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Study Detail

Barnes-Boyd, C., Norr, K. F., & Nacion, K. W. (1996). Evaluation of an interagency home visiting program to reduce postneonatal mortality in disadvantaged communities. Public Health Nursing, 13(3), 201-208.

Program(s) Reviewed: Resources, Education, and Care in the Home (REACH)

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
ModerateQuasi-experimental designNAEstablished on race/ethnicity and SES. Baseline equivalence on outcomes not feasible.NAFor morbidity outcomes (neonatal and at 12 months), the REACH group was assessed by a nurse at home and the comparison group was assessed by a nurse in a clinic. Because a nurse collected the data in both settings, this was judged as not being a threat to the study’s internal validity.

Study Characteristics

Study Participants Researchers recruited 1,269 infants who were healthy at birth and had high socioeconomic risk factors from target communities. At intake, 79 percent of the infants were African American and 18 percent were Hispanic. More than one-third of infants had mothers aged 19 or younger, and more than one-third had mothers with less than a high school education.
Setting Chicago, Illinois
Home Visiting Services Services included at least five home visits in the first year of life (at 2 weeks, 6-8 weeks, and 4, 8, and 12 months), and more as necessary. Timing of the home visits was designed to coincide with the child’s developmental changes and a greater likelihood of illness. Home visitors were registered nurses who coordinated the family’s care with participating agencies, made referrals, and provided individual counseling. The focus of the visits was health education and screening. Retention in the program (through 12 months) was 57.5 percent.
Comparison Condition The study included three comparison groups, which were used for different outcomes. The comparison group for the infant mortality outcome included infants residing in REACH target communities (but not participating in REACH) over a four-year span. The comparison group for the neonatal morbidity outcomes was 334 mothers and infants evaluated at 7-15 days postpartum for a study of early discharge conducted just before the REACH study began. For morbidity at 12 months, the comparison group was recruited from a pediatric clinic and was made up of 83 infants who lived either in REACH target communities or in other neighborhoods with high infant mortality rates.
Staff Characteristics and Training Registered nurses
Funding Source Special Project of Regional and National Significance Grant by the Office of Maternal and Child Health of the Department of Health and Human Services (MCJ 173851) and the University of Illinois Hospital.
Author Affiliation The authors are developers of this program model.

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