Includes an additional chapter on working in a multicultural society with a discussion on some of the challenges faced by health visitors
Trade Review
"Overall, this is an excellent and easy to read resource for anyone wishing to extend their knowledge and challenge their practice in health visiting and beyond. It should certainly assist practitioners in delivering high-quality, evidence-based care...It is both thought provoking and practical, containing a wealth of information that can be applied to assist professional development and widen knowledge"(The Journal of Health Visiting, March 2017)
Table of Contents
List of Contributors ix
Introduction 1
Karen A. Luker, Gretl A. McHugh and Rosamund M. Bryar
Prevention, public health, and health visiting 2
Health visiting: preparation for practice 4
1 Managing Knowledge in Health Visiting 8
Kate Robinson
Introduction 8
Defining health visiting practice 10
What do health visitors do ± and where do they do it? 13
Evidence-based practice 16
The current landscape of EBP 21
Managing knowledge and evidence in practice 26
Case study 1.1: Introducing new technology 26
Case study 1.2: Creating guidelines in primary care 27
Case study 1.3: Protocol-based decision making in nursing 29
Case study 1.4: Knowledge management in primary care 30
Communities of practice 35
Reflective practice 37
Clients: what do they know and how do they know it? 40
Social networking and the media 41
The debate 44
Summary 45
References 46
Activities 50
2 Health Visiting: Context and Public Health Practice 53
Martin Smith
Introduction 53
Public health 56
Defining ‘public’ 56
Defining ‘health’ 57
Defining ‘public health’ 59
Human rights and public health 60
The principles of health visiting 63
The search for health needs 65
The stimulation of an awareness of health needs 65
The influence on policies affecting health 66
The facilitation of health-enhancing activities 67
Summary 68
Health inequalities 69
Summary 76
References 77
Activities 82
3 The Community Dimension 85
Rosamund M. Bryar
Introduction 85
Public health and communities 87
Defining ‘community’ 89
Impact of communities on health 91
The role of health visitors in working with communities 96
Gaining an understanding of the health of your local community 100
Windshield survey 101
Public health walk 101
Health needs assessment 102
Building community capacity 110
Using health promotion models to support community working 113
Summary 116
References 118
Activities 124
4 Approaches to Supporting Families 127
Karen I. Chalmers and Karen A. Whittaker
Introduction 127
Models of intervention in family life 128
Three models relevant to health visiting practice in families with young children 129
Application of the models in practice 132
Policies 133
Evidence for interventions to support families 136
Characteristics of services and programmes to support families with young children 137
Early home visiting programmes 138
First Parent Health Visiting Programme 138
Community Mothers Programme (CMP) 139
Current home visiting programmes 140
Family Nurse Partnership (FNP) Programme 140
Flying Start ± Wales 143
The Triple-P (Positive Parenting Programme) 144
Maternal Early Childhood Sustained Home Visiting (MECSH) 145
Sure Start programmes 146
Summary 148
Working with families 148
Empirical evidence on relationship development 152
Challenges 154
Public health agenda 154
Level of evidence 155
Adhering to the programme criteria 155
High-needs families 156
Practice specialisation 157
Concerns about child safety 157
Adequate resources 157
Summary 158
Note 158
References 158
Activities 167
5 Safeguarding Children: Debates and Dilemmas for Health Visitors 170
Julianne Harlow and Martin Smith
Introduction 170
The key concepts 172
Defining ‘child’ 172
Defining ‘childhood’ 174
Defining ‘safeguarding’ 175
Defining ‘child abuse’ 180
Defining ‘significant harm’ 187
Incidence and prevalence of child abuse 193
Assessment of vulnerable children 197
Assessment of children in need and their families 198
Common Assessment Framework (CAF) 200
Graded Care Profile (GCP) 202
Working together 203
Confidentiality and information sharing 205
Supervision 206
Summary 210
References 211
Activities 217
6 Working with Diverse Communities 220
Sharin Baldwin and Mark R.D. Johnson
Introduction 220
Culture and migration 221
Cultural sensitivity and competence 222
Some useful tips for developing cultural competence 225
Institutional discrimination and organisational cultural competence 225
Understanding different cultural practices 226
Pregnancy 226
Birth customs 228
Confinement following birth 231
Breastfeeding 231
Diet, weaning, and feeding practices 232
Maternal mental health 235
Safeguarding, domestic violence, and abuse 237
Communication 239
Other communities 240
Case studies 241
Case study 6.1: Breastfeeding support project for Somali mothers in
Harrow 241
Case study 6.2: New ways of delivering health visiting services for
Orthodox Jewish community in Hackney 242
Summary 244
References 244
Activities 250
7 Evaluating Practice 252
Karen A. Luker and Gretl A. McHugh
Introduction 252
Sources of evidence for practice 253
Evaluation ± the problem of definition 257
Conceptualising evaluation 259
Example: tackling childhood obesity 261
Evaluation and evaluative research 263
Evaluation of health care 263
Structure, process, and outcome evaluation 266
Structure evaluation 266
Process evaluation 268
Outcome evaluation 270
Summary 272
The care planning process 272
Actual and potential problems 274
Problem solving 275
Additional issues in evaluating the practice of health visiting 275
Summary 280
References 281
Activities for Chapter 7 287
Index 291
