Formative research in the development of a salutogenic early intervention home visiting program integrated in public child health service in a multiethnic population in Norway.
BACKGROUND
Few early intervention programs aimed at maternal and child health have been developed to be integrated in the existing Child Health Service in a country where the service is free, voluntary and used by the majority of the eligible population. This study presents the process and the critical steps in developing the "New Mothers" program.


METHODS
Formative research uses a mixed method, allowing us to obtain data from multiple sources. A scoping review provided information on early intervention programs and studies, clarifying key elements when framing a new program. Key informant and focus group interviews offered insight of existing challenges, perceptions, identified power structures and offered reflections germane to the identified framework, securing user involvement at all stages. Monthly meetings with the project group enabled feedback loops for the data, securing program advancement.


RESULTS
The "New Mothers" program was formed based on a salutogenic theory, emphasizing resistance and strengths. Public health nurses in the existing Child Health Service were to offer universally all first-time mothers and children home visits from gestational week 28 until the child reached 2 years, with motivational interviewing and empathic communication as methods to mentor the mothers, help them identify their strengths and resources, and provide support and information.


CONCLUSIONS
Using formative research as mixed method ensures incorporation of detailed information from multiple resources when an early intervention program is developed. This method secured program appropriateness, both culturally and at system level, when integrating new elements in the existing service.
['Leirbakk|Maria J|MJ|http://orcid.org/0000-0001-8199-4569', 'Torper|Johan|J|', 'Engebretsen|Eivind|E|', 'Opsahl|Jorunn Neerland|JN|', 'Zeanah|Paula|P|', 'Magnus|Jeanette H|JH|']
D000067576:Child Health D002662:Child Health Services D002675:Child, Preschool D018479:Early Intervention, Educational D005260:Female D017144:Focus Groups D006293:Health Promotion D006302:Health Services Research D006792:House Calls D006801:Humans D007223:Infant D008297:Male D009035:Mothers D009664:Norway D015397:Program Evaluation
Formative research Early intervention Home visits Maternal and child health Program development Salutogenesis