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VoorZorg2: a good start for parents with negative childrearing experiences and their newborns.


VoorZorg2: Een goede start voor ouders en hun pasgeborenen


Ongeveer 14% van de kinderen in Nederland heeft een minder gunstige start bij de geboorte. Dit is sterk gerelateerd aan sociale risicofactoren en gebrek aan beschermingsfactoren. Als een ongeboren kind in deze vormende fase wordt blootgesteld aan stress, rook, slechte voeding, misbruik of andere risicofactoren, is dit de oorzaak van gezondheidsproblemen. Kwetsbare ouders moeten daarom passende steun krijgen om stress te verlichten, hun gezondheidsvaardigheden te verbeteren en sensitief ouderschap te bevorderen.

Onderzoek en verwachte uitkomst

3-5% van de Nederlandse kinderen wordt geboren in gezinnen met een cumulatie van risico’s; dat is de doelgroep van VoorZorg. VoorZorg is bewezen effectief in het verbeteren van de leefstijl en het verminderen van huiselijk geweld/kindermishandeling en het toeleiden naar passende hulp bij eerste zwangerschappen. VoorZorg wordt nu doorontwikkeld en onderzocht op effectiviteit voor niet-eerste zwangerschappen. Is VoorZorg2 effectief, dan kunnen er meer kinderen kansrijk opgroeien.


Samenvatting van de aanvraag

About 14% of the children in the Netherlands have a less favourable start at birth. This is due to premature birth, a low birth weight or a combination of both. A less favourable start is very strongly related to social risk factors and the lack of protection factors. If an unborn child in this formative phase, is exposed to stress, smoke, poor nutrition, abuse or other risk factors, this is the root for health problems. Vulnerable parents should therefore be given appropriate support aimed at relieving stress, improving health skills and sensitive parenthood. 3-5 % of Dutch children are born in very vulnerable families with a cumulation of risks. (Birth)care organizations often spend a lot of time and energy to support these families, who often lack communication and health skills, do not follow advice and do not show up for appointments. VoorZorg (VZ) contributes to the improvement of (birth)care for these families. VZ is a(n) (cost-)effective nurse home visit program for these very vulnerable women. It has been proven to be effective in improving lifestyle and diminishing home violence and child abuse (Mejdoubi, 2014). These effects are achieved because the VZ-nurses work on strengthening the clients and are able to play a role within the chain of (birth)care, so that suitable help is better deployed. VZ is developed and studied only with first pregnancies. The inclusion criteria of VZ derive from a RCT and cannot simply be deviated from. VZ-nurses, (birth)care organizations and municipalities think that with adjustments to the program, vulnerable women with non-first pregnancies could benefit from it. The difference with the current target group is that these families have negative parenting experience; children in these families often develop behavioural problems and are placed under direct supervision or outside the home. For these very vulnerable families there is no preventive intervention available yet. Based on the effective elements of VZ and the experiences of the birthcare and support organizations we will develop for non-first pregnancies with parenting problems VoorZorg 2 (VZ2), in which the core-elements of the origin program will be adapted and tested. Core elements are to support parents and strengthen their skills, based on build trust. Core elements are also communication and acceptation of professional support. The aim for the families of VZ2 is to reduce perinatal problems, reduce parental stress and parenting problems and child abuse, promote sensitive parenthood and improve lifestyle during pregnancy, and thereafter. VZ2 is not a cure-program, but a preventive care program, in which VZ2 also reinforces the cooperation of the birth- and healthcare. Verwey Jonker Institute and Netherlands Center for Youthcare (NCJ) would like to adjust VZ into an appropriate program VZ2; to give these parents the chance to get their problems under control and be a better parent. To get input and be supported during the period of the study, we form a broad project group and a consulting group. Participants will be asked for input, criticize ideas, reflect on possibilities, outcomes and conclusions. These groups have a diverse composition, with members of (birth)care, municipalities, experienced clients, nurses, client organization and researchers. This proposal starts with the development of the content of the program VZ2 based on pre-test clients. In the same time Verwey Jonker Institute does a study with the integral birth care systems, to know what is needed from that point of view. With these tools we make a manual, train at least 20 nurses in 10 VZ-organizations and start 10 case studies in which clients, nurses and involved birth care organizations participate. Measurement moments of the case studies: at start; 28 weeks and 36 weeks pregnancy; at birth; 6 weeks postpartum and follow up 12 months postpartum. All other families included will have only outcome measurements at start, 6 weeks postpartum and 12 months postpartum. We use the ToC approach with the case studies to gather information about the elements and process of VZ2 in the local (birth) care setting that helps us optimize the program. By adding outcome measurements during the program we also get a good idea of what works for these families and what is the impact on for example their lifestyle, parental skills and home safety. We will thoroughly analyse data (quantitative and qualitative), check results with our project- and consultation group and adapt the concept version of VZ2 into a definitive form. During the study we are in narrow contact with VZ organizations, birth care organizations and municipalities. So implementation starts from the beginning. At the end of the project all the results, including the adapted manual and training and implementing strategy, will be presented to VZ organizations, municipalities and professionals from health and birth care, with support of the 'Netwerk Geboortezorg Noord-West Nederland'.



Looptijd: 85%
Looptijd: 85 %
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
dr. F.E.P.L. Sondeijker
Verantwoordelijke organisatie:
Verwey-Jonker Instituut