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The parent-baby unit at the Jean-Verdier hospital in Seine-Saint-Denis offers outpatient and mobile care. Migrant families in extremely precarious situations, often with traumatic histories, are met. Home visits facilitate access and continuity of care. Nonetheless, this work and the broader context in which it is carried out have an impact on the therapists' experience and care methods. This makes it all the more essential to have a co-therapy system in place, to take primary needs into account and to support mothering care in therapeutic work., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

In recent years, medical staff including physicians and nurses have been participating in home health care, reflecting the needs of an aging society in Japan. Pharmacists are also asked to work on home health care teams to ensure the medical safety of patients. It currently remains unclear whether direct communication, i.e. a meeting, between home-visiting physicians and pharmacists contributes to the proper use of medications and continuous medical care. We retrospectively analyzed the medication management guidance records of home-visited patients who received their first home visit between April 2014 and March 2017. We collected data on pharmacist inquiries, the duration of visits, and details from a meeting between home-visiting physicians and pharmacists. Thirty-five patients were included. At the first visit, the inquiry rate by pharmacists was 65.7%. The prescription question rate was significantly lower in patients with a meeting than in those without (p=0.033). The average duration of visits was significantly shorter for home-visited patients whose health care providers had a meeting (p=0.007). These results suggest that pharmacists who held a meeting with the home-visiting physician before the first patient visit were able to resolve drug-related issues earlier, which increased the work efficiency of home-visiting pharmacists., Competing Interests: No potential conflict of interest relevant to this article was reported.

Aim: To describe paediatric postdischarge concerns manifesting in the first 96 hr after hospital discharge., Design: Analysis of nursing documentation generated as part of a randomized controlled trial evaluating the effect of a nurse home visit on healthcare re-use., Methods: We analysed home visit records of 651 children (age <18) hospitalized at a large Midwestern children's hospital in 2015 and 2016 who were enrolled in the trial. Registered nurses documented concerns in structured fields and free-text notes in visit records. Descriptive statistics were used to summarize visit documentation. Free-text visit notes were reviewed and exemplars illustrative of quantitative findings were selected., 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., Impact: Little empirical data are available describing concerns manifesting immediately after paediatric hospital discharge. Concerns about medication safety were most frequent followed by concerns related to housing and general safety. The results are important for clinicians preparing children and families for discharge and for community clinicians caring for discharged children., (© 2020 John Wiley & Sons Ltd.)

Background: Early postpartum facility discharge negatively impacts mothers' proper and effective use postnatal care. Cognizant of these facts, home-based postnatal care practices have been promoted to complement facility-based care to reduce neonatal mortality. This systematic review evaluated the effectiveness and cost-effectiveness of home-based postnatal care on exclusive breastfeeding practice and neonatal mortality in low-and-middle-income countries., Methods: Randomized trials and quasi-experimental studies were searched from electronic databases including PubMed, Popline, Cochrane Central Register of Controlled Trials and National Health Service Economic Evaluation databases. Random-effects meta-analysis model was used to pool the estimates of the outcomes accounting for the variability among studies., Results: We identified 14 trials implementing intervention packages that included preventive and promotive newborn care services, home-based treatment for sick neonates, and community mobilization activities. The pooled analysis indicates that home-based postpartum care reduced neonatal mortally by 24% (risk ratio 0.76; 95% confidence interval 0.62-0.92; 9 trials; n = 93,083; heterogeneity p < .01) with no evidence of publication bias (Egger's test: Coef. = - 1.263; p = .130). The subgroup analysis suggested that frequent home visits, home visits by community health workers, and community mobilization efforts with home visits, to had better neonatal survival. Likewise, the odds of mothers who exclusively breastfed from the home visit group were about three times higher than the mothers who were in the routine care group (odds ratio: 2.88; 95% confidence interval: 1.57-5.29; 6 trials; n = 20,624 mothers; heterogeneity p < .01), with low possibility of publication bias (Coef. = - 7.870; p = .164). According to the World Health Organization's Choosing Interventions that are Cost-Effective project recommendations, home-based neonatal care strategy was found to be cost-effective., Conclusions: Home visits and community mobilization activities to promote neonatal care practices by community health workers is associated with reduced neonatal mortality, increased practice of exclusive breastfeeding, and cost-effective in improving newborn health outcomes for low-and-middle-income countries. However, a well-designed evaluation study is required to formulate the optimal package and optimal timing of home visits to standardize home-based postnatal interventions.

Objective The objective of this study is to consider the role of universal nurse home visiting in the postpartum period as a potential strategy to promote women's postnatal health. This study was derived from a formative research project aimed at understanding the early implementation of the Illinois Family Connects (IFC) universal postpartum home visiting program as perceived by key informants. Methods Data from eighteen key informant (KI) interviews conducted between January and February 2018 and quantitative data extracted from reports from two IFC pilot counties were analyzed. Qualitative data were analyzed using Dedoose Version 8.0. Results Data suggest that universal postpartum nurse home visiting has appeal as a postpartum women's health strategy. The data also suggest that the success of such a strategy likely depends on: the value women, families, and community stakeholders attach to the program; the appeal of its universality and the support for home visiting by nurses in particular; the processes adopted by the hospitals and agencies implementing the program; strategies for engaging women after leaving the hospital; and, the initial and ongoing marketing of the program, which ultimately may affect women's willingness to participate. Conclusions for Practice Universal early postpartum home visiting is not a substitute for a woman's visit with a medical provider; however, it should be viewed not only as an early childhood program but an important strategy for improving the delivery of postpartum care for women.

Background: Gastrointestinal cancer is the third most common types of cancer in the world which leads to a lot of stress among sufferers. Pharmacological and non-pharmacological approaches are used to treat stress induced by serious diseases. Eye movement desensitization and reprocessing (EMDR) technique is considered as one of non-pharmacological method for decreasing patient’s stress. Objective: This study was conducted to determine the effect of home care using EMDR technique on the stress of patients with gastrointestinal cancer. Materials and Methods: The current semi-experimental study was performed on patients with gastrointestinal cancer residing in Ilam, Iran. The patients were randomly divided into two groups of intervention (n=30) and control (n=30). Home care was provided for intervention group in patients’ homes which included 2 sessions (a total of 60 sessions for all patients). Each session lasted for 45 to 60 minutes according to EMDR protocol. The data were analyzed using SPSS (version 16). Results: The findings of this study showed that most of patients were male (36, 60%), had diploma degrees (44, 73.3%), had a monthly income less than 500 thousand (38, 63.3%), were married (39, 65 %). The mean age of the patients was 69.18 ± 11.58 years. No statistically significant difference was observed between two groups before the intervention in terms of patients’ perceived stress (P>0.05). However, efficacy and perceived distress of the intervention group significantly was decreased following the intervention (P<0.05). Conclusions: According to the findings regarding the impact of home care using EMDR technique on reducing stress in patients with gastrointestinal cancer, the implementation of this intervention and provision of education for patients are recommended to expand the nursing duty to community health wards as well as to improve the health status of patients.

Purpose: Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death., Methods: A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient's profile, disease status, functional status, patient's symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient's actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home., Results: A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38)., Conclusion: Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand.

Objectives: To characterize the elderly population and their caregivers and to verify the association of depressive symptoms of the elderly and the caregiver's burden with the variables of interest., Methods: A cross-sectional study with 80 elderly people and 78 caregivers in a Primary Health Service in southern Brazil. Retrospective collection conducted in a structured database based on the multidimensional evaluation tool applied to home care for the elderly participants and their caregivers., Results: Most elderly participants were women (71.3%), with an average age of 82.1 years and 52.6% reported sadness or discouragement. Systemic arterial hypertension was the most frequent morbidity (68.8%). Most caregivers were women (85.7%), daughters of the elderly person (53.2%), mean age 57.8 years and 38.7% reported feeling the burden. The presence of depressive symptoms in the elderly was associated with Parkinson's disease (p=0.016) and to have a male caregiver (p=0.006). Caregiver's burden was associated with daily life activities such as bathing (p=0.021)., Conclusions: There was evidence of differences in caregiver's gender in the presence of depressive symptoms and differences in the assistance in daily life activities for the caregiver's burden., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Universidad de Antioquia.)

Background: Physician-led home visit care with medical teams (Zaitaku care) has been developed on a national scale to support those who wish to stay at home at the end of life, and promote a system of community-based integrated care in Japan. Medical care at the end of life can be expensive, and is an urgent socioeconomic issue for aging societies. However medical costs of physician-led home visits care have not been well studied. We compared the medical costs of Zaitaku care and hospital care at the end of life in a rapidly aging community in a rural area in Japan., Methods: A cross-sectional study was performed to compare the total medical costs during patients' final days of life (30 days or less) between Zaitaku care and hospital care from September 2012 to August 2013 in Fukuoka Prefecture, Japan., Results: Thirty four patients died at home under Zaitaku care, and 72 patients died in the hospital during this period. The average daily cost of care during the last 30 days did not differ significantly between the two groups. Although Zaitaku care costs were higher than hospital care costs in the short-term (≦10 days, Zaitaku care $371.2 vs. Hospital care $202.0, p = 0.492), medical costs for Zaitaku care in the long-term care (≧30 days) were less than that of hospital care ($155.8 vs. $187.4, p = 0.055)., Conclusions: Medical costs of Zaitaku care were less compared with hospital care if incorporated early for long term care, but it was high if incorporated late for short term care. For long term care, medical costs for Zaitaku care was 16.7% less than for hospitalization at the end of life. This physician-led home visit care model should be an available option for patients who wish to die at home, and may be beneficial financially over time.

Aim: Associations between markedly low activities of daily living (ADL) at the start of home visit care and patient home death were analyzed using data from a home care support clinic in Japan that has a low rate of home deaths., Methods: The study was a historical cohort study. It involved patients who began to receive home visit care from a home visit care support clinic between 1 April 2006 and 31 March 2011. Using home death as a dependent variable and presence/absence of markedly low ADL and other parameters (cancer, the patient's desire for home death, etc.) as independent variables, the adjusted hazard ratio and 95% confidence interval (CI) were calculated using the Cox proportional hazards model., Results: Markedly low ADL were associated with home death even after adjustment for factors that influence home death (adjusted hazard ratio 4.40; 95% CI 2.37-8.16). Cancer and the patient's desire for home death were statistically significant factors involved in home death. In a subgroup analysis according to the presence/absence of cancer, the association between markedly low ADL and home death was stronger in the cancer-free group (adjusted hazard ratio 10.78; 95% CI 2.89-40.26) than in the cancer group (adjusted hazard ratio 5.58; 95% CI2.39-13.05)., Conclusion: Patients' desire for home death could be fulfilled if home care support clinics provide home visit services to not only terminal-stage cancer patients, but also bedridden cancer-free patients. We must establish systems for older adults to remain at home during the terminal period of their lives., (© 2012 Japan Geriatrics Society.)

