Background The Parent-Infant Home Visiting Programme (PIVHP) is a home-based parenting programme targeted at new and expectant mothers, characterised as vulnerable. Participants are recruited from low-income communities situated on the Cape Flats, in Cape Town, South Africa. The programme consists of antenatal and postnatal sessions, facilitated by trained Parent Infant Attachment Counsellors (PIACs) recruited from target communities. There are two programme cycles per year: one from January to June, and a second one from July to December. The overarching goal of PIHVP is to contribute towards the prevention of child abuse, abandonment and neglect; and to promote positive infant growth and development. The programme has to date not been guided by an explicit theory of change (TOC). There was no Monitoring and Evaluation (M&E) system in place, at the time of the evaluation, either. The programme engages in extensive data collection for administrative purposes. This data, however, is not captured nor analysed systematically to monitor progress or measure impact. This formative evaluation aims to capitalise on the existing data. Evaluation Focus This evaluation focused on the first 2019 programme cycle. The main objective of this evaluation was to determine the extent to which the PIHVP had been implemented with fidelity. As such, a process evaluation was conducted to address the following evaluation questions: 1. Did the PIHVP beneficiaries recruited for the first 2019 programme cycle meet the eligibility criteria specified by programme? 2. What proportion of participants completed and dropped out of the PIHVP during the first programme cycle of 2019? What are the reasons provided for programme dropout? questions: 3. To what extent did the PIHVP meet its targeted number of participants? What are the reasons for over/under coverage? 4. Did the participants receive the home-visiting sessions at the duration and frequency prescribed by the programme model? 5. Did PIACs complete and conduct all programme activities, developmental screenings and demonstrations as intended? 6. How did participants perceive PIACs in terms of the support they provided and their preparation level, knowledge, and reliability? 7. To what extent do PIACs implement the skills acquired through their training into their sessions? 8. Are the participants satisfied with the service they received? What are the strengths and limitations they identified? 9. To what extent did participants engage with the PIACs (around the content) during home-visit sessions? Methodology The evaluator first extracted and refined the programme's TOC through structured consultations with the programme manager. The plausibility of the PIHVP's programme theory was then assessed through an extensive literature review. The evaluator then proceeded with the process evaluation. A mixed methods approach was used, as combination of both primary and secondary data sources, and quantitative and qualitative data analysis were used to systematically answer the evaluation questions.

Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Pregnant women living in South African peri-urban settlements face many challenges for their health and the health of their infants. Current health care services face many constraints and are not able to meet all the needs of pregnant mothers. Home-visiting programmes implemented by community health workers can alleviate these constraints. The current RCT assessed the effectiveness of the Philani Plus Intervention Program that addressed HIV, alcohol, maternal and child nutrition and mental health. The effectiveness of the intervention was assessed by measuring infant social withdrawal behaviour using the modified Alarm Distress Baby Scale (m- ADBB). A total of 681 cases were randomised into control (N=330) and intervention groups (N=351) and assessed using the m-ADBB. A cut-off score of two and above was used to determined significant social withdrawal behaviour. Data was analysed using descriptive statistics and cross-tabulation initially, followed by analysis of variance and multilevel modelling. Results indicated a prevalence of 46.7% of social withdrawal behaviour; however, no significant differences between groups were found. The current prevalence was substantially higher in comparison to the only other published study using the m-ADBB. Furthermore, the prevalence rate was also significantly higher compared to the majority of other studies using the original Alarm distress Baby Scale (ADBB). The high prevalence of social withdrawal behaviour found in this study indicates an increased risk for suboptimal infant development. Further research regarding social withdrawal behaviour and the casual mechanisms associated with the development of such behaviour is needed. Furthermore, validation of the m-ADBB in different settings is needed. / AFRIKAANSE OPSOMMING: Swanger vroue wat in Suid-Afrikaanse buitestedelike nedersettings woon staar baie uitdagings in die gesig met betrekking tot hul gesondheid en die gesondheid van hul babas. Huidige gesondheidsdienste is baie beperk en is nie in staat om in al die behoeftes van swanger moeders te voorsien nie. Huis-besoek programme wat deur gemeenskaplike gesondheidswerkers geïmplementeer word, kan hierdie beperkings verlig. Die huidige RCT het die effektiwiteit van die Philani Plus Intervensie Program wat MIV, alkohol, voeding en geestelike gesondheid aanspreek, geassesseer. Die effektiwiteit van die intervensie is geassesseer deur sosiale onttrekkingsgedrag met behulp van die gewysigde Alarm Nood Baba Skaal (m-ADBB) te meet. ‘n Totaal van 681 gevalle is lukraak in kontrole (N = 330) en intervensie groepe (N = 351) verdeel en geëvalueer volgens die m-ADBB. 'n Afsnypunt van twee en hoër is gebruik om beduidende sosiale onttrekkingsgedrag te bepaal. Data is aanvanklik ontleed met behulp van beskrywende statistiek en kruis-tabulering, gevolg deur analise van variansie en multi-modelle. Resultate toon 'n 46,7%-voorkoms van sosiale onttrekkingsgedrag, maar het egter geen beduidende verskille tussen groepe getoon nie. Die huidige voorkoms was aansienlik hoër in vergelyking met die enigste ander gepubliseerde studie wat gebruik gemaak het van die m- ADBB. Verder was die voorkomssyfer ook aansienlik hoër in vergelyking met die meerderheid van die ander studies wat gebruik gemaak het van die oorspronklike Alarm Nood Baba Skaal (ADBB). Die hoë voorkoms van sosiale onttrekkingsgedrag dui op 'n verhoogde risiko vir suboptimale baba ontwikkeling. Verdere navorsing oor sosiale onttrekkingsgedrag en die meganismes wat verband hou met die ontwikkeling van sulke gedrag, is nodig. Verder word die bekragtiging van die m-ADBB in verskillende instellings benodig.

Made available in DSpace on 2016-04-28T20:56:24Z (GMT). No. of bitstreams: 1 Marcela Pasqualucci Ronca.pdf: 641200 bytes, checksum: 7d904049a6e85729cff82a763e91c2e1 (MD5) Previous issue date: 2011-06-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of this research was: (i) to identify how teachers describe and analyze their involvement in a students' home visiting program; and (ii) to collect their suggestions to improve the program and to overcome its problems. The investigation was guided by the well documented fact that schools and families should cooperate between them in a joint effort to improve the quality of education offered to children and adolescents. The expectative was that home visiting could modify, in a positive direction, teachers' knowledge about their students, their families and their way of life, leading to the construction of new and more adequate teaching strategies. The research adopted a qualitative approach. The data was collected in one of the Great São Paulo s county (SP-BR) using semi-structured questionnaires (applied to 13 teachers) and in-depth interviews (conducted with those who agreed in conceding them).The results showed that, according to the participants, this program has brought results for the pedagogical practice, as they were acquainted with the reality of their students and their families. The reflection of this participation occurred in the construction of new teaching strategies through which they could serve better and more precise the individual needs of students. This knowledge, however, was not enough to positively change the perception of teachers about families. It was concluded that to achieve the expected results, the specific program of home visits needs to rethink their actions, incorporating into their planning teacher's view, expanding to other professionals and providing space for discussion and improvement / O objetivo dessa pesquisa foi: (i) identificar como professoras descrevem e analisam seu envolvimento em um programa de visitas domiciliares a seus alunos; e (ii) coletar suas sugestões acerca de como aprimorar o programa e superar seus eventuais problemas. A investigação foi guiada pelo fato bem documentado de que escolas e famílias devem cooperar entre si em um esforço conjunto voltado para aperfeiçoar a qualidade da educação oferecida a crianças e adolescentes. A expectativa era a de que as visitas domiciliares pudessem modificar positivamente o conhecimento das professoras sobre seus alunos, suas famílias e seu modo de vida, levando-as à construção de novas e mais adequadas estratégias de ensino. A pesquisa seguiu uma abordagem qualitativa. Os dados foram coletados em um município da Grande São Paulo que tinha adotado um Programa de Visitas Domiciliares em suas escolas. As