Home visiting and prenatal care: a survey of practical wisdom

Public health nurses and other professional and paraprofessional workers have engaged in prenatal home visiting for many decades. Yet, the extent to which this and other prenatal interventions influence maternal behavior is largely unknown. This study was undertaken to collect and categorize perceptions of experts in the organization and delivery of prenatal care about the value of selected strategies for encouraging participation in care, for education, and for changing behavior, with special emphasis on home visiting. The survey sample consisted of 151 experts who were identified by directors of maternal and child health programs in 48 of the 50 states. One hundred eighteen of the experts, almost half of whom were nurses, responded to the survey. The findings suggest important discrepancies between respondents' perceptions about the effectiveness of some prenatal strategies and the actual extent of their use in practice. In addition, the results raise questions about the appropriate mix of type of home visitor and purpose of visit. These questions should form the basis for subsequent investigations.