Background: Low–middle-income countries (LMICs) face increasing burdens from non-communicable disease (NCDs) requiring primary care task shifting to community health workers (CHWs). This study explored community members' perceptions of NCD-focused, CHW-led home visits in a historically disadvantaged township of South Africa. Methods: Trained CHWs visited community member homes, performing blood pressure and physical activity (PA) screenings, followed by brief counselling and a satisfaction survey. Semi-structured interviews were conducted within 3 days of the visit to learn about their experiences. Results: CHWs visited 173 households, with 153 adult community members consenting to participate (88.4%). Participants reported that it was easy to understand CHW-delivered information (97%), their questions were answered well (100%), and they would request home service again (93%). Twenty-eight follow-up interviews revealed four main themes: 1) acceptance of CHW visits, 2) openness to counselling, 3) satisfaction with screening and a basic understanding of the results, and 4) receptiveness to the PA advice. Conclusion: Community members viewed CHW-led home visits as an acceptable and feasible method for providing NCD-focused healthcare services in an under-resourced community. Expanding primary care reach through CHWs offers more accessible and individualized care, reducing barriers for individuals in under-resourced communities to access support for NCD risk reduction. [ABSTRACT FROM AUTHOR]

Psychiatric rehabilitation is to assist disabled people in developing the emotional, social, and cognitive skills required to live, learn, and work in the community with the least amount of professional assistance. The goal of the current case study revealed that support from family, friends, community, treating mental health professionals, and drug compliance contributes to the recovery. Many persons with mental illness will experience disability which becomes a barrier to regular follow-up. The needs of severely disabled people are often neglected or not met adequately by mental health professionals, family, and the community. They do not understand what is happening in the community and the home environment. Therefore, the current case study made an effort to know the actual situation of mentally disabled people in their home environment and evaluated psychiatric rehabilitation needs. A case study was presented in detail with findings of the home visit and the strengths and weaknesses of the home visit from a social work perspective. The case study concludes that community attitude; the economic burden was one of the leading causes of barriers to psychiatric rehabilitation in India. [ABSTRACT FROM AUTHOR]

Purpose: Little empirical data exists evaluating the feasibility of partnering with established home visiting programs to implement early childhood obesity prevention programs, despite the recommendation to do so. To inform this gap, we evaluated the feasibility of collecting anthropometric measurements of children by home visitors across multiple sites, and the alignment of these measurements with children in need, including with adverse family experiences (AFEs) given emerging evidence suggests an association with childhood obesity. Description: Our proof-of-concept study included primary data collection of child anthropometric measurements through an established home visiting program in four states. This sample included 248 children ages 6 months to 5 years. Assessment: In the sample, 37.1% of the children had overweight or obesity, 50% were female, 64.2% Hispanic/Latinx, 15.8% non-Hispanic Black, and 42.3% from rural/small towns. Households included substantial needs: 87.1% were low income, 73.8% low education, and 59.3% underemployment. Regarding AFEs, 38.3% of the children had at least one, with the most common being mothers who were treated violently. A multivariable model revealed community type, not AFEs, was significantly associated with overweight/obesity status, suggesting children in suburban and especially rural/small town residences (odds ratio 5.11; 95% CI [1.59, 16.39]) could be priority populations for childhood obesity prevention programs. Conclusion: Findings of this multi-site study inform the feasibility of partnering with home visiting programs to reach and measure a diverse sample of children and families in need of childhood obesity prevention. Significance: What is already known on this subject? Home visiting programs are a recommended gateway for early childhood obesity prevention efforts, but the feasibility of implementing this recommendation is understudied. What this study adds? This multi-site, multi-state study evaluated the feasibility of collecting anthropometric measurements through an established home visiting program, including the ability to reach children with overweight or obesity, from diverse backgrounds, and with adverse family experiences. This is an important step before implementing and scaling an early childhood obesity prevention program. Findings inform the development of childhood obesity prevention partnerships with home visiting programs. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article explores a male first-time stroke patient who was a low-income single parent taking care of three minors. During interviews, the case's low moods were observed leading to motivation for further investigation. The nursing period was from September 3 to September 10, 2019. By providing care, conducting interviews, and using Gordon's 11 functional health patterns for assessment, a cross-disciplinary team collaborated on the care model and conducted a home visit on the day after discharge. Several health problems were confirmed: Ineffective health maintenance ability, physical activity impairment, and anxiety. Through a good nurse-patient relationship, care guidance was provided, and the patient was accompanied and listened to, which helped improve anxiety, encouraged rehabilitation, and achieved seamless home care and rehabilitation. During the home visit, the home environment was found to be dirty and disorganized. Through community resources, the environment was improved and more social resources were obtained. It is suggested that hospitals should establish care teams to deepen community involvement, provide assistance through home visits, ensure proper home care for the patient, reduce the chance of rehospitalization, enhance the quality of home care, and reduce the consumption of medical resources. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the effect of a home visit program on the perceived care burden of family caregivers of adults with asthma. Design: A single‐blind randomized controlled trial. Sample: The study was conducted with 30 participants in both the intervention and control groups. Measurements: Care burden was measured via the Zarit Caregiver Burden Scale during the first interview at the pulmonology outpatient clinic and after the last home visit. Intervention: A nurse‐led home visit program with five visits over three months included education and health counseling with the intervention group. Control group received standard education given in the outpatient clinic. Results: The mean Zarit Caregiver Burden Scale scores of the intervention group in the post‐test were significantly lower than the control group. Conclusions: The current study revealed that the nurse‐led home visit program, including education and health counseling, was effective in reducing the care burden for family caregivers of adults with asthma. Nurses can play an active role in preventing the negative effects of caregivers' burden of care, protecting their sense of control, and improving their health. Home visits integrated into the health care system could be effective in reducing the care burden of family members. [ABSTRACT FROM AUTHOR]

Aim: To investigate reflections of public health nurses (PHNs) on implementing the New Families programme, a supplement to the usual Norwegian child health centre programme. It involves user‐led decisions on the content and number of home visits offered by the family's PHN from pregnancy week 28 until the child is 2 years. Design: An interpretive description approach. Methods: Altogether 206 anonymized, undated reflection notes by PHNs becoming familiar with the programme were collected in 2017–2020. NVivo 12 and inductive content analysis were used to convert the data into manageable segments. Results: Focusing on childhood experiences and parental role expectations among prospective parents during home visits was seen as a major shift in the nurses' counselling strategy. Providing relevant information to the parents‐to‐be ahead of a meeting was important. Given sufficient staff and guidance, the programme was considered a good basis for building a relationship with the family. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate acceptance of preventive home visits (PHVs) for older adults in rural Germany. Design: Qualitative descriptive approach. Sample: We investigated the personal, individual perspective of adults aged 65 to 85, who were not yet eligible for benefits from the long‐term care insurance, were able to understand and speak German, and who lived in the municipality under study. Measurements: Fifteen semi‐structured interviews were conducted between 02/2019 and 08/2020. They were transcribed, coded using MAXQDA, and content analyzed. Ethical approval was obtained. Results: The acceptance of PHVs was extremely high and characterized by five main effects: very close relationship with the nurse, well‐being, empowerment, satisfaction, ambivalence. Participants wish to receive PHVs in the future and would recommend it to others. Even those with a healthy or health‐promoting lifestyle are thankful to be able to refer to the counselling sessions if life circumstances should deteriorate. Those who became care‐dependent wish to continue and perceive it as a valuable addition to their care. Conclusion: From the participants' point of view, this low‐threshold counselling‐and‐support approach should be maintained in the future. PHVs can support health and independence in older adults and therefore prevent them from becoming care‐dependent. [ABSTRACT FROM AUTHOR]

Background: Pediatric home-based palliative care and/or hospice provider (Physician, Advanced Practice Nurse, or Physician Assistant) home visits are an underexplored subject in the literature with little available descriptive data and limited evidence guiding how best to utilize them. Objectives: Describe the population receiving hospice and palliative medicine (HPM) provider home visits and characterize visit themes. Design: Retrospective chart review of electronic medical record (EMR) data Setting/Subjects: A total of 226 individuals 1 month to 21 years of age, who received an HPM provider home visit from January 1, 2013, to December 31, 2018; two large quaternary medical centers in the Midwest. Measurements: Demographic data, content, and details from home visit abstracted from the EMR. Results: The three most common diagnostic groups receiving HPM provider home visits were neurological (42%), congenital chromosomal (26%), and prematurity-related (14%) conditions. Goals of care (GOC) were discussed at 29% of visits; most commonly, goals related to code status (42%), technology dependence (20%), and nutrition/hydration (15%). A change in GOC occurred in 44% of visits. Forms of anticipatory guidance addressed were nutrition (68%), side effects of treatment (63%), pain assessment (59%), decline/death (32%), and allow natural death/do not resuscitate/advance directives (26%). Conclusion: HPM provider visits are diverse in content and changes in plan of care with potential for proactive identification of GOC and provision of important anticipatory guidance around patient decline and end of life. Further research is indicated to establish which populations benefit most and how to leverage this scarce resource strategically. [ABSTRACT FROM AUTHOR]

Objective: Public health nurses in Norway provide a range of health promotion and primary prevention services to families in the postpartum period. The study objectives were to describe parents' experiences of: 1) being introduced to the Circle of Security Parenting program during a home visit and 2) participating in a parent group meeting. Design: Qualitative descriptive study. Sample: A purposeful sample of 24 caregivers (n = 15 mothers, n = 9 fathers) parenting an infant. Measures: In‐depth, semi‐structured interviews were conducted to document participants experiences. Content analysis was used to code and categorize the data. Findings: Three main categories with seven subcategories reflected the parents' experiences: 1) Confidence‐building home visit, 2) Awareness‐raising parental group, 3) Dissemination of knowledge. Conclusions: The parents experienced the home visit as being on their family's terms and reassuring. The parental group session started a reflection process which made them aware of the importance of being present for their child, how to modify their communication and have a common understanding of childrearing. The parents thought the group was a great way to introduce the Circle of Security Parenting program and experienced it as a continuation of the information presented at the home visit. The introduction provided them with new knowledge. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The significance of decisions made in the context of home visits is not doubted, yet little is known about how social workers form these decisions. This qualitative small-scale study investigated how decision-making may change with increased practice experience. The experiences of newly-qualified social workers (n = 2) and experienced practitioners (n = 2) were captured to explore key aspects of their use of knowledge. Key themes of emotion, intuition, judgement, interpretation, evidence-based reasoning and formal learning emerged for analysis. Over time the evidenced-based aspects of practice are seen to be valued more highly in social work reasoning, while the emotional elements of practice wane, and the study has critically reflected on the working environment for fostering this shift. Additionally, intuitive reasoning during home visits is prevalent in both groups. Whilst experienced social workers will be informed by previous practice experience, this study brings new understanding of decision-making by newly-qualified workers, and particularly their use of knowledge gained outside of social worker training. Regardless of experience, the narrative of the service user is found to be central to decision-making, and there is a vulnerability to this form of knowledge. [ABSTRACT FROM AUTHOR]

Background: Home visits are an important part of Geriatrics education for medical and dental students (MS), and the lessons learned by students from these experiences inform further curriculum development. A mixed methods analysis of students' lessons learned from a single Geriatrics home visit shapes the future focus and impact of similar educational programs to ultimately improve the care of older adults. Methods: Over a 3‐year period at Harvard Medical School, approximately 495 first year MS participated in an educational Geriatrics home visit to learn about the geriatric assessment. Three hundred and forty‐eight students completed voluntary anonymous evaluation forms, rating whether their interest in geriatrics increased after the home visit and describing two lessons learned. We analyzed the student responses and conducted a qualitative content analysis of the lessons learned, identifying major themes within the Geriatrics 5Ms Framework (Mobility, Mind, Medications, Multicomplexity, and Matters Most). Results: Most students (70.7%) reported their interest in Geriatrics somewhat or greatly increased after the home visit. Three hundred and ten students (89% of participants) reported 605 lessons learned; 174 students' lesson learned related to Multicomplexity (56.1%), and 158 students reported a lesson related to Mobility (51%). Discussion: After a Geriatrics home visit, a majority of students report an increase interest in Geriatrics. The most common lessons learned relate to Mobility and Multicomplexity, essential areas of focus in a Geriatrics curriculum. Educational home visits are an important opportunity to increase student interest in geriatrics and build their skills to improve the care of older adults using the Geriatrics 5Ms Framework. [ABSTRACT FROM AUTHOR]

