Maternal participation in the Healthy Baby Community Support Program and developmental vulnerability of offspring at age 6 years

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Struck, Shannon
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Roughly 30% of children in Manitoba are vulnerable in one or more important areas of development at school entry. The Healthy Baby Community Support Program (HBCSP) is a universally accessible supported playgroup that support mothers and babies up to 1 year postpartum across Manitoba. The purpose of this study was: i) examine HBCSP participation levels and the characteristics of participants and ii) investigate the relationship between HBCSP participation and later developmental health of children at school entry. This study used HBCSP attendance records linked to de-identified whole-population data housed at the Manitoba Centre for Health Policy. The study sample included all women with single live births in Manitoba between January 1, 2004 and March 31, 2011 who resided in or near communities with a HBCSP (n=78,772). . Logistic regression models were used to calculate the unadjusted odds of a mother attending the HBCSP given known characteristics. Logistic regression models calculated the odds of being vulnerable in individual, one or more, or two or more domains of the EDI after adjusting for child characteristics and applying inverse probability treatment weights (IPTW) to balance for measured maternal characteristics. HBCSP participation increased for any participation and for mothers that attended prenatally and postnatally. HBCSP participants had significantly higher odds of having an at-risk profile compared with non-participants. After applying IPTW and adjusting for child characteristics, HBCSP participation was associated with decreased odds of developmental vulnerability in three areas of child development at school entry: physical health and well-bring (aOR=0.87, 99% CI 0.78, 0.97); language and cognitive development (aOR=0.76, 99% CI 0.67, 0.86), and communication skills and general knowledge (OR=0.65, 99% CI 0.57, 0.74) and increased odds of vulnerability in emotional maturity (aOR=1.23, 99% CI 1.10, 1.37) among children with access to weekly programming. Universally accessible supported playgroups provide gap services to families in need of minimal support. Increased program recruitment efforts are warranted but should consider local context and target specific populations that are known to be less likely to participate. Supported playgroup attendance in infancy is associated with positive developmental health at school entry for children with access to more frequent programming.
Early Development Instument, Healthy Baby Community Support Program, Administrative Data, Supported Playgroups, Manitoba Centre for Health Policy