Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
The Social Support and Family Health Study: a randomised controlled trial and economic evaluation of two alternative forms of postnatal support for mothers living in disadvantaged inner-city areas.
OBJECTIVES To determine whether increased postnatal support could influence  maternal and child health outcomes . DESIGN This was a r and omised controlled trial comparing maternal and child health outcomes for women offered either of the support interventions with those for control women receiving st and ard services only . Outcome data were collected through question naires distributed 12 and 18 months postr and omisation . Process data were also collected . There was also an integral economic evaluation . SETTING AND PARTICIPANTS Women living in deprived enumeration districts in selected London boroughs were eligible for the trial if they gave birth between 1 January and 30 September 1999 . RESULTS The 731 participants were found to be well matched in terms of socio-economic characteristics and health and support variables ( 14 % of the participants were non-English speaking ) . Response rates at the two follow-up points were 90 % and 82 % . At both points there were no differences that could not be attributed to chance on the primary outcomes of maternal depression , child injury or maternal smoking . At the first follow-up , there was reduced use of general practitioners by support health visitor ( SHV ) children , but increased use of NHS health visitors and social workers by mothers . At the second follow-up , both community group support ( CGS ) and SHV mothers had less use of midwifery services ( fewer were pregnant ) , and SHV mothers were less worried about their child 's health and development . Uptake of the CGS intervention was low : 19 % , compared with 94 % for the SHV intervention . Satisfaction with the intervention among women in the SHV group was high . Based on the assumptions and conditions of the costing methods , the economic evaluation found no net economic cost or benefit of choosing either of the two interventions . CONCLUSIONS There was no evidence of impact on the primary outcomes of either intervention . The SHV intervention was popular with women , and was associated with improvement in some of the secondary outcomes . This suggests that greater emphasis on the social support role of health visitors could improve some measures of family well-being . Possible areas for future research include a systematic review of social support and its effect on health ; developing and testing other postnatal models of support that match more closely the age of the baby and the changing patterns of mothers ' needs ; evaluating other strategies for mobilising ' non-professional ' support ; developing and testing more culturally specific support interventions ; developing more culturally appropriate st and ardised measures of health outcomes ; providing longer term follow-up of social support interventions ; and exploring the role of social support on the delay in subsequent pregnancy
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .