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Which models of health visiting in England are most effective in reducing the harms associated with maternal ACEs?
Alcohol and substance misuse, mental health problems and domestic violence and abuse are common maternal ACEs associated with adverse child outcomes. Health visiting services are designed to monitor and support children affected by these maternal ACEs. However, we know little about the coverage, intensity, type and costs of health visiting in practice, and to what extent health visitors support families living with maternal ACEs. This study will determine 1) which factors determine the coverage, intensity, type, resource-use and cost of health visiting services received by families with and without maternal ACEs; 2) which health visiting models are most promising for mitigating the impact of maternal ACEs; and 3) what these results mean for local and national decision-makers and families. The study is based on data on all births in England 2015-2019. We will identify families exposed to maternal ACEs in longitudinal hospital admissions data on mother-baby pairs (HES) linked with health visiting data (Community Services Dataset; CSDS). We will combine this with information on local area need (e.g. deprivation) and surrounding services (e.g. the Family Nurse Partnership), and a national survey of practice in all 152 local authorities (LAs). We will conduct in-depth qualitative case studies in up to 6 LAs, including interviews with Directors of Public Health, health visiting commissioners and managers, health visitors and mothers, plus analysis of locally held administrative data. This study is funded by NIHR Policy Research Programme £1 million
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