Through the "Växa tryggt" initiative, first-time mothers and their children in Skåne receive more home visits from child health care services. The initiative is designed to promote health equity. Research findings from Malmö University show that these home visits help parents feel safe and secure by fostering trust in the interdisciplinary teams.
Children born in Skåne and Malmö face different circumstances from the very start. In disadvantaged areas, there are more vulnerable families, including young and teenage mothers, single parents, children with special needs, migrants, and families living in poverty. Families living in socioeconomically disadvantaged areas often experience high levels of stress, limited access to resources, and minimal social support. And children who grow up in disadvantaged areas are at a higher risk of failing to complete school, experiencing poorer health, or becoming involved in crime.
The expanded home visit program "Växa tryggt" is a pilot project in Skåne and a collaboration between Region Skåne, the municipalities of Skåne, and Malmö University. Child health care, maternal health care, preventive social services, and dental care are all involved in the initiative. Until the child is 15 months old, six home visits are made to families instead of the two typically conducted by child health care.
“Previous research shows that interventions, health promotion initiatives, and home visitation models for families and children at an early stage of development can prevent negative outcomes or minimize future health, educational, and social problems in the long term,” says Elisabeth Mangrio, a researcher at Malmö University who is leading the research project.
As part of the "Växa tryggt" program, midwives, pediatric nurses, parent support specialists, dental hygienists, and dental assistants work in interprofessional teams to visit first-time mothers and their children in their homes. A total of 26 teams in 18 municipalities in Skåne are participating in the project, which began in 2018 and will conclude this year.
– Collaboration between the different professions has been incredibly rewarding; it has contributed to a significant expansion of our knowledge. More perspectives have emerged, and the professions have been able to support one another in these discussions. Many families in the “Växa tryggt” program have received earlier support, for example through the early detection of violence and mental health issues, which otherwise would likely have been detected much later and thus caused greater harm,” says Anna-Maria Troedsson, project manager for health and social welfare at Skånes Kommuner.
Knowledge is needed regarding the effects of home visit programs
Researchers at Malmö University have been involved since the project’s inception and have been following its progress. Their task is to study and evaluate the home visits. They collect surveys and conduct interviews with parents, staff, and managers in maternal and child health care, social services, and dental care.
“Home visits require significant resources. We need to understand how the expanded program is perceived, valued, and contributes to the development of knowledge among first-time parents. We also want to learn about the experiences and effects of the working methods used by the professional teams and organizations involved in the project,” says Elisabeth Mangrio.
“Involving researchers in the project was an obvious choice, as it’s important to gather data to determine whether the initiatives are having an impact and what significance they hold for the target group. The collaboration has yielded new insights, provided different perspectives on the issues, and sparked interesting discussions,” says Anna-Maria Troedsson.
Different professions complement and learn from one another, which helps build trust among parents
Research shows that parents who participated in the "Växa tryggt" program felt that home visits and interprofessional teamwork were of great importance. For example, midwives and pediatric nurses complemented each other, and there was mutual respect for each other’s expertise.
“By meeting with several professionals at the same time, and in the comfort of their own home, parents felt that both their child’s needs and their own needs as new parents were taken into account and supported. This made them feel safe and secure and built trust,” says Elisabeth Mangrio.
Middle managers see several benefits to the "Grow with Confidence" program
Another finding shows that middle managers viewed the home visit program as an asset not only for parents and children, but also for the participating organizations, professionals, and the community.
– Our study shows that middle managers do not merely cite policy goals for equitable and equal health. In addition to improved child health, they believe the program also contributes to increased support for families, social benefits, and greater trust in both the professionals and the welfare system. Furthermore, the model offers benefits for professionals’ working conditions and for organizations, as preventive work and improved child health mean fewer resources need to be used later on,” says Eva-Lotta Nilsson, aresearcher at Malmö University.
It is unclear whether and how the program will continue
These findings are significant because middle managers play a key role in participation in home-visiting programs and change processes. Their views on a program and what makes it appealing will influence the implementation of a permanent program. The findings from the “Växa tryggt” program may also be of interest to regional policymakers who decide whether home-visiting programs should be made permanent and how they should be designed.
– Work is underway to prepare a basis for a policy decision by the Health and Medical Care Committee (HSN) and to hold discussions with the municipalities in Skåne. At this point, we do not know whether Växa tryggt will become a permanent program or on what scale, says Anna-Maria Troedsson.
Fact: Grow with confidence
The home visit program “Växa tryggt” (Growing Safely) – collaborative parenting support – is a pilot project running from 2018 to 2022, funded by a special-purpose government grant. The project is led by Region Skåne, and the municipalities of Skåne are responsible for its implementation. The aim is to improve access to child health care. In “Växa tryggt,” midwives, pediatric nurses, parenting support workers from Social Services, dental hygienists, and dental assistants work in interprofessional teams to visit parents and their children at home. Twenty-six teams and 18 of Skåne’s municipalities are participating. Until the child is 15 months old, they make six home visits instead of the two regular visits provided by child health care. An interdisciplinary group of researchers at Malmö University is monitoring and evaluating the project.