Child Health Care Nurses Research Articles

Supporting first-time parents in their homes: an informal setting enabling interprofessional collaboration.

Home visiting programmes aiming to support parents and promote more equal health amongst young children have grown in Sweden and in other countries. These programmes involve interprofessional teams. Teamwork in interprofessional contexts often requires setting boundaries, but professionals' boundary work in the home setting is unexplored. Therefore, this article focuses on interprofessional teams comprising child healthcare nurses, midwives, social workers, and dental hygienists in a home visiting programme for first-time parents in Sweden; it aims to explore how the professionals performed boundary work that enabled collaboration and to investigate important contextual conditions for this kind of boundary work. The data were drawn from semi-structured interviews with twelve professionals from the four different disciplines. Content analysis was used to explore their boundary work. The findings show that the professionals performed three forms of collaborative boundary work. They maintained boundaries by clarifying their distinct roles and expertise. However, the differences were viewed as complementary, and the professionals worked together humbly to complement each other's knowledge and perspectives. Lastly, they tended to drop perceptions of prestige and blurred the boundaries to accommodate their overlapping knowledge. Important conditions for the success of collaborative boundary work were meetings prior to the home visits, the opportunities for discussion and reflection after the home visits, and the informal character of the home setting. Consequently, the professionals were able to jointly contribute to a holistic view of the visited families, which increased the possibilities to meet these families' needs. This study contributes knowledge on boundary work in interprofessional collaborations in the home setting. The informal character of the home setting seemed to facilitate collaboration and contributed to creating informal professional roles. The findings suggest that having interprofessional teams in the home setting enabled collaboration as well as reinforced support for first-time parents, which emphasizes the merit of home visit programmes.

Child healthcare nurses' experience of communication with 4-year-old children during their visit to the child health care center.

To illuminate child healthcare nurses' experiences of communication with 4-year-old children during their visit to the child healthcare center. A qualitative method, using data collected from individual interviews. Fifteen semistructured interviews with nurses working in a child healthcare center. The results were analyzed using reflexive thematic analysis. The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter. Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter-assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child-centered approach.

To capture the child’s interest - nurses experiences of ‘Saga stories in health talks’

BackgroundAs unhealthy lifestyle habits have been found to be established early in life and often track into adulthood, early preventive initiatives are important. ‘Saga Stories in health talks’ is a newly developed material that is intended to be used as a support for nurses at child health care (CHC) centers in their health talks with children and parents in Sweden. The aim of this study is to explore how CHC nurses experience the usability of the ‘Saga Stories in health talks’ material.MethodsThis study used a qualitative design. The material ‘Saga Stories in health talks’ was tested by 33 CHC nurses working in 11 CHC centers in three regions in Sweden. All CHC nurses were invited to participate in the interviews and 17 agreed. The interviews were transcribed and analysed using content analysis.ResultsThree categories and eight sub-categories emerged. The categories were: (1) An appreciated tool suitable for health talks, (2) Illustrations to capture children’s interest in the conversation with families, and (3) Barriers and facilitators. Saga Stories in health talks’ was experienced by the CHC nurses as an appreciated tool with content highly relevant to what should be discussed during the health talks. The CHC nurses described the material as well-designed with illustrations that helped them capture the child’s interest and increase their participation, while still involving the parents. Support from colleagues, the researchers, and managers were seen as important facilitators. Challenges included structural factors such as how and when to best use the material, especially concerning that the 4-year visit contained many other mandatory parts.ConclusionsThis pilot study show that the material ‘Saga Stories in health talks’ was highly appreciated by CHC nurses and facilitated their health talks with families in CHC. Important aspects with the material were the relevant content and the focus on healthy living habits, as well as the child friendly illustrations. These findings can be used when similar material is developed to facilitate health talks with families in other contexts. Our results also highlight the importance to adjust the implementation of a new material with already established practice and routines.

