right@home is a randomised controlled trial (RCT) investigating whether an Australian model of sustained nurse home visiting (SNHV) can make a difference to child development and family wellbeing. right@home offers long-term, relationship-based home visiting by highly qualified child and family health nurses from the antenatal period until their child turns two.
Why is right@home so important?
In Australia today, more than one in five children is considered developmentally vulnerable at the time they enter kindergarten (AEDC, 2016). This means they are falling behind their peers in at least one of five categories of physical health, behaviour, emotions, language and communication. Research suggests that when children start school on the back foot, they usually don’t catch up – they fall further behind.
Only a small number of programs in Australia are designed to specifically meet the learning and development needs of young children before they enter school. A shortage of evaluation evidence means that we do not know if these are effective in shifting outcomes for children.right@home will help fill this gap by providing a robust evidence on how SNHV can improve children’s readiness for school, by helping to shape their home, parenting and learning environments.
About the research
right@home aims to find out how the universal child and family health nursing service might be improved to better meet the needs of all families. One way to do this is to offer more nurse visits in people's homes for families who might benefit from this type of approach.
There are two phases to this research. In Phase 1, we want to know if these extra visits, offered until babies turn 2 years old, make it easier for parents to learn about things like feeding, parenting and managing their baby's sleep.
Families in the intervention group will be offered the program from the antenatal period up to when children turn 2 years old. Families in the control group will continue to receive usual care. When children turn 2 years old, the study will evaluate the impact of the sustained nurse home visiting program on:
1. Parent care
2. Parent responsivity
3. Supportive home environment.
In Phase 2, we want to know if there are long-lasting effects of the extra visits on children's early learning and development by the time they start school.
About the intervention
right@home is delivered by highly trained child and family health nurses and is embedded in the universal system. It is based on the Maternal Early Childhood Sustained Home-visiting (MECSH) program ‒ a structured program of sustained nurse home visiting for families at risk of poorer maternal and child health and development outcomes. right@home also includes additional modules based on the best evidence to help parents care for and respond to their children, and to create a supportive home learning environment. All right@home teams include a social worker who offers additional support to the nurses and families.
When did it start?
The Victorian component of right@home was launched on 30 April 2013. The trial started in Tasmania in July 2013. Phase 1 results, analysis and public reporting are expected to occur in 2016-17; and for Phase 2, in 2018-19.
Who is running right@home?
right@home is a collaborative partnership that draws on the strengths of three significant organisations ‒ ARACY, the Centre for Community Child Health and the Translational Research and Social Innovation Group (TReSI) at Western Sydney University. Each of these partners contributes specific expertise to ensure the trial is conducted with world-class efficiency and effectiveness.
ARACY acts as project managers, overseeing funding, governance and reporting. With ARACY’s leadership and relationship brokering, each organisation in the collaboration is supported to excel in their role.
CCCH leads the research evaluation of right@home. They design and administer follow up assessments, coordinate data analysis, and plan the project publications.
TReSI leads implementation support for the intervention. They provide supervisory advice and support to right@home nurses, monitoring and reporting on program fidelity, and oversight of a community of practice of all clinicians delivering MECSH-based programs worldwide.
In this way, each organisation drives their area of the project with a high degree of rigour and independence. This unique collaboration ensures a rigorous and robust evaluation of right@home.
Who has funded the study?
right@home is supported by a combination of monetary and ‘in-kind’ contributions from the following organisations:
- Victorian Department of Education and Early Childhood Development
- Tasmanian Department of Health and Human Services
- The Ian Potter Foundation
- Sabemo Trust
- Sidney Myer Fund
- Vincent Fairfax Family fund
- National Health and Medical Research Council
A series of three literature reviews were conducted by CCCH to inform the design of the right@home intervention:
- Sustained nurse home visiting for families and children: A review of effective programs
- Sustained nurse home visiting for families and children: A review of effective processes and strategies
- Evidence-based service modules for a sustained nurse home visiting program
Project manager: Dr Charlene Smith, firstname.lastname@example.org
Research manager: Dr Anna Price, email@example.com
Sustained nurse home visiting program: Prof Lynn Kemp, firstname.lastname@example.org