Onset, duration and frequency. In the onset of programs there obviously are two choices: either prenatally or postnatally. In the studies reviewed by Xxxxxxxx onset is mostly prenatally (10 of 111
Onset, duration and frequency. Based on the findings presented in the previous section there seems to be no clear- cut preference for the onset of a preventive program. In some studies the onset is prenatal; in many studies an immediate postnatal onset is chosen. With regards to the outcome in terms of effect there seems to be no favorable choice either; both prenatal and postnatal programs have sorted positive effects (19). There are, however, some practical benefits of a prenatal onset, which mainly revolve around the establishment of a strong bond between parent and home visitor. The pregnancy period, being less hectic than the direct postnatal period, may cause parents to be more open to the intervention offer and furthermore it allows for attention to be paid to the parental personality, experiences and expectation. Also, especially in primiparas, a prenatal start will ensure that the development of patterns of negative experiences is avoided (1). On the other hand, primiparas will not be able to imagine to the full extent what parenting will entail until after the birth of their child. For parenting advice, the provision of examples and practice, the prenatal period is less suitable. With all these considerations the choice for either a pre- or postnatal onset becomes a somewhat arbitrary one, which is in our case guided by the implementation of our study: within the setting described above, that of the OKZ, a postnatal onset for our program is evident. As for the duration and frequency or ‘dosage’ of a program, the outcomes in terms of effect are mixed as well. It seems that long-term interventions (with a duration of approximately two years) as a majority generate positive effects. Furthermore, a 117 visiting frequency of at least once a month appears to increase positive effects of long-term studies (13; 19). On the other hand, some short-term interventions (with durations of three weeks, six months and a maximum of two year respectively) did also prove to be effective (see 19). However, these are short-term interventions that were directly evaluated, whereas short-term interventions evaluated through more extended follow-up did demonstrate less effectiveness (19). XxxXxxx and Xxxxxx found that effect sizes in intervention studies increased as the length of the intervention increased. They concluded that the smallest effect sizes were found in programs lasting less than six months. A similar trend was found for programs providing fewer than twelve visits, however, “in light of ...
