Maternal involvement in a nurse home visiting program to prevent child maltreatment

This thesis aimed to explore key maternal characteristics and program factors related to maternal involvement in a nurse home visiting program to prevent child maltreatment. The relationship between maternal involvement and program outcomes was also examined. Ecological Systems Theory and the Integrated Theory of Parental Involvement were used to contextualise the study design and shape research questions. Secondary data analysis was performed using data collected during an earlier randomised controlled trial, in which 40 women who met criteria placing them at risk of potential child abuse or neglect were enrolled in either the standard nurse home visiting program or the augmented intervention. Primary data related to maternal involvement were collected via chart audit. Statistical analysis focused on measures of clinical significance, and correlations examined the relationships between maternal involvement and the program outcomes of measurement of the home environment (HOME) scores and maternal responsivity to the infant. No clinically significant relationships were found between program augmentation and maternal involvement in the home visiting program. Women categorised as being at-risk received more home visits than other women. One notable exception to this finding is that women in relationships characterised by intimate partner violence were more likely to leave the program early and to receive less home visits. A positive relationship emerged in which women who received more home visits had a higher level of responsivity to their infant and also scored highly on HOME total scores. This study provides a valuable addition to the growing body of literature investigating how home visiting can contribute to positive outcomes for at-risk families. It highlights the importance of further, theoretically based research to disentangle antecedents of maternal involvement and the subsequent impact on program outcomes

Smoking Cessation Messages for Pregnant Aboriginal and Torres Strait Islander Women: A Rapid Review of Peer-Reviewed Literature and Assessment of Research Translation of Media Content

This review summarized literature about knowledge, attitudes, and beliefs of Aboriginal and Torres Strait Islander women from Australia who smoke during pregnancy, then examined the extent that existing health promotion materials and media messages aligned with evidence on smoking cessation for pregnant Aboriginal and Torres Strait Islander women. Knowledge, attitudes, and beliefs of pregnant Aboriginal women who smoke tobacco were identified in the literature. Health promotion campaigns were retrieved from a grey literature search with keywords and social and professional networks. Key themes from peer-reviewed papers were compared against the content of health promotion campaigns using the Aboriginal Social and Emotional Wellbeing Model, the Behavior Change Wheel and thematic analysis. Eleven empirical studies and 17 campaigns were included. Empirical studies highlighted women sought holistic care that incorporated nicotine replacement therapy, engaged with their family and community and the potential for education about smoking cessation to empower a woman. Health promotion campaigns had a strong focus on ‘engagement with family and community’, ‘knowledge of risks of smoking,’ ‘giving up vs cutting down’ and ‘culture in language and arts’. There were similarities and variances in the key themes in the research evidence and promotion materials. Topics highly aligned included risks from smoking and quitting related issues

The Daalbirrwirr Gamambigu (Safe Children) model: Embedding cultural safety in child protection responses for Australian Aboriginal children in hospital settings

The aim of this paper is to describe the development of a model of care to embed cultural safety for Aboriginal children into paediatric hospital settings. The Daalbirrwirr Gamambigu (pronounced “Dahl-beer-weer gum-um-be-goo” in the Gumbaynggirr language means ‘safe children’) model encompasses child protection responses at clinical, managerial and organisational levels of health services. A review of scholarly articles and grey literature followed by qualitative interviews with Aboriginal health professionals formed the evidence base for the model, which then underwent rounds of consultation for cultural suitability and clinical utility. Culturally appropriate communication with children and their families using clinical yarning and a culturally adapted version of ISBAR (a mnemonic for Identify, Situation, Background, Assessment and Recommendation) for interprofessional communication is recommended. The model guides the development of a critical consciousness about cultural safety in health care settings, and privileges the cultural voices of many diverse Aboriginal peoples. When adapted appropriately for local clinical and cultural contexts, it will contribute to a patient journey experience of respect, dignity and empowerment