Extra advice and support for parents of newborns delivered as part of routine pediatric care improved the health and safety of the babies as well as the parents' care-giving skills, says a study of families enrolled in a program in Washington state.
The program, called Healthy Steps, resulted in "higher levels of parental satisfaction with pregnancy and newborn well-child care," compared to those getting regular care, say Robert S. Thompson, M.D., director of the Center for Health Studies at Group Health Cooperative, and colleagues from the University of Washington in the American Journal of Preventive Medicine.
Getting added assistance was associated with positive effects on breastfeeding, maternal depressive symptoms, family support, discipline, reading with the child, knowledge of infant development and satisfaction with parenting, he says. Parental stress levels were similar among both the usual care and the Healthy Steps families.
Whether the additional care started during pregnancy or after birth made no difference in the health benefits for parents and children.
"Beneficial effects of the intervention affected all families," Thompson and colleagues say.
Their findings held true beyond the high-risk families usually targeted by such programs. Experienced and low-risk parents who are often excluded from this type of parenting support program benefited as well, Thompson says. The results suggest that all parents should get similar help, not just disadvantaged or at-risk families.
Parents with previous children reported improved social support and felt Group Health Cooperative cared more about them, while first-time parents emphasized gaining useful knowledge about things like breastfeeding and discipline.
Thompson's group studied 439 families, about one-third of whom were assigned to the usual standard of care. Families at other medical centers took part in the Healthy Steps program, starting either at four or five months into the pregnancy or shortly after birth.
Each family in the program was assigned a Healthy Steps Specialist who made home visits, helped solve problems or informed parents about developmental and behavioral questions and provided telephone support when needed. Healthy Steps care was integrated with routine pediatric well-child care. The researchers surveyed the parents before birth, one week after birth, and after three months to record the effects of the program.
Parents in the Healthy Steps program assigned to special care before their babies were born showed a greater willingness to remain enrolled in the health plan during the first three months after birth, Thompson says.
"Attention to patient/member satisfaction is especially important for health care organizations because patient satisfaction is an important determinant of enrollment and disenrollment," he says. "It is also being increasingly linked to better health outcomes."
Funding for this research was provided by the Kaiser Foundation Health Plan; the Employees Community Fund of Boeing, Puget Sound; the Group Health Community Foundation; and the Nesholm Family foundation.
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By Aaron Levin, Science Writer
Health Behavior News Service
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