach allows for a detailed examination of the interactions and topics covered during the home visits, offering a deeper understanding of the implementation of the intervention and its alignment with health equity perspectives on early childhood development.

Setting: The study setting is a disadvantaged area in Sweden where the extended postnatal home visiting program was implemented. Specifically, the program was carried out in the Rinkeby area, and the study focused on the content of the home visits conducted by Child Health Care (CHC) nurses to families in this setting . This context is important for understanding how the intervention was tailored to address the specific needs and challenges faced by families in a disadvantaged area, and how it aimed to promote health equity and early childhood development within this setting.

Population of Focus: The target audience for the study includes professionals and researchers involved in public health, early childhood development, and health equity initiatives. Additionally, policymakers and practitioners interested in implementing or evaluating interventions aimed at addressing health inequities among families with newborns and infants in disadvantaged areas may find the study's findings and insights relevant. The study's focus on the implementation of an extended postnatal home visiting program guided by proportionate universalism and its potential impact on equitable early childhood development makes it particularly relevant to individuals and organizations working in the field of maternal and child health, social determinants of health, and health equity.

Sample Size: The study included a total of 98 children whose families participated in the extended postnatal home visiting program. The documentation of 501 home visits to these families was analyzed as part of the qualitative content analysis . This sample size provides a substantial amount of data for the qualitative analysis of the home visiting program's implementation and content.

Age Range: The study focuses on the implementation of an extended postnatal home visiting program, which typically targets families with newborns and infants. While the specific age range of the children involved in the program is not explicitly mentioned in the provided excerpts, it can be inferred that the intervention primarily addresses the needs of families with infants and young children during the postnatal period.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Reporting & Response System, CLASSROOM_SCHOOL, PATIENT_CONSUMER, Feedback

Intervention Description: This study evaluated whether immediate feedback in response to poor indoor air quality in children’s bedrooms can reduce the potential for SHS exposure, as measured by adherence to a World Health Organization (WHO) indoor air standard.

Intervention Results: The likelihood that a child’s bedroom met the WHO indoor air quality standard on a given day increased such that the baseline versus post-baseline odds ratio (OR) of maintaining indoor PM2.5 levels below the WHO guideline was 2.38 times larger for participants who received the intervention. Similarly, the baseline versus post-baseline OR associated with achieving an SFH was 3.49 times larger for participants in the intervention group.

Conclusion: The real-time intervention successfully drove clinically meaningful changes in smoking behavior that mitigated indoor PM2.5 levels in children’s bedrooms and thereby reduced SHS exposure. These results demonstrate the effectiveness of targeting sensitive microenvironments by giving caregivers actionable information about children’s SHS risks. Future extensions should examine additional microenvironments and focus on identifying the potential for SHS exposure before it occurs.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Home Visits, Telephone Support

Intervention Description: To determine whether infants of women randomized to a prenatal and postpartum lactation support intervention incur fewer otitis media-, respiratory tract-, or gastrointestinal-related visits than controls.

Intervention Results: There was a significant interaction between treatment and Medicaid; among those not receiving Medicaid, the number of otitis media visits was higher among controls (P

Conclusion: Only the number of otitis media visits was reduced, in a subset of the intervention group. The intervention did not reduce visits for respiratory tract or gastrointestinal illness. Limited intervention contact and low exclusive breastfeeding rates may have attenuated intervention effects. Future interventions designed to yield markedly increased breastfeeding rates may show greater effects in low-income multiethnic samples. Health coverage for visits may moderate intervention effects.

Study Design: RCT

Setting: 2 urban community health centers in the Bronx, NY

Population of Focus: Women who were ≤ 24 weeks GA, spoke English or Spanish, had a twin or singleton birth, and who did not have medical or obstetric complications or longterm use of medications incompatible with breastfeeding

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=188) • Control (n=194) 26-Week Follow-Up • Intervention (n=115) • Control (n=136)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Home Visits, Telephone Support, Provision of Breastfeeding Item, PROVIDER/PRACTICE, Other (Provider Practice)

Intervention Description: Determined the effectiveness of primary care-based, and pre- and postnatal interventions to increase breastfeeding.

Intervention Results: In Best Infant Nutrition for Good Outcomes (BINGO) at 3 months, high intensity was greater for the LC+EP (odds ratio [OR] = 2.72; 95% confidence interval [CI] = 1.08, 6.84) and LC (OR = 3.22; 95% CI = 1.14, 9.09) groups versus usual care, but not for the EP group alone. In PAIRINGS at 3 months, intervention rates exceeded usual care (OR = 2.86; 95% CI = 1.21, 6.76); the number needed to treat to prevent 1 dyad from nonexclusive breastfeeding at 3 months was 10.3 (95% CI = 5.6, 50.7).

Conclusion: LCs integrated into routine care alone and combined with EP guidance from prenatal care providers increased breastfeeding intensity at 3 months postpartum.

Study Design: RCT

Setting: Urban, prenatal clinic in the Bronx, NY

Population of Focus: Women who spoke English or Spanish, ≥ 18 years old, in the first or second trimester of a singleton pregnancy, without risk factors for a premature birth or maternal/infant condition that would prevent or complicate breastfeeding

Data Source: Mother self-report

Sample Size: Best Infant Nutrition for Good Outcomes (BINGO) • Lactation Consultant (LC) (n=77/73) • Electronically Prompted (EP) Guidance by Prenatal Care provider (n=236/223) • LC + EP (n=238/226) • Control (n=77/73)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing

Intervention Description: We tested two aims: (1) the teachable moment (TM): whether second-hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma versus parents of healthy children (HC); and (2) whether greater intervention intensity [enhanced-precaution adoption model (PAM)] produces greater cessation than a previously tested intervention (PAM).

Intervention Results: Aim 1: The teachable moment was supported at 7 day and 2 month measurements. Aim 2: enhanced PAM was more likely to achieve 30-day ppa at the primary end-point, 4 months.

Conclusion: Smoking cessation intervention (Motivational Interviewing plus biomarker feedback) appear to motivate smoking cessation more strongly among parents of asthmatic children than among parents of healthy children. Increased intervention intensity yields greater smoking cessation among parents of asthmatic children and better asthma outcomes.

Study Design: RCT

Setting: Community (home and telephone)

Population of Focus: Parents of children with asthma and healthy children (ages 3-17 years)

Data Source: Parental self-report data, passive nicotine monitors.

Sample Size: 560 smoking primary caregivers of children with asthma and healthy children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Educational Material, Referrals,

Intervention Description: To determine whether participation in a home visiting program increases and expedites utilization of early intervention services for suspected developmental delays. Methods Children participating in Every Child Succeeds (ECS), a large home visiting (HV) program serving greater Cincinnati, between 2006 and 2012, were propensity score matched to a sample of children identified from birth records who did not receive services from ECS. Data were linked to early intervention (EI) data acquired from the Ohio Department of Health.

Intervention Results: Among 3574 HV and 3574 comparison participants, there was no difference in the time to EI service utilization; however a higher percentage of HV participants accessed services. Overall, 6% of the HV group and 4.3% of the comparison group accessed services (p = 0.001). Modeling revealed an odd ratio = 1.43 [95% confidence interval (CI) 1.16-1.78, p value = 0.001] and hazard ratio = 1.42 [95% CI 1.15-1.75, p value = 0.001]. Differences in utilization were greatest directly after birth and between approximately 2 and 3 years.

Conclusion: Participation in home visiting was associated with greater utilization of EI services during two important developmental time points, demonstrating that home visiting may serve as an important resource for facilitating access to early intervention services.

Study Design: Retrospective Cohort Study

Setting: Every Child Succeeds (ECS) program in the Greater Cincinnati area in Ohio

Population of Focus: Children and families involved in the Every Child Succeeds (ECS) home visiting program in the Greater Cincinnati area between 2006 and 2012

Sample Size: Matched cohort of 7,148 families (3,574 families participating in the Every Child Succeeds (ECS) home visiting program in comparison with 3,574 families identified from birth records who did not receive services from ECS)

Age Range: Infants and children ages 0-3 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Patient-Centered Medical Home, CAREGIVER, Home Visit (caregiver), PATIENT/CONSUMER, Home Visits, Outreach (caregiver), Nurse/Nurse Practitioner, Enabling Services

Intervention Description: (1) To improve connections to the medical home for infants from one low-income neighborhood (2) To increase the number of families enrolled in a local home visiting program, and (3) To improve communication between medical staff and home visitors.

Intervention Results: Outcomes were timeliness of well child care and enrollment in home visiting. Time series analyses compared patients from the intervention neighborhood with a demographically similar neighborhood. Mean age at newborn visit decreased from 14.4 to 10.1 days of age. Attendance at 2- and 4-month well child visits increased from 68 to 79% and 35 to 59 %, respectively. Rates did not improve for infants from the comparison neighborhood. Confirmed enrollment in home visiting increased. After spread to 2 more clinics, 43 % of infants in the neighborhood were reached.

Conclusion: Neighborhood-based newborn registries, proactive nursing outreach, and collaboration with a home visiting agency aligned multiple clinics in a low-income neighborhood to improve access to health-promoting services.

Study Design: Quasi-experimental: Nonequivalent control group

Setting: Primary care clinics and a home visiting program in a neighborhood defined by two zip codes

Population of Focus: All children born in the intervention and comparison neighborhoods

Data Source: Data from the local children’s hospital’s Emergency Department was used to identify the most common primary medical providers for children from the study zip codes • Newborn registry data (maintained manually with a Microsoft Excel spreadsheet) • Electronic health record data (with an automated newborn registry) • Manual chart review • Automated report of appointment data • Outcome measures using clinic data • Process measures using clinic and home visiting agency data

Sample Size: n=237 (cumulative number of babies on a registry); n=30 (cumulative number of families enrolled in home visiting)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Motivational Interviewing, Motivational Interviewing/Counseling

Intervention Description: Intervention (INT) was a home-based asthma follow-up after ED visit and two visits for an environmental control educational program delivered by trained nurses and nurse practitioners to the child and caregiver. For caregivers of children with positive cotinine results, brief motivational interviewing sessions were conducted to implement total home smoking ban.

Intervention Results: Over half of children in the study tested positive for SHS. Targeting SHS exposure was major component of the intervention [but] no significant reduction in cotinine exposures was associated with the intervention at 12 months.

Conclusion: In this study, a home-based EC intervention was not successful in reducing asthma ED revisits in children with poorly controlled asthma with SHS exposure. Allergic sensitization, young age, and increased controller medication use were important predictors of asthma ED visits.

Study Design: Prospective randomized controlled trial

Setting: Home-based (following ED visit)

Population of Focus: Children with physician diagnosed persistent asthma, having two or more ED asthma visits or more than one hospitalization over the past 12 months and residing in the Baltimore metropolitan area

Data Source: For SHS exposure, child saliva samples collected during the ED visit and at 6- and 12-month follow up visits.

Sample Size: 222 inner city children ages 3-12

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Peer Counselor, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker.

Intervention Results: The overall follow-up rate was high (91.3%). Changes in mean fine and coarse particulate matter (PM) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group. No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased in both air cleaner groups compared with the control group.

Conclusion: Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.

Study Design: 3-arm RCT

Setting: Hospital and home

Population of Focus: Inner-city children with asthma and SHSe

Data Source: Caregiver self-report, urine cotinine levels, and air nicotine concentrations

Sample Size: 126 children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Educational Material, Group Education, Home Visits, Telephone Support

Intervention Description: Evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants.

Intervention Results: Significant differences in the percentage of women initiating breastfeeding in the video (50%), peer counselor (62%), and video + peer counselor (52%) groups vs control group (26%)

Conclusion: Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

Study Design: Cluster RCT

Setting: 4 WIC clinics in Baltimore, MD

Population of Focus: WIC eligible African American women starting prenatal care < 24 GA, with a singleton pregnancy, planning to keep the baby and stay in the clinic’s catchment area

Data Source: Mother self-report

Sample Size: Video (n=64) • Peer Counselor (n=55) • Video + Peer Counselor (n=66) • Control (n=57)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits, Telephone Support, Provision of Breastfeeding Item

Intervention Description: To evaluate a specialized breastfeeding peer counseling (SBFPC) intervention promoting exclusive breastfeeding (EBF) among overweight/obese, low-income women.

