Objective: To assess the effectiveness of trained cultural mediators in promoting, among immigrant mothers, four preventive interventions for their infants: immunization, breastfeeding, sleeping position, passive smoking exposure. Methods: 142 immigrant pregnant women in Trieste and Bologna, speaking Chinese, Serbian-Croatian, Arabian and Urdu, were randomized in two intervention groups: one receiving a booklet or home visits from trained cultural mediators and a control group exposed to routine health care. Quantitative data were collected at enrolment, soon after birth, and at three and six months after birth. Qualitative data were collected from a sub-group of 19 women through focus groups and in-depth interviews. Results: A considerable proportion of data was missed after birth (49%) and at six months (30%) for different reasons. Analysis of results, limited to data gathered at enrolment (98%) and at three months (87%), shows no difference in compliance with preventive interventions among the three study groups. There were, however, statistically significant differences among both linguistic groups and research sites. Multivariate analysis confirmed the lack of differences among groups, but could not isolate language and residence as variables associated with different health practices due to the homogeneity within linguistic groups and research sites. The qualitative analysis associated differences in health practices with cultural motivations that were specific for each linguistic group, but not with the three study groups. Discussion: The lack of a demonstrated effectiveness of a booklet or a home visit by cultural mediators could be due to different reasons. Some may be related with the design of these interventions, some to the limitations of the study, some with specific cultural elements within each linguistic group.

Immigrant mothers Preventive interventions Cultural mediator infancy

immigrant controlled clinical trial sleep health promotion home care clinical trial human controlled study randomized controlled trial language ethnic difference female preventive health service Multivariate Analysis qualitative analysis cultural factor passive smoking Article patient compliance health education breast feeding education pregnant woman immunization child care