Skip Navigation

Parents as Teachers (PAT)®

Meets HHS criteria for an evidenced based model

In Brief

Last Updated

July 2013

Top

Evidence of Model Effectiveness

This model meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

Top

Model Description

The goal of the Parents as Teachers (PAT) program is to provide parents with child development knowledge and parenting support, provide early detection of developmental delays and health issues, prevent child abuse and neglect, and increase children’s school readiness. The PAT model includes one-on-one home visits, monthly group meetings, developmental screenings, and linkages and connections for families to needed resources. Parent educators conduct the home visits using structured visit plans and guided planning tools. Local sites offer at least 12 hour-long home visits annually with more offered to higher-need families. PAT serves families for at least two years between pregnancy and kindergarten. PAT affiliate programs select the target population they plan to serve and the program duration. For more information, please read the Model Overview.

This report also includes a review of an adaptation to PAT called Parents as First Teachers (PAFT-New Zealand). The New Zealand Ministry of Social Development’s Family and Community Services created this adaptation of PAT to specifically meet the needs of their indigenous populations. As of 2016, implementation support is no longer available for PAFT (New Zealand).

Top

Extent of Evidence

Results of Research and ReviewNumber of Studies for Parents as TeachersNumber of Studies for Parents as First Teachers (New Zealand)
Released from 1979 to 2012 6022
Eligible for review 235
     Rated high 20
     Rated moderate 32
     Rated low 133
     Additional sources1 50

1Additional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

Top

Summary of Findings



Parents as Teachers
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 7
No effect: 58
Unfavorable or ambiguous: 1

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Child Health

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 16
Unfavorable or ambiguous: 0

Family Economic Self-Sufficiency

Favorable: 1
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 38
Unfavorable or ambiguous: 2

Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 3
No effect: 43
Unfavorable or ambiguous: 4

Favorable: 0
No effect: 42
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment

Favorable: 1
No effect: 2
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Parents as First Teachers (New Zealand)
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 0
No effect: 6
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 5
Unfavorable or ambiguous: 0

Child Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 10
Unfavorable or ambiguous: 0

Family Economic Self-Sufficiency

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 19
Unfavorable or ambiguous: 1

Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 8
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured
Table Help
CLOSE

This table summarizes the effects found in research across outcome domains. Outcomes with a favorable impact are listed in green and outcomes with an unfavorable or ambiguous impact are listed in red. Outcomes that have high attrition or lack of baseline equivalence are excluded from this report.

Favorable Impact: A statistically significant impact on an outcome measure in a direction that is beneficial for children and parents. This impact could statistically be positive or negative, and is determined “favorable” based on the end result. For example, a favorable impact could be an increase in children’s vocabulary or daily reading to children by parents, or a reduction in harsh parenting practices or maternal depression.

Unfavorable or Ambiguous Impact: A statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents. This impact could statistically be positive or negative, and is determined “unfavorable or ambiguous” based on the end result. NOTE: While some outcomes are clearly unfavorable, for other outcomes it is not as clear which direction is desirable. For example, an increase in children’s behavior problems is clearly unfavorable, while an increase in number of days mothers are hospitalized is more ambiguous. This may be viewed as an unfavorable impact because it indicates that mothers have more health problems, but it could also indicate that mothers have increased access to needed health care due to their participation in a home visiting program.

Primary Outcome Measure: For the HomVEE review, an outcome measured through direct observation, direct assessment, or administrative data; or self-reported data collected using a standardized (normed) instrument.

Secondary Outcome Measure: For the HomVEE review, most self-reported data, excluding self-reports based on a standardized (normed) instrument.

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

Top

Criteria Established by the Department of Health and Human Services

 Parents as TeachersParents as First Teachers (New Zealand)
Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? YesYes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
YesYes
Favorable impacts on full sample? YesNo
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1 YesNA
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1 YesNA

NA = not applicable.

1This information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Models for more information.

Top