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Short- and longer-term impacts of the Healthy Families Healthy Babies (HFHB) postnatal home visiting program on child health and developmental outcomes in New Brunswick

Author: Sandra Magalhaes, Jillian Cameron, Samuel Cookson, Chris Folkins, Sadie Gorman-Asal, Chandy Somayaji
Year: 2023
Category: Health Publications

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Early childhood development is a fundamental social determinant of health. Home visiting is a public health strategy to mitigate negative impacts from poverty and early childhood adversity, typically offered to families at high risk of poorer outcomes. Families are enrolled prenatally or postnatally and followed through pregnancy and the first years of the child’s life.

Home visiting programs are shown to have benefits for both program participants and service providers; however, their longer-term impacts have not been properly evaluated among Canadian populations. Each Canadian province and territory offers a home visiting program, with several currently undergoing program review. More research is needed to inform these efforts.
The overall goal of this study is to evaluate the short- and longer-term impacts of participation in targeted postnatal home visiting services on breastfeeding behaviour and child development, and results will inform a review of the Healthy Families, Healthy Babies (HFHB) targeted postnatal home visiting program in New Brunswick.

A matched retrospective cohort study of all live births in New Brunswick, Canada, between April 1, 2012, and March 31, 2014, among families parenting for the first-time was developed using population-based administrative data accessible at the New Brunswick Institute for Research, Data and Training (NB-IRDT). Several linkable administrative data sets were used to define the study cohort, HFHB postnatal program participation, breastfeeding duration, and child developmental outcomes in toddlers and preschoolers, as well as a number of confounding variables.

A propensity score matching methodology was used to select a group of families that did not participate who were similar to those who participated. Multivariable regression models were used to provide statistical estimates of the differences in outcomes between groups while accounting for relevant confounding variables. A birth cohort of 6096 families parenting for the first time was established and followed longitudinally from birth to school age; 1211 participated in the postnatal home visiting program, and 1366 non-participating families were matched to participants.

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