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These are published research papers that iHV has been involved with:

Dr. Sharin Baldwin, Dr. Michael Fanner, Hilda Beauchamp, Vicky Gilroy, Professor Jane Barlow

Babies are born with amazing social abilities. They are ready to relate and engage with the world around them, communicating how they feel through their behaviours. It is normal for babies to use withdrawal behaviours (such as looking away, closing eyes, sneezing) to control the pace of social engagement. Sustained social withdrawal behaviours, however, could suggest an ‘early alarm signal’ for relational
challenges and a coping mechanism that babies may use if their initial protests are not responded to.

The Alarm Distress Baby Scale (ADBB) is an observation aid, validated by research, used to  observe how babies are interacting with the world around them and to assess for social withdrawal. The short version of the scale (the m-ADBB) allows babies who may be in need of a more thorough assessment
and support to be quickly identified. We carried out a mixed methods study to explore the acceptability
and feasibility of using the full ADBB and the modified ADBB (m-ADBB) as part of routine health visiting
practice in England.

To cite this report, please use the link to the pdf here:

Sharin Baldwin, Nafisa Insan, Hilda Beauchamp, Vicky Gilroy, Alison Morton, Jane Barlow

Abstract Introduction The Alarm Distress BaBy (ADBB) scale developed by Guedeney and Fermanian in 2001, is a validated screening tool designed for use by healthcare practitioners to identify infant social withdrawal. This study will explore the acceptability and feasibility of the use of the full ADBB scale and a modified ADBB (m-ADBB) scale as part of routine health visiting visits in England.

Caitlin Notley, Tracey J Brown, Linda Bauld, Allan B Clark, Sharon Duneclift, Vicky Gilroy, Tess Harris, Wendy Hardeman, Richard Holland, Gregory Howard, Mei-See Man, Felix  Naughton, Dan Smith, David Turner, Michael Ussher


Many people quit smoking during pregnancy, but postpartum smoking relapse is common. Maintaining smoking abstinence achieved during pregnancy is key to improving maternal and child health. There are no evidence-based interventions for preventing postpartum smoking relapse. This trial aims to determine whether an intervention to prevent postpartum relapse is effective and cost-effective.

Sharin Baldwin, Rachel Stephen, Patricia Kelly, Philippa Bishop


The Institute of Health Visiting (iHV) Emotional Wellbeing at Work Programme was developed during the COVID-19 pandemic to support the health visiting services to deal with the increased demands placed on them. This paper discusses the development of the iHV Emotional Wellbeing at Work (EWW) Champions Programme, which has built on the original model to enable the creation of EWW Champions. The iHV has a good track record of building leadership and capacity for rolling out training and development on a wider scale using the iHV Champions model of training. The portfolio currently includes a range of Perinatal and Infant Mental Health Champions (Baldwin and Kelly, 2016; Baldwin et al., 2018) [1,2], Research Champions (Mugweni et al., 2019) [3], Delivering Different News Champions, Healthy Weight and Healthy Nutrition Champions, Changing Conversations: Autism Ambassadors, and Neonatal Families Ambassadors. This paper discusses how the EWW programme was further developed to create this Champions’ model to enable other experienced and skilled health visitors to become EWW facilitators. Through this model, trained health visitors can support their colleagues in the workplace, protecting and enhancing their emotional wellbeing at work and broadening access to support services and resources.

Sharin Baldwin, Rachel Stephen, Patricia Kelly, Philippa Bishop


The coronavirus disease 2019 (COVID-19) pandemic has had and continues to have a huge effect on the health and wellbeing of children and families in the UK. Health visitors have been at the forefront of providing support and care to these families, which has been challenging and has resulted in increased levels of stress among the workforce. For health visitors to have the capacity to support families adequately, it is important that they focus on their own wellbeing.

This article describes the Emotional Wellbeing at Work virtual programme for health visitors developed by the Institute of Health Visiting and funded by the RCN Foundation. It also discusses the early evaluation findings and learning points, and considers how the programme has developed.

