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Early Head Start-Home Visiting (EHS-HV)§

Meets DHHS criteria for an evidenced based model

Last Updated: July 2016

Effects Shown in Research & Outcome Measure Details for Maternal Health Outcomes

Impact Studies Rated High


Love, J., Kisker, E., Ross, C. M., Schochet, P. Z., Brooks-Gunn, J., Paulsell, D., et al. (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Volumes I-III: Final technical report [and] appendixes [and] local contributions to understanding the programs and their impacts. Washington, DC: U.S. Department of Health and Human Services, Head Start Bureau.
Additional Sources:

Love, J. M., Kisker, E. E., Ross, C., Raikes, H., Constantine, J., Boller, K., et al. (2005). The effectiveness of Early Head Start for 3-year-old children and their parents: Lessons for policy and programs. Developmental Psychology, 41(6), 885–901. doi:10.1037/0012-1649.41.6.885

Roggman, L. A., Boyce, L. K., Cook, G. A., & Hart, A. D. (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Vol. 3, Local contributions to understanding the programs and their impacts. Washington, DC: Administration for Children and Families, Office of Planning, Research, and Evaluation, Child Outcomes Research and Evaluation.

Raikes, H. H., Chazan-Cohen, R., Love, J. M., & Brooks-Gunn, J. (2010). Early Head Start impacts at age 3 and a description of the age 5 follow-up study. In Childhood Programs and Practices in the First Decade of Life: A Human Capital Integration. Reynolds, A.A., Rolnick, A.J., Englund, M.M, and Temple, J.A., eds. New York: Cambridge University Press, 99-118.

Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Subsequent birth by 24 months after random assignment No Effect EHS-HV impact sample 28 months after assignment 941 mothers 21.8% 24.7% MD = -2.9 Not statistically significant,
p > 0.05
Study reported = -0.07 Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Subsequent birth by 24 months after random assignment Percentage of parents who had a subsequent birth by 24 months after random assignment Parent/caregiver report Not applicable Secondary

Love, J., Kisker, E., Ross, C., Schochet, P., Brooks-Gunn, J., Boller, K., et al. (2001). Building their futures: How Early Head Start programs are enhancing the lives of infants and toddlers in low-income families. Summary report. Report to Commissioner’s Office of Research and Evaluation, Head Start Bureau, Administration on Children, Youth and Families, and Department of Health and Human Services. Princeton, NJ: Mathematica Policy Research.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
FES: Family conflict No Effect EHS-HV impact sample 24 months postpartum 966 mothers Adjusted mean = 1.7 Adjusted mean = 1.7 MD = 0.0 Not statistically significant,
p > 0.05
Study reported = -0.12 Primary
PSI Parent-Child dysfunctional interaction No Effect EHS-HV impact sample 24 months postpartum 966 mothers Adjusted mean = 17.1 Adjusted mean = 17.5 MD = -0.4 Not statistically significant,
p > 0.05
Study reported = -0.07 Primary
PSI parental distress No Effect EHS-HV impact sample 24 months postpartum 966 mothers Adjusted mean = 25.1 Adjusted mean = 26.2 MD = -1.1 Not statistically significant,
p > 0.05
Study reported = -0.11 Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
FES: Family conflict The FES assesses the social-environmental characteristics of families. The researchers used the Family Conflict dimension, which measures the extent to which anger, aggression, frustration, and contentious interactions are common in the family. Parent/caregiver report Cronbach’s α = 0.67 Primary

PSI–SF: Parental Distress

PSI: Parent-Child Dysfunctional Interaction

The PSI–SF assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. The researchers used two subscales: (1) Parental Distress, which measures the level of distress parents feel in their role because of personal factors; and (2) Parent-Child Dysfunctional Interaction, which measures parents’ perception of parent-child interaction not meeting expectations and feelings of child rejection and abuse. Parent/caregiver report Cronbach’s α = 0.82 (Parental Distress)
Cronbach’s a = 0.78 (Parent Child Dysfunctional Interaction)
Primary
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Impact Studies Rated Moderate


