magazines/journals
Early Intervention at Home (IPPAD) to Support Parent-Child Relationships: What Are the Key Factors for Promoting Its Implementation in France?
As part of the "First 1,000 Days of a Child’s Life" policy, Santé publique France has published a guide offering guidelines for the implementation and rollout of IPPAD, intended for decision-makers and frontline professionals seeking to develop, implement, or improve this type of intervention.
The First 1,000 Days
A website that provides guidance to expectant parents and parents of children up to two years old on how to create an environment that supports their child’s development.
During the “first 1,000 days” (the period from pregnancy to a child’s second birthday), a child’s brain development plays a major role in their overall development, as it enables them to acquire cognitive, physical, motor, emotional, social, and language skills and abilities. The individual’s health, learning, and well-being throughout their life will depend on these skills and abilities. In order to develop them, the child needs to form relationships with others and, more specifically, an attachment bond with their mother or any other caregiver who looks after them and meets their basic needs. To strengthen this bond and/or prevent attachment disorders, early home-based prevention interventions (IPPAD) were developed in the early 1980s. These evidence-based programs, rooted in research, have been the subject of numerous international scientific publications and now constitute a robust body of knowledge upon which to identify EIPH practices and intervention strategies.
As part of its mandate, Santé publique France is responsible for promoting the dissemination of evidence-based information from scientific and experiential literature. To fulfill commitments related to the “First 1,000 Days of a Child’s Life” policy, the agency has developed a guide on IPPAD to support the expansion of these interventions in France.
Early Intervention at Home: Effective Support in the Field of Perinatal Health
What is an IPPAD?
IPPADs are defined as any activity aimed at preventing illness and promoting physical and mental health, developing psychosocial skills, or providing care, targeting families from pregnancy through the child’s second or third year of life and carried out in the home. These interventions primarily target families with multiple medical, psychological, and social risk factors for vulnerability, who are difficult to reach due to low utilization of and low trust in healthcare and community support networks.
What do they involve?
This involves trained home visitors who meet with expectant parents or families multiple times during the child’s first 1,000 days to provide a range of primary and secondary prevention services, psychosocial support, or parenting support.
These interventions, which rely on families’ voluntary participation, are designed or adapted and tested for delivery in the home. During these visits, home visitors aim to build strong, positive relationships and provide opportunities for support and engagement with parents and families to strengthen the skills of both children and families.
What are the benefits?
Early prevention home-based interventions have been developed in many countries, and according to studies, certain positive effects have been demonstrated on:
the child’s psycho-emotional development, with fewer attachment issues at age one, fewer behavioral problems, and better cognitive, language, and motor development;
the child’s health, with fewer accidents, hospitalizations, and emergency room visits, higher vaccination rates, and fewer cases of low birth weight and prematurity;
the child’s academic success;
the mother’s health, with better prenatal and postpartum care, fewer cases of gestational diabetes, fewer prenatal hospitalizations, fewer cesarean sections, and less perinatal stress and depression; longer intervals between pregnancies;
parenting, with greater parental knowledge; better identification of and response to the baby’s needs; greater satisfaction and a sense of parental competence; improved maternal ability to create a safe and stimulating environment; greater engagement, greater confidence, and less anxiety among fathers.
Guidelines to Support the Rollout of IPPADs in France
broadEarly home-based prevention interventions are recognized as having the potential to improve support for parents, but their implementation in France requires a clear definition of: the various intervention models, the theoretical concepts underlying the interventions, the specific objectives, the profiles of the home visitors, and the target populations.
The defined guidelines are based on findings from three studies conducted by Santé publique France: a review of the international literature, a population-based survey on the acceptability of these interventions among expectant and new parents, and an overview of IPPADs currently deployed in France. Based on the knowledge gathered and shared in this guide, 13 quality criteria for IPPADs and three key areas are proposed to promote the development of quality and territorial coverage of this type of intervention in France, such as:
Supporting organizations wishing to establish or evaluate IPPADs
Capitalizing on experiences to gain a detailed understanding of IPPADs and deploy them
Deepening the cost-effectiveness evaluation of IPPADs by conducting intervention research
This report is a first step in the Agency’s commitment to supporting stakeholders in developing IPPADs.
Based on the lessons learned from this report, Santé publique France will engage in consultation with relevant stakeholders to develop a practical guide for field professionals, funders, and policymakers. This guide will provide scientific and methodological support to the promoters of these interventions so that as many affected families as possible can benefit from these services.
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guide
20 November 2023
Guidelines for Implementing Early Prevention Interventions in the Home to Support Parent-Child Relationships. Government Plan: The First 1,000 Days, 2020–2022
An initiative that is part of Santé publique France’s “1,000 Days” program
Since its inception, Santé publique France has been committed to promoting health and prevention in the fields of perinatal care and early childhood.
This commitment is grounded in a robust scientific foundation that encompasses biological, psychosocial, and economic factors, demonstrating the value and effectiveness of intervening as early as possible to address social and regional health inequalities. These inequalities, which remain evident in France, emerge as early as pregnancy and become entrenched during early childhood. Santé publique France’s
“Perinatal and Early Childhood” program aligns with public policy priorities such as the “First 1,000 Days.”
Launched through a series of national measures in 2020, the “First 1,000 Days” policy has gained widespread traction through the mobilization of local communities and the various stakeholders involved in the daily lives of children, parents, expectant parents, and the environments in which they live. As part of the 2024–2027 multi-year roadmap, two measures have been entrusted to Santé publique France:
raising awareness among the general public and parents about the challenges of the first 1,000 days;
providing the scientific framework to support the rollout of pre- and postnatal home visits.
These two measures entrusted to Santé publique France are part of the strategy on the first 1,000 days developed since 2016, which is being implemented along three main lines:
Generating knowledge and indicators on the health determinants of the first 1,000 days;
providing information to parents, expectant parents, and professionals through campaigns and the website 1000-premiers-jours.fr;
the development and support of early prevention interventions (IPPAD, Panjo, etc.)
thematic dossier
The First 1,000 Days
The period from conception through the first two years of life is critical for a child’s development and the health of the adult they will become. That is why it is essential to prioritize the...
