Home visits by paraprofessionals did not improve maternal and child health
QUESTION: Do home visits by paraprofessionals (lay visitors/peer support or community workers) trained in a programme model that is effective when delivered by nurses, improve maternal and child health?
Randomised (allocation concealed), blinded (data collectors), controlled trial with follow up to 24 months postpartum.
21 antepartum clinics in Denver, Colorado, USA.
735 pregnant women (mean age 20 y) who had no previous live births and either qualified for Medicaid or had no health insurance. Follow up was >80% for maternal interviews at 6, 12, 21, and 24 months postpartum; and 83% for child assessment at 21 months of age.
Participants were allocated to prenatal and postpartum (≤24 mo) home visitation by paraprofessionals (PHV group, n=245) or professional nurses (NHV group, n=235), or to a control group (n=255). All home visitors received intensive training. Paraprofessionals were community workers with high school education but no postsecondary education. All participants …