informações necessárias foram obtidas por meio de questionários semi-estruturados aplicados a 13 professoras e de entrevistas em profundidade conduzida junto às duas delas, que concordaram em concedê-las. Os resultados da análise empreendida mostraram que, para as professoras, participar deste programa trouxe resultados para a prática pedagógica, pois puderam conhecer melhor a realidade de seus alunos e suas famílias. O reflexo desta participação se deu na construção de novas estratégias pedagógicas, por meio das quais puderam atender melhor e de forma mais precisa e individualizada as necessidades dos discentes. Esse conhecimento, entretanto, não foi suficiente para alterar positivamente a percepção das professoras a respeito das famílias. Concluiu-se que para atingir os resultados esperados, esse programa específico de visitas domiciliares precisa repensar suas ações, incorporando em seu planejamento a visão das professoras, ampliando seu campo de ação para outros profissionais da escola e oferecendo espaço para discussão e aperfeiçoamento do programa

This study was intended to evaluate the impact of socioeconomically disadvantaged children's participation in the Texas Home Instruction for Parents of Preschool Youngsters (TX HIPPY) Program on their school readiness and academic achievement. The study used a quasi-experimental design and applied full and optimal propensity score matching (PSM) to address the evaluation concern of the impact of the TX HIPPY program on HIPPY participants' academic achievement compared to non-HIPPY participants. This evaluation targeted former HIPPY participants and tracked them in the Dallas ISD database through Grade Levels K-8. Data were obtained by administering Istation's Indicators of Progress (ISIP) for kindergarten, TerraNova/SUPERA for Grades K-2, and State of Texas Assessments of Academic Readiness for math and reading (STAAR) for Grades 3-8. HIPPY and non-HIPPY groups were matched using propensity score analysis procedures. The evaluation findings show that the TX HIPPY program positively influences kindergarten students to start school ready to learn. The findings of math and reading achievements suggest that HIPPY children scored at the same level or higher than non-HIPPY children did on math and reading achievement, indicating that TX HIPPY program has achieved its goal of helping children maintain long-term academic success. However, the evaluation findings also indicated that the impact evaluation framework must be designed with attention to higher-level factors beyond academic achievement that influence children's academic success.

Contexte : le travail réalisé dans cette thèse s'inscrit dans le projet de prévention précoce CAPEDP qui comprenait une intervention longitudinale adressée à une population de grande vulnérabilité psychosociale. Nos objectifs étaient de tester l'efficacité des interventions à domicile sur la qualité de l'attachement chez l'enfant et de comparer longitudinalement les comportements et les représentations d'attachement avec un groupe témoin qui a reçu les soins usuels. Méthodologie : notre travail est divisé en trois études et temps de mesure : 12, 18 et 48 mois de l'enfant. Les comportements d'attachement ont été évalués à travers la Situation Étrange à 12 mois et l'Attachment Q-sort à 18 mois. A 48 mois, nous avons évalué les représentations d'attachement avec l'Attachment Story Completion Task. Résultats : à 12 mois, les différences en termes de sécurité ne sont pas significatives mais nous remarquons plus d'enfants sécures dans le groupe intervention. A 18 mois, le groupe intervention a des scores de sécurité plus élevés. Nous remarquons aussi une amélioration significative entre 12 et 18 en termes de sécurité dans le groupe intervention. A 48 mois, nous retrouvons une amélioration au niveau des facteurs sociodémographiques et un effet de genre, les filles du groupe intervention étaient significativement plus sécures que celles du groupe contrôle. Discussion : l'intervention CAPEDP a eu un effet positif en augmentant la sécurité de l'attachement entre 12 et 18 mois. Les filles du groupe intervention semblent avoir profité plus de l'intervention CAPEDP. Plusieurs limites de l'étude sont discutées ainsi que les ouvertures de recherche, notamment une intervention conjointe psychologue-assistante sociale pour atténuer l'impact des facteurs de risque sur l'efficacité de l'intervention psychologique. / Context: this PhD research fits into the early prevention CAPEDP project: a home-visiting intervention addressing a high-risk population. Our goals were to test the efficiency of the intervention on infant attachment and to longitudinally compare attachment behaviours and representations with a control group that