Dr Esther Mugweni, Tamsyn Eida, Tracy Pellat-Higgins, Melita Walker, Angie Emrys-Jones, Sabrena Jaswal, Professor Sally Kendall


The first 1001 days covering from pregnancy to the time that a child is two years old are critical for their physical, emotional and cognitive development. There is increased vulnerability for babies and their families during this period when congenital anomalies are identified. The diagnostic process has significant implications for parent and child emotional and mental wellbeing. In this study, we refer to this diagnostic process as delivering different news (DDN). Ineffective delivery of different news (DN) and the DN itself can result in chronic stress, depression, anxiety or other mental health conditions in parents. In the first 1001 days of life, this may impair parenting ability which potentially has a direct immediate and long-term impact on the infant’s physical, cognitive, emotional and social development. Parents must receive DN from healthcare professionals (HCPs) with skills to deliver the news sensitively and compassionately. Currently, not every family has access to such HCPs due to a lack of standardised training or policy to guide professionals on how to effectively deliver DN. Providing communication skills training can potentially minimise the negative psychological impact of the news, maximise the psychological wellbeing of the whole family and reduce staff burnout.

Read the Easy Read version of the report

Also read iHV Policy Brief – Improving the way healthcare professionals inform parents about their child having congenital anomalies in the first two years of life


Sharin Baldwin, Rachel Stephen, Philippa Bishop, Patricia Kelly

The COVID-19 pandemic has changed the way in which health visiting services are delivered in the UK. Health visitors are now having to work more remotely, with virtual methods for service delivery as well as using personal protective equipment where face-to-face contacts are necessary. This rapid change has resulted in many health visiting staff working under greater levels of pressure, feeling isolated, anxious and unsettled. This article discusses a virtual programme that has been funded by the RCN Foundation and developed by the Institute of Health Visiting to support the emotional wellbeing of health visiting teams in the UK. It outlines the background to the project, the theoretical underpinnings to inform the programme model and the evaluation process that will be used to further refine the programme before wider implementation.

Sally Weston-Price, Julia Csikar, Karen Vinall-Collier, Philippa Bishop, Donatella D’Antoni, Cynthia Pine

Objective: To explore the potential barriers and facilitators to health visiting (HV) teams delivering oral health promotion during the 9-12-month old child mandated visit in Ealing, England.

Background: HV schemes and their counterparts worldwide share similar priorities to discuss oral health at 6-12 months of age. The HV programme in England stipulates at 9-12 months old, diet and dental health should be discussed. HVs believe dental decay is important however oral health knowledge is varied.

Perceived facilitators: good levels of knowledge and skills, sense of professional role, emotions, belief in capability, organisational structure and resources.

Perceived barriers: gaps in knowledge, conflicting advice from other professionals, conflicting issues for parents/ carers, use of interpreters.

Conclusions: These findings can be harnessed to support oral health promotion delivered by HV teams.

Esther Mugweni, Catherine Lowenhoff, Melita Walker, Sabrena Jaswal, Angela Emrys‐Jones, Cheryll Adams, Sally Kendall

Background: In the United Kingdom, pregnant women are offered foetal anomaly screening to assess the chance of their baby being born with eleven different conditions. How health care professionals (HCPs) deliver news about a child having a congenital anomaly affects how it is received and processed by parents. We refer to this news as different news.

Conclusions: The significant improvements in confidence and skills reported by HCPs suggest that the training may be effective in equipping HCPs to minimize the distress, anxiety, and depression associated with receiving different news. This represents a key aspect of the prevention of mental ill health across the life course.

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Background: Perinatal mental health (PMH) problems are a major public health concern because they may impair parenting ability which potentially has an immediate and long-term impact on the physical, cognitive and emotional health of the child.

Aims: We evaluated a Perinatal Support Service (PSS) which supports positive attachment between mothers with PMH problems and their child, to evidence its impact on maternal mental health and maternal-infant interaction.

Results: We found significant improvement in anxiety after the PSS. Anxiety post service was lower than baseline anxiety. Receiving emotional and practical support contributed to improvements in mental health and mother–child interaction.

Conclusion: Given the paucity of PMH services in the UK, it is imperative that services such as the PSS continue to receive funding to address unmet PMH needs.

