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Study Detail

Jacobs, F., Easterbrooks, M. A., Goldberg, J., Mistry, J., Bumgarner, E., Raskin, M., Fosse, N., & Fauth, R. (2015). Improving adolescent parenting: Results from a randomized controlled trial of a home visiting program for young families. American Journal of Public Health, published online ahead of print, e1-e7.

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

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
ModerateRandomized controlled trialLowBaseline equivalence is not established on race/ethnicity, SES, or baseline measures of the outcomes; some outcomes were not feasible to assess at baseline.NoneNone
Notes:

In addition to the outcomes that rated moderate, several outcomes in this study rated low: corporal punishment at 1 and 2 years, parenting stress measures at 1 and 2 years, healthy baby, child behavior problems, high school diploma or equivalent at 1 year, completed at least 1 year of college at 1 year, employment at 1 and 2 years, use of hormonal birth control at 1 and 2 years, use of condoms at 1 and 2 years, engagement in risky behavior, marijuana use, intimate partner violence (self-perpetrated) at 1 and 2 years, and intimate partner violence (perpetrated by partner) at 1 and 2 years. These outcomes rated low because they had high attrition and baseline equivalence was not established on race/ethnicity or SES. Information on attrition and baseline equivalence was based on correspondence with the author.

Study Characteristics

Study Participants This is a randomized controlled trial that randomly assigned 837 women to the Healthy Families Massachusetts (HFM) program or to a control group. From the 837 randomized women, 704 mothers (517 treatment, 320 control) were recruited and completed the initial (baseline) interview and/or allowed access to administrative data. Participants were from 18 HFM sites, female, at least 16 years old, conversant in English or Spanish, new to HFM, and able to provide informed consent. Based on HFM enrollment criteria, mothers also had to be first-time parents under age 21 who enrolled while they were pregnant or during the child's first year. The full baseline sample of 704 mothers was 37 percent white non-Hispanic, 19 percent black non-Hispanic, 36 percent Hispanic, and 8 percent other; 74 percent preferred speaking in English only, 20 percent preferred English and another language, and 6 percent preferred Spanish only. Before enrollment, mothers were 19 years old, on average, and 19 percent received cash assistance, 17 percent received food assistance, 35 percent were parenting, and 4 percent had been previously reported for child maltreatment.
Setting 18 sites in Massachusetts.
Home Visiting Services Home visiting services were offered from pregnancy through the child's third birthday. Visits were offered biweekly during pregnancy, weekly for at least six months following the baby's birth, and then less frequently. Home visiting services included setting goals, curriculum-based activities, family support, routine developmental and health screenings, and linkages to medical and other needed services. On average, mothers received 24 home visits (SD = 26.4, median = 14) over an average of 14.7 months (SD = 12.8, median = 9.8).
Comparison Condition The control group received information about child development and referrals to other services.
Staff Characteristics and Training Staff characteristics and training were not described in the current study; however, they were described in the Initial Findings Report (Easterbrooks et al., 2012). Home visitors were paraprofessionals with experience working with families, knowledge of child development and family relationships, and other characteristics (such as the ability to establish trusting relationships and a willingness to work with culturally diverse populations). Home visiting staff completed an initial six-day core training and, within their first year of employment, 10 additional topical trainings. Home visitors, supervisors, and program coordinators received weekly supervision (1 – 1.5 hours) from professionally trained staff.
Funding Source The Massachusetts Children’s Trust and the Pew Center for States funded this research.
Author Affiliation All authors are affiliated with the Tufts University Eliot-Pearson Department of Child Study and Human Development, with the exception of Dr. Bumgarner, who is affiliated with Abt Associates.

Study Registration

Clinicaltrials.gov Identifier: NCT01926223. Study registration was assessed by HomVEE beginning with the 2014 review.

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