Association between participation in the Families First Home Visiting programme and First Nations families’ public health outcomes in Manitoba, Canada: a retrospective cohort study using linked administrative data

• Main Authors: Jennifer E Enns, Mariette Chartier, Nathan Nickel, Dan Chateau, Rhonda Campbell, Wanda Phillips-Beck, Joykrishna Sarkar, Elaine Burland, Janelle Boram Lee, Alan Katz, Rob Santos, Marni Brownell
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2019-06-01
• Series: BMJ Open
• Online Access: https://bmjopen.bmj.com/content/9/6/e030386.full

ObjectiveTo determine whether the Families First Home Visiting (FFHV) programme, which provides home visiting services to families across Manitoba, is associated with improved public health outcomes among First Nations families facing multiple parenting challenges.DesignRetrospective cohort study using population-based administrative data.SettingManitoba, Canada.ParticipantsFirst Nations children born in Manitoba in 2003–2009 (n=4010) and their parents enrolled in FFHV compared with non-enrolled families with a similar risk profile.InterventionFFHV supports public health in Manitoba by providing home visiting services to First Nations and non-First Nations families with preschool children and connecting them with resources in their communities.OutcomesPredicted probability (PP) and relative risk (RR) of childhood vaccination, parental involvement in community support programmes and children’s development at school entry.ResultsFFHV participation was associated with higher rates of complete childhood vaccination at age 1 (PP: FFHV 0.715, no FFHV 0.661, RR 1.08, 95% CI 1.03 to 1.14) and age 2 (PP: FFHV 0.465, no FFHV 0.401, RR 1.16, 95% CI 1.08 to 1.25), and with parental involvement in community support groups (PP: FFHV 0.149, no FFHV 0.097, RR 1.54, 95% CI 1.27 to 1.86). However, there was no difference between FFHV participants and non-participants in rates of children being vulnerable in at least one developmental domain at age 5 (PP: FFHV 0.551, no FFHV 0.557, RR 1.00, 95% CI 0.91 to 1.11).ConclusionsFFHV supports First Nations families in Manitoba by promoting childhood vaccination and connecting families to parenting resources in their communities, thus playing an important role in fulfilling the mandate of public health practice.