scholarly journals Conducting Population Health Intervention Research using Linked Databases: An Evaluation of Home Visiting Programs for At-Risk Families

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Mariette Chartier ◽  
Marni Brownell ◽  
Mike Isaac ◽  
Dan Chateau ◽  
Nathan Nickel ◽  
...  
Keyword(s):  
Child Development ◽  
Population Health ◽  
Real World ◽  
Home Visiting ◽  
Intervention Research ◽  
School Entry ◽  
Population Health Intervention Research ◽  
Population Health Intervention ◽  
Program Effects ◽  
Home Visiting Program

ABSTRACTObjectiveThe objective of this population health intervention research was to determine the effectiveness in improving children’s outcomes of a provincial home visiting program for at-risk families in Manitoba, Canada. Home visiting programs have been evaluated in highly structured and supervised conditions which may provide different results than those evaluated in real-world delivery systems. ApproachIn this retrospective cohort study, data for 4,562 children from home visiting program families and 5,184 comparison children were linked to de-identified administrative health, social services, and education data held securely at the Manitoba Centre for Health Policy. Inverse probability of treatment weights were used to address the selection bias inherent in delivering a voluntary program. We used generalized linear modelling to calculate program effects among those exposed to the program, those unexposed and the average effect. Child outcomes examined included being taken into care of child welfare, hospitalizations for maltreatment-related injuries, and child development scores at school entry. ResultsThe home visiting program was associated with lower rates of children being taken into care and lower rates of hospitalization for maltreatment-related injuries. For being taken into care by child’s first birthday, the adjusted Risk Ratio (aRR) was 0.75 (95% Confidence Interval [CI]: 0.66, 0.86); for being taken into care by second birthday, aRR=0.79, (95% CI: 0.70, 0.88); and for hospitalizations for maltreatment-related injuries by third birthday, aRR=0.59 (95% CI: 0.35, 0.99). Similar program effects would be expected among comparison children if they had received the program (i.e., average treatment effect for the untreated). No differences between groups were found across five domains of child development at school entry. ConclusionHome visiting programs can be an effective strategy for decreasing child maltreatment at a population level. Home visiting program enhancements are necessary to improve child development scores when children enter school. Use of population-based linkable data systems provides an opportunity to evaluate interventions using large, real-world samples, adjusting for a wide range of risk factors, and examining a variety of outcomes.

scholarly journals Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development?

2017 ◽  
Vol 22 (2) ◽  
pp. 121-131 ◽  
Author(s):  
Mariette J. Chartier ◽  
Marni D. Brownell ◽  
Michael R. Isaac ◽  
Dan Chateau ◽  
Nathan C. Nickel ◽  
...  
Keyword(s):  
At Risk ◽  
Child Development ◽  
Child Maltreatment ◽  
Social Services ◽  
Home Visiting ◽  
School Entry ◽  
Adjusted Risk ◽  
Education Data ◽  
Home Visiting Program ◽  
Families First

While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data. FFHV was associated with lower rates of being in care by child’s first, second, and third birthday (adjusted risk ratio [aRR] = 0.75, 0.79, and 0.81, respectively) and lower rates of hospitalization for maltreatment-related injuries by third birthday (aRR = 0.59). No differences were found in child development at kindergarten. FFHV should be offered to at-risk families to decrease child maltreatment. Program enhancements are required to improve child development at school entry.

scholarly journals The AAPRISS Platform: Learning and Taking Action to Reduce Social Inequalities in Health to help PHIR

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Lang ◽  
C Marquis ◽  
N Haschar-Noé ◽  
M Kelly-Irving ◽  
M Huot-Royer ◽  
...  
Keyword(s):  
Public Health ◽  
Population Health ◽  
Financial Stability ◽  
Social Inequalities ◽  
Intervention Research ◽  
Health Intervention ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Population Health Intervention Research ◽  
Population Health Intervention

Abstract Today, the reduction of social inequalities in health is on the political agenda in public health. The complex reality of the determinants of these health inequalities remains difficult to understand and translate into practical actions. One of the reasons is that the circulation of expertise amongst researchers, actors in the field, and public decision is not systematic and still too rare. In 2013, the Federative Institute of Interdisciplinary Research and Studies Health Society (IFERISS) of Toulouse has an interdisciplinary platform (health, the humanities, and the social sciences) that directly offers expertise to public health actors, institutions, and local communities in order to respond to public health issues. At the request of the actors, AAPRISS can intervene at all stages of a study or an intervention, from conceptual and methodological construction to implementation support, and data analysis and use. In particular, the team has expertise in public policy evaluation, support for transferability according to the key functions/implementation/context (FIC) model, and awareness-raising at the intersection of urban planning and health. The platform is in a multi-year partnership with local authorities, the regional health agency of Occitanie, the primary health insurance funds of Occitanie, and various partners in civil society. Six years after the establishment of the AAPRISS platform, there is a strong demand for support and research from the actors and institutions. However, funding for activities remains uncertain despite the support of the National Cancer League and an increasingly strong network of partners. Mixed structures housing spaces for both research and action, which create a dynamic of Population Health Intervention Research, are showing themselves to be effective and seem to meet a need, but their financial stability is insufficient to sustain their activities and promote sustainable reduction of social inequalities in health. Key messages Mixed structures housing spaces for both research and action, which create a dynamic of Population Health Intervention Research, are showing themselves to be effective and seem to meet a need. But the financial stability of this mixed structures is insufficient to sustain their activities and promote sustainable reduction of social inequalities in health.

scholarly journals Population health intervention research: what is the place for pilot studies?

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Lehana Thabane ◽  
◽  
Linda Cambon ◽  
Louise Potvin ◽  
Jeanine Pommier ◽  
...  
Keyword(s):  
Population Health ◽  
Intervention Research ◽  
Health Intervention ◽  
Pilot Studies ◽  
Population Health Intervention Research ◽  
Population Health Intervention

Innovation in population health intervention research

2019 ◽  
pp. 243-260
Author(s):  
Paul Hackett ◽  
Juanita Bascu ◽  
Tom McIntosh ◽  
Bonnie Jeffery ◽  
Nazeem Muhajarine
Keyword(s):  
Population Health ◽  
Intervention Research ◽  
Health Intervention ◽  
Population Health Intervention Research ◽  
Population Health Intervention
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