Intervention Results: The intervention had no impact on EBF or breastfeeding continuation at 1, 3, or 6 months postpartum. In adjusted posthoc analyses, at 2 weeks postpartum the intervention group had significantly greater odds of continuing any breastfeeding (adjusted odds ratio [aOR]: 3.76 [95% confidence interval (CI): 1.07-13.22]), and giving at least 50% of feedings as breast milk (aOR: 4.47 [95% CI: 1.38-14.5]), compared with controls. Infants in the intervention group had significantly lower odds of hospitalization during the first 6 months after birth (aOR: 0.24 [95% CI: 0.07-0.86]).

Conclusion: In a Baby-Friendly hospital setting, SBFPC targeting overweight/obese women did not impact EBF practices but was associated with increased rates of any breastfeeding and breastfeeding intensity at 2 weeks postpartum and decreased rates of infant hospitalization in the first 6 months after birth.

Study Design: RCT

Setting: Hartford Hospital in Hartford, CT

Population of Focus: Pregnant women ≥ 18 years, with prepregnancy BMI ≥ 27, ≤ 36 weeks GA, singleton pregnancy, without medical conditions that may interfere with breastfeeding, ≤ 185% federal poverty level, planning to stay in the area for 6 months, and considering breastfeeding

Data Source: Mother self-report

Sample Size: Randomized Intervention (n=76) Control (n=78) 6-Month Follow-Up • Intervention (n=55) • Control (n=53)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Adult-led Support/Counseling/Remediation, Telephone Support, PATIENT_CONSUMER, YOUTH

Intervention Description: This study tested long-term posttreatment efficacy of this treatment through a 12-month follow-up.

Intervention Results: Compared with controls, children in FRESH had significantly lower cotinine (β= -0.31, p<0.01) and lower maternal-reported TSE (β= -1.48, p=0.001) through the 12-month follow-up. A significant effect of time (β= -0.03, p=0.003) reflected a posttreatment decrease in cotinine. There was no treatment × time interaction, suggesting the treatment effect at EOT was sustained after treatment. Compared with controls, FRESH mothers maintained significantly higher odds of quitting smoking from EOT through 12-month follow-up (OR=8.87, 95% CI=2.33, 33.75).

Conclusion: Study results with a sample of underserved maternal smokers demonstrated that the short-term effect of FRESH counseling at 16-week EOT was maintained through 12 months after treatment-for both bioverified child TSE reduction and maternal smoking cessation. Smokers in low-income communities demonstrate elevated challenges to success in standard smoking treatment. FRESH follow-up results suggest the high potential value of more-intensive behavioral intervention for vulnerable smokers.

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), Outreach (Provider), PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Home Visits

Intervention Description: To evaluate the effectiveness of a lay delivered intervention to reduce Latino children’s exposure to environmental tobacco smoke (ETS). The a priori hypothesis was that children living in households that were in the intervention group would have lower exposure over time than measurement only controls.

Intervention Results: There were no significant condition-by-time interactions. Significant or near significant time main effects were seen for children’s hair cotinine and parent’s report of exposure.

Conclusion: Applying a lay promotora model to deliver the behavioural problem solving intervention unfortunately was not effective. A likely explanation relates to the difficulty of delivering a relatively complex intervention by lay women untrained in behaviour change theory and research methods.

Study Design: Two group, randomized control trial

Setting: Community (home)

Population of Focus: Latino children

Data Source: Recruited from community organizations and venues such as Head Start Programs and cultural fairs

Sample Size: 143 Latino parents of children aged 1 to 9 who reported smoking at least 6 cigarettes a week

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, CAREGIVER, Home Visit (caregiver)

Intervention Description: A health education program was evaluated which used child development specialists as home visitors and served a population of first-time mothers living in rural communities.

Intervention Results: Significant group differences were found on health and safety outcomes. As compared with controls, the intervention mothers (i) had safer homes; (ii) were more likely to use birth control, thus had fewer pregnancies since birth of their first child; (iii) reported smoking fewer cigarettes; (iv) knew more about effects of smoking on their child’s health and (v) were more likely to use health department services.

Conclusion: It is highly recommended that a program such as this be implemented as part of health delivery program with new mothers and infants.

Study Design: Quasi-experimental Design

Setting: Community (home)

Population of Focus: Pregnant women who smoked

Data Source: Mother’s self-report.

Sample Size: 355 pregnant women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Midwife, Referrals

Intervention Description: This was a demonstration project designed to assess whether frequency of midwives’ smoking cessation advice within the home environment had an impact on smoking rates for the women and their wider household contacts over a 15 month period.

Intervention Results: Young and Māori women within this project were more likely to become smoke-free than others. A significant number of the women lived in households with other smokers, which may have made it more difficult for them to become smoke-free. The midwives provided smoking cessation interventions using the ABC to the women with varying frequency; however, the frequency of these interventions did not appear to be related to the likelihood of the women becoming smoke-free. The midwives did not provide ABC at every single visit for every woman; however, for some women it was provided more often than for others.

Conclusion: Although midwifery care is provided within, and acknowledges the woman’s context, the majority of women in this project faced considerable day-to-day challenges to becoming smoke- free, as they lived in households with others who also smoked. Broad strategies are needed to reduce smoking, that reach beyond the realm of midwifery practice and the health care sector, such as wider tobacco control policies, public health campaigns and smoke-free environments.

Study Design: Cohort /Prospective observational study

Setting: Home-based midwife services

Population of Focus: Pregnant women who smoked receiving midwife care in New Zealand

Data Source: Standard point of care data form

Sample Size: 6 midwives, 101 women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, Telephone Support, Motivational Interviewing

Intervention Description: The objective of this study was to determine whether a motivational intervention for smoking parents of young children will lead to reduced household passive smoke exposure.

Intervention Results: The 6-month nicotine levels were significantly lower in MI households. Repeated measures analysis of variance across baseline, 3-month, and 6-month time points showed a significant time-by-treatment interaction, whereby nicotine levels for the MI group decreased significantly and nicotine levels for the SH group increased but were not significantly different from baseline.

Conclusion: This study targeted a large sample of racially and ethnically diverse low-income families, in whom both exposure and disease burden is likely to be significant. This is the first study to our knowledge that has been effective in reducing objective measures of passive smoke exposure in households with healthy children. These findings have important implications for pediatric health care providers, who play an important role in working with parents to protect children's health. Providers can help parents work toward reducing household passive smoke exposure using motivational strategies and providing a menu of approaches regardless of whether the parents are ready to quit.

Study Design: Randomized control study

Setting: Recruitment at community health centers, home based intervention

Population of Focus: Diverse low-income populations

Data Source: Air nicotine assessments and assessment of the participant’s carbon monoxide level with caregiver selfreport.

Sample Size: 291 participants

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits,

Intervention Description: The Early Intervention Parenting Partnerships (EIPP) program is a home visiting program that provides a range of services to expectant parents and families with infants who experience socioeconomic barriers, emotional and behavioral health challenges, or other stressors. The program offers home visits, group services, assessments and screenings, and referrals delivered by a multidisciplinary team. The primary aim of the program is to screen families for social and environmental factors that may increase the risk of children's developmental delays and connect them to the larger statewide early intervention (EI) system.

Intervention Results: Primary study outcomes including EI referrals, evaluations, and service receipt for children from 3 months to 3 years were measured using EI program data. Secondary outcomes included EI referral source, EI eligibility criteria (e.g., presence of biological, social, or environmental factors that may increase later risk for developmental delay), and information on service use. Impacts were assessed by fitting weighted regression models adjusted for preterm birth and maternal depression and substance use. EIPP participants were more likely than the comparison group to be referred to, evaluated for, and receive EI services. EIPP facilitated the identification of EI-eligible children who are at risk for developmental delays due to social or environmental factors, such as violence and substance use in the home, child protective services involvement, high levels of parenting stress, and parent chronic illness or disability.

Conclusion: Yes, the study reported statistically significant findings related to the impact of the Early Intervention Parenting Partnerships (EIPP) program on early intervention (EI) referrals, evaluations, and individualized family service plans (IFSPs). The study used weighted multivariable regression models to assess the impacts of EIPP on EI referrals, evaluations, and IFSPs, and the results indicated statistically significant differences between the EIPP and comparison groups.

Study Design: The study design used in this research is a quasi-experimental impact study. The study used statistical matching methods to derive a comparison group and compared the outcomes of families who participated in the Early Intervention Parenting Partnerships (EIPP) program to those who did not receive EIPP services.

Setting: The study was conducted in the context of the Early Intervention Parenting Partnerships (EIPP) program, which aims to identify and support families with social and environmental risks in accessing early intervention services for their children.

Population of Focus: The target audience for the study includes professionals and researchers in the fields of early childhood development, early intervention, public health, and social services. Additionally, policymakers and practitioners involved in home visiting programs and early intervention services may also find the study relevant to their work.

Sample Size: The study's sample included 1,201 participants from the Early Intervention Parenting Partnerships (EIPP) program and 18,205 participants in the comparison group, all of whom were identically distributed on the covariates.

Age Range: The study focuses on children between the ages of 3 months and 3 years.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Assessment (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing

Intervention Description: The aim of this study is to evaluate effects of the counseling method “Smoke-free children” that focuses on protection of infants.

Intervention Results: Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine.

Conclusion: The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.

Study Design: RCT

Setting: Child health centers

Population of Focus: Swedish mothers who had given birth to a healthy child

Data Source: Self-reporting of smoking; cotinine levels of mothers’ saliva

Sample Size: 26 mothers in the intervention group and 15 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Telephone Support, CAREGIVER, Home Visit (caregiver), Assessment (caregiver), Attestation (caregiver), Motivational Interviewing/Counseling

Intervention Description: This pilot study evaluated the effectiveness of a nurse-delivered home-visiting program during the postpartum period that included a low-intensity smoking relapse-prevention intervention.

Intervention Results: Although both groups showed significant relapse from being smoke free, the intervention group was twice as likely to be smoke free at 3 and 6 months, and three times as likely to be smoke free at both times. The cotinine verification revealed a misclassification rate of 37% at the 6-month follow-up (i.e., participants self-reported as abstinent but shown by cotinine not to be abstinent).

Conclusion: The effectiveness of this brief, low-cost, and potentially replicable intervention in improving the rate of persistent postpartum smoke-free status for women who quit smoking during pregnancy is encouraging. A randomized trial of the approach is warranted.

Study Design: Pilot study; Prospective two-group design

Setting: Birthing hospital plus home visit

Population of Focus: English-speaking women who delivered healthy babies, resided in Franklin County, Ohio, and reported quitting smoking during pregnancy and at least 7 days before delivery

Data Source: Questionnaire that included smoking history and attitudes and intent to stay smoke free administered at baseline. Saliva sample for maternal cotinine analysis collected at baseline and 3 and 6 months for all participants who self-reported abstinence (defined as no smoking for the previous 7 days)

Sample Size: 97 in the baseline group and 122 in the intervention group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: The objective was to investigate the effect of a theory-based educational program in promoting exclusive breastfeeding for at least 6 months in asthmatic families.

Intervention Results: The proportion of women breastfeeding exclusively at 6 months was significantly higher in the intervention group than among the control group (21/44 [48%] versus 12/45 [27%]; odds ratio 2.91; 95% Confidence Interval [1.10-7.71] (p = 0.03), controlled for maternal age, education level, and breastfeeding experience.

Conclusion: This study provides evidence that the new program (written and oral advice about breastfeeding) is effective in improving the exclusive breastfeeding rates at 6 months in asthmatic families. A next step would be to make this program available for health professionals who support pregnant women who have a familial history of asthma.

Study Design: Cluster RCT

Setting: Southeastern region of the Netherlands

Population of Focus: Women < 7 months pregnant who had at least one first-degree relative with asthma

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=58) • Control (n=55) 6-Month Follow-Up • Intervention (n=44) • Control (n=45)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Home Visits, Lactation Consultants, Peer Counselor, Professional Support,

Intervention Description: Breastfeeding education and support are core services provided by WIC, and numerous policies and initiatives ensure breastfeeding support is provided throughout the prenatal period and first year postpartum. Site-level characteristics related to staffing, policies, and practices that support breastfeeding were collected for the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITEPS-2). Study data included interviews with 27 WIC state agency representatives affiliated with study sites, site visits to all 80 sites to collect data on facilities and staffing and a one hour interview with a site supervisor or coordinator, and surveys with staff (n=802) working in each of the 80 sites during the period when participants were enrolled in the study.

Intervention Results: Five WIC site-level supports were significantly and independently associated with any and fully breastfeeding: access to breastfeeding peer counselors, access to International Board Certified Lactation Consultants, postnatal home visits, allowing any WIC staff member to provide breast pump education, and having a policy not to provide formula during the first 30 days postpartum. Likelihood of any and fully breastfeeding increased with each additional site-level support present (odds ratio = 1.09, 95% confidence interval, 1.06–1.12; and odds ratio = 1.26, 95% confidence interval, 1.21–1.31, respectively).

Conclusion: Positive associations between site-level supports and breastfeeding at 2, 6, and 12 months were observed. Additional research is needed to understand how site-level supports interrelate and whether specific combinations are more effective, and to identify variations in implementation of breastfeeding supports.

Study Design: Secondary analysis

Setting: WIC programs in 27 states

Population of Focus: Women enrolled in WIC for the first time for that pregnancy prenatally or before their infant was 2.5 months old in 80 WIC sites across 27 states and territories during the 20 week recruitment period

Sample Size: 1,235 mothers and their infants (80 WIC sites; 802 staff surveys)

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, PROVIDER/PRACTICE, Outreach (Provider)

Intervention Description: This article describes the smoking behavior outcomes of a feasibility project testing a proactive approach, utilizing Māori voluntary community health workers to identify and reach Māori pregnant women who smoke and provide cessation support.

Intervention Results: The majority of women were Māori, 20-30 years old, had their first cigarette within 30 minutes of waking and 58% had not tried to quit during the current pregnancy. Of the participants who completed a follow-up interview 33% had stopped smoking while they were pregnant and 57% had cut down. There was an increase at follow-up of people who had used cessation support or products.

Conclusion: Aunties are well-placed to find pregnant women and provide cessation support and referral in a way consistent with traditional Māori knowledge and practices. This study suggests such an intervention could increase quit attempts and increase use of effective cessation methods. A more robust study is warranted to develop an enhanced Aunties intervention.

Study Design: Prospective intervention trial- evaluation

Setting: Home-based culturally tailored community health smoking cessation support

Population of Focus: Pregnant Māori women smokers

Data Source: In person questionnaires, interviews, and hospital birth records

Sample Size: 67

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Access,

Intervention Description: Family Connects is a short-term nurse home visiting approach designed to deliver brief education and intervention, assess family needs, and connect families to community resources for ongoing support. Impact evaluation compared outcomes for families of infants born in the months immediately prior to program launch (comparison group n = 360; Feb. 1, 2014–July 31, 2014) to families of infants born during the FC implementation period (intervention group n = 1068; Sept. 1, 2014-Dec. 31, 2015). Outcomes were assessed for both groups via a 30-min telephone interview when the infants were 6 months old.

Intervention Results: No group differences were found in total emergency care utilization for birthing parents (see Table 3). FC parents reported making more ED and urgent care visits for themselves than did comparison group parents (95% CI = 0.04, 0.51; effect size = 0.14) and (non-significantly) fewer hospital overnight stays. FC parents reported greater perceived social support relative to comparison group parents (95% CI = 0.01, 0.14; effect size = 0.13). No differences were observed for maternal 6-week postpartum health-check completion or endorsed symptoms of depression or anxiety.

Conclusion: Results from this quasi-experimental field trial indicate that FC effectively engages families living in high-poverty rural counties during the postpartum period with broad reach and high program fidelity, leading to positive population impacts on family health and well-being. Implementation findings indicate FC had broad community reach, high nurse reliability and fidelity to the manualized protocol, and nurse-family referral connection rates that exceeded rates observed in prior trials (Dodge et al., 2014, 2019). The findings provide compelling evidence that FC can be disseminated through rural public health departments with high quality. The high completion rate (65% of all eligible families) suggests that the FC is well suited for rural contexts.

Study Design: Quasi-experimental design

Setting: Four rural Eastern North Carolina counties

Population of Focus: Families living in high-povery rural counties

Sample Size: 392 intervention group families and 126 families with infants born between Feb. 1, 2014–July 31, 2014 (natural comparison group).

Age Range: Reproductive age (≥Teenage)

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Telephone Support

Intervention Description: To investigate whether offering volunteer support from counsellors in breast feeding would result in more women breast feeding.

Intervention Results: No differences in breastfeeding initiation between intervention and control groups (95% vs 96%; RR=.99, 95% CI: .84-1.16, p=.44)

Conclusion: Offering support in breast feeding did not significantly increase the prevalence of any breast feeding to six weeks (65% (218/336) in the intervention group and 63% (213/336) in the control group; relative risk 1.02, 95% confidence interval 0.84 to 1.24). Survival analysis up to four months confirmed that neither duration of breast feeding nor time to introduction of formula feeds differed significantly between control and intervention groups. Not all women in the intervention group contacted counsellors postnatally, but 73% (123/179) of those who did rated them as very helpful. More women in the intervention group than in the control group said that their most helpful advice came from counsellors rather than from other sources.

Study Design: RCT

Setting: 32 general practices in London and south Essex

Population of Focus: Women 28-36 GA who were considering breastfeeding, had not breastfed a previous child for 6 weeks, English-speaking, and planned to live in area until at least 4 months after the birth

Data Source: Mother self-report

Sample Size: Intervention (n=336) Control (n=336)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Collaboration with Local Agencies (State), STATE, POPULATION-BASED SYSTEMS

Intervention Description: As part of a larger randomized study of the Healthy Families America home visiting program being conducted in Oregon (Healthy Families Oregon, HFO), we conducted a telephone survey with a randomly selected group of mothers to assess early outcomes at children's 1-year birthday.

Intervention Results: Results found that mothers assigned to the Healthy Families program group read more frequently to their young children, provided more developmentally supportive activities, and had less parenting stress. Children of these mothers were more likely to have received developmental screenings, and were somewhat less likely to have been identified as having a developmental challenge. Families with more baseline risk had better outcomes in some areas; however, generally there were not large differences in outcomes across a variety of subgroups of families.

Conclusion: Implications of these results for understanding which short-term program impacts are most feasible for early prevention programs, as well as for understanding how these services might be better targeted are discussed.

Study Design: RCT

Setting: Seven Health Families Oregon program sites in Oregon

Population of Focus: First-born children from birth through 36 months of age

Data Source: Parent telephone survey

Sample Size: Telephone surveys (n=803 mothers) - Intervention (n=402) - Control (n=401)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Home Visit (caregiver)

Intervention Description: We conducted a randomized controlled trial to determine whether a home-based intervention program could reduce infant passive smoking and lower respiratory illness.

Intervention Results: 1) A significant difference in the amount of exposure to tobacco smoke—5.9 fewer cigarettes per day at 12 months; (2) no difference in infant cotinine excretion; (3) lower prevalence of persistent lower respiratory symptoms among intervention-group infants of smoking mothers whose head of household had no education beyond high school (14.6% versus 34.0%).

Conclusion: The prevalence of persistent lower respiratory symptoms was lower among intervention-group infants of smoking mothers whose head of household had no education beyond high school: intervention group, 14.6%; and controls, 34.0%.

Study Design: RCT

Setting: In the home

Population of Focus: Infants weighing at least 2000 g at birth, free of significant postnatal medical problems, and residing in Alamance or Chatham County in central North Carolina

Data Source: Urine collection from the infants; self-report about smoking and smoke exposure from the mother and other questions designed to identify maternal and family characteristics that might modify the effect of the intervention and to identify risk factors for infant lower respiratory disease.

Sample Size: 933 total started the study, 659 completed it; 168 infants in the reduced data collection groups

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Referrals, Educational Material

Intervention Description: Home visiting programs represent an important primary prevention strategy for adverse prenatal health behaviors; the various ways in which home visiting programs impact prenatal smoking cessation and reduction behaviors remain understudied.

Intervention Results: A program effect was seen for smoking cessation such that clients who smoked less than ten cigarettes per day and those who smoked 20 or more cigarettes per day during the first trimester were more likely to achieve third trimester cessation than comparison women (p <0.01 and p = 0.01, respectively). Only for heavy smokers (20 or more cigarettes during the first trimester) was there a significant reduction in number of cigarettes smoked by the third trimester versus comparison women (p = 0.01). Clients expressed the difficulty of cessation, but addressed several harm-reduction strategies including reducing smoking in the house and wearing a smoking jacket. Clients also described smoking education that empowered them to ask others to not smoke or adopt other harm reducing behaviors when around their children.

Conclusion: While a significant impact on smoking cessation was seen, this study finds a less-clear impact on smoking reduction among women in home visiting programs. As home visiting programs continue to expand, it will be important to best identify effective ways to support tobacco-related harm reduction within vulnerable families.

Study Design: Cohort - Mixed methods using a retrospective cohort of propensity score

Setting: Home visiting programs

Population of Focus: English or Spanish speaking mothers who smoked during pregnancy who currently participated in a home visiting program and received welfare benefits

Data Source: Enrollment data, in-person or telephone interviews, birth certificate data

Sample Size: 10,296 women: 2595 study participants and 7701 controls

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits, Telephone Support

Intervention Description: To estimate the causal effect of a Michigan peer counselor (PC) breastfeeding support program for low-income women on infant health outcomes.

Intervention Results: The PC program increased the fraction breastfeeding at birth by 19.3 percent and breastfeeding duration by 2.84 weeks. Program participation also reduced the fraction of infants with gastrointestinal disorders by a statistically significant 7.9 percent. The program, if anything, increased the overall health care utilization.

Conclusion: This Michigan PC breastfeeding support program resulted in improvements in breastfeeding and infant health outcomes as measured by the diagnosis of ailments while increasing health care utilization.

Study Design: QE: non-equivalent control group

Setting: 5 counties in MI

Population of Focus: Women with available Medicaid claims data, recruited prenatally

Data Source: State administrative data, including WIC, Medicaid, and Vital Records

Sample Size: Intervention (n=274) Control (n=572)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Home Visits, Other Education, PROFESSIONAL_CAREGIVER, Education/Training (caregiver)

Intervention Description: Illinois develped an innovative model in which programs utilizing evidence-based home-visiting models incorporate community doulas who focus on childbirth education, breastfeeding, pregnancy health, and newborn care. They serve as specialized home visitors, providing home-based education and support during the last half of pregnancy and for 6 weeks postpartum. The doula worked with the mother more intensively during pregnancy and the first weeks postpartum, while the home visitor became the primary provider by 6 weeks postpartum. The goal of this randomized controlled trial is to examine whether young, low-income families receiving doula-home visiting services, compared to families receiving lower-intensity case management services, have improved maternal and child health outcomes during the period between birth and 3 months of age.

Intervention Results: Intervention-group mothers were more likely to attend childbirth-preparation classes (50 vs. 10%, OR = 9.82, p < .01), but there were no differences on Caesarean delivery, birthweight, prematurity, or postpartum depression. Intervention-group mothers were less likely to use epidural/pain medication during labor (72 vs. 83%; OR = 0.49, p < .01) and more likely to initiate breastfeeding (81 vs. 74%; OR = 1.72, p < .05), although the breastfeeding impact was not sustained over time. Intervention-group mothers were more likely to put infants on their backs to sleep (70 vs. 61%; OR = 1.64, p < .05) and utilize car-seats at three weeks (97 vs. 93%; OR = 3.16, p < .05).

Conclusion: The doula-home-visiting intervention was associated with positive infant-care behaviors. Since few evidence-based home-visiting programs have shown health impacts in the postpartum months after birth, incorporating doula services may confer additional health benefits to families.

Study Design: RCT

Setting: Doula-home visiting programs in high-poverty IL communities

Population of Focus: Women under 26 years of age, less than 34 weeks gestation, living in the program geographic catchment area

Sample Size: 312 young, pregannt woman across four communities

Age Range: Pregnant women under 26 years old

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Enabling Services, Telephone Support

Intervention Description: To evaluate a web-based contingency management program (CM) and a phone-delivered cessation counseling program (Smoking Cessation for Healthy Births [SCHB]) with pregnant smokers in rural Appalachia who were ≤12 weeks gestation at enrollment.

