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dc.contributor.authorRimehaug, Tormod
dc.contributor.authorHolden, Karianne Framstad
dc.contributor.authorLydersen, Stian
dc.contributor.authorIndredavik, Marit Sæbø
dc.date.accessioned2020-02-11T09:59:11Z
dc.date.available2020-02-11T09:59:11Z
dc.date.created2019-09-26T12:46:21Z
dc.date.issued2019
dc.identifier.issn1472-6963
dc.identifier.urihttp://hdl.handle.net/11250/2640964
dc.description.abstractBackgrounds: In 2009, the prevention service “Familieambulatoriet” (FA) was established in three pilot hospital areas offering psychosocial support and health monitoring to parents in high risk regarding mental health and substance use, for the purpose of preventing child mental health and developmental problems through preschool years. This study selected new-born health as a preliminary endpoint for evaluation of population effects in three pilot areas, utilizing national statistics for birth cohorts from 2005 to 2013. The aim of the study is to evaluate changes in population new born health incidences associated with the establishment of new supportive and preventive FA-services at three pilot sites from 2009 in contrast to previous years and the remaining country. This quasi-experimental design evaluated changes in populations with new services available not those receiving the services, and controlled for national historical changes, variation between hospital districts, and random variation across the years before or years after the pilot services were introduced. Our hypothesis was to expect reduced frequencies of preterm births, SGA births, low APGAR scores, pediatric transfer, and new born abstinence symptoms in the pilot areas. Methods: The baseline was established through 4 years preceding 2009, contrasting changes at pilot sites the following 4 years 2009–2013 using the remaining hospital area populations in Norway 2005–2008 and 2009–2013 as contrasts. Results: Related to the introduction of FA services, we found three significant improvements in new born health using mixed effects logistic regression. 1) In the population rate of babies born prematurely with small for gestational age (SGA), using the 10th percentile criteria as the definition; odds ratio (OR) = 0.73 (95% Cl: 0.60 to 0.88). 2) A similar reduction using the 2.5th percentile criteria, although with wider confidence limits; OR = 0.73 (95% Cl: 0.54 to 0.99). 3) A decrease in the frequency of low APGAR scores (0–6) 5 min. after birth; OR = 0.80 (95% Cl: 0.68 to 0.95). Thus, the FA-areas remained significantly lowered on SGA rates or Low APGAR rates across the years after FA establishment, despite considerable variation, in contrast to the baseline years and to the remaining country. No significant effect was found for the outcomes frequency of premature births (unrelated to SGA), SGA among full-term babies, child abstinence symptoms or pediatric transfer of the baby. False negative findings may result from low-rate outcomes or studying the population rather than users. Conclusions: Population rates suggest that introducing FA services offering support and monitoring in high-risk families may contribute to improving aspects of new born infant health. Intervention components and strategies should be studied more closely using individual data.nb_NO
dc.language.isoengnb_NO
dc.publisherBMCnb_NO
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.title"Five-year changes in population newborn health associated with new preventive services in targeted risk-group pregnancies"nb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionpublishedVersionnb_NO
dc.source.pagenumber1-9nb_NO
dc.source.volume19nb_NO
dc.source.journalBMC Health Services Researchnb_NO
dc.source.issue658nb_NO
dc.identifier.doi10.1186/s12913-019-4392-7
dc.identifier.cristin1729522
dc.description.localcode© The Author(s). 2019Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.nb_NO
cristin.unitcode194,65,35,0
cristin.unitcode194,65,35,5
cristin.unitcode194,65,15,0
cristin.unitnameInstitutt for psykisk helse
cristin.unitnameRKBU Midt-Norge - Regionalt kunnskapssenter for barn og unge - psykisk helse og barnevern
cristin.unitnameInstitutt for klinisk og molekylær medisin
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2


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