Maternal involvement and outcomes in nurse home visiting

Purpose– Home visiting is a strategy widely implemented to support families following the birth of a baby. There is a broad consensus that home visiting programmes are successful. But there is little understanding of factors moderating this success. The purpose of this paper is to examine the relationship between maternal involvement in a nurse home visiting programme, maternal depression, and adjustment to the parenting role.Design/methodology/approach– A retrospective design was employed in which the medical records of 40 mothers who had been enroled in a nurse home visiting programme were examined. The number of nurse home visits from birth to six months, maternal depressive symptoms, Home Observation for Measurement of the Environment (HOME) and responsivity scores were examined. Mothers had been selected for the programme if they had a history of mental illness, were in a violent relationship, or reported drug or alcohol problems.Findings– A significant, positive relationship was found between maternal involvement, positive HOME environment and maternal responsivity scores. Furthermore, the mothers with the highest scores for HOME environment and responsivity to their infant ' s cues at six months were mothers experiencing deteriorating symptoms of depression. These mothers had the highest levels of involvement with the programme. Despite their mothers’ deteriorating mental health, infants whose mothers received the greatest number of visits from a nurse received the greatest benefit ameliorating their risk for developing poor attachment and impaired behavioural, emotional and cognitive development.Originality/value– This is the first study to examine the relationship between changes in maternal depression and programme outcomes in a home visiting programme. It is one of the first explorations of the relationship between maternal involvement and programme outcomes in a targeted nurse home visiting programme to prevent child maltreatment. The findings from this study are critical to future home visiting programme development and evaluation.