Intervention Results: For CM, two of seven (28.57%) of the participants achieved abstinence, and three of 10 (30%) of those enrolled in SCHB were abstinent by late in pregnancy. Participants in CM attained abstinence more rapidly than those in SCHB. However, those in SCHB experienced less relapse to smoking, and a greater percentage of these participants reduced their smoking by at least 50%.

Conclusion: Based on this initial evaluation, the web-based CM and SCHB programs appeared to be feasible for use with rural pregnant smokers with acceptable program adherence for both approaches. Future researchers could explore combining these programs to capitalize on the strengths of each, for example, rapid smoking cessation based on CM incentives and better sustained cessation or reductions in smoking facilitated by the counseling support of SCHB.

Study Design: RCT pilot

Setting: Home- based smoking cessation programs

Population of Focus: English speaking pregnant women less than 12 weeks of pregnancy at the beginning in rural Appalachia

Data Source: Questionnaires, standardized scales, urinary cotinine levels

Sample Size: 17

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Other Education, Expert Support (Provider), HEALTH_CARE_PROVIDER_PRACTICE, PATIENT_CONSUMER

Intervention Description: A social worker coordinated medical care for children in foster care in a foster care medical home (FCMH) and tracked care coordination (CC) activities using a modified Care Coordination Measurement Tool© (mCCMT).

Intervention Results: The CC prevented 11 emergency department (ED) visits, 9 placement disruptions, and 42 patient privacy violations.

Conclusion: Children assigned to a FCMH have diverse CC needs and benefit from social workers’ specialized skills.

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Training (Parent/Family), CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling, Notification/Information Materials (Online Resources, Information Guide), PATIENT/CONSUMER, Pharmacotherapy (Nicotine), Home Visits, Educational Material, Motivational Interviewing, Peer Counselor, Telephone Support

Intervention Description: We tested a combined intervention to reduce children's secondhand smoke exposure (SHSe) and help parents quit smoking.

Intervention Results: Parents’ reports of their smoking and children’s exposure showed moderate and significant correlation with children’s urine cotinine levels and home air nicotine. 13 intervention group mothers and 4 controls reported quitting smoking for 7 days prior to 1 or more study measurements without biochemical contradiction. Results of generalized estimating equations showed significantly greater decrease in reported SHSe and mothers’ smoking in the counseled group compared with controls. Reported indoor smoking and children’s urine cotinine decreased, yet group differences for changes were not significant.

Conclusion: Nicotine contamination of the home and resulting thirdhand exposure may have contributed to the failure to obtain a differential decrease in cotinine concentration. Partial exposure to counseling due to dropouts and lack of full participation from all family members and measurement reactivity in both conditions may have constrained intervention effects. Secondhand smoke exposure counseling may have been less powerful when combined with smoking cessation.

Study Design: Two-group, repeated measures RCT

Setting: Community (home)

Population of Focus: WIC clients in San Diego, California

Data Source: 3 weekly baseline child urine cotinine measures collected before trial randomization then reported and urine cotinine measures at 3 (midintervention), 6 (post-intervention), 12, and 18 months

Sample Size: 150 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits,

Intervention Description: This qualitative study uses a Black Feminist approach to center the lived experiences and perspectives of Black women. Focus groups were conducted with clients and staff of a culturally-specific program that provides perinatal care for Black families. A thematic analysis was conducted using a Reproductive Justice framework as a guide.

Intervention Results: Participants consisted of 23 program clients and staff who all identified as Black women. Four themes emerged from the analysis: 1) The pervasive reach of structural racism, 2) Shared identities facilitate trust and healing, 3) Racism directly impacts mental health, and 4) Advocacy on macro and micro levels is a vital service.

Conclusion: Results show the chronicity and toxicity of structural racism on Black women’s physical and mental health. The presence of overt and subtle forms of racism occur in multiple systems and require interventions on macro- and micro-levels. Culturally- specific perinatal care programs that prioritize racial concordance between providers and clients/ patients are well-received and effective models of care. Black perinatal care should include culturally-specific approaches, advocacy on behalf of and alongside Black people, mental health support with attention to racism-related stress, and interrogation of implicit bias. Multipronged interventions guided by Reproductive Justice principles provide a holistic framework to address interpersonal and systemic racial oppression.

Study Design: Qualitative study design using focus groups

Setting: Community-based

Population of Focus: Black women

Sample Size: 23

Age Range: Not disclosed

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Telephone Support

Intervention Description: To test the effects of the Healthy Steps for Young Children program (HS) (which supports parents managing children's developmental and behavioral issues)-with and without a prenatal component-on child health and development, parenting practices, and parental well-being.

Intervention Results: Intervention was associated with positive outcomes in timely well-child care, immunization rates, breastfeeding, television viewing, injury prevention, and discipline strategies. Prenatal initiation of services was associated with larger expressive vocabularies at age 24 months. Mothers who received the intervention reported more depressive symptoms, but there was no increase in the proportion with clinically significant depression.

Conclusion: For members of an integrated delivery system, the HS intervention was associated with positive effects on children's health and parenting practices. There was little evidence of any additional benefit of HS services initiated during the prenatal period.

Study Design: RCT

Setting: Integrated delivery system in the Pacific Northwest

Population of Focus: Pregnant women <22 weeks GA at enrollment, <45 years old, English speaking, and planning to attend a study clinic for pediatric care

Data Source: Mother self-report

Sample Size: Healthy Steps (HS) only (n=117) HS + PrePare (n=122) Control (n=104)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits, Telephone Support

Intervention Description: To assess the effectiveness of a peer support worker (PSW) service on breast-feeding continuation.

Intervention Results: No significant difference in exclusive breastfeeding at 6 months between the intervention and control group (17.8% vs 19.6%)

Conclusion: Universal antenatal peer support and postnatal peer support for women who initiated breast feeding did not improve breast-feeding rates up to 6 months in this UK population.

Study Design: Cluster RCT

Setting: Primary Care Trust (PCT) health district in Birmingham

Population of Focus: All pregnant women registered with a general practice within the PCT, with an approximate due date between Feb 1, 2007 – July 31, 2007

Data Source: Mother self-report

Sample Size: • Intervention (n=33) • Control (n=33) N=clinics Randomized • Intervention (n=1267) • Control (n=1457) 6-Month Follow-Up • Intervention (n=271) • Control (n=301) N=women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Educational Material, Home Visits

Intervention Description: This study examined the effectiveness of a breast-feeding promotion program to increase the continuation of breast-feeding.

Intervention Results: The 3-month breast-feeding rate was 32% in the intervention and 38% in the control groups (OR = 0.79, 95% CI = 0.58-1.08).

Conclusion: The program was not effective. We discuss possible explanations from the design and execution of the trial and give some points for improvement of our program, such as the categories of caregivers involved and the number and duration of contacts after parturition.

Study Design: Cluster RCT

Setting: 10 maternity and child health centers within home health care organizations in Limburg

Population of Focus: Pregnant women who applied for maternity care in one of the participating centers who gave birth to infants ≥2000 g

Data Source: Mother self-report

Sample Size: • Intervention (n=5) • Control (n=5) N=clinics • Intervention (n=371) • Control (n=330) N=women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), PATIENT/CONSUMER, Home Visits, Educational Material, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.

Intervention Results: The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P= .138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189–$721.

Conclusion: Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Families in low-income households with children with asthma

Data Source: In-home interviewing, dust sample and standardized home inspection

Sample Size: 274 randomized participants

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: To assess the impact of a supportive intervention on the duration of breastfeeding.

Intervention Results: Mothers in the intervention group had a 14% lower cessation rate (HR = 0.86 CI: 0.75-0.99). Similar results were seen for primipara, and multipara with previously short breastfeeding experience. Mothers in the intervention group received their first home visit earlier, had more visits and practical breastfeeding training within the first 5 weeks. Babies in the intervention group were breastfed more frequently, fewer used pacifiers, and their mothers reported more confidence in not knowing the exact amount of milk their babies had received when being breastfed.

Conclusion: Home visits in the first 5 weeks following birth may prolong the duration of exclusive breastfeeding. Postnatal support should focus on both psychosocial and practical aspects of breastfeeding. Mothers with no or little previous breastfeeding experience require special attention.

Study Design: Cluster RCT

Setting: 22 municipalities in Western Denmark

Population of Focus: All mothers living within the 22 municipalities with singleton birth at ≥37 weeks GA

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=780) • Control (n=815) 6-Month Follow-Up9 • Intervention (n=766) • Control (n=815)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Home Visits, Telephone Support

Intervention Description: To determine the effectiveness of a breastfeeding support service attached to a general practice.

Intervention Results: There was a high, breastfeeding initiation rate for both baseline (94.6%) and intervention (93.4%) groups. There were significantly higher breastfeeding rates in the intervention group at 24 and 26 weeks (63.3% vs 51.2% at 24 weeks [p = 0.015] and 64.7% vs 50.6% at 26 weeks [p = 0.018]). While there was no significant difference in the total number of breastfeeding problems encountered by either group significantly more mothers from the baseline group suffered from engorgement and/or too much milk. Evaluation of the service indicated a high degree of satisfaction. Over 94% of the mothers found the service friendly, supportive, and useful.

Conclusion: This service provides an effective method for the support and protection of breastfeeding.

Study Design: QE: non-equivalent control group

Setting: A general practice in Happy Valley, Adelaide

Population of Focus: Pregnant patients registered in the practice

Data Source: Mother self-report

Sample Size: Intervention (n=119) Control (n=168)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Peer Counselor, Telephone Support, Lactation Consultant, Home Visits,

Intervention Description: The establishment of Loving Support Peer Counseling Programs (LSPCP) services in Washington State began in April 2005 when 5 local WIC agencies accepted USDA funding to implement the program. The model is structured according to evidence-based curricula with a focus on benefiting WIC recipients via mother-to-mother support regarding breastfeeding initiation and continuation. Peer counselors typically consist of women who were or are WIC clients and who successfully breastfed their children. An important characteristic of this program is the ability of peer counselors to provide breastfeeding support off-site and after clinic hours.

Intervention Results: Both PHSKC and CHIFMG clinics with a LSPCP expressed significant (P < .001) improvement in BF initiation and BF duration for >6 months. The likelihood that women enrolled in WIC would initiate BF at PHSKC clinics increased by 3%, whereas those in CHIFMG clinics increased by 6.8%. Women receiving services in smaller PHSKC clinics (n < 60 women) were likely to breastfeed their infants at >1 week. The proportionalities of non-Hispanic and black participants in PHSKC clinics were the primary and secondary predictors of the likelihood of BF discontinuing between 7 and 28 days' duration. In addition, clinics serving participants who spoke Tigrigna had increased rates of BF for a minimum of 6 months.

Conclusion: Findings may be used to reevaluate funding allocations, secure grants to reduce program constraints to stabilize LSPCP, develop strategies to reduce BF cessation at larger clinics, and improve peer counseling and other BF support to black and non-Hispanic women in the early postpartum period. The findings contribute to the study of the effects of LSPCP on BF initiation and duration while furthering a scholarly understanding of the way in which the WIC program interacts with participant characteristics at 2 local WIC agencies in Washington State.

Study Design: Nonrandomized treatment and control

Setting: Public Health-Seattle and King County (PHSKC), Catholic Health Initiatives Franscian Medical Group (CHIFMG)

Population of Focus: Women enrolled in WIC

Sample Size: PHSKC: n=15,290 women; CHIFMG: n=3582 women

Age Range: Infants from birth through 8 months of age

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Enabling Services,

Intervention Description: MGMC's multipronged approach addresses the complex interactions among social determinants of health, societal drivers of inequity, health care systems, implicit bias for health professionals and the importance of engaging with the community. The 4 evidence‐based strategies of MGMG are (1) racial concordance between Black midwives and patients, (2) group prenatal care, (3) nurse navigation, and (4) one year of in‐home postpartum doula support.

Intervention Results: Racial concordance among care providers and patients, group prenatal care, perinatal nurse navigation, and 12 months of in-home postpartum doula support are 4 evidence-based interventions that are bundled in MGMC.

Conclusion: We posit that a model that restructures maternity care to increase health system accountability and aligns with the needs and desires of Black pregnant and postpartum people will increase trust in the health care system and result in better clinical, physical, emotional, and social outcomes.

Study Design: Multicomponent

Setting: Community-based

Population of Focus: Black birthing community

Sample Size: Not disclosed

Age Range: Not disclosed

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Care Coordination,

Intervention Description: The specific intervention involves a multidisciplinary team providing comprehensive home-based primary care for children with medical complexity. The program includes routine examinations, urgent sick visits, vaccinations, and coordination with subspecialists, as well as addressing the families’ psychosocial needs. The physicians provide primary care in the home if the patients live within the catchment area; otherwise, they are seen in the office. The intervention described in the PDF file aligns with a discernable strategy of providing comprehensive home-based primary care for children with medical complexity. The program involves a multidisciplinary team that includes physicians, social workers, and care coordinators who work together to provide care in the home setting. The PDF file describes a retrospective analysis of data collected from the program, which includes information on demographics, clinical characteristics, and health care use. The study analyzes the impact of the program on health care use and costs, and examines the association between the time-dependent post-enrollment health care use and numbers of home visits. Therefore, it is a study that analyzes a multicomponent intervention.

Intervention Results: We reviewed data collected from 121 patients. With our findings, we demonstrate that enrollment in our program is associated with reductions in average length of stay. More home visits were associated with decreased emergency department visits and hospitalizations. We also observed in patients with available cost data that total costs of care decreased after enrollment into the program.

Conclusion: Our model has the potential to improve health outcomes and be financially sustainable by providing home-based primary care to CMC.

Study Design: The study design of the multidisciplinary home visiting program for children with medical complexity is primarily retrospective in nature. The researchers reviewed medical records from their institution for patients enrolled in the program from July 2013 through March 2019. The study involved a retrospective analysis of data collected from the program, including demographics, clinical characteristics, health care use, and total costs of care for a subset of patients. The analysis included comparisons of pre- and post-program enrollment health care use, as well as the examination of the association between post-enrollment health care use events and numbers of home visits. Additionally, the study applied Cox proportional hazard models to examine the association between home visits and specific health care use outcomes, while adjusting for clinic visits and corresponding pre-enrollment health care use. Overall, the study design involves the retrospective analysis of data collected from the multidisciplinary home visiting program to assess its impact on health care utilization, costs, and the association between home visits and health care use events.

Setting: The study setting for the multidisciplinary home visiting program for children with medical complexity is a general pediatrics clinic in a large tertiary academic hospital located in an urban setting. The clinic serves nearly 9000 unique patients annually, with a population that is 87% Medicaid covered and primarily low-income. The clinic's patient population often experiences psychosocial complexity and barriers that limit their ability to access high-quality health care. The program was initiated as part of a Patient-Centered Medical Home demonstration project and has evolved to focus predominantly on children with medical complexity, providing both home and office-based care through a multidisciplinary team. Additionally, the program includes a complex care clinic within the physical space of the general pediatrics clinic to access the same multidisciplinary team, providing care that follows the program model, including extended appointment times, multidisciplinary support, and coordination with subspecialty appointments when possible.

Population of Focus: The target audience for the study of the multidisciplinary home visiting program for children with medical complexity includes healthcare providers, policymakers, and researchers interested in improving care for children with medical complexity (CMC). The study provides insights into the development, structure, and outcomes of a home-based primary care program for CMC, which can inform the design and implementation of similar programs in other settings. Additionally, the study highlights the challenges faced by families of CMC in accessing high-quality care and navigating the complex healthcare system, which can inform policy discussions around improving care coordination and access for this population. Finally, the study provides evidence of the effectiveness of a multidisciplinary home visiting program for CMC, which can inform future research on innovative models of care for this population.

Sample Size: The sample size for the study of the multidisciplinary home visiting program for children with medical complexity includes 121 patients enrolled in the program from July 2013 through March 2019. This sample size represents the cohort of children with medical complexity (CMC) included in the analysis. The study focuses on this cohort to assess the impact of the program on health care utilization, costs, and the association between home visits and health care use events.

Age Range: The study focuses on children with medical complexity (CMC), and the age range of the patients enrolled in the program is not explicitly stated in the PDF file. However, the study mentions that the median age at enrollment was 5.0 years, indicating that the program primarily serves children and young adolescents. Additionally, the study notes that the program enrolled 121 patients as CMC, and another 99 patients as high-risk newborns. Therefore, while the age range of the patients is not explicitly stated, the program appears to primarily serve children and young adolescents with medical complexity.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Home Visits, Prenatal Care Access,

Intervention Description: The intervention was a telephonic perinatal care coordination program that included risk assessment, patient education, coordination of care for home services and clinic appointments, coordination of interventions requested by care providers, and patient advocacy. The program was based on best management practices and agreed-upon methods of patient care delivery developed by a panel of experts organized by the Case Management Society of America (CMSA). The program was designed to improve both clinical and financial outcomes for low-income, high-risk pregnant women, particularly those from minority cultural and racial backgrounds

Intervention Results: The intervention was a telephonic perinatal care coordination program that included risk assessment, patient education, coordination of care for home services and clinic appointments, coordination of interventions requested by care providers, and patient advocacy. The program was based on best management practices and agreed-upon methods of patient care delivery developed by a panel of experts organized by the Case Management Society of America (CMSA). The program was designed to improve both clinical and financial outcomes for low-income, high-risk pregnant women, particularly those from minority cultural and racial backgrounds

Conclusion: The study concluded that the telephonic perinatal care coordination program led to increased mean birth weights for the treatment group when intervening variables were controlled. However, the mean gestational age at delivery was not significantly different between the treatment and control groups. Additionally, the program resulted in cost savings, with an average of $501.31 saved per patient in inpatient and outpatient costs combined. The study suggested that the telephonic case management model could be used with other populations to obtain similar results, indicating its potential for broader application

Study Design: The study utilized a quasi-experimental design, with a treatment group and a control group. The treatment group received the telephonic perinatal care coordination program, while the control group received standard care. The study aimed to evaluate the impact of the intervention on pregnancy outcomes for low-income, high-risk pregnant women

Setting: The study was conducted in two large obstetric clinics and a level-3 tertiary care center in Minneapolis, Minnesota, USA .

Population of Focus: The target audience for the study was low-income, high-risk pregnant women, particularly those from minority cultural and racial backgrounds , . The program aimed to demonstrate the value of telephonic perinatal case management for this specific population by improving both clinical and financial outcome

Sample Size: The initial number of participants in the treatment group was 64, and the number of participants in the control group was 59. However, due to the exclusion of twin gestations, the total of singleton pregnancies included in the analysis was 111, with 50 in the control group and 61 in the treatment group

Age Range: The age range of the participants was not explicitly stated in the study. However, the study did report that almost one in ten participants were age 19 or younger, and nearly one in ten were age 35 or older

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits

Intervention Description: To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding.

Intervention Results: The groups did not differ for initiation of breast feeding: 69.0% (747/1083) in the intervention group and 68.1% (896/1315) in the control groups; cluster adjusted odds ratio 1.11 (95% confidence interval 0.87 to 1.43). Ethnicity, parity, and mode of delivery independently predicted initiation of breast feeding, but randomisation to the peer support worker service did not.

Conclusion: A universal service for initiation of breast feeding using peer support workers provided within antenatal clinics serving a multiethnic, deprived population was ineffective in increasing initiation rates.

Study Design: Cluster RCT

Setting: Prenatal clinics

Population of Focus: Women registered with practices in the primary care trust

Data Source: Medical record review

Sample Size: Intervention (n=33) • Control (n=33) N=practice clusters • Intervention (n=1083) • Control (n=1315) N=women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Quality Improvement/Practice-Wide Intervention

Intervention Description: To measure progress toward the collaborative aim, the HV CoIIN developed a common group of measures that local implementing agencies (LIAs) report and analyze monthly. HV CoIIN measures were selected to capture steps in the process of promotion, early detection, and intervention.

Intervention Results: Within the first 9 months, the HV CoIIN is generating promising movement toward breakthrough change across indicators, for example: By instituting mechanisms to track and provide ongoing surveillance of developmental and behavioral well-being, home visitors are asking over 80% of parents about their child’s development, behavior, or learning at every home visit. By standardizing and measuring efficacy of processes for developmental and behavioral screening, programs are screening approximately 70% of children at appropriate intervals. By incorporating protocol and practice for intentionally supporting children with a positive screen or parental concerns, home visitors are providing 80% or more of families with individualized support related to their child’s development, behavior, or learning within regularly scheduled home visits.

Conclusion: The HV CoIIN’s theory of change includes a comprehensive approach for the development and implementation of reliable and effective systems for surveillance, screening, referral, follow-up, and intervention, with the goal of supporting all children’s development and getting vulnerable children access to appropriate and timely supports.

Study Design: Quality improvement time series design

Setting: Maternal, Infant, and Early Childhood Home Visiting Programs within 8 states and one Tribe: AR, MI, IN, NJ, GA, OH, PA, FL and White Earth Home Health Agency

Population of Focus: Prenatal to age 5 children and families

Data Source: Local team data registries

Sample Size: • Phase I – 11 sites (n≈1019) • Phase II – 5 sites (n≈676) N=families per month

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Quality Improvement/Practice-Wide Intervention

Intervention Description: To measure progress towards the SMART aim, the HV CoIIN developed a common group of measures that LIAs report and analyze monthly. HV CoIIN measures were selected to capture key steps in the process of breastfeeding.

Intervention Results: The HV CoIIN’s theory of change includes a comprehensive approach to increasing the percentage of mothers that exclusively breastfeed their infants until they are three and six months of age by redesigning the ways we engage mothers, provide breastfeeding support in home visits, and ensure seamless linkages for mothers to access and engage in peer and community breastfeeding supports. Within the first eleven months, the HV CoIIN is generating promising movement toward breakthrough change across indicators, On average, 74% of all home visitors within the breastfeeding collaborative across 11-months, are being trained in lactation and infant feeding, with a trend in the data towards meeting our overall Process AIM. Over the last four months, the average has increased to more than 89%. On average, 69% of mothers with an identified need for breastfeeding support are receiving professional or peer breastfeeding support across the collaborative. Efforts in Action period three will aim to strengthen community and peer supports for families. The average percent of women exclusively breastfeeding is 16%, up 13 percentage points from the baseline of 3% of women.

Conclusion: The HV CoIIN’s theory of change includes a comprehensive approach for the development and implementation of reliable and effective systems for surveillance, screening, referral, follow-up, and intervention, with the goal of supporting all children’s development and getting vulnerable children access to appropriate and timely supports.

Study Design: Quality improvement time series design

Setting: Maternal, Infant, and Early Childhood Home Visiting Programs within FL, MI, OH, PA, RI, VA, WI

Population of Focus: Prenatal to age 3 children and families

Sample Size: • Phase 1 – 11 local teams (n≈1074) • Phase II – 9 sites (n≈873) N=families per month

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Continuity of Care (Caseload), Expert Support (Provider), HEALTH_CARE_PROVIDER_PRACTICE, PATIENT_CONSUMER

Intervention Description: The goal of this study was to evaluate the impact of integrating CHWs into the medical teams of children with HL and identify the social needs associated with their caregivers at a large urban hospital center.

Intervention Results: Of the 30 charts reviewed, 93% demonstrated social needs including food insecurity (24%) and educational service needs (45%). Eighty-seven percent of caregivers reported a sense of control over the child's condition, yet 73% reported a stress level of four or greater on the distress thermometer scale. At 3 months follow-up, 70% of patients completed referrals; a significant number of patients had obtained hearing aids and cochlear implants compared to baseline (p = 0.017).

Conclusion: Caregivers of children with HL face multiple social obstacles, including difficulties connecting to educational and financial resources. CHWs are instrumental in identifying social needs and connecting caregivers to services.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Peer Counselor, Telephone Support, Lactation Consultant, Home Visits,

Intervention Description: As part of its ongoing efforts to promote and support breastfeeding, Minnesota WIC in 2005 began offering peer counseling through local programs, utilizing the Loving Support model. By 2012, peer counselor programs in Minnesota were active in 14 local agencies, covering 23 counties, and 2 tribes. Peers provide telephone counseling to pregnant and postpartum women up until the infant's first birthday, with referral to an International Board Certified Lactation Consultant when necessary. Other program components such as face-to-face meetings, text messaging, and home visiting vary across agencies.

