Health home visiting for vulnerable families: what has occurred and what is yet to arrive?

Sustained health home visiting (SHHV) is a valuable means of implementing early intervention for vulnerable families with infants or young children. This first of a two-part report describes clients and identifies nurses' activities with or on behalf of clients as part of a pilot SHHV program undertaken within a socioeconomically disadvantaged suburban area of Sydney, New South Wales, Australia. A forthcoming report describes the results of the intervention. Child and family health nurses visited vulnerable clients who were pregnant and/or had an infant aged 36 months or younger. Interventions consisted of direct and indirect (i.e. services involving a third party) client contact. Nurses documented all activities undertaken with or on behalf of clients using pre-determined codes. Over 29 months, the program accepted 136 referrals and 118 (87%) consented to the evaluation. Families had a mean of eight risk factors, which commonly included current mental health symptoms or disorders (49%), a history or current experience of domestic violence (51%) and being known to the Department of Community Services (40%). Nurses' most frequent interventions addressed the main carer's emotional and health needs, and infant development. Clients' level of need required coordinated care from a specialised multidisciplinary team, which was unavailable to program clients and their families.