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Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries

BACKGROUND: Disparities in health persist even in high-income countries, and healthcare systems do not reach disadvantaged families as needed. A number of home-visiting interventions in high-income countries offering peer support for parents have been implemented to bridge the gaps in health in a co...

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Autores principales: Kåks, Per, Målqvist, Mats
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376883/
https://www.ncbi.nlm.nih.gov/pubmed/32703302
http://dx.doi.org/10.1186/s12913-020-05540-8
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author Kåks, Per
Målqvist, Mats
author_facet Kåks, Per
Målqvist, Mats
author_sort Kåks, Per
collection PubMed
description BACKGROUND: Disparities in health persist even in high-income countries, and healthcare systems do not reach disadvantaged families as needed. A number of home-visiting interventions in high-income countries offering peer support for parents have been implemented to bridge the gaps in health in a cost-effective way. The lack of standard for intervention design has however resulted in a large variety of the strategies used. The objective for this article is to conduct a review of peer support home visiting interventions for parents and children in high-income countries, aiming to assess the strategies used, their outcomes and the challenges faced by peer supporters. METHODS: Relevant articles published in English between January 2004 and August 2019 were identified using PubMed, and reference lists were reviewed to identify additional articles. Studies were included if they reported on individual peer support health interventions, delivered at home to socioeconomically disadvantaged parents in high-income countries. Nineteen studies were found that met the inclusion criteria, and data were extracted on study characteristics, intervention design and outcomes. Data on intervention design was characterized iteratively to generate overarching categories of strategies used in the programs. RESULTS: Most studies used healthcare facilities for recruitment, even when the interventions were not delivered by the formal healthcare system. The strategies used to engage supported parents included (1) connection in the form of emotional support, relationship building and matching for background, (2) flexibility in regards to content, intensity, location and mode of contact, and (3) linking through referrals and facilitation of other contacts. A number of significant quantifiable improvements could be demonstrated. Due to large heterogeneity of outcomes, meta-analyses were not viable. Peer supporters experienced challenges with involving other family members than the supported parent as well as with finding their role in relation to other support structures. CONCLUSIONS: Peer support delivered as home visiting interventions have been used for hard-to-reach parents in a variety of high-income contexts and for a multitude of health concerns. Overall, despite variation in intervention design, the strategies employed followed common themes and were generally well received.
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spelling pubmed-73768832020-07-23 Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries Kåks, Per Målqvist, Mats BMC Health Serv Res Review BACKGROUND: Disparities in health persist even in high-income countries, and healthcare systems do not reach disadvantaged families as needed. A number of home-visiting interventions in high-income countries offering peer support for parents have been implemented to bridge the gaps in health in a cost-effective way. The lack of standard for intervention design has however resulted in a large variety of the strategies used. The objective for this article is to conduct a review of peer support home visiting interventions for parents and children in high-income countries, aiming to assess the strategies used, their outcomes and the challenges faced by peer supporters. METHODS: Relevant articles published in English between January 2004 and August 2019 were identified using PubMed, and reference lists were reviewed to identify additional articles. Studies were included if they reported on individual peer support health interventions, delivered at home to socioeconomically disadvantaged parents in high-income countries. Nineteen studies were found that met the inclusion criteria, and data were extracted on study characteristics, intervention design and outcomes. Data on intervention design was characterized iteratively to generate overarching categories of strategies used in the programs. RESULTS: Most studies used healthcare facilities for recruitment, even when the interventions were not delivered by the formal healthcare system. The strategies used to engage supported parents included (1) connection in the form of emotional support, relationship building and matching for background, (2) flexibility in regards to content, intensity, location and mode of contact, and (3) linking through referrals and facilitation of other contacts. A number of significant quantifiable improvements could be demonstrated. Due to large heterogeneity of outcomes, meta-analyses were not viable. Peer supporters experienced challenges with involving other family members than the supported parent as well as with finding their role in relation to other support structures. CONCLUSIONS: Peer support delivered as home visiting interventions have been used for hard-to-reach parents in a variety of high-income contexts and for a multitude of health concerns. Overall, despite variation in intervention design, the strategies employed followed common themes and were generally well received. BioMed Central 2020-07-23 /pmc/articles/PMC7376883/ /pubmed/32703302 http://dx.doi.org/10.1186/s12913-020-05540-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Kåks, Per
Målqvist, Mats
Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
title Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
title_full Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
title_fullStr Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
title_full_unstemmed Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
title_short Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
title_sort peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376883/
https://www.ncbi.nlm.nih.gov/pubmed/32703302
http://dx.doi.org/10.1186/s12913-020-05540-8
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