'Think Baby': online learning for student health visitors.

'Think Baby' is an innovative online learning resource which has been developed to help student health visitors (and other specialist community public health nurses) build their skills in observing and assessing mother-infant interactions. The project's development and pilot work was funded by a small grant from the Higher Education Academy. It builds on the findings of the team's previous research, which found health visitors' initial training had left them ill-prepared to assess the intricacies of mother-infant relationships. The 'Think Baby' project sought to develop online training resources for student health visitors using video footage of mothers and babies to illustrate different types of interactions. A small group of student health visitors were engaged in reviewing and evaluating the materials and considering their acceptability. Once developed, the materials were piloted with student health visitors from three universities, community practice teachers and a health visitor academic, and they were then adapted for wider roll out. 'Think Baby' enables student health visitors to develop their core skills in assessment, which is really important in identifying when early help and support are needed for mothers and infants.

Evaluating health visitor assessments of mother-infant interactions: a mixed methods study.

BACKGROUND: Given the significance of reliably detecting cases where mother-infant relationships are not developing successfully, it is important that initial assessment processes are as sensitive and specific as possible. OBJECTIVES: This study sought to examine the processes by which health visitors identify problems in mother-infant relationships in the post-natal period. DESIGN: Mixed methods. SETTINGS: Two universities and two primary care trusts. PARTICIPANT: In Phase One 17 first-time mothers and their 6- to 16-week-old infants were recruited. In Phase Two, a sample of 12 health visitors participated. METHODS: The study incorporated two data collection phases. In Phase One, each mother's interaction with her baby was video-recorded for 20min in an observation laboratory. The video-recordings were coded and resultant data were analysed to derive a number of quantitative measures of interaction quality, including mothers' responsiveness and sensitivity to their infants as rated by the Global Ratings Scales (GRS) of Mother-Infant Interaction. In Phase Two, 12 health visitors rated and assessed 9 clips of the video-recorded mother-infant interactions. The rationales for their ratings were then explored through in-depth interviews. Health visitor ratings of the video clips were compared to the GRS ratings. The relationship between the main focus of each health visitor rating, as reported in the interview, and the consistency of ratings with the GRS ratings were then investigated. RESULTS: Correlations between individual health visitors' ratings and the GRS ratings ranged from .17 to .83 and were statistically significant in only four cases. There was a weak relationship with health visitors' years of experience (r(s)=.47, NS). When explaining their judgements, health visitors tended to comment on the mother's behaviours or the relationship between the mother and baby and often ignored the behaviour of the baby. There was a highly significant relationship between the consistency of health visitor/GRS ratings and the number of references to the baby in the health visitors' explanations (r(s)=.75, p=.005). CONCLUSION: This study contributes to the understanding of how health visitors make assessments of mother-infant interactions. The frequent lack of attention and reference to the baby's behaviour suggests an area for further training.