Implementation and staffing Sample Clauses

Implementation and staffing. As we mentioned at the beginning of this paragraph, many of the studies reviewed concern a program of home visitation. However, a number of programs combined these visits with other types of intervention. Some of the programs combined home visits with medical (child) care, social work involvement or specific parenting training programs (32). Other programs provided consultation at hospitals or other healthcare institutions, so-called parenting support groups or contact by phone. The latter was sometimes used to replace home visits when the situation in a family ameliorated (15). Staffing essentially consisted of professionals, paraprofessionals, or volunteers with or without training. Most programs employed professionals, nurses, social workers or so- called early childhood specialists, who were backed up by a multi-disciplinary team consisting of psychologists and pediatricians. Then there were a number of programs employing paraprofessionals, referred to as family workers, parenting consultants, ‘visiting moms’ etc. There often were specific criteria for the selection of these home visitors and all of them got specific training prior to starting the intervention, although duration of this training varied largely from two sessions to multiple weeks. A small number of programs employed volunteers without any training. These volunteers were however always backed up by a multidisciplinary team (15). Two studies employed student nurses or students (19; 32).

Implementation and staffing. As we have stated at the beginning of this paragraph, home based services appear to hold particular promise in the prevention of child maltreatment. Through the previous section it became clear that a number of programs deploy other services aside from home visitation, for instance parenting education. Within the Dutch setting there is no need for the development of special parenting courses to be a part of our program as these courses are generally provided by the OKZ in some way or other (44). Within the program referrals to such courses can easily be made. A final more practical issue concerns the choice of staffing within a program. Some programs employ the services of paraprofessionals. Often these service providers are selected based on their background: they come from the same community and share many of the same values and experiences as do the families they are visiting. The reason for this choice is that a common background will help overcome class and cultural barriers between provider and client. A counter-argument could be that parents are hesitant to reveal personal matters to a home visitor from their own neighborhood for fear of a loss of privacy. Also, especially in prevention programs targeted at families at risk there will be a high demand for various services and advice, which may be difficult to provide for paraprofessionals as they lack the necessary skills (see 13). As we have already chosen a setting for our program it makes sense to apply the necessary staffing from within this setting and thus employ nurses from the OKZ. Off course the argument provided against paraprofessionals to some extent applies to nurses as well: although they do have the necessary education to address a number of health- and development-related issues in families, they are not equipped for psychotherapeutic treatments or family therapy. However, this is not the purpose of our intervention. Rather, by providing the 119 home visiting nurses with substantial training, they should be able to know when to refer parents to more extensive treatment.