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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

New families- Innovation and Development of the Child Health Services in Oslo

Alternative title: Innovasjon og utvikling i helsestasjonstjenesten i Oslo

Awarded: NOK 8.0 mill.

Given years of serious challenges, in 2013, District Stovner launched the development of a project focusing on primary prevention. The result was "New Mothers", a pilot program designed as a universal service for all first-time parents, where Public Health nurses conducted repeated home visits to the first-time parents, from week 28 in pregnancy until the child was two years old. The project was integrated in the primary health services, which meant that the same nurse conducted both the home visits and follow-ups at the Child Health Service (CHS). The rationale for home visits during pregnancy was that the public health nurse would get to know the family before birth, thus creating the basis for a good relationship that provided assurance and confidence. The theoretical perspective was salutogenic, where self-efficacy and user involvement are central elements. Thus, the focus for the home visits was resource mobilization that could strengthen the family and be a driving force for positive changes and choices. Founded on experiences from "New Mothers" and available knowledge about early intervention, in the 2016, Oslo City Council decided to continue to build on this pilot. The result was the "New Families" program (NF), which included mother, father/co-mother and child. NF consists of the same theoretical and methodological approaches as "New Mothers". One difference is a change of the target group, which now includes couples expecting their first child together, their first child in Norway and multiparents with a need for additional guidance and support. The aims for NF are to strengthen families with children and promote parents and children's health, create a good and safe early childhood, promote child maturity with respect to schooling, and strengthen mothers and father's mastery and confidence as parents. In addition, interdisciplinary work will be undertaken to strengthen family participation in community life. The long-term aims are to reduce costly secondary- and tertiary prevention measures, such as child welfare interventions, and to reduce cost related to welfare benefits. Currently, the program is implemented in 11/15 districts and by the end of 2019, it will be implemented in the last four districts in Oslo. There's been increased media attention on the program, given its strong political priority from Oslo City Councils Government for Education. In addition to participating in different forums, congresses and Conferences, both domestic and abroad, the program has been presented orally and by posters. In 2018 the NF program has been presented or been in the media seven times, and in 2019 the program has been presented at 12 occasions. The research project is historical, by being the first one owned by the Oslo City Council where VID is academically responsible, in cooperation with FHI and UiO. The project has completed the recruitment of parents in case and control districts in October 2019. There are 403 participants who have agreed to participate in the project. Data collection will continue until spring 2021. Data collections is closed for the first three measuring points and data is plotted. A questionnaire survey was conducted for participating parents in connection with the consequences of Covid 19. Data has been analyzed and an article has been submitted to a journal for publication. A new survey for participating parents about the consequences of Covid 19 will be conducted in November / December 2020. In the autumn of 2020, interviews will be conducted with parents in the intervention intervention districts. All data (5 questionnaires) are plotted and checked and ready for analysis. There are 428 participants in the study (mothers and fathers) at the first measurement time 28 weeks in pregnancy. 60% of the participants answered the last questionnaire 12 months after birth. Two scientific articles from the project were published in 2021. The project was presented at four conferences and in four research-related meetings in 2021. The project group has had 2 steering group meetings and 4 project group meetings and a seminar with the Advisory Committee.

The Primary health care (PHC) in Norway is experiencing an escalating demand for complex and long-term social services. A high degree of social disparity and poverty increases the need for comprehensive measures and expanded services for a larger number of families and individuals. The Child Health Service (CHS) is an integrated part of the primary care services. CHS includes all children from birth until 18 years. CHS is perhaps the most under-researched entity in the PHC. New families (NF), an early intervention program will be implemented in all of Oslo by the end of 2020. The NF universally targets all first-time parents regardless of socioeconomic status, and consists of PHNs providing extensive home visits from gestational week 28 until the child is two, in order to support and help families based on their needs. The intention of the proposed project is to use the four next years, to explore if, and to what degree, the NF improves the quality of the existing services, secures personalised service and early intervention in CHS in Oslo. We will create two work packages; The effect of a primary prevention family-centred healthcare intervention and Service development in Child Health Service. The primary objective is that the New Families project will secure innovative and needed practice-based research that enhances the quality, knowledge-base and impact of the CHS service in Norway. An experienced group of researchers and content experts are confident in the merits of the proposed evaluation. The project will be led by the Department for Primary Health and Social Affairs, City of Oslo and VID Specialized University (VID) as administrative responsible main partner. Core collaborators are UiO and the Norwegian Institute of Public Health (FHI). The project has an international Advisory Committee. The risks are mainly lack of funding, long term illness among central team members, and political decisions that could change the context of the involved areas.

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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester