gms | German Medical Science

Background: Vulnerable parents have a special need for information and support, however, they less often take up preventative support offers than less vulnerable families [1]. At the same time, identifying families in need and contacting them early on proves difficult, as specially designed prevention measures, unlike universal measures, carry a stigma and can appear controlling [2].

Against this background, a midwifery related study about the effectiveness of contacting young families early on, in order to carry out measures of early intervention programs and identifying this target group, was conducted at the Protestant University of Applied Sciences Berlin, on behalf of the Berlin Senate Department for Education, Young People and Science.

Aim: The study examined through which means of assessment or by what criteria vulnerable parents were identified in their home setting after the birth of their child and whether a home visit, in order to make contact early on, has proven effective towards implementing measures of early intervention programs. The results are to inform recommendations to optimise procedures for establishing early contact.

Methods: The study followed a mixed-method-design. Employees of early intervention programs (n=48) were asked to complete an online-questionnaire about the use of means of assessment and any standardisation of the first home visit as well as to evaluate different ways of contacting parents early on. Participants of early intervention programs (n=9) were asked through guideline-based interviews about how they experience the first contact and what motivates them to engage with measures of early intervention programs.

Results: Most of the employees (73%) stated that their facility follows set out pathways to identify vulnerable families. The criteria mentioned most were “substance abuse, mental health problems, behavioural problems or disabled child”. Approved means of assessment are only used occasionally.

The study conductors were able to recruit educated participants for the interviews only. Those participants voiced their appreciation for the measures of early intervention programs. However, a home visit leaves them feeling stigmatised and controlled by the facility who carried out the home visit.

Relevance: Midwives and family midwives have to identify precisely those families in need of their help but have to avoid stigmatisation to deliver high quality service [3]. Getting into contact with parents early on impacts on their feelings for autonomy and control. Employees of early intervention programs need to be aware of these effects.

Recommendation: Where possible, approved criteria should be used to identify vulnerable parents. In order to reach parents for measures of early intervention programs in an effective and non-stigmatising way, all parents-to-be should be informed early on about the reasoning and intentions of home visits. This can also happen through digital media. Having parents participate and transparency supports making early contract. Universal offers do reinforce the prevention paradox [4], but they also destigmatise early contact with vulnerable parents [5].

Ethics and conflicts of interest: No vote on ethics was obtained. The research was supported by external funding. There are no conflicts of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].