Objectives 

Health inequalities exist among children in Sweden, and one effort that the Swedish government has focused on to promote health among small children and their parents is an extended home-visiting program during the child’s first 15 months. This study aimed to illuminate healthcare professionals’ experiences of meeting parents in different social situations during the home visits within Grow safely. 

Methods

The chosen method was qualitative, and 13 interviews were carried out with healthcare, social, and dental professionals working with the extended home-visiting program within the child healthcare in the south of Sweden. 

Results

The results revealed that the parents raised differing needs in the meetings with the healthcare professionals in the program. The needs included advice on children with special needs, support with problematic breastfeeding, and more psychosocial support. The professionals met different groups of parents, such as young parents or newly arrived migrant parents, that in different ways needed the team to reach out to them. The professionals also met families who came from better-off areas and who were not initially considered to really need the program. As the program progressed, these parents could see that diverse, unpredictable needs could be met by the intervention. For example, the program provided access to and advice from social workers, which in turn created contacts that lasted longer than the program itself.

Conclusions

The professionals encountered various family situations and needs within the extended home-visiting program. This highlights the need for a close collaboration between child healthcare nurses and social workers, in order to be able to support the families and work towards the aim of reaching equal health among all children in Sweden. 

Under åren 2019–2022 genomfördes en satsning på ett utökat hembesöks-program för förstagångsföräldrar inom barnhälsovården i Skåne. Satsningen hade namnet Växa tryggt och baserades på erfarenheter av ett liknande program i Rinkeby. I Växa tryggt erbjöds förstagångsföräldrar sammanlagt sex hembesök under barnets första 15 månader. Besöken genomfördes i ett sam-arbete mellan barnmorskor, barnhälsovårdssjuksköterskor, föräldrastödjare och tandsköterskor/tandhygienister.En tvärvetenskaplig forskargrupp från Malmö universitet har på uppdrag av Region Skåne forskat om Växa tryggts genomförande och effekter. Forsk-ningen har inkluderat intervjuer och enkäter riktade till deltagande familjer, de professioner som genomförde hembesöken, verksamhetschefer och politiska beslutsfattare.I denna rapport redovisas forskargruppens övergripande resultat. Resultaten visar genomgående att både professioner och deltagande familjer var mycket nöjda med de utökade hembesöken. För professionerna, främst familjestöd-jaren och tandsköterskan/tandhygienisten, har Växa tryggt inneburit möj-ligheter att tidigt komma i kontakt med barnfamiljer i upptagningsområdet. Utöver stöd och support i enskilda frågor har professionerna även kunnat informera om ytterligare stöd som barnhälsovården, socialtjänsten och tand-vården kan erbjuda. För familjerna har de utökade hembesöken varit ett stöd i den intiala osäkerhet som ofta präglar ett nyblivet föräldraskap. Samtidigt har Växa tryggt främjat möjligheten att bygga tillitsfulla relationer med välfärds-professioner som utifrån sina skilda kompetenser är experter på barn- och familjeliv. Hemmet har i det föreliggande projektet visat sig vara en bra arena för att kunna individanpassa råd och stöd. Ytterligare en positiv effekt av Växa tryggt har varit att fera professioner samverkat i hembesöken och därmed kunnat komplettera och stärka varandra i dialoger med familjerna.

The aim of this article is to outline a theoretical framework for how the concept of trust can be used as analytical tool for a study of the aim, design, output and societal legitimacy of a Swedish welfare programme conducted to reduce disparities in health and social inequities and to give newborn a positive start in life. This programme, labelled Grow Safely, implies that home visits will be conducted at six occasions at first-time parents by different professionals: child health care nurses, midwifes, dental hygienists and counsellors from the social services. Prior to when the intervention is carried out, the involved professionals in the programme will be participating in training in order to increase the possibility that the home visits will be carried out in similar ways and be followed the same manual throughout the programme.

The welfare programme will be based on relationships on different levels: between professionals and parents, between different professionals, between professionals and managers, and between organisations. Trust is believed to be of significance for the development of relationships as well as for the social legitimacy of the implantation of welfare programmes. Therefore, our ambition is to embrace a broad perspective on trust, combining insights from a variety of research traditions and analyses on macro, meso and micro levels in the outline a model for how the concept of trust can be used as an analytical tool for studying welfare programmes like Grow Safely. We argue for that the model can capture the significance of trust at different levels: individual, professional, organisational and societal levels as well as interplays between these levels, and consequently be useful in to analyse implementations of welfare programmes.