Meeting families in various social situations: reflections from healthcare staff working with an extended home-visiting program in Sweden

ObjectivesHealth inequalities exist among children in Sweden, and one effort that the Swedish government has focused on to promote health among small children and their parents is an extended home-visiting program during the child’s first 15 months. This study aimed to illuminate healthcare professionals’ experiences of meeting parents in different social situations during the home visits within Grow safely.MethodsThe chosen method was qualitative, and 13 interviews were carried out with healthcare, social, and dental professionals working with the extended home-visiting program within the child healthcare in the south of Sweden.ResultsThe results revealed that the parents raised differing needs in the meetings with the healthcare professionals in the program. The needs included advice on children with special needs, support with problematic breastfeeding, and more psychosocial support. The professionals met different groups of parents, such as young parents or newly arrived migrant parents, that in different ways needed the team to reach out to them. The professionals also met families who came from better-off areas and who were not initially considered to really need the program. As the program progressed, these parents could see that diverse, unpredictable needs could be met by the intervention. For example, the program provided access to and advice from social workers, which in turn created contacts that lasted longer than the program itself.ConclusionsThe professionals encountered various family situations and needs within the extended home-visiting program. This highlights the need for a close collaboration between child healthcare nurses and social workers, in order to be able to support the families and work towards the aim of reaching equal health among all children in Sweden.

Breastfeeding training improved healthcare professional's self-efficacy to provide evidence-based breastfeeding support: A pre-post intervention study

ObjectiveTo describe healthcare professional's (HCP's) perceived self-efficacy in their ability to provide breastfeeding support before and after a breastfeeding training program. DesignPre-post intervention study. SettingAntenatal care and child healthcare (CHC) centres in Sweden during 2020. ParticipantsAn intervention group consisting of 39 HCPs (midwives 51.3%, child healthcare nurses 46.2%) completing a questionnaire at baseline and after intervention, and a control group of 34 HCPs (midwives 61.8%, child healthcare nurses 38.2%) completing a questionnaire at baseline. InterventionA breastfeeding training program in line with the Ten Steps to Successful Breastfeeding and WHO recommendations about breastfeeding. Measurements and findingsThe 11-item Breastfeeding Support Confidence Scale (BSCS) measures HCP's self-efficacy regarding providing breastfeeding support in line with Ten Steps to Successful Breastfeeding and WHO recommendations. The intervention group experienced a significantly increased self-efficacy from pre-intervention to post-intervention for 8 of the 11 BSCS items, with the overall BSCS index score increasing from 36.87 to 39.56 points (p = 0.001). The index score in the intervention group at follow-up was significantly higher than the corresponding score in the control group at baseline (p = 0.025). The intervention group had significantly higher scores at follow-up than the control group at baseline on the questions: “I'm sure that I can help mothers continue to breastfeed even if the infant doesn't follow the growth curve” (p = 0.026) and “I'm sure that I can help mothers continue to breastfeed when the breastfeeding is painful” (p = 0.048). Key conclusionsThe breastfeeding training program improved HCP’ self-efficacy to provide evidence-based support to breastfeeding mothers. Implications for practiceThis training program is well suited to implement in clinical practice and follows the Ten Steps to Successful Breastfeeding. Trial registrationACTRN12623000648628

Health, social, and dental professionals’ experiences of working within an extended home-visit program in the child healthcare: a qualitative interview study in Sweden

BackgroundThe goal of the Swedish child healthcare system is to reach all children with health-promotive actions and to create equal health opportunities for all children. In that context, an extended home-visit program – called Grow Safely – for first-time parents, with an interprofessional collaboration between child healthcare nurses, midwives, social workers, and dental assistants, was initiated. The current study aims at illuminating and evaluating the health, social, and dental professionals’ experiences of working within this program and how such collaboration could benefit the professions.MethodsA qualitative method was chosen, and 13 interviews were carried out with professionals working within child healthcare centers that participated in an extended home-visit program in the southernmost part of Sweden. The interviews were analyzed via Burnard’s approach to content analysis.ResultsThe results showed that it was satisfying for the health, social, and dental professionals to work with the home-visit program and that they encountered positive feelings among the parents receiving it. The creation of deep conversations and parents opening up about feelings that could otherwise be shameful to express, was a positive aspect of the home visits. A negative aspect was the difficulty of handling the (sometimes necessary) interpretation over the phone during the visits, and another one was the fact that the visits were time-consuming and required logistical planning. Overall, the professionals were positive about the home-visit program in that they felt that they were able to give the families what they needed and to have discussions on sensitive issues. They also appreciated the fact that different professions collaborated in order to reach the same goal.ConclusionsThis study showed that the health, social, and dental professionals enjoyed working with the home-visit program and that they encountered positive feelings among the parents regarding the collaborative visits being conducted within the home, where the families felt safe and relaxed. The professionals expressed that the home visits, despite the extended time they required and the logistical challenges involved, created a deeper collaboration between the professionals.

Child health care nurses' experience of language screening for 2.5-year-old children: A qualitative study.

To investigate the experience of Child Health Care Nurses (CHCNs) using language screening for 2.5-year-old children. An exploratory qualitative design with an inductive approach. Data were collected through semi-structured, interviews with Swedish CHCNs who regularly performed language screening for children. The interviews were analysed by thematic analysis. Four themes were identified: 'The difficult visit', 'Explanations for language delay', 'Language screening across cultures' and 'Language screening with children exposed to adverse life events'. Our findings suggest that in routine care a modified procedure is used for the language screening of children aged 2.5 to secure the child's cooperation and to preserve an alliance with the parents. Consequently, the validity of the screening is called into question, particularly when it comes to children from families with origins outside the dominant culture and children exposed to adverse life events.

Healthcare professionals' perceptions of a digital parental support, Childbirth Journey, constructed as a serious game-An intervention study.

Globally, the digital sources developed and available in antenatal care differ, and infrastructure challenges may impede the further development of such sources. Challenges accompanying digital developments can include the commonly occurring high workload, which affects healthcare professionals' ability to acquire professional knowledge about how to best support parents in using digital sources. Including healthcare professionals in the development process of digital sources may increase the likelihood that such sources will be adopted and employed by these professionals in their future care work. Therefore, the present research explored healthcare professionals' perceptions of the digital support intervention Childbirth Journey, which was constructed as a serious game for expectant parents. Data were collected through semi-structured focus-group interviews with 11 midwives at antenatal, labour and postnatal clinics as well as with child healthcare nurses. Prior to the interviews, all participants were provided the intervention, Childbirth Journey, which is a serious game in a mobile application format consisting of two distinct parts: (1) a story-driven game and (2) a Knowledge Portal. The data were analysed using phenomenographic methods. The perceptions of Childbirth Journey by healthcare professionals, midwives and child healthcare nurses are presented in four descriptive categories: extended professional support, trustworthy contents, diversity or individuality, and both appealing and in need of development. Current study revealed that Childbirth Journey may be utilised as a digital support for parents, allowing healthcare professionals to offer a digital solution as a complementary support to standard, face-to-face meetings with caregivers. However, the research results also revealed that some elements of Childbirth Journey must be improved, thereby representing a main contribution of this study: insights into how to better develop digital tools under the umbrella of health care. Thus, we conclude that in order to create sustainable and safe digital care solutions that function as trustworthy professional supports instead of technical products that risk harming users, the perspectives of both patients and healthcare professionals should be considered in the exploration and development of these solutions.

Dental professionals participating in a home visiting programme for first-time parents.

A home visiting programme was offered to first-time parents in the south of Sweden to reduce health inequalities among young children and support parents. The programme involved a collaboration between child healthcare nurses and midwives, social workers, and dental hygienists/dental nurses. It is unusual for dental professionals to participate in such programmes. To describe the experiences of collaboration between child healthcare nurses and dental professionals and their views on the programme from a dental perspective. Qualitative semi-structured interview study with content analysis. Four child healthcare nurses, three dental hygienists, and two dental nurses. Analysis identified five themes: contribution of knowledge, reinforced oral health advice, family-based oral health advice, financial considerations, and future role of the dental care. Participants stressed the importance of dental professionals' knowledge, the need for child healthcare nurses and dental professional to conduct home visits together to deliver family-based and reinforced dental advice. They suggested a follow-up visit and the participation of the public dental service before a private dental care provider since most children will visit a public dentist later. The programme was perceived as worth the costs, but for the best utility, the resources should primarily be for non-native parents. Further research should focus on the effect of the home visiting programme on the children's oral health.

User experiences of an app-based mHealth intervention (MINISTOP 2.0) integrated in Swedish primary child healthcare among Swedish-, Somali- and Arabic-speaking parents and child healthcare nurses: A qualitative study.

