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ObjectiveNurse home visiting (NHV) is designed to redress child and maternal health inequities. Of the previous trials to investigate NHV benefits beyond preschool, none were designed for populations with universal healthcare. To address this evidence gap, we investigated whether the Australian ‘right@home’ NHV programme improved child and maternal outcomes when children turned 6 and started school.MethodsA screening survey identified pregnant women experiencing adversity from antenatal clinics across two states (Victoria, Tasmania). 722 were randomised: 363 to the right@home programme (25 visits promoting parenting and home learning environment) and 359 to usual care. Child measures at 6 years (first school year): Strengths and Difficulties Questionnaire (SDQ), Social Skills Improvement System (SSIS), Childhood Executive Functioning Inventory (CHEXI) (maternal/teacher-reported); general health and paediatric quality of life (maternal-reported) and reading/school adaptation items (teacher-reported). Maternal measures: Personal Well-being Index (PWI), Depression Anxiety Stress Scales, warm/hostile parenting, Child-Parent Relationship Scale (CPRS), emotional abuse and health/efficacy items. Following best-practice methods for managing missing data, outcomes were compared between groups (intention-to-treat) using regression models adjusted for stratification factors, baseline variables and clustering (nurse/site level).ResultsMothers reported on 338 (47%) children, and teachers on 327 (45%). Patterns of group differences favoured the programme arm, with small benefits (effect sizes ranging 0.15–0.26) evident for SDQ, SSIS, CHEXI, PWI, warm parenting and CPRS.ConclusionsFour years after completing the right@home programme, benefits were evident across home and school contexts. Embedding NHV in universal healthcare systems from pregnancy can offer long-term benefits for families experiencing adversity.Trial registration numberISRCTN89962120.

To explore whether lay support for government funding of colorectal cancer (CRC) screening is influenced by framing effect. Consecutive sample of patients attending GPs in central Sydney, an urban region with poor population health outcomes. In our self-administered survey, patients were asked to rate their level of support for government funding of each of three CRC screening programs where benefits were expressed first as a relative risk reduction (RRR); second, as absolute risk reduction (ARR); or, third, number needed to screen (NNS). We received 1,137 responses (67% response fraction). There was significantly greater support for funding of the program whose benefits were expressed as RRR than either ARR (McNemar's test: 21=60.1, p<0.001) or NNS (McNemar's test: 21=143.0, p<0.001). Respondents who were influenced by ‘framing effect’ were significantly and independently more likely to speak English at home and to have completed higher levels of formal education than others. Among GP patients, support for funding of CRC screening is significantly influenced by the way information about its benefits is conveyed. This ‘framing effect’ also appears to be moderated by socio-demographic characteristics. Our findings invite clarification of public views about the value of CRC screening as part of pilot projects funded by the Commonwealth Government.

To evaluate response‐aiding strategies feasible in large surveys, we randomly allocated general practitioners (GPs) to one of four intervention groups: Group 1 received ‘exhaustive’ telephone prompts by a medical peer in advance of a questionnaire; Group 2, inclusion of an embossed pen with the questionnaire; Group 3, an advance letter prompt; and Group 4, a ‘single attempt’ advance telephone prompt by a non‐medical research assistant. Follow‐up procedures were identical. Response rates by group were not significantly different overall (χ24.59, df=3, p=0.20) although advance prompts by a medical peer were significantly more effective than other strategies for male GPs. The difference in overall response rates between males (63%) and females (74%) was significant (χ2=15.40, df=1, p<0.01). No other response bias was evident. Our demonstration of a significant interaction between respondent sex and response‐aiding strategy invites further research.

To evaluate response-aiding strategies feasible in large surveys, we randomly allocated general practitioners (GPs) to one of four intervention groups: Group 1 received ‘exhaustive’ telephone prompts by a medical peer in advance of a questionnaire; Group 2, inclusion of an embossed pen with the questionnaire; Group 3, an advance letter prompt; and Group 4, a ‘single attempt’ advance telephone prompt by a non-medical research assistant. Follow-up procedures were identical. Response rates by group were not significantly different overall (χ24.59, df=3, p=0.20) although advance prompts by a medical peer were significantly more effective than other strategies for male GPs. The difference in overall response rates between males (63%) and females (74%) was significant (χ2=15.40, df=1, p<0.01). No other response bias was evident. Our demonstration of a significant interaction between respondent sex and response-aiding strategy invites further research.