Chazan-Cohen, R., Raikes, H. H., & Vogel, C. (2013). V. Program subgroups: Patterns of impacts for home-based, center-based, and mixed-approach programs. Monographs of the Society for Research in Child Development, 78(1), 93-109.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Parent depression No Effect Home-based program approach Age 5 927 Not reported Not reported Not reported Not statistically significant, p > 0.05 Study reported = -0.081 Secondary
Someone in household had alcohol/drug problem in past year No Effect Home-based program approach Age 5 927 Not reported Not reported Not reported Not statistically significant, p > 0.05 Study reported = -0.041 Secondary

1 Negative value favors the intervention.

Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Parent depression The Composite International Diagnostic Interview (CIDI) measured depression. Parent survey Internal consistency= 0.88 Secondary
Someone in household had alcohol/drug problem in past year Parent survey response. Parent survey Not reported by author Secondary

Love, J., Kisker, E., Ross, C. M., Schochet, P. Z., Brooks-Gunn, J., Paulsell, D., et al. (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Volumes I-III: Final technical report [and] appendixes [and] local contributions to understanding the programs and their impacts. Washington, DC: U.S. Department of Health and Human Services, Head Start Bureau.
Additional Sources:

Love, J. M., Kisker, E. E., Ross, C., Raikes, H., Constantine, J., Boller, K., et al. (2005). The effectiveness of Early Head Start for 3-year-old children and their parents: Lessons for policy and programs. Developmental Psychology, 41(6), 885–901. doi:10.1037/0012-1649.41.6.885

Roggman, L. A., Boyce, L. K., Cook, G. A., & Hart, A. D. (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Vol. 3, Local contributions to understanding the programs and their impacts. Washington, DC: Administration for Children and Families, Office of Planning, Research, and Evaluation, Child Outcomes Research and Evaluation.

Raikes, H. H., Chazan-Cohen, R., Love, J. M., & Brooks-Gunn, J. (2010). Early Head Start impacts at age 3 and a description of the age 5 follow-up study. In Childhood Programs and Practices in the First Decade of Life: A Human Capital Integration. Reynolds, A.A., Rolnick, A.J., Englund, M.M, and Temple, J.A., eds. New York: Cambridge University Press, 99-118.

Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
FES: Family conflict No Effect EHS-HV impact sample 36 months postpartum 950 mothers Adjusted mean = 1.7 Adjusted mean = 1.7 MD = 0.0 Not statistically significant,
p > 0.05
Study reported = -0.01 Primary
PSI Parent-Child dysfunctional interaction No Effect EHS-HV impact sample 36 months postpartum 950 mothers Adjusted mean = 17.5 Adjusted mean = 18.1 MD = -0.6 Not statistically significant,
p > 0.05
Study reported = -0.10 Primary
PSI Parental distress No Effect EHS-HV impact sample 36 months postpartum 950 mothers Adjusted mean = 24.9 Adjusted mean = 26.3 MD = -1.4 Not statistically significant,
p > 0.05
Study reported = -0.14 Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
FES: Family conflict The FES assesses the social-environmental characteristics of families. The researchers used the Family Conflict dimension, which measures the extent to which anger, aggression, frustration, and contentious interactions are common in the family. Parent/caregiver report Cronbach’s α = 0.68 Primary

PSI: Parental Distress

PSI: Parent-Child Dysfunctional Interaction

The PSI–SF assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. The researchers used two subscales: (1) Parental Distress, which measures the level of distress parents feel in their role because of personal factors; and (2) Parent-Child Dysfunctional Interaction, which measures parents’ perception of parent-child interaction not meeting expectations and feelings of child rejection and abuse. Parent/caregiver report Cronbach’s α = 0.84 (Parental Distress)
Cronbach’s a = 0.81 (Parent-Child Dysfunctional Interaction)
Primary