received only usual care. Method: our work is divided into 3 studies with different times and measures: 12, 18 et 48 months. Attachment behaviour was assessed with the Strange Situation at 12 months and with the Attachment Q-sort at 18 months. Attachment representations were assessed with the Attachment Story Completion Task at 48 months. Results: at 12 months, there are more secure infants in the intervention group although these differences are not statistically significant. At 18 months, the intervention group has higher scores of security. Results also show an improvement in terms of security between 12 and 18 months for the intervention group. At 48 months, results point out an improvement in socio-demographic factors and a gender difference: girls from the intervention group showed significantly higher attachment security than the control group. Discussion: the CAPEDP intervention had a positive effect in enhancing attachment security between 12 and 18 months. Girls seem to have profited the most from our intervention. The limitations and future directions are discussed, particularly the interest of a joint intervention between psychologists and social workers to diminish the socio-economic risk impact on the psychological intervention. / Contexto: este trabalho de tese insere-se no projeto de prevenção precoce CAPDP constituído por uma intervenção longitudinal dirigida a uma população com elevado risco psicossocial. Os objetivos eram testar a eficácia da intervenção a domicílio sobre a qualidade da vinculação na criança e comparar longitudinalmente os comportamentos e as representações de vinculação com um grupo controlo que beneficiou apenas do sistema de cuidados já existente. Metodologia: o nosso trabalho é dividido em três estudos ou tempos: 12, 18 e 48 meses da criança. Os comportamentos de vinculação foram avaliados com a Situação Estranha aos 12 meses e com o Attachment Q-sort aos 18. Aos 48 foram avaliadas as representações de vinculação com o Attachement Story Completion Task. Resultados: aos 12 meses, as diferenças em termos de segurança da vinculação não são significativas, mas constatámos a presença de mais crianças seguras no grupo intervenção. Aos 18 meses, o grupo intervenção verifica scores mais elevados de segurança. De notar também uma melhoria significativa entre os 12 e os 18 meses em termos de segurança da vinculação no grupo intervenção. Aos 48 meses, encontrámos melhorias a nível sociodemográfico e um efeito de género, sendo que as meninas do grupo intervenção apresentam scores de segurança das representações mais elevados comparativamente às do grupo controlo. Discussão: a intervenção CAPEDP teve um efeito positivo aumentando a segurança da vinculação entre 12 e 18 meses. As meninas do grupo intervenção parecem ter beneficiado mais da nossa intervenção. Os limites do estudo são discutidos assim como as aberturas para futuras investigações, nomeadamente para uma intervenção conjunta entre psicólogos e assistentes sociais para diminuir o impacto negativo dos factores de risco sobre a intervenção psicológica.

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<p>The Nurse-Family Partnership (NFP) is a targeted, nurse home visitation program for young, low-income, first time mothers. While the effectiveness of the NFP has been established in the context of the US, and is currently being evaluated in the Canadian public health care system, little has been done to document how work of this nature influences or impacts public health nurses (PHNs), an essential component of this program delivery model, on both professional and personal levels. This qualitative interpretive descriptive study explored PHNs’ experiences of long-term home visiting a targeted population of young, vulnerable mothers in a Canadian NFP program. The study was conducted in two phases beginning with a secondary analysis of five focus groups conducted with public health nurses (N = 6) who delivered the NFP intervention as part of the feasibility and acceptability pilot in Hamilton, Ontario. This was followed by further exploration of identified themes and a practice, problem and needs analysis through individual, semi-structured interviews with the original focus group participants and all PHNs who have since delivered the NFP (N =10). Relationships formed with clients, the NFP program and support of NFP colleagues were rewarding factors while workload and workplace factors were significant contributors to stress. The study findings have implications for the identification of strategies to minimize staff turnover, PHN burnout, secondary traumatic stress and compassion fatigue, and improve program delivery.</p> / Master of Science in Nursing (MSN)

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