A randomized controlled trial of alternative approaches to community follow-up for postpartum women.

This three-group randomized controlled trial assessed the effectiveness of a postpartum public health nurse telephone visit on infant-care behaviours of primiparous women in Ottawa-Carleton. The impact of a clerk call on recruiting mothers to parent-baby groups was also described. Low risk primiparas were randomized into telephone visit, clerk call and control groups. At three months postpartum, there were no significant differences in infant-care behaviour scores among the study groups. Women who received the telephone visit had the highest parent-baby group attendance rates and among attenders, the highest rates of smoking during pregnancy, the least education, and lowest incomes. Analysis of variance revealed a significant interaction term between attendance at parent-baby groups and assigned study group. This effect disappeared after adjusting for age and education. The telephone visit was no more effective in producing the desired infant-care behaviour changes than a mailed out information package with or without a clerk phone call. However, the intervention did increase the utilization of parent-baby support groups by women who were more socioeconomically disadvantaged.