Intervention Results: Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19–2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33–0.61; months two through twelve: 0.33; 95% CI 0.18–0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother’s country of origin.

Conclusion: Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.

Study Design: Retrospective analysis of observational data

Setting: Minnesota's WIC program

Population of Focus: WIC-enrolled women who accepted referral to a peer counseling program while pregnant

Sample Size: 2,219 women and their infants

Age Range: Infants birth through 12 months of age

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Midwife, Educational Material, Home Visits, Telephone Support

Intervention Description: To evaluate the effects of an extended midwifery support (EMS) programme on the proportion of women who breast feed fully to six months.

Intervention Results: Findings: there was no difference between the groups at six months postpartum for either full breast feeding [EMS 43.3% versus SMS 42.5%, relative risk (RR) 1.02, 95% confidence interval (CI) 0.87-1.19] or any breast feeding (EMS 63.9% versus SMS 67.9%, RR 0.94, 95%CI 0.85-1.04).

Conclusion: The EMS programme did not succeed in improving breast-feeding rates in a setting where there was high initiation of breast feeding. Breast-feeding rates were high but still fell short of national goals.

Study Design: RCT

Setting: King Edward Memorial Hospital (KEMH), Perth, Western Australia

Population of Focus: Women who gave birth at KEMH who intended to breastfeed

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=425) • Control (n=424) 6-Month Follow-Up • Intervention (n=393) Control (n=389)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, CAREGIVER, Home Visit (caregiver)

Intervention Description: To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population.

Intervention Results: Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum.

Conclusion: Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits

Intervention Description: Home visitors from the HFNY program delivered a multifaceted intervention that included educating high-risk mothers on the benefits of breastfeeding, encouraging them to breastfeed, and supporting their breastfeeding efforts during prenatal and postnatal home visits.

Intervention Results: The study found that including breastfeeding discussion during home visits was significantly and positively associated with both breastfeeding initiation and continuation among the high-risk mothers participating in the HFNY program. Specifically, the likelihood of breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that covered breastfeeding topics. While there was no significant effect on continuing breastfeeding from birth to 1 month, the likelihood of breastfeeding continuation did increase for later time periods based on the percentage of earlier visits that discussed breastfeeding. For example, continuation from 1 to 2 months increased by 0.8% for every 1-point rise in first month visits with breastfeeding discussion. Similarly, continuation from 2 to 3 months and from 3 to 6 months increased by 1.1% for each 1-point increase in second and third month breastfeeding discussions, respectively. Notably, receiving just one additional home visit in the third month post-partum increased the likelihood of breastfeeding at 6 months by 11%, regardless of whether breastfeeding was discussed during that visit.

Conclusion: Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates among high-risk mothers. A more consistent focus on breastfeeding in this supportive home visiting context may help reduce breastfeeding disparities.

Study Design: Secondary analysis of program data from the statewide HFNY home visitation program

Setting: 36 Healthy Families New York (HFNY) home visiting program sites across New York

Sample Size: 3,521 pregnant mothers at risk of poor child health and developmental outcomes

Age Range: The mean maternal age at birth was 25.2 years (SD = 6.1 years).

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Professional Support, Educational Material (caregiver),

Intervention Description: The Following Baby Back Home (FBBH) home visiting program supports families of high-risk low birth weight preterm infants after discharge from a hospital NICU. This study compares the health care use, immunization, and infant mortality rate of low birth weight preterm infants enrolled in FBBH with similar infants not in the program.

Intervention Results: In the first year after discharge and compared with a propensity-score matched cohort of control infants, those enrolled in FBBH were significantly more likely to have higher numbers of medical appointments and more compliant immunization history. The odds of dying in the first year of life for control infants was 4.4 times (95% confidence interval: 1.2-20.7) higher than those managed in the program.

Conclusion: A goal of the FBBH home visiting program is to work with parents to educate and support them as they care for their medically fragile infants. We conclude that education and support was instrumental in the infant health care use and outcome differences we observed during the first year of life.

Study Design: Cross-sectional prospective quasi-experimental study

Setting: Following Baby Back Home program in Arkansas

Population of Focus: Children enrolled in the Following Baby Back Home program in Arkansas from January 2013 to December 2017

Sample Size: 498 children

Age Range: Infants in the first year of life

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits

Intervention Description: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program sends trained professionals like nurses or social workers to visit families in at-risk communities throughout pregnancy and a child's early years. These home visitors provide guidance on maternal health, child development, and economic security. They connect mothers with prenatal care and postpartum checkups, screen for depression and developmental delays, and offer advice on safe sleep practices and early literacy activities. The program also helps families access health insurance and supports caregivers who want to continue their education.

Intervention Results: Studies show that the MIECHV program has positive results across various areas. For instance, MIECHV participation has been linked to increased rates of mothers receiving prenatal care and postpartum checkups, as well as a decrease in emergency department visits for children. There's also evidence that the program improves children's development and school readiness.

Conclusion: In conclusion, the MIECHV program offers a valuable resource for families in at-risk communities. By providing in-home support and connecting families with crucial services, MIECHV helps improve maternal and child health, promotes child development, and strengthens families' overall well-being.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Data Collection Training for Staff

Intervention Description: To determine the impact of the Healthy Steps for Young Children Program on quality of early childhood health care and parenting practices.

Intervention Results: Percentage of children with developmental assessments was 83.1% for intervention and 41.4% for control group (OR=8.00; 95% CI=6.69, 9.56; P<.001)

Conclusion: Universal, practice-based interventions can enhance quality of care for families of young children and can improve selected parenting practices.

Study Design: RCT and QE: nonequivalent control group

Setting: Pediatric practices in 14 states (6 randomization sites: San Diego, CA; Iowa City, IA; Allentown, PA; Pittsburgh, PA; Florence, SC; Amarillo, TX. 9 QE sites: Birmingham, AL/Chapel Hill, NC; Grand Junction, CO/Montrose, CO; Chicago, IL; Kansas City, KS; Boston, MA; Detroit, MI; Kansas City, MO; New York, NY; Houston, TX/Richmond, TX)

Population of Focus: Children ages 0-36 months

Data Source: Child medical record

Sample Size: Randomization Sites: - Intervention (n=832) - Control (n=761) - Total (n=1593) Quasi-Experimental Sites: - Intervention (n=1189) - Control (n=955) - Total (n=2144) Total: - All families (n=3737) - Intervention: (n=2021) - Control (n=1716)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, Midwife, Feedback

Intervention Description: Maternal smoking can cause health complications in pregnancy. Particulate matter (PM2.5) metrics applied to second hand smoke (SHS) concentrations provide indoor air quality (IAQ) measurements and have been used to promote smoking behaviour change among parents of young children. Here, we present the qualitative results from a study designed to use IAQ measurements to help pregnant women who smoke to quit smoking.

Intervention Results: There were 39 women recruited (18 in Aberdeen and 21 in Coventry) and qualitative interviews were undertaken with nine of those women. Diverse accounts of smoking behaviours and experiences of participation were given. Many women reported changes to their smoking behaviours during pregnancy. Most women wanted to make further changes to their own behaviour, but could not commit or felt constrained by living with a partner or family members who smoked. Others could not envisage quitting. Using themes emerging from the interviews, we constructed a typology where women were classified as follows: 'champions for change'; 'keen, but not committed'; and 'can't quit, won't quit'. Three women reported quitting smoking alongside participation in our study.

Conclusion: Pregnant women who smoke remain hard to engage,. Although providing IAQ measurements does not obviously improve quit rates, it can support changes in smoking behaviour in/around the home for some individuals. Our typology might offer a useful assessment tool for midwives.

Study Design: Mixed methods case series

Setting: UK National Health Services (NHS) antenatal clinics

Population of Focus: Pregnant women who smoked receiving NHS antenatal services

Data Source: Indoor air quality measurements (IAQ), interviews

Sample Size: 39

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: To establish the relative cost effectiveness of postnatal support in the community in addition to the usual care provided by community midwives.

Intervention Results: At six weeks there was no significant improvement in health status among the women in the intervention group. At six weeks the mean total NHS costs were pound 635 for the intervention group and pound 456 for the control group (P=0.001). At six months figures were pound 815 and pound 639 (P=0.001). There were no differences between the groups in use of social services or personal costs. The women in the intervention group were very satisfied with the support worker visits.

Conclusion: There was no health benefit of additional home visits by community postnatal support workers compared with traditional community midwifery visiting as measured by the SF-36. There were no savings to the NHS over six months after the introduction of the community postnatal support worker service.

Study Design: RCT

Setting: University teaching hospital and women’s homes

Population of Focus: Women ≥ 17 years old who delivered a live baby and lived in the area served by community midwives

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=311) • Control (n=312) 6-Month Follow-Up • Intervention (n=260) • Control (n=233)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Telephone Support, Adult-led Support/Counseling/Remediation, YOUTH, PATIENT_CONSUMER, Incentives

Intervention Description: The First Breath Wisconsin study examined the cost-effectiveness of providing incentives to pregnant women who smoked to engage in stop smoking treatment.

Intervention Results: Cost-effectiveness analysis calculated the incremental cost-effectiveness ratio (ICER) per one additional smoker who quit. The incentive group had higher 6-month post-birth biochemically-confirmed tobacco abstinence than the control group (14.7% vs. 9.2%). Incremental costs averaged $184 per participant for the incentive group compared to controls ($317 vs $133). The ICER of financial incentives was $3399 (95% CI $2228 to $8509) per additional woman who was tobacco abstinent at 6 months post-birth. The ICER was lower ($2518 vs $4760) for women who did not live with another smoker.

Conclusion: This study shows use of financial incentives for stop smoking treatment is a cost-effective option for low-income pregnant women who smoke.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Educational Material, Motivational Interviewing, PATIENT_CONSUMER, Feedback

Intervention Description: This study aimed to change parents’ perceptions of exposure by providing information on second- and third-hand exposure and personalised information on children’s exposure [NIH.

Intervention Results: Parental perceptions of exposure (PPE) were significantly higher at the study end (94.6 ± 17.6) compared to study beginning (86.5 ± 19.3) in intervention and enhanced control groups (t(72) = −3.950; p < 0.001). PPE at study end were significantly higher in the intervention group compared to the regular control group (p = 0.020). There was no significant interaction between time and group. Parallel changes in parental smoking behaviour were found. Parental perceptions of exposure were increased significantly post intervention, indicating that they can be altered.

Conclusion: By making parents more aware of exposure and the circumstances in which it occurs, we can help parents change their smoking behaviour and better protect their children.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Home Visit (caregiver), PROFESSIONAL_CAREGIVER, PATIENT_CONSUMER

Intervention Description: The Team for Infants Exposed to Substance abuse (TIES) Program provides a holistic, multi-disciplinary, community-based model to address the complex needs of families with young children affected by maternal substance use.

Intervention Results: A multi-year implementation study of the model yielded results that indicate the effectiveness of this home-based family support intervention. The model focuses on reducing maternal alcohol and other drug use, increasing positive parenting, promoting child and maternal health, and improving family income and family housing. A key component of the model is establishing a mutual, trusting relationship between the home visiting specialists and the family. Foundational to the TIES model is a family-centered, culturally competent, trauma-informed approach that includes formal interagency community partnerships

Conclusion: This article describes elements of the model that lead to high retention and completion rates and family goal attainment for this unique population.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, PATIENT_CONSUMER, Educational Material,

Intervention Description: In this pilot study, the breastfeed care plus intervention program was implemented to support women and their families in breastfeeding success.

Intervention Results: Both interventions proved to be effective in improving the ‘perception of breastfeeding self-efficacy,' with higher scores being found in the experimental group (p < 0.001). The proportion of exclusive breastfeeding was also higher in the experimental group

Conclusion: The BCP intervention program, during the first 120 days postpartum, showed promissory results in improving ‘perception of breastfeeding self-efficacy’ compared to conventional care, favoring breastfeeding duration and exclusivity, and cumulative breastfeeding competence of women/families.

