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社区母亲项目:非专业育儿干预的随机对照试验

Community mothers' programme: randomised controlled trial of non-professional intervention in parenting.

作者信息

Johnson Z, Howell F, Molloy B

机构信息

Eastern Health Board, Health Information Unit, Dr Steevens Hospital, Dublin, Ireland.

出版信息

BMJ. 1993 May 29;306(6890):1449-52. doi: 10.1136/bmj.306.6890.1449.

Abstract

OBJECTIVE

To see whether non-professional volunteer community mothers could deliver a child development programme to disadvantaged first time mothers for children aged up to 1 year.

DESIGN

Randomised controlled trial.

SETTING

A regional health authority in Dublin.

SUBJECTS

262 first time mothers who were delivered during six months in 1989 and who lived in a deprived area of Dublin; 30 experienced mothers from the same community recruited as community mothers.

INTERVENTIONS

All the first time mothers received standard support from the public health nurse. In addition, those in the intervention group received the services of a community mother, who was scheduled to visit monthly during the first year of the child's life.

RESULTS

232 (89%) first time mothers completed the study--127 in the intervention group, 105 controls. At the end of the study children in the intervention group were more likely to have received all of their primary immunisations, to be read to, and to be read to daily, played more cognitive games; and were exposed to more nursery rhymes. They were less likely to begin cows' milk before 26 weeks and to receive an inappropriate energy intake and inappropriate amounts of animal protein, non-animal protein, wholefoods, vegetables, fruit, and milk. Mothers in the intervention group also had a better diet than controls. At the end of the study they were less likely to be tired, feel miserable, and want to stay indoors; had more positive feelings; and were less likely to display negative feelings.

CONCLUSION

Non-professionals can deliver a health promotion programme on child development effectively. Whether they can do so as effectively as professionals requires further study.

摘要

目的

探讨非专业志愿者社区母亲能否为处境不利的初产妇提供针对1岁以下儿童的儿童发展项目。

设计

随机对照试验。

地点

都柏林的一个地区卫生当局。

研究对象

1989年6个月内分娩且居住在都柏林贫困地区的262名初产妇;从同一社区招募的30名经验丰富的母亲作为社区母亲。

干预措施

所有初产妇均接受公共卫生护士的标准支持。此外,干预组的产妇还可获得社区母亲的服务,社区母亲计划在孩子出生后的第一年每月进行家访。

结果

232名(89%)初产妇完成了研究——干预组127名,对照组105名。研究结束时,干预组的儿童更有可能完成所有基础免疫接种、有人给他们读书且每天都有人读书、玩更多认知游戏、接触更多儿歌。他们在26周前开始喝牛奶、摄入能量不当、摄入动物蛋白、非动物蛋白、全食物、蔬菜、水果和牛奶量不当的可能性较小。干预组的母亲饮食也比对照组更好。研究结束时,她们感到疲倦、难受和想待在室内的可能性较小;有更积极的情绪;表现出消极情绪的可能性较小。

结论

非专业人员可以有效地开展关于儿童发展的健康促进项目。他们是否能像专业人员一样有效地开展该项目还有待进一步研究。

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