Families First Home-Visiting Program: Impact on Child and Adolescent Education, Mental Disorders, and Service Use

Objective: To determine the effectiveness of the Families First Home-Visiting (FFHV) program, versus risk-matched controls, on mental disorder, education, and service use outcomes in childhood and adolescence. Methods: Administrative-linked data from a retrospective, population-based cohort drawn from the Manitoba Centre for Health Policy repository, in Manitoba, Canada, was analysed. All families with a child born between 2003-2009 who were eligible for the FFHV program (N = 9,761) were included. Families were exposed to the FFHV program or not (risk-matched controls) when children were 0-3 years old. Outcomes of interest included mental disorders, educational, and service use. Moderators came from the FFHV program universal newborn screener and included child, parent psychosocial, and socioeconomic risk factors. Results: Children/Adolescents from the FFHV program were more likely to receive a mental disorder diagnosis (Attention Deficit/Hyperactivity Disorder, mood and/or anxiety disorders, any mental illness) and engage with health services compared to risk-matched controls. No significant difference in education outcomes were found. Outcomes were moderated by the presence of child (service use), parent psychosocial (mental disorder and Early Development Instrument), and socioeconomic (service use, provincial education assessments, and Early Development Instrument) risk factors identified at birth. Conclusion: To our knowledge, this study is the first to evaluate mental disorders, educational, and service use outcomes for children/adolescents who previously received the FFHV program. Findings have important implications for tailoring home-visiting programs based on significant moderation of risk factors identified at birth to optimize child outcomes. Trial Registration: N/A