Longhi, E;
Murray, L;
Hunter, R;
Wellsted, D;
Taylor-Colls, S;
Mackenzie, K;
Rayns, G;
+ view all
(2018)
Supporting young mothers (aged 14-25) in the first two years of life: A Randomized Control Trial (RCT) of the NSPCC UK Minding the Baby (MTB) Home Visiting Programme.
UCL Research Department of Clinical, Educational and Health Psychology: London, United Kingdom.
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Abstract
The NSPCC, in collaboration with University College London and the University of Reading, is initiating an ambitious multi-site study of the effectiveness of a targeted prevention programme that incorporates well established principles of home visiting with a more comprehensive package of care for the developing mother-infant relationship. The programme represents an important opportunity to advance the UK’s provision of evidence-based support for at-risk families and to intervene effectively in the intergenerational cycle of disadvantage. The Minding the Baby (MTB) programme represents a unique intervention that integrates many of the benefits of home visiting programmes – particularly their relative cost-effectiveness, client acceptability and accessibility – with a coherent, evidence-based clinical dimension that is informed by, and directly targets, well studied mechanisms of risk in early child development. In focusing on key domains of parent-child relationships where disturbances are known risk factors for later child maladjustment, particularly the sensitivity of parental care, the security of infant-parent attachment and the parent’s capacity to reflect on the child as an autonomous agent with needs, feelings and thoughts, the programme aims to combine best clinical practice in early prevention with the best scientific data regarding the developmental processes that promote optimal child outcomes. Currently, the UK health and social care systems offer limited services to young families targeting mental health or promoting family relationships from birth. Routine care for at-risk parents can vary from enhanced health visiting to postnatal support groups to family therapy. The type and length of treatment often depends on where the parent lives and as a result the treatment offered sometimes does not adequately address the needs of the parent. What tends to be either absent or left to chance in routine care are consistent and reliable key figures that are capable of addressing a broad range of parenting concerns from the practical to the emotional, with the aim to promote a positive parent-child relationship. Several influential policy documents from government departments and third sector organizations have repeatedly called for such early intervention. Longitudinal outcome studies clearly show that major disturbances in the quality of care can have lasting negative consequences for children’s development, and the long-term social and financial costs associated with these poor outcomes are considerable. The potential value of effective early intervention therefore cannot be overstated. This randomized clinical trial will test the hypothesis that an intensive home visiting programme focused on promoting young parents’ sensitive attunement to their infants and their capacity to reflect on their baby’s thoughts, feelings and needs, will lead to improvements in the sensitivity of parenting at age 2 years compared to parents who receive routine care. The study will also examine several secondary hypotheses, including that the programme will increase offspring rates of secure attachment, improve cognitive and behavioural outcomes and promote maternal mental health.
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