Republic of the Philippines

UNIVERSITY OF MAKATI
COLLEGE OF ALLIED HEALTH STUDIES
J. P. Rizal St. Extension, West Rembo, Makati City
1215 Philippines

CENTER OF NURSING

JOURNAL CRITIQUE IN MATERNAL AND

CHILD NURSING

Submitted by:

Alcaraz, Alejandra Bien V.

Submitted to:

Prof. Cynthia Umila, RN, MAN

08 October 2020
 Effectiveness of Home Visiting in Improving Child Health and Reducing Child
Maltreatment

Sarah A. Avellar, PhD and Lauren H. Supplee, PhD

BACKGROUND AND OBJECTIVE

The Patient Protection and Affordable Care Act established the Maternal, Infant, and
Early Childhood Home Visiting Program, which provides $1.5 billion to states over 5
years for home visiting program models serving at-risk pregnant women and children
from birth to age 5. The act stipulates that 75% of the funds must be used for programs
with evidence of effectiveness based on rigorous evaluation research. Home Visiting
Evidence of Effectiveness reviewed the home visiting research literature and provided
an assessment of the evidence of effectiveness for program models that serve families
with pregnant women and children from birth to age 5.

METHODS

Home Visiting Evidence of Effectiveness included a systematic search and screening

process, a review of the research quality, and an assessment of program effectiveness.
Reviewers rated studies’ capacity to provide unbiased estimates of program impacts
and determined whether a program met the Department of Health and Human Services’
criteria for an evidence-based model.

RESULTS

As of July 2012, 32 models were reviewed, of which 12 met the Department of Health
and Human Services criteria. Most of these models were shown to have favorable
effects on child development. Other common favorable effects included health care
usage and reductions in child maltreatment. Less common were favorable effects on
birth outcomes.
CONCLUSIONS

Home visiting is a promising way to serve families who may be difficult to engage in
supportive services. Existing rigorous research indicates that home visiting has the
potential for positive results among high-risk families, particularly on health care usage
and child development.

REFERENCE

Filene, J.H., Kaminski, J.W., Valle, L.A. and Cachat, P. (2013). Components Associated
With Home Visiting Program Outcomes: A Meta-analysis. Pediatrics, [online]
132(Supplement 2), pp.S100–S109.
Available at:
https://pediatrics.aappublications.org/content/132/Supplement_2/S100#abstract-1
[Accessed 2 Oct. 2020].

INTRODUCTION

 Did the title of the article interest you and give you an immediate idea of
what the research is about? Who are the authors of the article/conductors
of the research and in which journal is the article published? Does the
introduction of the article, clearly describe what problem they were
addressing in the research?

The article entitled “Effectiveness of Home Visiting in Improving Child Health and Reducing
Child Maltreatment” caught my attention because this research study focuses on programs that
provide home visiting as a service delivery strategy to reach pregnant women and families with
children birth through school-entry. It also provides service, information and guidance in a way
that overcomes many of the traditional barriers to service delivery. For example, many high-risk
families have limited transportation options. Home visitation reaches families in their homes,
eliminating this barrier.
 The author of the article, “Effectiveness of Home Visiting in Improving Child Health and
Reducing Child Maltreatment” are Sarah A. Avellar, PhD and Lauren H. Supplee, PhD and it was
published under the American Academy of Pediatrics on August 26, 2013. The introduction of
this article described the problem clearly.

 Does the introduction clearly describe the purpose of the research?

The introduction clearly described the purpose of the research and it is to determine the
efficacy of the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program because
the research remains mixed about the efficacy of home visiting, largely due to the widely
varying programs and program goals. Thus, not all home visiting programs may be effective for
improving the health and well-being of children and families.

 Is the research likely to have an impact on our nursing practice?

The research does have an impact to the nursing practice because with the help of this
study, we as level II student nurses can learn and relate this to our subjects such as Maternal
and Child Nursing (MCN) and Community Health Nursing (CHN) because Home visiting is a
service delivery mechanism that has been used across many disciplines, for prevention or
intervention, to reach individuals from pregnancy through old age. These individuals are part of
a family and families makes up a community.

LITERATURE REVIEW

 Is the literature current? (in the last 5-10 years).

Some of the literature are past the ranges of 5-10 years from the present year and from the
year it was published. Each year, the conductors initiate a broad search for literature on home
visiting program models serving pregnant women or families with children from birth to age 5.
conclude that some of the literature that was used in this study is not current.
  Is the literature review relevant to the research that has been conducted?

The review of literature is relevant because it supports the purpose of the research,
which is to determine the efficacy of the Maternal, Infant and Early Childhood Home Visiting
(MIECHV) program.

RESEARCH QUESTION

 What is the research question/hypothesis?

RESEARCH METHODS

 Is the research quantitative/qualitative?

The article entitled “Effectiveness of Home Visiting in Improving Child Health and
Reducing Child Maltreatment” is a qualitative type of research.

 What is the research method?

According to the study the method that was used in the article were a systematic search
and screening process, a review of the research quality, and an assessment of program
effectiveness.

 Do you think it is appropriate/the best way?

Based on the results and finding of the said study, I think that the method that was used
was appropriate in a way that the study wants to measure and compare the gathered
information on the efficacy of home visiting programs.

 What was the method of sampling participants?

There was no specific method of sampling that was stated in the study.

 Was the sample big enough?

There was no specific number of sampling that was stated in the study.

 Could there be any bias in the sample? If yes, why?

 Trained reviewers assessed the research on selected models and rated studies based on
their capacity to provide unbiased estimates of program impacts. The review included 2
types of designs:(1) randomized controlled trials and (2) quasi-experimental designs
(including matched comparison studies, single case designs, and regression discontinuity
designs). I conclude that there was no bias in the sample.

 How was the data collected?

The data was gathered based on the DHHS evidence-based programs that included
statistically significant findings—either favorable or unfavorable/ambiguous—on child
health and development or child maltreatment. Programs that did not meet the DHHS
criteria are not discussed.

 Where any tools used? Were they reliable and accurate?

The tool they used is called Artifact Analysis where they conducted a comprehensive
search of the literature. Which includes details of the searching, screening, and
prioritization process. The team identified published and unpublished research through
database searches, a call for studies, Web searches, and reference lists from recently
published reviews. Which I conclude are reliable and accurate.

 Did they need/get ethics approval to conduct the study?

There were no ethics approval needed stated in the article to conduct the study.

RESULTS AND FINDINGS

 How was the data analyzed?

They focused on the DHHS evidence-based programs that included statistically significant
findings—either favorable or unfavorable/ambiguous—on child health and development or
child maltreatment. Programs that did not meet the DHHS criteria are not discussed. Direct
comparisons were conducted.
 Out of the 32 models reviewed, 12 met the DHHS criteria for an evidence-based early
childhood home visiting model: (1) Child FIRST, (2) Early Head Start-Home Visiting (EHS), (3)
Early Intervention Program for Adolescent Mothers (EIP), (4) Early Start (New Zealand), (5)
Family Check-Up, (6) Healthy Families America (HFA), (7) Healthy Steps, (8) Home
Instruction for Parents of Preschool Youngsters (HIPPY), (9) Nurse-Family Partnership (NFP),
(10) Oklahoma’s Community-Based Family Resource and Support(CBFRS)Program, (11)
Parents as Teachers (PAT), and (12) Play and Learning Strategies (PALS) for Infants.

 What were the findings of the research?

A c c o r d i n g t o t h
models were reviewed, of which 12 met the Department of Health and Human Services criteria.
Most of these models were shown to have favorable effects on child development. Other
common favorable effects included healthcare usage and reductions in child maltreatment. Less
common were favorable effects on birth outcomes.

 Where the results displayed in a clear and understanding way?

 The results and data are in narrative form and in a table to identify and compare the 12
program models about the favorable or unfavorable outcomes on child health and
development or child maltreatment.

 Did the authors discuss the results in relation to the original problem
identified?

The authors clearly elaborated the results the best and easiest way to answer the
problem.

 What were the main strengths of the study?

 What do you think were the limitations of the study and were they identified
by the authors?

REFLECTION

 Could the study be replicated?

 Does the study, or could you, make any suggestions as to how this
research could be taken further?
 How can you relate this research and its findings to your nursing practice
and patient care?
 Consider one thing you have learnt from reading this article.