Preventive and scalable interventions, accessible to all, to counteract childhood obesity are urgently needed. We have recently developed a novel, digital parental intervention (MINISTOP 2.0 app) available in Swedish, Somali, Arabic and English. We have previously reported its positive effects on children's health behaviors and on parental self-efficacy. However, before introducing the app at scale in primary child healthcare, implementation aspects also need to be explored. This study aims to explore and describe user experiences as well as acceptability and feasibility of the MINISTOP 2.0 app-based intervention in a diverse group of parents (end-users) and Swedish child healthcare nurses (implementers). Individual interviews were conducted with Swedish- (n = 9), Somali- (n = 9), Arabic- (n = 5) and English-speaking (n = 1) parents as well as Swedish primary child healthcare nurses (n = 15). Data was analyzed using content analysis with an inductive latent approach. Parents described how the app facilitated behavior change through increased awareness regarding current diet and physical activity behaviors. Furthermore, the evidence-based app content further facilitated trust and behavior change. Both parents and nurses acknowledged the app's preventive potential and the potential for reaching parents with diverse backgrounds or in need of extra support. The MINISTOP 2.0 app was perceived as a useful tool for health promotion both by parents and healthcare professionals, especially since it was adapted to several languages. These findings coupled with the previously shown beneficial effects on health behaviors support the large-scale implementation of the app in primary child healthcare.

Lessons learned from child health care nurses' experiences of teaching infant massage groups: A qualitative interview-based study.

To describe child health care nurses' experiences of teaching infant massage in parent groups. This was an exploratory-descriptive qualitative study based on individual interviews. Qualitative semi-structured interviews were conducted with child health care nurses (N=9) according to the COREQ guidelines and analyzed with qualitative content analysis. Five categories were identified: (1) Infant massage can promote attachment between parents/guardians and their children; (2) Infant massage can have a calming impact; (3) Stress and lack of time can be challenging; (4) The composition of parent groups can be important and (5) The child health care nurse can observe parents'/guardians' relationships with their children. Child health care nurses are uniquely familiar with infant massage and the benefits it provides both parents/guardians and their infants. Specifically, infant massage has a calming effect that reduces stress and strengthens the relationship between infants and their parents/guardians. Child health care nurses were interviewed.

Mobile phone-based lifestyle support for families with young children in primary health care (MINISTOP 2.0): Exploring behavioral change determinants for implementation using the COM-B model.

Obesity in childhood is a public health concern worldwide and mobile phone-based interventions (mHealth) has shown to facilitate obesity prevention. However, more research is needed on the implementation of digital tools in routine primary care. This study explored behavior change determinants for implementing a health promotion mHealth intervention (MINISTOP 2.0 app) targeting parents of 4-year-olds. Secondary data from telephone interviews (n = 15) with child health care nurses working within primary child healthcare in Sweden was analyzed using directed content analysis and the COM-B model. Barriers for implementation included: limited knowledge about using technology and reservations about how and to what extent parents would use mHealth. Potential facilitators included nurses' openness to learn and try new tools, confidence in their role and engagement in reaching parents as well as beliefs that the app could improve practice by prompting dialogue and being a shared platform. Nurses expressed a strong professional identity and shared understanding of their practice, mechanisms that could potentially inhibit or facilitate implementation. Findings suggest cautious optimism regarding implementing mobile phone-based tools in child primary healthcare in terms of capability, opportunity and motivation among stakeholders. Implementation strategies such as educational outreach visits and making the intervention testable among stakeholders could further facilitate implementation in this clinical context. However, more research is needed on behavior change determinants in different stages of real-world implementation.

Child health care nurses' cultural competence in health visits with children of foreign background.

The aim of this study is to investigate child health care nurses' cultural competence in health visits with children and their families of foreign background. A cross-sectional design combined with a qualitative explorative design. The nurses assessed their cultural competence using a modified version of the Clinical Cultural Competency Questionnaire. Interviews were used to obtain a detailed description of the nurses' cultural competence. The nurses assessed themselves as rather culturally competent. They scored above mid-score in the total score for cultural competence and on all subscales. Education in cultural diversity at the nurses' workplace had the highest association to cultural competence. The nurses described their awareness as recognizing each child and her/his family rather than their cultural background, and viewing the child as a unique part of her/his cultural context. Despite their high scores on cultural competence, the nurses described a lack of cultural knowledge and explained their need of further knowledge.

Forms of professional interkinesthesia in nurses' body work: A case study of an infant's stepping

Moving their bodies in knowledgeable and professional ways in order to handle and connect affectively with infants entails a large part of child health care nurses' work. We deploy a phenomenological approach to videoanalysis of interaction to analyze an episode of a 1-month-old infant visiting the child health care clinic with their caregiver to have their body assessed for a neonatal stepping. Focusing on the co-movement of the baby and the nurse, we ask: how do various ways of moving as a co-embodied entity allow and corporeally prompt the baby's age-appropriate bodily ability to emerge? We develop the notion of professional interkinesthesia to indicate specific forms of body work of nurses which in this case entails moving together with the baby to make her successfully perform a specific health care task—the stepping. Building on Charles Goodwin's concept of professional vision, we uncover how the nurse moves and touches the infant's body in ways relevant to the institutional task. The study shows that accomplishing “normally” developed neonatal stepping is not work accomplished by the baby alone but requires that the bodies of the baby and the professional move in unison. While neonatal stepping is but one specific type of health care task, we propose that nurses' work entails numerous forms of professional touch and interkinesthesia that make it possible to successfully perform different types of health care operations.

Professionals' experiences of supporting two-mother families in antenatal and child health care in Sweden.

In Sweden, antenatal and child health care are offered free of charge to all expectant and new parents. Professionals in antenatal and child health care play an important role in supporting parents. Previous research shows that same-sex mothers face heteronormative assumptions and insufficient support during their transition to parenthood. To explore professionals' experiences of supporting two-mother families in antenatal and child health care. A qualitative method with focus group discussions was used. An interview guide was followed, and the discussions were held online. The data was analysed according to inductive content analysis. The participants were midwives (n= 8) and nurses (n= 5) in antenatal and child health care from different parts of Sweden. Participants were recruited through the coordinating midwives and child health care nurses in the different regions. One main category was identified: Striving to be open-minded in supporting same-sex mothers. Health care professionals described meeting well-prepared mothers, with an equal commitment between each other, and mothers on guard against heteronormative views. Professionals provided support through empowerment by creating a safe environment and aiming at providing equal support to all parents or tailored support to same-sex mothers. Mothers described handling challenges, as a balancing act to acknowledge both mothers. Struggling with documents and communication and a lack of information were other challenges to be handled. Professionals reflected on their own professional competence and expressed that knowledge acquired through education, experience and personal interest all contributed to their competence. Forms and documentation need to be updated to be gender neutral to be including to a variety of family constelleations. Health care professionals need time to reflect on norms and challenges to better support both mothers in a two-mother family.

Parental sociodemographic characteristics and mental health referrals by nurses in Swedish child health centres.

AimTo explore the influence of parents' socio‐economic characteristics on child healthcare nurses' mental health referrals of 3‐ to 5‐year‐olds and also to test the association between mental health problems and referrals.MethodsRepeated cross‐sectional data including parents' Strengths and Difficulties Questionnaire (SDQ) assessments and referral data (psychologist and speech and language pathologist). Hierarchical regression was used to analyse whether parents' country of birth, education level, marital status and mental health problem scores (SDQ; total difficulties and impact scores) were associated with nurses' referrals.ResultsAbout 9% of mothers and 12% of fathers rated high SDQ scores (total difficulties) in their children. Approximately, 1% of the children were referred. The influence of parents' socio‐economic characteristics on referral rates was not observed. However, for children with Swedish‐born mothers, referral rates were significantly lower. Scores for SDQ total difficulties and impact were associated with the child's referral to specialists.ConclusionIn general, parental sociodemographic characteristics do not influence Swedish child healthcare nurses' mental health referrals. Although there was a significant association between problem behaviour and referral, a disproportion between children rated with high SDQ scores (9% and 12%) and children referred to specialists (1%) should be addressed.

Interprofessional Teamwork to Promote Health: First-Time Parents' Experiences of a Combined Home Visit by Midwife and Child Health Care Nurse.

