Public Health Nurse Home Visitation for the Tertiary Prevention of Child Maltreatment: Results of a Pilot Study*

The purpose of this pilot study was to assess the feasibility of using public health nurse home visitation for the tertiary prevention of child maltreatment. The intervention was designed to provide support to the parents, education about child-rearing and child development and to assist families obtaining help from other services. Eighteen families referred from the Hamilton-Wentworth child protective agencies participated in the intervention. Enrolment criteria included first episode of suspected or verified child physical abuse or neglect, ongoing involvement with a child protective agency, index child less than 12 years of age and remaining in the home, and agreement to participate in the study. Home visits were provided weekly on average over a period of six months and the nurses were available by telephone. Pilot assessment included review of medical records, semi-structured interviews to gather background information, checklists of child-rearing attitudes, child behaviour and development. The participants were interviewed about their response to the intervention. The high degree of mobility of the families posed a problem in recruitment. Nevertheless, the public health nurses were able to develop a working alliance with 14 of the 18 families (77%) who participated. The participants gave permission for review of their medical records and reported that the methods of assessment were acceptable. The authors conclude that the intervention and assessment procedure are feasible and acceptable for preventing the recurrence of child maltreatment. Any decision about effectiveness of the intervention awaits a longitudinal, controlled trial.