Significance testing not Improved maternal general and conducted. social self-efficacy, relationship Moderate positive effects: Significance testing with baby and parenting reflective functioning, not conducted. Overall, greater Overall, decreased IPV stress. Decreased depression caregiving behaviour. Small All infants remained reduction in incidence during Improved tangible and total and state anxiety and positive effects: maternal safely in home with AUDIT scores for pregnancy. babies support, family functioning, increased overall full coherence and sensitivity no removals or Meta-analytic IG (only born with very LBW and and reduced maternal mindfulness, (quality of representations of child protection review findings significant for at very preterm moodiness/ emotional lability particularly "acting child) and psychiatric investigations. Improved infant Program confirmed delivery. Greater and social isolation/ withdrawal with awareness" and symptoms (depression and Reduced risk in 80% attachment drinkers) gestational age. (grandmother reported) "describing". global distress). of families. security. Element Manual/protocol ? ? Y Y Y ? Y/? Targeted issue Y Y Y Y Y N Y Trained/qualified deliverers Y Y Y Y Y ? Y Y (EI) ? Y (adapted from EI program) ? ? ? Y/? Fidelity monitoring ? ? Y ? Y ? Y/? Delivery during routine visits ? Y N N N N N/? Risk assessment/ screening Y Y N Y Y Y ? Individualised approach* Y Y ? N Y Y Y Therapeutic component Y Y Y Y Y Y Y † Pre- and natal support N Y N N N N N/? Tangible support N ? ? ? Y Y N/? Ongoing support N N Y N N Y Y/N Y Individual (plus and session Y Y N N Y community context) Y/N
Program Element Overall, greater reduction in AUDIT scores for IG (only significant for confirmed drinkers) Overall, decreased IPV incidence during pregnancy. babies born with very LBW and at very preterm delivery. Greater gestational age. Improved maternal general and social self-efficacy, relationship with baby and parenting stress. Improved tangible and total support, family functioning, and reduced maternal moodiness/ emotional lability and social isolation/ withdrawal (grandmother reported) Decreased depression and state anxiety and increased overall full mindfulness, particularly "acting with awareness" and "describing". Significance testing not conducted. Moderate positive effects: reflective functioning, caregiving behaviour. Small positive effects: maternal coherence and sensitivity (quality of representations of child) and psychiatric symptoms (depression and global distress). Significance testing not conducted. All infants remained safely in home with no removals or child protection investigations. Reduced risk in 80% of families. Meta-analytic review findings Improved infant attachment security. Manual/protocol ? ? Y Y Y ? Y/? Targeted issue Y Y Y Y Y N Y Trained/qualified deliverers Y Y Y Y Y ? Y (EI) ? Y Y (adapted from EI program) ? ? ? Y/? Fidelity monitoring ? ? Y ? Y ? Y/? Delivery during routine visits ? Y N N N N N/? Risk assessment/ screening Y Y N Y Y Y ? Individualised approach* Y Y ? N Y Y Y Therapeutic component † Y Y Y Y Y Y Y Pre- and natal support N Y N N N N N/? Tangible support N ? ? ? Y Y N/? Ongoing support N N Y N N Y Y/N Individual session Y Y N N Y Y (plus and community context) Y/N
improving_service_responses_to_vulnerable_families_during_pregnancy_and_infancy.docx