Family support and parenting education in the home: an effective extension of clinic-based preventive health care services for poor children.

A study was designed to assess the effect and cost of providing parenting and child care education in the home to inner-city mothers of poor infants receiving comprehensive health care in a large federal Children and Youth Program. Randomly selected, healthy neonates weighing more than 2000 gm and born to black women aged 18 years and older (n = 131) and to comparable control subjects (n = 132) were followed for a mean of 23.4 and 22.9 months, respectively. A community woman, with educational, social service, and medical backup support from the Children and Youth Program, made home visits 7 to 10 days after the birth and between regularly scheduled well-child-care visits. Improved compliance with well-child care, fewer illness visits, and sharp reductions in hospitalization and in neglect or abuse were found in the visited group compared with the control group, and substantial cost was averted. Prerequisite and concomitant to focusing the mother's attention on the infant was the resolution of the numerous crises and survival problems experienced by these poor women. Only then was parenting education accepted by the mother.