Right@Home

About the program

The Right@Home program aims to improve parent care and responsivity, and the home learning environment. The program is structured around the core MECSH framework and training (Kemp et al. 2011), bolstered by five evidence-based strategies for content (sleep, safety, nutrition, regulation, and bonding and/or relationship) and two evidence-based strategies for the delivery process (video feedback and motivational interviewing strategies).

Who does it work for?

The program is designed for families of infants who have been identified as at risk, based on a broad range of psychosocial and socioeconomic risk factors, identified by an assessment.

Right@Home is an Australian program, evaluated in Australia. In an RCT study of 722 mothers (596 in final sample) and their infants, 41.4% of mothers lived in an area with the lowest decile of locational disadvantage in the country, 41.3% were living on welfare payments, 24.4% did not complete high school, and 8.6% spoke a language other than English at home (Goldfeld et al. 2019). The study did not report on the Indigenous status of the sample.

What outcomes does it contribute to?

Positive outcomes

Hostile parenting, Parental warmth, Safe home environment: The program had a positive effect on hostile parenting, warm parenting, and child safety, through the provision of a safe home environment (Goldfeld et al. 2019). Improvements were shown in specific outcomes such as regular bedtimes for children, improved parental involvement in children’s learning, and a greater variety of social interactions and stimulation.

No effect

None.

Negative outcomes

None.

Is the program effective?

Overall, the program had a positive effect on client outcomes.

How strong is the evidence?

Promising research evidence:

• At least one high-quality RCT/QED study reports statistically significant positive effects for at least one outcome, AND
• Fewer RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects

How is it implemented?

The program comprises 25 nurse home visits, from pregnancy through to when the child is 2 years old. Visits become less frequent over time.

How much does it cost?

Information not available

What else should I consider?

Right@Home is delivered by a multidisciplinary team of nurses and social workers.

Where does the evidence come from?

One RCT with 722 women; 306 of the 363 women in the intervention group provided data when the child was 2 years old, compared with 290 of 359 women in the control group (Goldfeld et al. 2019).

Further resources

• https://www.aracy.org.au/the-nest-in-action/righthome
• Goldfeld, S., et al. (2019). “Nurse Home Visiting for Families Experiencing Adversity: A Randomized Trial.” Pediatrics 143(1): 1-12.
• Kemp L, Harris E, McMahon C, et al. (2011) Child and family outcomes of a long-term nurse home visitation programme: a randomised controlled trial. Arch Dis Child ; 96:533-540.