Healthy upbringing of children through the empowerment of women in a disadvantaged neighbourhood: evaluation of a peer group project

摘要

Aim The study evaluates a community-based intervention programme, using a peer approach. The programme's objective is to improve life opportunities for children from disadvantaged families in a poor district of Berlin by empowering their mothers. Women of varying cultural backgrounds-most of them from immigrant families-are educated in subjects like child development, early education and health in order to work as community mothers (CMs). Their major task is to obtain access to the families, strengthen the mothers' parenting and personal skills, and promote early nursery school attendance and access to social support systems. Community settings are integrated in the programme through the establishment of family cafes in nursery and primary schools.Methods The evaluation analyses the organisational structure and process determinants of the programme, and its impact on the CMs as well as on the visited family mothers (FMs), identifying the supporting and inhibiting factors. To match the comprehensive programme design, a mixed method approach was chosen, combining primarily qualitative methods with quantitative methods and participatory observation. Target groups for the investigation are the CMs, the FMs, and professionals directly or indirectly involved in the programme.Results According to preliminary results, the programme has been successful in recruiting women from the community for training as CMs (n-67) and in reaching disadvantaged families of German and migrant backgrounds through home visits (n=86) as well as in single contacts in various settings (n=170). Access to families by home visits and sometimes in family cafes, however, has turned out to be more difficult than expected. The FMs interviewed qualitatively (n=15) within the first year after the start of home visits and with a semi-structured questionnaire (n=44) after 2.5 years, report increased self-esteem, improved relationships with their children, better access to public services, emotional support and practical assistance. The results also demonstrate a significant gain for the CMs themselves as part of the target group. Professionals (n=42) assess the project primarily positively; co-operation with the CMs sometimes presents barriers. Conclusion Peer-based home visitation programmes are successful in reaching otherwise hard-to-reach populations but also have limits in access to some of the families. The combination of home visits with other forms of activities located in various settings seems promising.