Objective

We investigated whether nurse home visiting (NHV) affects the uptake and quality of formal early childhood education and care (ECEC) at child ages 2 and 3 years, and reasons for using ECEC at 3 years.

Methods

Design: Secondary analysis of the “right@home” randomized trial of NHV. Participants: 722 pregnant Australian, English-speaking women experiencing adversity recruited from antenatal clinics across 2 states. Intervention: 25 nurse home visits to 2 years; Control: universal well-child nursing service. Measures: Parents reported formal ECEC use (government approved and subsidized), comprising long or family day care (LDC), and reasons for use. ECEC quality was classified using the Australian government's national ratings. Eighty-three percent of parents provided data at 2 years (306 intervention/290 control); and 69% at 3 years (255 intervention/240 control). Analysis: Intention-to-treat analyses were conducted using adjusted regression models, addressing missing data using multiple imputation and inverse probability weighting.

Results

There was no evidence of group differences in ECEC uptake or quality, although control families may have used more LDC at 3 years (mean difference 2.8 hours, 95% confidence interval, -0.2 to 5.8 hours). Intervention parents reported using ECEC to support their children's social development more frequently than controls (48% vs 33%) but less for work/study (39% vs 46%).

Conclusions

The right@home NHV program did not impact ECEC uptake or quality, although it may influence parents’ reasons for using ECEC. If supported by policy and provision, there is an opportunity for NHV programs to promote the transition to high-quality ECEC and evaluate the synergistic benefit on children's development.

中文翻译：

---

护士家访对正规托儿服务的使用、剂量和质量的影响：一项随机试验的 3 年随访

客观的

我们调查了护士家访 (NHV) 是否会影响 2 岁和 3 岁儿童的正规幼儿教育和护理 (ECEC) 的吸收和质量，以及在 3 岁时使用 ECEC 的原因。

方法

设计：NHV“right@home”随机试验的二次分析。参与者：从 2 个州的产前诊所招募的 722 名怀孕的澳大利亚、讲英语的妇女正在经历逆境。干预：25 次护士家访，持续 2 年；控制：普遍的儿童护理服务。措施：家长报告了正式的 ECEC 使用（政府批准和补贴），包括长期或家庭日托 (LDC)，以及使用原因。ECEC 质量使用澳大利亚政府的国家评级进行分类。83% 的父母提供了 2 年的数据（306 次干预/290 次控制）；3 年时为 69%（255 次干预/240 次控制）。分析：使用调整回归模型进行意向治疗分析，使用多重插补和逆概率​​加权处理缺失数据。

结果

尽管对照组家庭在 3 年时可能使用了更多的 LDC（平均差异 2.8 小时，95% 置信区间，-0.2 至 5.8 小时），但没有证据表明 ECEC 摄取或质量存在组间差异。干预父母报告说，使用 ECEC 支持孩子的社会发展的频率高于对照组（48% 对 33%），但用于工作/学习的频率较低（39% 对 46%）。

结论

right@home NHV 计划不会影响 ECEC 的使用或质量，尽管它可能会影响父母使用 ECEC 的原因。如果得到政策和规定的支持，NHV 项目就有机会促进向高质量 ECEC 的过渡，并评估对儿童发展的协同效益。