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Workers (CHWs), Home Visits,

Intervention Description: The Baby Love program, administered by the Social Work Division of the University of Rochester Strong Memorial Hospital, pairs licensed, master’s-prepared social workers with community health workers (CHWs) to address barriers to health for high-risk pregnant and parenting women and infants as part of an interdisciplinary, perinatal health care team. The program serves participants by (1) increasing linkage with health and community support services, (2) educating participants on perinatal- and parenting-related topics along with stress-reduction strategies, and (3) providing support and advocacy for participants. The CHW serves as the primary Baby Love service provider, completing regular home visits and forming supportive relationships throughout the course of a women’s pregnancy and for one year postpartum. To facilitate integrated care, all interventions are documented in the participant’s medical record.CHWs are trained based on the Family Development Credential Program, a strengths-based approach of partnership between the family and CHW that is focused on achieving identified service goals.

Intervention Results: During the study period, Baby Love participants had fewer adverse outcomes than did nonparticipants, including lower rates of preterm birth. Neonatal intensive care unit (NICU) admission rates were 16% among participants compared with 21% among nonparticipants. The odds of NICU admission, preterm birth, and low birth weight were all lower among Baby Love participants than nonparticipants, whereas the odds of attending a postpartum visit within 60 days and attending at least four well-child visits within six months after births were higher.

Conclusion: The societal imperative to improve perinatal outcomes continues to pose a public health challenge. Well-structured CHW-supported home-visiting programs are a promising tool to more fully address the needs of a broader population of diverse and socioeconomically disadvantaged pregnant women. The Baby Love program’s effectiveness at improving perinatal outcomes and addressing social determinants of health from its integrated placement within the health delivery system positions this program as a valuable contributor to a fully integrated care delivery system

Study Design: Retrospective cohort study

Setting: Social Work Division of the University of Rochester Strong Memorial Hospital

Population of Focus: At-risk pregnant women

Sample Size: 353 enrolled with Baby Love;102 in comparison group

Age Range: Childbearing age

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Home Visits

Intervention Description: Evaluate the efficacy of a lay health advisor (LHA) intervention for improving Pap testing rates, to reduce cervical cancer, among women in need of screening.

Intervention Results: Based on medical record review, more women in the LHA arm had a Pap test by the end of the study compared to those randomized to usual care.

Conclusion: LHA interventions show promise for improving screening behaviors among non-adherent women from underserved populations.

Study Design: RCT

Setting: Fourteen Ohio Appalachian clinics

Population of Focus: Women living in Ohio Appalachia, who were not pregnant, and who were in need of a Pap test based on riskappropriate guidelines

Data Source: Medical record review and self-report

Sample Size: Total (N=286) Analysis Medical Record Review (n=270) Intervention (n=139); Control (n=131) Self-Report (n=233) Intervention (n=115); Control (n=118)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Other Education, Referrals, PATIENT_CONSUMER

Intervention Description: Our nationally recognised enriched medical home intervention (EMHI) utilised community health worker home visitation to improve health outcomes of children by engaging the entire family and removing barriers to care-seeking.

Intervention Results: The EMHI participants were primarily families with infants <24 months old, Medicaid-insured and Latino. In the multivariable logistic regression model, EMHI program factors as well as community factors independently predicted program continuation and retention. Specifically, families learning about newborn care or with preferred spoken language Spanish were more likely to complete the program. Participants reporting neighbourhood distrust had a greater likelihood of non-completion than others. Results underscore the importance of cultural competency and community involvement in program design and dissemination.

Conclusion: Our findings are applicable to other home-based interventions with the goal of supporting underserved families in following recommended clinical care.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Adult-led Support/Counseling/Remediation, PATIENT_CONSUMER, YOUTH, Feedback

Intervention Description: This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied.

Intervention Results: The intervention increased women’s capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others’ smoking in the home.

Conclusion: The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage.

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Access, Patient Navigation,

Intervention Description: The implementation of clinical-community linkages to engage Medicaid-insured pregnant women in underutilized home visiting services for enhanced prenatal care coordination.

Intervention Results: Clinical-Community Linkages: The Impact of Standard Care Processes that Engage Medicaid-Eligible Pregnant Women in Home Visiting. When compared with similar women from the rest of the state, the Federally Qualified Health Center observed a 9.1 absolute percentage points (APP; 95% confidence interval [CI], 8.1–10.1) increase in MIHP participation and 12.5 APP (95% CI, 10.4–14.6) increase in early first trimester enrollment. The obstetrics and gynecology residency practice experienced increases of 4.4 APP (95% CI, 3.3–5.6) in overall MIHP participation and 12.5 APP (95% CI, 10.3–14.7) in first trimester enrollment. Significant improvements in adequate prenatal care, emergency department use, and postpartum visit completion were also observed.

Conclusion: Clinical–community linkages can significantly improve participation of Medicaid-insured women in an evidence-based home visiting program and other prenatal services. This work is important because health providers are looking for ways to create clinical–community linkages

Study Design: Quasi-experimental design

Setting: A Federally Qualified Health Center (FQHC) and a hospital-based obstetrics and gynecology residency practice

Population of Focus: Medicaid-insured pregnant women; healthcare pracitioners

Sample Size: 1,017 (Combined FQHC and Ob/Gyn residency practice)

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Educational Material, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), CAREGIVER, Education/Training (caregiver), Home Visit (caregiver), Educational Material (caregiver)

Intervention Description: Secondhand smoke (SHS) and other air pollutants adversely affect the health of pregnant women and infants. A feasibility study aimed at reducing air pollution in homes of pregnant women or infants living with a smoker was completed.

Intervention Results: Post-intervention, 70% of participants reported smokers were less likely to smoke indoors, and 77% had at least one air purifier turned on at the final visit. Participant satisfaction was high (91%) and 98% would recommend air purifiers. Indoor PM2.5 was significantly decreased (P < 0.001). Salivary cotinine was significantly decreased for non-smoking women (P < 0.01) but not infants, and no significant change in air nicotine occurred (P = 0.6).

Conclusion: Air purifiers with SHS education is a feasible intervention in homes of women and infants. These data demonstrate reduction in indoor PM2.5 and salivary cotinine in non-smoking adults. Air purifiers are not an alternative for smoking cessation and a home/car smoking ban. Smoking cessation should be strongly encouraged for all pregnant women, and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure. This study provides support for a future intervention evaluating clinical endpoints.

Study Design: A single arm, unmasked clinical trial

Setting: Home-based (4 home-visits during the 5 week study)

Population of Focus: Women > 18 years of age and either pregnant nonsmokers or post-partum (any smoking status) with an infant age 0-12 months

Data Source: Air quality assessment, salivary cotinine

Sample Size: 50 women, 32 had infants and 18 were pregnant at time of enrollment

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Educational Material

Intervention Description: As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.

Intervention Results: The results of this study indicate that the intervention was able to reduce exposure to mite, pet and food allergens, but not to passive smoking. Despite this reduction, there was no effect on either parentally reported or GP-observed symptoms during first 2 yrs of life, nor on total and specific IgE at 2 yrs. However, asthma-like symptoms at the end of the 2nd yr were less frequently reported in the intervention group.

Conclusion: In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.

Study Design: RCT

Setting: Community

Population of Focus: Pregnant moms whose child would be high-risk for developing asthma

Data Source: Parental and GP report of asthma-like symptoms using questionnaires Measurement of mite, cat and dog allergen levels at baseline and 1 year.

Sample Size: 476 randomized to intervention and control groups

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, Educational Material

Intervention Description: To determine if low-cost air-quality monitors providing personalised feedback of household second-hand smoke (SHS) concentrations plus standard health service advice on SHS were more effective than standard advice in helping parents protect their child from SHS.

Intervention Results: 120 mothers were recruited of whom 117 were randomised. Follow up was completed after 1-month in 102 and at 6-months in 78 participants. There was no statistically significant reduction in PM2.5 concentrations by either intervention type at 1-month or 6-months, nor significant differences between the two groups at 1-month (p = 0.76) and 6-month follow-up (p = 0.16).

Conclusion: Neither standard advice nor standard advice plus personalised air-quality feedback were effective in reducing PM2.5 concentrations in deprived households where smoking occurred. Finding ways of identifying homes where air-quality feedback can be a useful tool to change household smoking behaviour is important to ensure resources are targeted successfully.

Study Design: RCT

Setting: Home-based

Population of Focus: Disadvantaged mothers who were exposed to SHS at home

Data Source: Air quality data, and caregiver selfreport

Sample Size: 117 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Technology-Based Support, Peer Counselor, Home Visits, PATIENT_CONSUMER

Intervention Description: To evaluate the feasibility of an mHealth-supported breastfeeding peer counselor intervention implemented in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including exclusive breastfeeding (EBF).

Intervention Results: The intervention was delivered as intended, maintained over the study period, and had high acceptability ratings. There were statistically significant differences in all outcomes between groups. The intervention group had a significantly higher likelihood of EBF at 6 months compared to the control group (adjusted odds ratio 3.57, 95% confidence interval 1.80–7.07).

Conclusion: Integration of mHealth with community-based peer counselors to educate women about EBF is feasible and acceptable in rural India and impacts maternal breastfeeding behaviors.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Home Visits, Transportation Assistance

Intervention Description: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents.

Intervention Results: Significant increase in preventive care visit rates in the intervention group vs control group (p<.01)

Conclusion: A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents.

Study Design: RCT

Setting: 8 urban primary care practices in Rochester, New York

Population of Focus: Adolescents ages 11-15 enrolled in one of the practices

Data Source: Medical record review

Sample Size: Total (N=7546) Intervention (n=3707) Control (n=3,839)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Patient Navigation, Enabling Services, Home Visits

Intervention Description: A randomized controlled trial to evaluate the effectiveness of two alternative cervical cancer screening interventions for Chinese women living in North America.

Intervention Results: Women in both intervention groups significantly more likely to have Pap smear than women in control group (39% in outreach worker group vs 15% in control, p<.001; 25% in direct mail group vs 15% in control, p=.03)

Conclusion: Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America.

Study Design: RCT

Setting: Seattle, WA and Vancouver, British Columbia

Population of Focus: Women who spoke Cantonese, Mandarin, or English, with no history of cervical cancer or hysterectomy, who were defined as underutilizers of cervical cancer screening (no Pap test in the past 2 years and/or did not intend to have a Pap test in the next 2 years)

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=402) Intervention Group 1 (n=129); Intervention Group 2 (n=139); Control (n=134)

Age Range: 20-69

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits

Intervention Description: Evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers.

Intervention Results: Ever-screened experimental group women were significantly more likely to report Pap testing (P < .02) and to have records verifying Pap testing (P < .04) than were ever-screened control group women. There were no significant differences between the trial arms for women who had never been screened.

Conclusion: Lay health worker–based interventions for Vietnamese American women are feasible to implement and can increase levels of Pap testing use among ever-screened women but not among never-screened women.

Study Design: RCT

Setting: Seattle, Washington

Population of Focus: Vietnamese women who spoke Vietnamese or English, and who had not received a Pap test in the past 3 years

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=234) Intervention (n=118); Control (n=116)

Age Range: 20-89

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Patient Navigation, Enabling Services, COMMUNITY, Community Events, POPULATION-BASED SYSTEMS, Home Visits

Intervention Description: A group-randomized controlled trial to evaluate a cervical cancer screening intervention program targeting Seattle’s Cambodian refugee community.

Intervention Results: The proportion of women in the intervention group reporting recent cervical cancer screening increased from 44% at baseline to 61% at follow-up (+17%). The corresponding proportions among the control group were 51 and 62% (+11%). These temporal increases were statistically significant in both the intervention (P < 0.001) and control (P = 0.027) groups.

Conclusion: This study was unable to document an increase in Pap testing use specifically in the neighborhood-based outreach intervention group; rather, we found an increase in both intervention and control groups. A general awareness of the project among women and their health care providers as well as other ongoing cervical cancer screening promotional efforts may all have contributed to increases in Pap testing rates.

