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Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden

BACKGROUND: Understanding the mechanisms of implementation of public health interventions in community settings is a key aspect of programme assessments. To determine core components and establish a programme theory are important tools to improve functioning and support dissemination of programme mo...

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Autores principales: Barboza, Madelene, Marttila, Anneli, Burström, Bo, Kulane, Asli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9158140/
https://www.ncbi.nlm.nih.gov/pubmed/35650586
http://dx.doi.org/10.1186/s12889-022-13492-3
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author Barboza, Madelene
Marttila, Anneli
Burström, Bo
Kulane, Asli
author_facet Barboza, Madelene
Marttila, Anneli
Burström, Bo
Kulane, Asli
author_sort Barboza, Madelene
collection PubMed
description BACKGROUND: Understanding the mechanisms of implementation of public health interventions in community settings is a key aspect of programme assessments. To determine core components and establish a programme theory are important tools to improve functioning and support dissemination of programme models to new locations. An extended early childhood home visiting intervention has been developed on-site in a socioeconomically disadvantaged area of Sweden since 2013 with the aim of reducing persisting health inequities in the population. This study aimed at investigating the core programme components and how the intervention was perceived to contribute towards health equity from early childhood. METHODS: Qualitative framework method was applied in a document analysis and subsequent semi-structured interviews with 15 key actors involved in the programme. RESULTS: The intervention was found to be constituted of five core components centred around the situation-based, parental strengthening work method delivered by a qualified team of child health care nurse and social worker. The programme theory foresaw positive effects on child and parental health, responsive parenting practices, families’ use of welfare services according to need and increased integration and participation in society. The principles of Proportionate Universalism were recognised in the programme theory and the intervention was perceived as an important contribution to creating conditions for improved health equity for the families. Still, barriers to health equity were identified on the structural level which limit the potential impact of the programme. CONCLUSIONS: The core components of the Extended home visiting programme in Rinkeby correspond well to those of similar evidence-based home visiting interventions. Combining focus on early childhood development and responsive parenting with promoting access to the universal welfare services and integration into society are considered important steppingstones towards health equity. However, a favourable macro-political environment is required in the endeavour to balance the structural determinants’ influence on health inequities. Improved availability and accessibility to welfare services that respond to the needs of the families regarding housing, education and employment are priorities. TRIAL REGISTRATION: The study was retrospectively registered on 11/08/2016 in the ISRCTN registry (ISRCTN11832097). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13492-3.
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spelling pubmed-91581402022-06-02 Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden Barboza, Madelene Marttila, Anneli Burström, Bo Kulane, Asli BMC Public Health Research BACKGROUND: Understanding the mechanisms of implementation of public health interventions in community settings is a key aspect of programme assessments. To determine core components and establish a programme theory are important tools to improve functioning and support dissemination of programme models to new locations. An extended early childhood home visiting intervention has been developed on-site in a socioeconomically disadvantaged area of Sweden since 2013 with the aim of reducing persisting health inequities in the population. This study aimed at investigating the core programme components and how the intervention was perceived to contribute towards health equity from early childhood. METHODS: Qualitative framework method was applied in a document analysis and subsequent semi-structured interviews with 15 key actors involved in the programme. RESULTS: The intervention was found to be constituted of five core components centred around the situation-based, parental strengthening work method delivered by a qualified team of child health care nurse and social worker. The programme theory foresaw positive effects on child and parental health, responsive parenting practices, families’ use of welfare services according to need and increased integration and participation in society. The principles of Proportionate Universalism were recognised in the programme theory and the intervention was perceived as an important contribution to creating conditions for improved health equity for the families. Still, barriers to health equity were identified on the structural level which limit the potential impact of the programme. CONCLUSIONS: The core components of the Extended home visiting programme in Rinkeby correspond well to those of similar evidence-based home visiting interventions. Combining focus on early childhood development and responsive parenting with promoting access to the universal welfare services and integration into society are considered important steppingstones towards health equity. However, a favourable macro-political environment is required in the endeavour to balance the structural determinants’ influence on health inequities. Improved availability and accessibility to welfare services that respond to the needs of the families regarding housing, education and employment are priorities. TRIAL REGISTRATION: The study was retrospectively registered on 11/08/2016 in the ISRCTN registry (ISRCTN11832097). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13492-3. BioMed Central 2022-06-01 /pmc/articles/PMC9158140/ /pubmed/35650586 http://dx.doi.org/10.1186/s12889-022-13492-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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 Research
Barboza, Madelene
Marttila, Anneli
Burström, Bo
Kulane, Asli
Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
title Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
title_full Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
title_fullStr Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
title_full_unstemmed Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
title_short Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
title_sort towards health equity: core components of an extended home visiting intervention in disadvantaged areas of sweden
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9158140/
https://www.ncbi.nlm.nih.gov/pubmed/35650586
http://dx.doi.org/10.1186/s12889-022-13492-3
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