Esther Mugweni1, Melita Walker1, Samantha Goodliffe1, Sabrena Jaswal2, Catherine Lowenhoff3,
Cheryll Adams1, Angie Emrys-Jones & Sally Kendall1,2

  1. Institute of Health Visiting
  2. University of Kent
  3. Oxford Brookes University

The way healthcare professionals deliver “different news” is an important factor in how it is received, interpreted, understood and processed by parents. The term “different news (DN)” is used in this study to describe the process of imparting and receiving information relating to an unborn or newly born child being diagnosed with a condition associated with a learning disability. Parents may experience a range of emotions immediately after receiving DN including significant distress, fear, grief, depression, anxiety and chronic stress.

Published March 2019

Journal of Health Visiting › May 2018 › Volume 6 Issue 5

Amanda Bye, Nicola Mackintosh, Jane Sandall, Abigail Easter, Melita Walker

Published May 2018

The transition to motherhood can be challenging for many women due to the changes that are common to pregnancy, such as changes in appetite and body shape and weight. These challenges can be particularly pronounced for women with eating disorders. There is growing evidence that eating disorders can be associated with adverse maternal and infant outcomes; and given the elevated risks, early identification and tailored antenatal and postnatal care are highly important. This article examines the role of the health visitor in supporting women with eating disorders during pregnancy and the postnatal period.

Journal of Health Visiting › April 2018 › Volume 6 Issue 4

Sharin Baldwin, Patricia Kelly, Melita Walker

Published April 2018

The transition to parenthood can be a challenging time for parents and during the perinatal period some parents may experience mental health difficulties. The Institute of Health Visiting (iHV) Perinatal Mental Health Champions training programme addresses the fundamental requirements that are necessary for health visitors to manage anxiety, depression and other perinatal mental illnesses, to understand the impact of these conditions on the infant, family and society, and to know when to refer on. This article evaluates the implementation of the training programme in a Trust in north-west London.

Oge OA, Douglas GVA, Seymour D,
Adams C, Csikar J. Knowledge, attitude and practice among
Health Visitors in the United Kingdom toward children’s oral

Public Health Nurs. 2018;00:1–8. https://doi.

Published 2018

Objectives: The purpose of this study was to determine knowledge, attitude, and practical behavior of health visitors regarding children’s oral health in the United Kingdom (UK). Methods: A web-based self-administered survey with 18 closed and 2 open ended questions was distributed to a convenience sample of approximately 9,000 health visitors who were currently employed in the United Kingdom and a member of the Institute of Health Visiting.
(PDF) Knowledge, attitude and practice among Health Visitors in the United Kingdom toward children’s oral health. Available from: [accessed Jun 19 2018].

Bhavita Vishram, Louise Letley, Albert Jan Van Hoek, Louise Silverton, Helen Donovan, Cheryll Adams, David Green, Angela Edwards, Joanne Yarwood, Helen Bedford, Gayatri Amirthalingam & Helen Campbell

Published online: 27 Nov 2017

Objective: To examine amongst healthcare professionals in England; knowledge of vaccinations in pregnancy, their perceived roles in these programmes and whether they recommend scheduled vaccines to pregnant women.

Key messages from a Liaison Health Visitor Survey (November 2017)

Authors: Anne Byrne 1 , Mary Boullier 2 , Cheryll Adams 3 , Mitch Blair 2

  • 1 – Liaison Health Visitor, London North West Healthcare NHS Trust.
  • 2  – River Island Paediatric Academic Unit, London, North West Healthcare NHS Trust
  • 3 – Institute of Health Visiting

Rosamund Mary Bryar, Dame Sarah Ann Cowley, Cheryll Mary Adams, Sally Kendall, Nigel Mathers

Published March 2017

When did you last see a health visitor? When did you last communicate with a health visitor? These seem apt questions given the evidence from a recent survey of health visitors by the Institute of Health Visiting (iHV); (Working with GPs Survey, unpublished, London, 2016. For further information contact Dr C Adams, Director, iHV). The evidence shows great variability in contact between health visitors (HVs) and GPs in England: of 1179 respondents, 23% of HVs saw a GP at least once a week; 33% 1–2 times a month, and 33% less frequently or hardly ever. In this editorial we review the recent history of health visiting and how, in particular in England, we have arrived at the current situation where HVs, once considered essential members of the wider (non-practice employed) primary health care team (PHCT),1 are now so detached that at a recent meeting (ICCHNR Symposium, University of Kent, September, 2016), a GP could say that they, HVs, are ‘out there somewhere’ but where seemed to be a mystery to him and possibly others.

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