BackgroundTo achieve the requisites for a child's healthy development and to reduce health inequalities, it is important to promote health initiatives at an early stage in a child's life and to include the parents. Home visits by healthcare professionals have been found to have positive health effects for both the baby and the parents. From an extended home visit programme in Sweden, our aim was to illuminate first-time parents' experience of a home visit conducted by a midwife and a child health care nurse 1–2 weeks postnatal.MethodsData was collected by interviews (n = 13) with first-time parents. The transcribed texts were analyzed using inductive content analysis.ResultsThe participants' experiences could be understood from the two themes, A trust in the professionals and Feeling safe as a new parent. The participants experienced that the midwives and the child health care nurses complemented each other and appreciated to get knowledge and information from both professions. In their own home, they felt secured and relaxed, and the professionals could help them provide a safe home environment for the child.ConclusionBy meeting both professionals at the same time and in their own home, the participants experienced that the needs of the baby and their needs and concerns as new parents were included and supported.

The Existential Breastfeeding Difficulty Scale's influences on the caring dialogue-Child healthcare nurses' lived experiences.

Breastfeeding is experienced as an existential journey, and breastfeeding difficulties put mothers in existentially vulnerable situations. For care to be caring, it must be based on the mother's breastfeeding story. Previous research show that healthcare professionals struggle to perform individualised breastfeeding care. The Existential Breastfeeding Difficulty Scale (ExBreastS) was developed to support an existential focus in caring dialogues and was introduced in child healthcare in Sweden.The aim of this study is to describe child healthcare nurses’ lived experience of how the Existential Breastfeeding Difficulty Scale (ExBreastS) influences the caring dialogue.Seventeen child healthcare nurses with experience in using ExBreastS as a basis for caring dialogues with breastfeeding mothers were interviewed, in groups, pairs or individually. The interviews were analysed using a thematic analysis based on descriptive phenomenology.The results show that the caring dialogue becomes re‐evaluated when using ExBreastS because existential aspects of breastfeeding is acknowledged. ExBreastS also visualises new perspectives of the mother's breastfeeding experiences. However, the use of ExBreastS also risks overshadowing the caring dialogue when the nurses focus too much on the instrument.The use of ExBreastS supports caring dialogues—and caring care—by highlighting the existential aspects of breastfeeding/breastfeeding difficulties and the uniqueness of every mothers’ breastfeeding experience. However, the instrument sometimes evokes a vulnerability in the nurses that calls for support from the care organisation.

Assessing and promoting responsive interaction between parents and children – A qualitative study of the experiences of child health care nurses in Sweden

PurposeOne of the main tasks of a child health care nurse is to assess and promote a responsive interaction and secure connection between children and their parents for the future. This study aims to develop an understanding of Swedish child health care nurses´ experiences of assessing and promoting responsive interaction between parents and children. Design and methodA qualitative interview study using an inductive approach was implemented. Eleven nurses were interviewed (range: 30–58 min) during the period March to August 2016, and the transcripts were analysed using qualitative content analysis according to Graneheim and Lundman. ResultsThree categories emerged: Interpreting signals in parent and child behaviour, Reinforcing the parents in their role and Feeling inadequate as professional. Interpreting signals in parent and child behaviour was described fundamental when promoting responsive interaction. Further reinforcing the parents in their role was described central. The child health care nurses also described how they often felt inadequate in promoting responsive interaction. ConclusionsAssessing and promoting responsive interaction is an important but challenging task which requires extensive knowledge and good communication skills. The child health care nurses express their insufficiency in that regard. Practice implicationsA targeted education and sufficient time for each visit at the child health care center should be allocated to facilitate the important work on parenting and child interaction and to enhance nurses' feelings of managing their work.

Middle Managers’ Views on Participation in a Home Visiting Program for First-Time Parents in Scania, Sweden

Family home visiting programs delivering early childhood services are supported by politicians and policy makers in many countries. This study focuses on a home visiting program for first-time parents in a county in Sweden. The program comprises six home visits conducted by interprofessional teams, including child healthcare nurses, midwives, social workers and dental hygienists, with the aim to increase accessibility to child healthcare and to promote more equal health in young children. Child healthcare, maternal care, social services and dental care organisations participated voluntarily in the program. This study explores how middle managers of the participating organisations view the program. Data were collected from semi-structured interviews with ten middle managers. The interviews were analysed using qualitative content analysis as a method. The results show that the middle managers saw the home visiting program as beneficial for society, parents and children, and the participating organisations and professionals. In other words, they expressed both altruistic goals and a self-interest in participating. The study is of importance as middle managers’ decision to participate in a home visiting program might be grounded on their perceptions of the program.