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Study Detail

Fergusson, D. M., Horwood, L. J., Grant, H., & Ridder, E. M. (2005). Early start evaluation report. Christchurch, NZ: Early Start Project Ltd.

Program(s) Reviewed: Early Start (New Zealand) - Full Sample, Early Start (New Zealand) – Māori subgroup

Additional Sources:

Fergusson, D. M., Grant, H., Horwood, L. J., & Ridder, E. M. (2005). Randomized trial of the Early Start program of home visitation. Pediatrics, 116(6), e803-e809.

Fergusson, D. M., Grant, H., Horwood, L. J., & Ridder, E. M. (2006). Randomized trial of the Early Start program of home visitation: Parent and family outcomes. Pediatrics, 117(3), 781-786. doi:10.1542/peds.2005-1517

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
ModerateRandomized controlled trialHighEstablished on race/ethnicity, SES, and outcomesNoneNone

Maternal outcomes could be assessed at baseline, but were not measured, so these outcomes rate low and are not reported.

Study Characteristics

Study Participants

Nurses screened all families in the Christchurch area who had new infants. Screening included an 11-point assessment of family stress and an evaluation of the client's need for Early Start services. A total of 588 families were determined to be eligible and 443 families agreed to participate. Those 443 families were then randomly assigned to either the treatment or comparison group. The analysis sample consisted of 184 families in the treatment group and 207 in the comparison group. Approximately one quarter of the analysis sample was Māori, and weekly income in both the Early Start and comparison groups averaged about $340 per week (according to information provided by the authors). Results are reported as of the 36-month follow-up (certain outcomes have fewer than 391 respondents at this follow-up).


The study was conducted in Christchurch, New Zealand.

Home Visiting Services

Trained family support workers engaged in home visits to encourage positive family change in the following areas: child health, maternal well-being, parenting skills, family economic functioning, and crisis management. The services were tailored to each family’s particular circumstances. Initially, families received two hours of contact with a home visitor per week. Some families in crisis received more contact. The intensity of services decreased as families made progress. Once families became self-reliant, they received a home visit every three months.

Comparison Condition

Comparison participants were not offered any services beyond what is typically available to families in the Christchurch, NZ area.

Staff Characteristics and Training

Family support workers must have a relevant educational background, awareness of cultural issues, experience dealing with high-risk families, and evidence of good interpersonal skills and sound judgment. They participated in a four-week training program and received regular supervision and support.

Funding Source

Major funders are The Department of Child, Youth, and Family, Ministry of Health, Canterbury District Health Board, Christchurch City Council, Trustbank Community Trust and Health Research Council of New Zealand. Hyman Marks Trust, Mayor’s Welfare Fund, McKenzie Trust, Telecom New Zealand and UMC Ltd. provided other financial and non-financial support.

Author Affiliation

David M. Fergusson, a study author, is a board member of Early Start. Hildegard Grant, another study author, is the general manager of the program.


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