Love, J., Kisker, E., Ross, C., Schochet, P., Brooks-Gunn, J., Boller, K., et al. (2001). Building their futures: How Early Head Start programs are enhancing the lives of infants and toddlers in low-income families. Summary report. Report to Commissioner’s Office of Research and Evaluation, Head Start Bureau, Administration on Children, Youth and Families, and Department of Health and Human Services. Princeton, NJ: Mathematica Policy Research.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
CIDI short screening scales: Major depression (probability) No Effect EHS-HV impact sample 24 months postpartum 966 mothers Adjusted mean = 14.7 Adjusted mean = 12.0 MD = 2.8 Not statistically significant,
p > 0.05
Study reported = 0.09 Primary
Parent’s health status No Effect EHS-HV impact sample 24 months postpartum 966 mothers Adjusted mean = 3.4 Adjusted mean = 3.4 MD = 0.0 Not statistically significant,
p > 0.05
Study reported = 0.00 Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
CIDI short screening scales: Major depression (probability) Provides a probability for a DSM-IV major depressive episode in the past 12 months Parent assessment Not reported by author Primary
CIDI-SF: Major depression The CIDI-SF assesses the presence of six Diagnostic and Statistical Manual of Mental Disorders and two DSM-IIIR substance disorders. The researchers used one section of the CIDI-SF, Major Depression, which provided the probability of a depressive episode having been experienced during the previous 12 months. Parent/caregiver report Not reported by author Primary
Parent’s health status A measure of perceived health status on a scale of 1 (poor) to 5 (excellent) Parent/caregiver report Not reported by author Secondary

McKelvey, L., Schiffman, R. F., Brophy-Herb, H. E., Bocknek, E. L., Fitzgerald, H. E., Reischl, T. M., Hawver, S., & DeLuca, M. C. (2015). Examining long-term effects of an infant mental health home-based Early Head Start Program on family strengths and resilience. Infant Mental Health Journal, 36(4), 353-365.
Results for IMH-HB EHS
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
F-COPES: cognitive reframing No Effect Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Not statistically significant, p >0.10 Not reported Secondary
F-COPES: seeking support from family and friends No Effect Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Not statistically significant, p >0.10 Not reported Secondary
F-COPES: seeking support from neighbors Unfavorable Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Statistically significant, p<0.051 Not reported Secondary
F-COPES: seeking support from service providers No Effect Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Not statistically significant, p >0.10 Not reported Secondary
F-COPES: spiritual coping No Effect Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Not statistically significant, p > 0.10 Not reported Secondary
McMaster FAD: healthy functioning Favorable Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Statistically significant, p<0.012 Not reported Secondary
McMaster FAD: unhealthy functioning Favorable Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Statistically significant, p<0.013 Not reported Secondary
Pearlin Mastery, age 7 Favorable 0 Age 7 152 Not reported Not reported Not reported Statistically significant, p<0.054 Not reported Secondary
PES: attitudes Favorable Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Statistically significant, p<0.015 Not reported Secondary
PES: skills & knowledge Favorable Full sample Pooled (ages 3, 5, and 7) 152 Not reported Not reported Not reported Statistically significant, p<0.016 Not reported Secondary
PSI: parent-child dysfunctional interaction No Effect Full sample Pooled (ages 3 and 7) 152 Not reported Not reported Not reported Not statistically significant, p > 0.05 Not reported Primary
PSI: parental distress No Effect Full sample Pooled (ages 3 and 7) 152 Not reported Not reported Not reported Not statistically significant, p > 0.05 Not reported Primary

1 Comparison group was more likely to seek neighbor support. P-value reported by the author was based on an F-test of repeated measure analysis.

2 IMH-HB EHS group had higher scores on healthy functioning. P-value reported by the author was based on an F-test of repeated measure analysis.