Background: In this pilot study, the breastfeed care plus intervention program was implemented to support women and their families in breastfeeding success. Primary interests were women's self-efficacy in breastfeeding and exclusive breastfeeding. Methods: A pilot study was developed in the region of Aveiro–Portugal in two Family Health Units. The experimental and control groups consisted of sixteen women each, initially. Four home visits with assessment and guidance focused on breastfeeding support aimed at women and families were delivered in the experimental group, while the control group received conventional care. Both groups were followed between the 5th and the 120th day postpartum and were subjected to three evaluation moments. Results: On the 120th day postpartum, eleven women completed the BCP intervention program (three women stopped breastfeeding), and nine women received conventional care (seven women stopped breastfeeding). 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. Conclusions for Practice: 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. [ABSTRACT FROM AUTHOR]

Objective: To explore fathers' experiences with a Norwegian home visiting program during the prenatal period and the first‐year postpartum. Design: Qualitative design with interpretive description (ID) as the methodological approach. Sample: Individual interviews with fathers (n = 13) who received home visits by a public health nurse (PHN) within the New Families home visiting program. Measures: Interviews were guided by a semi‐structured interview‐guide, which contained open‐ended questions encouraging informants to reflect on their experiences with home visits. The analysis of the data was informed by content analysis. Results: Two main themes that reflect the fathers' experiences emerged: (1) The importance of being on their home ground captures the fathers' experience of receiving home visits and building a trusting relationship with the PHN. (2) Including fathers in the home visit represents their thoughts about the content and focus of the home visits. Conclusions: Fathers experienced the universal New Families home visiting program as an important contribution towards a more available and tailored service, with the home environment as a suitable arena for developing a trusting relationship with the PHN. However, the fathers often felt insufficiently included in the home visits, with only scant attention towards them as independent caregivers, their emotional reactions, roles, and family relationships. Pre‐birth home visits might contribute to strengthening preparations for fatherhood and increase fathers' engagement in the Child Health Service. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to explore the communication tools that child healthcare nurses can use during home visits to families when language barriers exist. Design: Qualitative study using data collected from focus group sessions. Sample: Six semi‐structured focus group interviews with twenty nurses in child healthcare services. Measurements: The results were analyzed with a thematic content analysis. Results: The analysis resulted in two themes: Using pictures as support in the conversation, with subthemes Not using pictures as support, Wanting to know how to use pictures as support, Pictures as support for invitations, Different types of pictures as support, and Alternative means of communication with the subthemes Possibilities of using an interpreter, Obstacles to using an interpreter, Mixed communication. Conclusion: If language barriers are present during home visits, decision‐making nurses in Child Health Care (CHC) put families in an unequal position when communicating with them. These results point to a need for more education, guidelines and support regarding alternative and augmentative communication (AAC) tools and structures to assist in overcoming language barriers. [ABSTRACT FROM AUTHOR]

Background: Little is known about clinicians' perspectives on the use of point of care (POC) tests in assessment of acute illness during primary care out of hours (OOH) care. During a service improvement project, POC tests (including creatinine, electrolytes, haemoglobin and lactate) were made available to clinicians undertaking OOH home visits, with the clinicians allowed absolute discretion about when and whether they used them. Method: To explore clinicians' perspectives on having POC tests available during OOH home visits, we undertook a qualitative study with clinicians working in Oxfordshire OOH home visiting teams. We conducted 19 Semi-structured interviews with clinicians working in OOH, including those who had and had not used the POC tests available to them. To explore evolving perspectives over time, including experience and exposure to POC tests, we offered clinicians the opportunity to be interviewed twice throughout the study period. Our sample included 7 GPs (4 interviewed once, 3 interviewed twice - earlier and later during the study), 6 emergency practitioners (EPs) including advanced nurse practitioners and paramedics, 1 Healthcare Assistant, and 2 ambulatory care physicians. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Results: The clinicians reflected on their decision-making to use (or not use) POC tests, including considering which clinical scenarios were "appropriate" and balancing the resources and time taken to do POC tests against what were perceived as likely benefits. The challenges of using the equipment in patients' homes was a potential barrier, though could become easier with familiarity and experience. Clinicians who had used POC tests described benefits, including planning onward care trajectories, and facilitating communication, both between professionals and with patients and their families. Conclusion: Clinicians described a discriminatory approach to using POC tests, considering carefully in which situations they were likely to add value to clinical decision-making. [ABSTRACT FROM AUTHOR]

Introduction: The home visit, as an educational strategy allows assessing families in their context, this influences health promotion and disease prevention. However, there are limitations that generate deficient intervention. Objective: To describe the experiences of the nursing professional in home visits as a strategy for primary health care in families in rural areas. Methods: Qualitative with descriptive approach, 10 nursing professionals working in health centers in the rural area of Morrope-Peru participated; the sampling was non-probabilistic by convenience and the sample was obtained by saturation and redundancy criteria. A semistructured interview was used with virtual modality through a zoom platform and WhatsApp. Results: a) Reasons for home visits in primary care: identification of risks, follow-up and health education, b) Strategies that benefit home visits: gaining trust and attending to needs with a humanized sense, c) Limitations for the execution of home visits: beliefs, inaccessibility, insecurity and scarce resources. Conclusions: The nursing professional, despite the restrictions, aligns his actions to the preventive-promotional, in order to recognize deficiencies and needs of the family within their cultural environment. [ABSTRACT FROM AUTHOR]

Introduction: Home-based care seeks to provide a solution to home health care issues supported by healthcare professionals, practitioners and the participation of the family, whose dynamics in COVID-19 times should be adjusted to this new context. Objective: To understand the significance of the nursing experience providing care in home-based care settings in pandemic times. Materials and Methods: A hermeneutic-phenomenological study was conducted with 15 nurses who work in a home care service provider. In-depth interviews were conducted from which the information was analyzed and classified into categories representing the experiences. Results: The following categories were obtained from the phenomenological analysis: social distancing as a change in daily life, preventing COVID-19 infection is everyone's responsibility and home care challenges for patients and families. Conclusions: Nursing professionals must ensure compliance with biosafety protocols and for the good of themselves, their patients and families, teamwork and continuing education with active listening ensure that home care of patients does not deteriorate in these pandemic times [ABSTRACT FROM AUTHOR]

