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Study Detail

Lee, E., Mitchell-Herzfeld, S., Lowenfels, A. A., Greene, R., Dorabawila, V., & DuMont, K. A. (2009). Reducing low birth weight through home visitation: A randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154–160.

Program(s) Reviewed: Healthy Families America (HFA)®

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
HighRandomized controlled trialLowEstablished on race/ethnicity and SES; outcomes not feasible to assess at baseline.NoneNone
Notes:

Two outcomes, frequency of prenatal care visits and whether the mother has a primary care provider, received a rating of moderate because the study demonstrates baseline equivalence for socioeconomic status but not for race and ethnicity. In addition, baseline measures of the primary care provider outcome were measurable at baseline and baseline equivalence was not demonstrated for this outcome.

Study Characteristics

Study Participants Potential participants at three Healthy Families New York sites (Healthy Families America program) were screened for socioeconomic risk factors and administered the family stress checklist. Eligible participants lived at or under 200 percent of the federal poverty level and were pregnant or had given birth within three months of enrollment. In total, 1,297 pregnant mothers or mothers who had recently given birth were eligible and agreed to participate in the study and were randomized to either a Healthy Families New York group or a comparison group. This study focused on the subsample of mothers who were randomized at 30 or fewer weeks of gestation and who had a single birth. Within this subsample, 264 mothers were randomized to the intervention group and 291 to the comparison group. Among the total 501 mothers in the study, 44.9 percent were black, 22.4 percent were Hispanic, and 30.1 percent were white; 21.8 percent were below the age of 18, 23.2 percent participated in the Temporary Assistance for Needy Families (TANF) program, 26.9 percent had smoked while pregnant, and 56.3 percent were first-time mothers.
Setting The study took place within three Healthy Families of New York sites: Erie, Rensselaer, and Ulster counties.
Home Visiting Services Mothers assigned to the Healthy Families of New York (based on Healthy Families America) group received bi-weekly visits. On average, home visits were an hour in duration. The home visits focused on improving the mothers' social support, providing prenatal education, and linking the mothers to other community services. Home visitors discussed preparedness for motherhood, helped the mothers develop problem-solving skills and healthy prenatal behaviors, encouraged mothers to follow all medical advice and attend all medical appointments, and helped the mothers obtain a health care provider and connect with other services, such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
Comparison Condition Members of the comparison group received information about and referrals to other community services.
Staff Characteristics and Training Home visitors were “indigenous to the community,” and had the same language and “cultural background” as the women participating in the program. The home visitors were a median age of 38 years old and typically had experience working with infants and young children. About half of the home visitors had at least some college education. The home visitors were trained by certified Healthy Families of America trainers and were supervised weekly.
Funding Source Not reported
Author Affiliation Center for Human Services Research, School of Social Welfare, University of Albany, State University of New York; and the Bureau of Evaluation and Research, New York State Office of Children and Family Services.

Study Registration

Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

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