3 IMH-HB EHS group had lower scores on unhealthy functioning. P-value reported by the author was based on an F-test of repeated measure analysis.

4 IMH-HB EHS group showed higher levels of perceived mastery. P-value reported by the author was based on an F-test of repeated measure analysis.

5 IMH-HB EHS group had higher levels of empowerment based on reported attitudes. P-value reported by the author was based on an F-test of repeated measure analysis.

6 IMH-HB EHS group had higher levels of empowerment based on reported knowledge and skills. P-value reported by the author was based on an F-test of repeated measure analysis.

Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
F-COPES: cognitive reframing The F-COPES measures behaviors and attitudes that families use to respond to problems. Parent/caregiver report The reframing subscale had Cronbach's alphas of .72, .68, and .68 for the study sample at ages 3, 5, and 7, respectively. Secondary
F-COPES: seeking support from family and friends The F-COPES measures behaviors and attitudes that families use to respond to problems. Parent/caregiver report The seeking support from family and friends subscale had Cronbach's alphas of .81, .83, and .80 for the study sample at ages 3, 5, and 7, respectively. Secondary
F-COPES: seeking support from neighbors The F-COPES measures behaviors and attitudes that families use to respond to problems. Parent/caregiver report The seeking support from neighbors subscale had Cronbach's alphas of .72, .79, and .69 for the study samples at ages 3, 5, and 7, respectively. Secondary
F-COPES: seeking support from service providers The F-COPES measures behaviors and attitudes that families use to respond to problems. Parent/caregiver report The seeking support from service providers subscale had Cronbach's alphas of .60, .61, and .74 for the study sample at ages 3, 5, and 7, respectively. Secondary
F-COPES: spiritual coping The F-COPES measures behaviors and attitudes that families use to respond to problems. Parent/caregiver report The spiritual coping subscale had Cronbach's alphas of .85, .82, and .85 for the study sample at ages 3, 5, and 7, respectively. Secondary
McMaster FAD: healthy functioning The McMaster FAD healthy functioning subscale assesses emotional supportiveness between family members. Parent/caregiver report The healthy functioning subscale had Cronbach's alphas of .85, .76, and .86 for the study sample at ages 3, 5, and 7, respectively. Secondary
McMaster FAD: unhealthy functioning The McMaster FAD unhealthy functioning subscale assesses lack of family cohesion. Parent/caregiver report The unhealthy functioning subscale had Cronbach's alphas of .78, .80, and .84 for the study sample at ages 3, 5, and 7, respectively. Secondary
Pearlin Mastery, age 7 The Pearlin Mastery Scale assesses the degree to which a person has a sense of mastery or control over their life. Parent/caregiver report The Pearlin Mastery Scale had a Cronbach's alpha of .69 for the study sample at age 7. Secondary
PES: attitudes The PES measures psychological empowerment for parents of children with a disability. Parent/caregiver report The attitudes subscale had Cronbach's alphas of .83 and .86 for the study samples at ages 3 and 5, respectively. Secondary
PES: skills & knowledge The PES measures psychological empowerment for parents of children with a disability. Parent/caregiver report The skills and knowledge subscale had a Cronbach's alpha of .77 for the study sample at both ages 3 and 5. Secondary
PSI: parent-child dysfunctional interaction This subscale from the PSI measures parents’ perception of parent-child interaction not meeting the parent's expectations. Parent/caregiver report The parent-child dysfunctional interaction subscale had Cronbach's alphas of .79 and .78 for the study sample at ages 3 and 7, respectively. Primary
PSI: parental distress This subscale from the PSI measures the level of distress parents feel in their role because of personal factors. Parent/caregiver report The authors report that the parental distress subscale was associated with stress associated with parenting demands and with depressive symptomatology. The subscale had Cronbach's alphas of .83 and .82 for the study sample at ages 3 and 7, respectively. Primary
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