right@home

Right@home is an Australian multi-state, sustained nurse home visiting randomised controlled trial (RCT) designed to promote family wellbeing and child development. The trial is based on the Maternal Early Childhood Sustained Home-visiting program and incorporates additional modules based on the best evidence to help parents care for and respond to their children, creating a supportive home learning environment.

Program Area:
Education
Location:
Victoria
Amount:
$600,000
Project Dates:
July 2011 - June 2015
right@home family and researcher from CCCH

Background

A collaborative partnership, right@home draws on the strengths of three organisations: the Australian Research Alliance for Children and Youth (ARACY), the Centre for Community Child Health (CCCH) at the Murdoch Children's Research Institute, and the Translational Research and Social Innovation (TReSI) group at Western Sydney University.

• ARACY acts as project manager, overseeing funding, governance and reporting,
• CCCH leads the research evaluation, including designing and administering follow up assessments and coordinating data analysis.
• TReSI lead implementation, providing supervisory advice and training to right@home nurses and social care practitioners, as well as monitoring and reporting on program fidelity.

The right@home project is based on the evidence that investment in the early years provides the best return in terms of children’s health and development across the life course. In Australia today, more than one in five children is developmentally vulnerable by the time they enter kindergarten. Research suggests that when children start school on the back foot, they usually don’t catch up – they fall further behind.

Only a small number of programs in Australia are designed to specifically meet the learning and development needs of young children before they enter school. A shortage of evaluation evidence means that we do not know if these are effective in shifting outcomes for children.

Right@home was designed to help fill this evidence gap by providing robust evidence on whether sustained nurse home visiting (SNHV) can improve children’s readiness for school, by helping to shape their home, parenting and learning environments.

Approach

The right@home research trial is underway in seven Australian sites and will measure outcomes for more than 700 families.

Right@home offers long-term relationship-based home visiting by highly qualified child and family health nurses from the antenatal period until a child turns two.  It is based on the Maternal and Early Childhood Sustained Home-visiting (MECSH) program – a structured program of SNHV for families at risk of poorer maternal, child health and developmental outcomes. Right@home includes additional modules to help parents care for and respond to their children, and to create a supportive home learning environment.

There are two phases to this research. In Phase 1, we aimed to find out via a randomised control trial (RCT) if these extra visits, offered until babies turn 2 years old, make it easier for parents to learn about things like feeding, parenting and managing their baby's sleep.

Families in the intervention group are offered the program from the antenatal period up to when children turn 2 years old. Families in the control group continue to receive usual care. When children turn 2 years old, the study will evaluate the impact of the sustained nurse home visiting program on:

1. Parent care
2. Parent attunement and responsivity
3. Supportive home environment.

In Phase 2, we will conduct research to determine long-lasting effects of the SNHV program on children's early learning and development, with research conducted at 3, 4 and 5 years up to the start  of primary school. Phase 1 relied predominently on maternal measures to test the effectiveness of the intervention. In phase 2 of the project we will conduct research on children's language and development measures.

Success

Under right@home’s collaborative model, each organisation drives their area of the project with a high degree of rigour and independence, and is supported to excel in their role. This has ensured a trial of exceptional quality, which is delivered with strong fidelity and excellent dose and retention rates.

Past research in this field has shown more vulnerable populations are very difficult to engage in research, especially this kind of longitudinal study. Despite this, our research cohort has been retained at a high level, with 94% of participants continuing in the study as of December 2015.

Conclusion

Primary outcomes from the trial will be published in 2017. If the trial shows that right@home has a significant positive impact, we will know it is a good investment to improve child development and family well-being. Both the Tasmanian and Victorian governments are considering offering right@home to families through their child and family health systems if the RCT results support its implementation.

Author: Rebecca Beard, ARACY

Further information can be found on the ARACY website

'This project meets incredibly well with our Education objectives and funding principles seeking to reduce educational disadvantage by enhancing parents' ability to provide a positive home learning environment. The project is innovative, collaborative and preventative and we are looking forward to the findings in 2017. Not only has the project been collaborative in terms of the organisations involved but also in terms of the funding approach. This project is jointly funded by Vincent Family Fairfax Foundation and The Sidney Myer Fund along with support from the Victorian and Tasmanian State Governments.'

Nicole Bortone, Education Program Manager, The Ian Potter Foundation

 

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