Modified Nurse-Family Partnership Home Visiting Program on Prenatal and Postnatal Health Outcomes in Thai Adolescent Mothers: A Cluster Randomized Controlled Trial

Abstract

This research aimed to examine the effects of modified Nurse-Family Partnership home visiting program on prenatal and postnatal health outcomes in Thai adolescent mothers. A cluster randomized controlled trial was conducted in district health promoting hospitals in Maha Sarakham province, Thailand from July 2017 to May 2018. The experimental group and the control group were from five different districts hospital. The sample was one hundred and ten adolescent pregnancy for the intervention group and the same number for the control group. The experimental group received Home Visiting Prenatal and Postnatal program for Thai Adolescent Mothers (HVPPT), 10-time visits starting from 20-week gestation of pregnancy until 6 weeks after childbirth. The control group received a routine program. Outcomes were assessed at baseline, 36-week gestation of pregnancy, and 6 weeks after childbirth follow. Data were analyzed by using descriptive statistic, Z-test for proportion, and independent t-test.

The results shown that the participants in the experimental group had significant higher number of antenatal visit, higher rate of exclusive breastfeeding, and lower means score of pre-postnatal depression. In terms of the maternal-infant relationship, the mean scores of scale 1 (impaired bonding), 3 (anxiety about care), and 4 (risk of abuses) in the experimental group were significantly lower than the control group. The mean scores of scale 2 (rejection and angry) in the experimental group was also lower; however, there was no significant differences. In addition, there was also no significant differences in terms of infant birth weight.

In conclusion, the participatory home visiting program by family-nurse may be a feasible strategy for improving maternal and child health outcomes in adolescent mothers. Therefore, home visiting program should be implemented for a long period of time and should be used as a local policy for sustain benefits.

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