Abstract
BackgroundSupport to strengthen the early parent-infant relationship is recommended to ensure the infant’s future health and development. Little is known about the universal approaches taken by health visitor to support this early relationship. The aim of this study is to investigate the effects of health visitors’ use of the Newborn Behavioral Observation (NBO) method among new parents.MethodsThis is a cluster-randomised community-based study implemented in four Danish municipalities. Health visitors will conduct the trial, and the geographical districts they work in will constitute the clusters as units of randomisation. The participants will be approximately 2800 new families, randomised into an intervention or a comparison group according to their health visitor. The families are recruited at the first postpartum home visit. Parents in both groups receive care as usual: parents in the intervention group also receive the standardised NBO method in home visits performed from 3 weeks to 3 months postpartum. Data consist of self-reported parent questionnaires and video recordings of a selected group of vulnerable first-time mothers recorded 4 months postpartum. The self-reported data are obtained: at baseline 1 week postpartum and then at follow-up 3, 9 and 18 months postpartum. Data will be analysed using the intention-to-treat method and the analyses will include comparison of change in the primary variables across time supplemented by multiple regression analysis. The primary study outcomes are measured by the following factors: parental confidence, infants’ socio-emotional development and mother-infant relationship. Other measures include parental mood and stress, breastfeeding duration and utility of the health visitor services. Data collection among the health visitors in both groups will serve to monitor any change in practice regarding the work with early parent-infant interactions.DiscussionThis protocol describes an evaluation of the NBO method used universally in health visiting practice. The intervention seeks to support early parenting by increasing parents’ understanding of their infants’ cues. The NBO is currently implemented in Denmark even though an evaluation of the NBO has yet to be made in a community setting in Denmark and internationally. The study may contribute to building an increasingly evidence-based practice for health visitors.Trial registrationClinicalTrials.gov ID: NCT03070652. Registered February 22, 2017.
Highlights
Support to strengthen the early parent-infant relationship is recommended to ensure the infant’s future health and development
Foundation of early parenting and parents at risk The postnatal period is important for establishment of a healthy parent-infant relationship
Aim and hypothesis The aim of this study is to examine the short-term and long-term effects on child and family outcomes of the implementation of a universal Newborn Behavioral Observation (NBO) method provided by health visitors to a general population of parents in a community setting
Summary
Support to strengthen the early parent-infant relationship is recommended to ensure the infant’s future health and development. Foundation of early parenting and parents at risk The postnatal period is important for establishment of a healthy parent-infant relationship. The quality of this relationship is associated with the infant’s subsequent physical [1, 2] and psychosocial health [3,4,5,6] and cognitive development [7, 8]. More than half of first-time mothers have reported that they experience difficulties and need of support in the early postpartum period [18, 19]
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