Introduction: Home visiting is recommended for mothers and young infants during the first week of life to provide needed support. This study describes the significance of home visiting in providing care to Filipino mothers and their infants during the postpartum period. Methodology: Using a descriptive qualitative design, individual interviews were conducted with 10 mothers, four registered nurses, and five barangay health workers involved in home visits. Data analysis was guided by the four phases of Leininger's ethnonursing method. Results: Three themes emerged: (1) home visiting provides accessible, affordable, and meaningful interventions; (2) home visiting allows for contextual understanding of mothers' behaviors and realistic planning of care; and (3) barangay health workers promote mothers' engagement in care. Conclusion: Home visits enable negotiation of differences between generic and professional care practices, thus enhancing professional collaboration with families and community workers, potentiating culturally congruent participation and empowerment of clients in their care. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to identify the experiences of student nurses who made home visits for the first time within the scope of public health nursing course. Methods: The descriptive phenomenological approach design, a qualitative model, was used in the study. The sample of study consisted of 15 fourth-year nursing students. The interview guide prepared by the researchers consists of 6 questions related to the students' experiences regarding home visits. The interviews were conducted in classroom, lasted for about 40 minutes, and recorded on the tape recorder. All the records obtained during the interviews were transcribed verbatim and analyzed consecutively. The participants' answers were read separately and repeatedly by both researchers and encodings were made and themes were created. Results: The data obtained from the interviews were collected under five themes: "home visit practice concern", "professional role", "difficulties encountered during home visit practice", "dealing with the difficulties encountered in home visit practice", and "difference between theory and field practice". Conclusions: Nursing students were initially found to be reluctant and anxious about performing a home visit. Furthermore, the lack of professional home visits in Turkey has reduced the motivations of students in their practices. [ABSTRACT FROM AUTHOR]

Background: This study aims to improve the skills of the undergraduate nursing students about data collection for postpartum evaluation of the mother and the infant at home environment by using simulation experience. Method: The study was conducted between February and May 2019. 63 third-year undergraduate students, who were enrolled to the department of nursing of a foundation university in Istanbul, constituted the sample of the study. First implementation stage of the study, which had one-group pretest-posttest quasi-experimental design, was conducted at the simulation center of the university by using a simulation-based scenario. Second implementation stage was conducted at the Family Health Centers, located in Ümraniye district of İstanbul province in Turkey. Data was collected by using "Family Diagnosis Performance Checklist for Home Visits (FDPC)" and "Students Satisfaction and Self-confidence in Learning Scale (SCLS)". Results: We found a statistically significant difference between the self-confidence subscale of the SCLS after the simulation activity and the actual home visits (p < 0.05). Comparison of the scores obtained from the satisfaction subscale of the SCLS after the simulation activity and the actual home visits reveals no statistically significant difference (p > 0.05). Finally, we found a statistically significant difference between FDPC scores obtained from the simulation-based home visit scenario and the actual home visits (p < 0.001). Conclusions: The results of this study suggest that simulation-based learning in community health nursing improves self-confidence of nursing students and contributes to their skills on data collection and diagnosis during home visits. [ABSTRACT FROM AUTHOR]

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: This study aimed to gain insight in specific characteristics and beliefs of FLS non-responders. Introduction: The proportion of non-responding fracture liaison service (FLS) invitees is high but characteristics of FLS non-responders are unknown. Methods: We contacted FLS non-responders by telephone to consent with home visit (HV) and to fill in a questionnaire or, if HV was refused, to receive a questionnaire by post (Q), to gain insight in beliefs on fracture cause and subsequent fracture risk. Results: Out of 716 FLS invitees, 510 attended, nine declined, and 197 did not respond. Of these non-responders, 181 patients were consecutively traced and phoned until 50 consented with HV. Forty-two declined HV but consented with Q. Excluded were eight Q-consenters in whom no choice was offered (either HV or Q) and 81 patients who declined any proposition (non-HV|Q). 62% HV and Q could recall the FLS invitation letter. The fracture cause was differently believed between HV and Q; the fall (96% versus 79%, p =.02), bad physical condition (36% versus 2%, p =.0001), dizziness or imbalance (24% versus Q 7%, p =.03), osteoporosis (16% versus 2%, p =.02), and increased fracture risk (26% versus 17%, NS). Age ≥ 70, woman, and major fracture were significantly associated with HV consent compared to Q (OR 2.7, 2.5, and 2.4, respectively) and HV compared to non-HV|Q (OR 16.8, 5.3, and 6.1). Conclusion: FLS non-responders consider fracture risk as low. Note, 50 patients (about 25%) consented with a home visit after one telephone call, mainly older women with a major fracture. This non-responder subgroup with high subsequent fracture risk is therefore approachable for secondary fracture prevention. [ABSTRACT FROM AUTHOR]

Introduction: Home assessments are integral to the occupational therapy role, providing opportunities to personalise and integrate care. However, they are resource intensive and declining in number. A 3-month service development within one United Kingdom National Health Service acute hospital setting explored the concept of using digital technology to undertake remote home assessments. Methods: Four work streams explored the concept's feasibility and acceptability: real-world testing; user consultations; narrative case study collection; traditional visit resource use exploration. Project participants were occupational therapists and patient and public representatives recruited via snowball sampling or critical case sampling. Qualitative data were thematically analysed identifying key themes. Analysis of quantitative data provided descriptive statistics. Findings: The remote home visit concept was feasible within four specific contexts. Qualitative themes suggest acceptability depends on visitor safety, visitor training, visitor induction and standardisation of practice. Consultees perceived the approach to have potential for resource savings, personalisation and integration of care. Barriers to acceptance included data security, data governance, technology failure and threat to occupational therapists' role and skills. Conclusion: Applying digital technology to occupational therapy home assessment appears feasible and acceptable within a specific context. Further research is recommended to develop the technology, and test and investigate perceived benefits within wider contexts and stakeholder groups. [ABSTRACT FROM AUTHOR]