Study Design: Cluster RCT

Setting: Seattle, Washington

Population of Focus: Cambodian women

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=370) Analysis (n=289) Intervention (n=144); Control (n=145)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visit (caregiver), Home Visits, Other Education, PROFESSIONAL_CAREGIVER, PATIENT_CONSUMER

Intervention Description: To describe paediatric postdischarge concerns manifesting in the first 96 hr after hospital discharge.

Intervention Results: Overall, nurses documented at least one concern in 56% (N = 367) of visits. Most commonly, they documented concerns about medication safety (15% or 91 visits). Specifically, in 11% (N = 58) of visits nurses were concerned that caregivers lacked a full understanding of medications and in 8% (N = 49) of visits families did not have prescribed discharge medications. Pain was documented as present in 9% of all visits (N = 56). Nurses completed referrals to other providers/services in 12% of visits (N = 78), most frequently to primary care providers. In 13% of visits (N = 85) nurses documented concerns considered beyond the immediate scope of the visit related to social needs such as housing and transportation.

Conclusion: Inpatient and community nurses and physicians should be prepared to reconcile and manage discharge medications, assess families’ medication administration practices and anticipate social needs after paediatric discharge.

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Home Visit (caregiver), PATIENT/CONSUMER, Home Visits, Motivational Interviewing

Intervention Description: Secondhand smoke (SHS) is a significant cause of acute respiratory illness (ARI) and 5 times more common in indigenous children. A single-blind randomized trial was undertaken to determine the efficacy of a family centered SHS intervention to reduce ARI in indigenous infants in Australia and New Zealand.

Intervention Results: Two hundred and ninety-three mother/infant dyads were randomized and followed up. Three quarters of mothers smoked during pregnancy and two thirds were smoking at baseline (as were their partners), with no change for more than 12 months. Reported infant exposure to SHS was low (≥95% had smoke-free homes/cars). Infant CCRs were higher if one or both parents were smokers and if mothers breast fed their infants. There was no effect of the intervention on ARI events [471 intervention vs. 438 usual care (reference); incidence rate ratio = 1.10, 95% confidence intervals (CI) = 0.88–1.37, p = .40].

Conclusion: Despite reporting smoke-free homes/cars, mothers and their partners continue to smoke in the first year of infants’ lives, exposing them to SHS. Emphasis needs to be placed on supporting parents to stop smoking preconception, during pregnancy, and postnatal.

Study Design: Single-blind randomized trial

Setting: Community (homes)

Population of Focus: Indigenous mothers/infants from homes with more than one smoker

Data Source: Baseline data at home visit; Baseline, 2 month, and 3 month quantitative and qualitative process evaluation indicators; outcome data from face-toface home visits and urine samples

Sample Size: 293 mother/infant dyads

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Community-Based Group Education, Telephone Support

Intervention Description: To evaluate the effect of two forms of postnatal social support for disadvantaged inner city mothers on maternal and child health outcomes.

Intervention Results: At 12 and 18 months, there was little impact for either intervention on the main outcomes: child injury (SHV: relative risk 0.99; 95% confidence intervals 0.68 to 1.45, CGS: 0.91; 0.61 to1.36), maternal smoking (SHV: 0.86; 0.62 to 1.19, CGS: 0.97; 0.72 to 1.33) or maternal depression (SHV: 0.86; 0.62 to1.19, CGS: 0.93; 0.69 to 1.27). SHV women had different patterns of health service use (with fewer taking their children to the GP) and had less anxious experiences of motherhood than control women. User satisfaction with the SHV intervention was high. Uptake of the CGS intervention was low: 19%, compared with 94% for the SHV intervention.

Conclusion: There was no evidence of impact on the primary outcomes of either intervention among this culturally diverse population. The SHV intervention was associated with improvement in some of the secondary outcomes.

Study Design: RCT with two intervention groups

Setting: Community (Well-child visit)

Population of Focus: Women from culturally diverse background with infants in two disadvantaged boroughs of London, UK

Data Source: Questionnaires at baseline, 12 and 18 month follow-ups.

Sample Size: 731 mothers with 183 allocated to support health visitor intervention, 184 to community group services intervention, and 364 to control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Parent Engagement,

Intervention Description: The intervention described in the article to increase healthcare access is the integration of evidence-based home visiting services, particularly the Nurse-Family Partnership (NFP), into the provision of primary care. The NFP program involves home visits by nurses to provide support and guidance to young, first-time mothers and their families. By integrating this evidence-based home visiting service into primary care, the NFP nurse becomes part of the care team, working collaboratively with primary care providers to address the social determinants of health, avoid child maltreatment, and improve child preventive care utilization . This intervention aims to enhance healthcare access by leveraging the expertise of nurse home visitors to provide comprehensive support to families, particularly those facing adversity. The integration of evidence-based home visiting services into primary care allows for shared care planning with patients, families, and support systems, which can lead to better anticipation of needs, improved accountability, and support for patient self-management. This collaborative approach can help address barriers to healthcare access and promote the overall well-being of families .

Intervention Results: The integration of evidence-based home visiting services into primary care, particularly the Nurse-Family Partnership program, can help address social determinants of health, avoid child maltreatment, and improve child preventive care utilization. By collaborating with nurse home visitors, primary care providers can promote shared care planning with patients, families, and support systems, which can lead to better anticipation of needs, improved accountability, and support for patient self-management. This collaborative approach can help address barriers to healthcare access and promote the overall well-being of families . Additionally, the exploratory case study presented in the PDF file found that healthcare providers interacted with home visiting nurses mainly during the referral process, while social workers provided more specific examples of service coordination. The study also found mutual awareness, cooperation, and collaboration to serve families with high needs. However, even in this case, there were opportunities to enhance coordination to improve the health and social needs of young families experiencing adversity

Conclusion: In this case study, we saw mutual awareness, co-operation and collaboration to serve families with high needs. Even in this case, purposefully selected to represent strong collaboration, there were opportunities to enhance co-ordination to improve the health and social needs of young families experiencing adversity.

Study Design: The study used in-depth qualitative interviews with 22 PCPs, including nurses, physicians, social workers, and non-direct care professionals, to explore topics of referral processes and collaborative activities, with subtopics of outreach, communication, and care coordination . The study used a thematic interview guide to conduct the interviews and implemented a practical approach to conducting thematic analysis for this single case study by first familiarizing with the data. The researchers used NVivo11 to code inductively, assigning meaning to data and identifying segments that related to the research questions. They participated in coding consistency meetings, utilizing the kappa statistic to assess inter-rater reliability and to facilitate discussions to reach a common consensus regarding code definitions. Two coders wrote memos for each coded transcript to synthesize participant perspectives and used analytical notes to explain thought patterns in relation to the codes used and emerging themes

Setting: The study presented in the PDF file was conducted in one Nurse-Family Partnership (NFP) site in the USA, serving two counties. The study aimed to explore the collaborative dynamics between primary care providers (PCPs) and NFP nurses in this specific site. The study was not bound by time, meaning that providers were asked about their past and current collaboration with NFP nurses, but was bound by geography, within the two counties served by NFP nurses in this NFP site . The study setting includes various healthcare and social service providers, such as hospitals, family medicine clinics, obstetrics clinics, federally qualified health centers, and private practices, serving a population that PCPs described as underserved and often publicly insured, including single mothers and families experiencing economic adversity who were largely covered by Medicaid, the national public health insurance program in the USA for people .

Population of Focus: The target audience for the study presented in the PDF file includes professionals and researchers in the fields of public health, primary care, maternal and child health, social work, and healthcare administration. Specifically, the study is relevant to those interested in understanding the collaborative dynamics between primary care providers (PCPs) and Nurse-Family Partnership (NFP) nurses in serving families with high needs, particularly low-income, first-time mothers and their families. Additionally, policymakers and organizations involved in developing and implementing programs aimed at improving healthcare access and addressing social determinants of health for young families experiencing adversity may also find the study's findings and insights valuable.

Sample Size: The sample size for the study presented in the PDF file was 22 primary care providers (PCPs) who had worked with Nurse-Family Partnership (NFP) nurses in one NFP site in the USA. The study aimed to explore the experiences of seven unique data sources, including nurse supervisors, obstetricians and midwives, pediatricians, family medicine practitioners, clinical social workers, clinical nurses, and other non-direct care professionals. The estimated sample size was 20, and the participation rate was 59%

Age Range: The PDF file does not explicitly mention the specific age range of the individuals or families involved in the study. However, the study focuses on the collaboration dynamics between primary care providers (PCPs) and Nurse-Family Partnership (NFP) nurses to meet family needs in one NFP site. The NFP program typically serves low-income, first-time mothers and their families from pregnancy until the child reaches two years of age . Therefore, the age range of the families involved in the NFP program and, by extension, the focus of the study, would likely encompass prenatal care and early childhood development, typically from pregnancy through the first two years of the child's life.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Home Visits,

Intervention Description: RCT to determine the effect of breastfeeding training on mothers’ knowledge, behaviors, and exclusive breastfeeding for 6 months. The training group received breastfeeding education during the prenatal and postnatal periods from the researcher. Besides the breastfeeding training that the pregnant women in the control group were provided by the hospital, they received education in the prenatal period about modern family planning methods. Prenatal training was provided to each pregnant woman in two lessons in a room allocated for training within the hospital. Each group consisted of 8-14 participants. Both groups were monitored through home visits in the 1st and 24th weeks postpartum. Postnatal training was provided within the first 24 h postpartum. The training lasted for at least 30 minutes and focused mostly on breastfeeding problems and breastfeeding techniques.

Intervention Results: The difference between the number of correct answers in pre- and posttest was higher in the training group (four questions) than in the control group (two questions) (p < .001). The number of mothers exclusively breastfeeding for 6 months was significantly higher in the training group (26.5%) than in the control group (3.3%) (p = .015). The median of the exclusive breastfeeding period was longer in the training group (5 months) than in the control group (4 months) (p = .013).

Conclusion: Training and supporting pregnant women and breastfeeding mothers on breastfeeding increased their knowledge, the period of exclusive breastfeeding, and the rate of 6-month exclusive breastfeeding.

Study Design: RCT

Setting: Outpatient OB/GYN clinics of a private baby-friendly hospital in the city center of Kayseri Province, Turkey

Population of Focus: Pregnant women in their 2nd or 3rd trimester attending the OB/GYN polyclinics of a baby-friendly hospital

Sample Size: 120 women (60 for training and 60 in the control groups)

Age Range: Women 20 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: This experimental field study was performed with the aim of evaluating the efficacy of training given to women about cervical cancer risk factors and primary and secondary prevention precautions.

Intervention Results: No significant changes in Pap smear rates between baseline and follow-up

Conclusion: Women were in need of knowledge about risk factors related to cervical cancer, prevention from and early diagnosis of cervical cancer, but there was no significant increase in the rate of having a Pap smear test despite the increase in the knowledge level with the training given.

Study Design: QE: pretest-posttest

Setting: Evka 4 Health Care Center in Izmir

Population of Focus: Women who were literate, married, had social security, and were registered at the Evka 4 Health Care Center

Data Source: Written questionnaire

Sample Size: Baseline (n=254) Follow-up (n=227)

Age Range: 25-29

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), Telephone Support, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling, Outreach (caregiver), Home Visit (caregiver)

Intervention Description: The aim of this randomized-controlled trial was to evaluate the effectiveness of an intensive intervention to reduce children’s environmental tobacco smoke (ETS) exposure at their home compared with a minimal intervention.

Intervention Results: The levels of cotinine in the intensive intervention and minimal intervention groups in the final follow-up were significantly lower than the initial levels. The proportion of mothers reporting a complete smoking ban at home in the final follow-up was higher in the intensive intervention group than the minimal intervention group. This increase was statistically significant. The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children’s exposure to ETS at their home. The decrease in cotinine levels was higher in the intensive intervention group than the minimal intervention group but the difference was not statistically significant.

Conclusion: The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children’s exposure to ETS at their home.

Study Design: RCT

Setting: Community (home and hospital)

Population of Focus: Mothers of children aged 1-5 who lived in the Cengizhan district of Izmir in Turkey, who smoked and/or whose spouses smoked

Data Source: Urinary cotinine samples and forms

Sample Size: 80 mothers with 40 in the intensive intervention group and 40 in the minimal intervention group

Age Range: Not specified