Purpose: To review evidence regarding the role of paraprofessional support in improving maternal and infant outcomes in pregnant and parenting women. Although support provided by significant others (social support), by professionals, and by paraprofessionals are frequently considered together in literature reviews, this is inappropriate because the components of the support in each case differ.
Data Sources: Data were limited to published studies. Searches of computerized databases (CINAHL, Medline, PsychLit, Social sciences abstracts, Social sciences citation, and Social work abstracts), hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched.
Study Selection: The studies included had statistically significant outcomes of paraprofessional support to pregnant and parenting women. Studies were published in 1985 or later, were conducted in the United States or Canada, and included maternal and/or infant outcomes.
Data Extraction: Data were extracted from each study concerning the theoretical framework, design, sample, measuring instruments, interventions, and outcomes.
Conclusions: Programs providing paraprofessional support to childbearing women are clearly providing an important service, but empirical evidence is not adequate to determine which specific paraprofessional program works for a specific population of women to achieve the best long-term outcomes for both women and children. Although proponents of paraprofessional support programs for pregnant and parenting women have reported some successes, more data are needed. Researchers should continue to conduct well-designed and controlled studies to compare outcomes from the three types of support. Nurses in practice should build on services provided by paraprofessionals in order to meet women's need for support and to achieve desired outcomes.
Many have suggested that pregnant women could have better outcomes if they were given support and teaching, not necessarily by a professional, but by a lay person trained to do so. What do you think? These authors reviewed that literature for the answer.
M. Cynthia Logsdon is Associate Professor, School of Nursing, University of Louisville, Louisville, KY. She can be reached at University of Louisville, School of Nursing, 555 S. Floyd Street, Louisville, KY 40202 (mclogs01@gwise.Louisville.edu).
Deborah Winders Davis is Associate Professor, School of Medicine, Department of Pediatrics, University of Louisville, Louisville, KY.