Introduction: As part of hospital discharge planning, occupational therapists often provide recommendations to improve the interaction between a person and their home environment. The aim of this study was to investigate the number and type of recommendations made by occupational therapists during a home assessment visit compared to hospital‐based assessment for patients recovering from hip fracture. A secondary aim was to explore adherence rates to the different types of recommendations. Methods: Process evaluation of a randomised controlled trial of 65 participants recovering from hip fracture, returning to community living after hospital discharge. All participants received inpatient multidisciplinary rehabilitation and hospital‐based assessment by an occupational therapist (usual care). In addition, the intervention group participated in a single home visit with an occupational therapist prior to hospital discharge. Analysis included the number and type of occupational therapy recommendations, adherence to recommendations at 30 days after discharge, and mediation analysis. Results: Participants in the home visit group received more recommendations than the usual care group (mean difference [MD] 2.8, 95% CI 1.6 to 3.9) and adhered to a greater proportion of recommendations for assistive technologies (MD 11.4%, 95% CI 2.6 to 20.2) and task modifications (MD 10.0%, 95% CI 0.7 to 19.3). Participants in both groups had lower rates of adherence to recommendations for home modifications compared with other types of recommendations. Adherence to recommendations was a mediator in the relationship between participants' involvement in a pre‐discharge home visit and reduced hospital readmissions. Conclusion: There was greater adherence to occupational therapy recommendations when patients recovering from hip fracture participated in a home visit compared to hospital‐based assessment, contributing to reduced readmissions to hospital in the first 30 days. Home visits offer additional benefits to hospital‐based assessment through the use of a collaborative approach to decision making in the home environment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of an integrated transitional care program on health outcomes in stroke survivors based on an original community for healthcare. Design: A pilot randomized controlled trial with blinded assessment. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. Setting: A tertiary hospital and participants' home across Lishui, China. Subjects: A total of 98 people with acute cerebral hemorrhage or cerebral infarction, eight weeks following discharge from our hospital. Interventions: Each participant received stroke unit–based treatment including acute medical treatment, early rehabilitation and health education. Patients in the intervention group received ongoing rehabilitation at home through multidisciplinary team, while patients in the control group received secondary stroke prevention. Main measures: Short-Form Health Survey-36, Modified Barthel Index and Caregiver Strain Index at four and eight weeks, respectively, after discharged. Results: A total of 98 participants were recruited (intervention n = 49, control n = 49). Patients had an average age of 61.4 years (61.4 ± 18.3). Mean values of Physical Components Summary and Mental Components Summary, integral components of Short-Form Health Survey-36, were significantly better in the intervention group at four and eight weeks (40.2 ± 6.3 and 42.9 ± 3.7 for the former; 43.9 ± 2.6 and 46.1 ± 1.8 for the later). The same trend was observed in Modified Barthel Index (87.1 ± 9.2 and 92.5 ± 6.7 at four and eight weeks, respectively). But the significant improvement in Caregiver Strain Index was only observed at four weeks. There were significant differences between groups in these scores. Conclusion: The transitional care program has been proven to be feasible and improve health-related outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Chronic hypoxemia in patients with COPD is a limiting factor that is associated with disease progression and significantly contributes to decreased physical activity. Although correction of hypoxemia results in physiological improvements, oxygen therapy may be related to social isolation and inactivity. However, few studies have objectively investigated the level of physical activity in daily life (PADL) in these patients. The objective of this study was to compare the level of PADL in subjects with COPD on home oxygen therapy and in subjects with no oxygen therapy, and to investigate whether home oxygen therapy is associated with the level of PADL. METHODS: In this study, 29 subjects with COPD composed the home oxygen therapy group, and 30 subjects with COPD composed the control group. All of them underwent assessment of anthropometric measurements, spirometry, peripheral muscle strength, limitations in activities of dalily living, perception of dyspnea, health status, as well as PADL monitoring. RESULTS: Home oxygen therapy subjects showed less time walking (P = .001), in active physical activities (P = .003), in physical activities ≥ 3 METs (P = .001), and in physical activities < 1.5 METs (P = .042), as well as fewer steps (P = .001). Physical inactivity was present in 24 home oxygen subjects (82.8%) and 18 control subjects (60%). Oxygen therapy was associated with severe physical inactivity (Cramer's V = 0.29, P = .040). The time using oxygen therapy (h/d) was the strongest predictor of the level of PADL (r² = 0.38-0.43, P < .001). CONCLUSION: Subjects with COPD using oxygen at home showed reduced level of PADL. The results indicate that oxygen therapy is associated with severe physical inactivity and may be a predictor of the level of PADL. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article describes the evaluation of an innovative nursing education curriculum project, preventive home visiting practice, which began full implementation in 2015, in terms of students' learning outcomes. For the purpose of learning how elder persons live in community, all the 327 undergraduate nursing students, from freshmen to seniors, provided monthly or bi‐monthly visits to home‐dwelling elderly persons aged 75 or above in their home over 1 year period, in order to provide support for their independent living and to learn from them. The students' reports submitted at the end of the first academic year were qualitatively analyzed to evaluate what they learned. They acquired multiple perspectives for understanding elder persons, including a variety of individual and environmental aspects of wellness, prevention, and community life. They also acknowledged the importance of team practice through working and collaborating with different grade levels and generations. Overall, the observed learning contents were useful for future nursing education with elder persons and facilitating critical changes in nursing education systems to address the problems of aged society. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate whether home assessment visits prior to hospital discharge for patients recovering from hip fracture reduce falls and prevent hospital readmissions, within the first 30 days and six months after discharge home. Design: A randomized controlled trial was conducted. Setting: The study setting included hospital wards and the community. Participants: The study included adults 50 years and over recovering from hip fracture (n = 77). Intervention: Both groups received inpatient rehabilitation and hospital-based discharge planning. In addition, the intervention group received a home assessment visit by an occupational therapist prior to discharge from hospital. Main measures: Primary outcomes were falls and hospital readmissions. Secondary outcome measures included Functional Independence Measure, Functional Autonomy Measurement Scale, Nottingham Extended Activities of Daily Living Scale, EuroQol five dimension scale questionnaire and Falls Efficacy Scale-International. Results: The intervention group had fewer hospital readmissions in the first 30 days compared to the control group (intervention n = 1, control n = 10; odds ratio (OR) 12.9, 95% confidence interval (CI) 1.5 to 99.2). The intervention group was observed to have fewer falls than controls in the 30 days after discharge (intervention n = 6, control n = 14; incidence rate ratio (IRR) = 0.41, 95% CI 0.15 to 1.11). Between-group differences favoured the intervention group for functional independence at six months (11.2 units, 95% CI 4.2 to 18.2). There were no other between-group differences. Conclusion: Home assessment visits by occupational therapists prior to hospital discharge for patients recovering from hip fracture reduced the number of readmissions to hospital, increased functional independence at six months and may have reduced the risk of falls in the first 30 days after discharge. [ABSTRACT FROM AUTHOR]

We assessed how third-year medical students' written reflections on home visit experiences with families of children with special needs demonstrate evidence of exposure to 9 selected competencies for pediatric clerkships designated by the Council on Medical Student Education in Pediatrics. We reviewed written reflections from 152 third-year medical students. For each competency (2 related to communication were combined), we tabulated the number of reflections in which a given competency was demonstrated. Within each competency, themes are described and presented with exemplary quotes to provide a more robust picture of students' exposure and experience. Of 152 reflections, 100% demonstrated at least 1 of the 8 expected competencies. Each reflection exhibited an average of 3 (3.1) competencies (range: 1–7). The competencies most frequently mentioned were demonstration of respect for patient, parent, and family attitudes, behaviors, and lifestyles (90%) and demonstration of positive attitude toward education (76%). Less frequently mentioned competencies included demonstration of behaviors and attitudes that promote patients' and families' best interests (41%), demonstration of effective verbal and nonverbal communication skills (a combination of 2 communication-related competencies) (33%), and description of barriers that prevent children from accessing health care (37%). The following competencies were least often mentioned: description of a pediatrician's role and responsibility in advocating for patients' needs (10%), description of the important role of patient education (8%), or description of the types of problems that benefit from a community approach (17%). Our analysis demonstrates that community-based home visits can provide medical students with opportunities to meet required pediatric clerkship competencies. [ABSTRACT FROM AUTHOR]

The objective of this study was 1) to assess the length of stay in hospital after birth among multiparous and primiparous women, 2) to investigate relational continuity of midwifery care, 3) to investigate the validity and reliability of the home visit questionnaire, and 4) to investigate the possible positive influences of a home visit by a midwife two to six days after birth. A total of 85 postnatal women participated in the intervention group, which received home visits from a midwife, while 98 women participated in the control group, which did not receive home visits from a midwife. Of the multiparous women, 16.9% left hospital within 24 hours after birth, whereas only 4.0% of the primiparous women left hospital at this stage. No significant differences between the intervention group and the control group were evident with regard to the length of the postnatal stay. However, considering the primiparous women in the total sample, the intervention group tended to leave hospital earlier than the control group. The women who received a home visit from a midwife reported higher scores on the experience of predictability and continuity in the postnatal care than the control group. The primiparous women experienced the home visit to have a significant influence on their ability to handle the care of their newborn baby, on their mental health, and their feeling of being recognized and supported. A home visit by a midwife early after discharge from hospital seems to have a positive health-promoting influence on primiparous women's confidence and ability to handle the care of their newborn babies, and on perceived support, predictability and continuity of midwifery care. [ABSTRACT FROM AUTHOR]

Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator’s role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore. [ABSTRACT FROM AUTHOR]

Abstract: The present study gives an insight into the health visitors' perceptions on their role in assessing, managing, and supporting mothers with postpartum depression (PPD). The study took place in Cyprus among health visitors of a community Maternity and Child Welfare Clinic using qualitative approach. Data were collected through individual semistructured interviews. The findings showed that although health visitors are able to identify PPD cases, they stress the importance of protocols and evidence‐based care as well as preventive interventions, and they also point out the importance of home visits. Finally, they support the need for education. It is concluded that health visitors can play an important role in women's health and their intervention on the prevention of PPD in the community especially through home visits is very important. [ABSTRACT FROM AUTHOR]

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction The Maternal Infant Health Outreach Worker (MIHOW) program is a home visiting program, utilizing peer mentors to improve maternal/child health outcomes in underserved communities. Findings are presented from a randomized clinical trial (RCT) testing the efficacy of the MIHOW model in a sample of Hispanic women in Tennessee. We hypothesized maternal and infant outcomes would be better in women assigned to MIHOW than women assigned to the minimal education intervention (MEI) group (receipt of educational materials). Methods Women entered the study during pregnancy (< 26 weeks gestation) and were followed through 6 months postpartum. A total of 188 women were enrolled and randomly assigned (MEI = 94; MIHOW = 94), with 178 women completing the study (MEI = 87; MIHOW = 91). Results Positive and statistically significant (p < 0.01) effects of MIHOW were observed on breastfeeding self-efficacy and exclusivity, levels of depressive symptoms and parenting stress, safe sleep practices, and infant stimulation in the home. No statistically significant differences were noted in number of prenatal visits. Discussion Results expand limited empiric evidence and provide strong support of the effectiveness of MIHOW on improving health outcomes in this sample of Hispanic mothers and their infants. MIHOW is a viable option for providing culturally sensitive services to immigrant and underserved families. [ABSTRACT FROM AUTHOR]