Maternal Infant Health Outreach Worker (MIHOW)® Meets HHS Criteria

Model effectiveness research report last updated: 2022

Effects shown in research

To see details on each finding HomVEE reviewed in well-designed research, click on the name of an outcome domain.

Effects shown in research

Maternal health

Findings rated high

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance

Average number of prenatal visits during pregnancy

FavorableUnfavorable or ambiguousNo Effect

Prenatal period

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

177 mothers Unadjusted mean = 9.00 Visits Unadjusted mean = 9.20 Visits Mean difference = -0.20 HomVEE calculated = -0.09

Not statistically significant, p= 0.48

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Edinburgh Postnatal Depression Scale (EPDS)

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 1.26 Unadjusted mean = 1.26 Mean difference = 0.00 Study reported = -0.01

Not statistically significant, p= 0.95

Author-reported effect size was calculated with Cohen's D.

Edinburgh Postnatal Depression Scale (EPDS)

FavorableUnfavorable or ambiguousNo Effect

35 weeks gestation

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

102 mothers Unadjusted mean = 1.44 Unadjusted mean = 1.47 Mean difference = -0.02 Study reported = -0.06

Not statistically significant, p= 0.75

Author-reported effect size was calculated with Cohen's D.

Edinburgh Postnatal Depression Scale (EPDS)

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 1.20 Unadjusted mean = 1.43 Mean difference = -0.23 Study reported = -0.56

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

12 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 67.00 Unadjusted mean = 79.40 Mean difference = -12.40 Study reported = -0.77

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 59.10 Unadjusted mean = 77.10 Mean difference = -18.00 Study reported = -1.19

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 79.80 Unadjusted mean = 76.90 Mean difference = 2.90 Study reported = 0.14

Not statistically significant, p = 0.43

Author-reported effect size was calculated with Cohen's D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 75.70 Unadjusted mean = 77.70 Mean difference = -2.00 HomVEE calculated = -0.09

Not statistically significant, p= 0.64

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted mean = 75.30 Unadjusted mean = 75.30 Mean difference = 0.00 Study reported = 0.00

Not statistically significant, p = 1.00

Author-reported effect size was calculated with Cohen's D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted mean = 72.20 Unadjusted mean = 78.50 Mean difference = -6.30 Study reported = -0.35

Statistically significant, p = 0.04

Author-reported effect size was calculated with Cohen's D.

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Edinburgh Postpartum Depression Scale (EPDS)

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted median = 0.00 Unadjusted median = 3.00 Median difference = -3.00 Study reported = -1.08

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen’s D.

Edinburgh Postpartum Depression Scale (EPDS)

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

177 mothers Unadjusted median = 0.00 Unadjusted median = 5.00 Median difference = -5.00 Study reported = -1.41

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen’s D.

Edinburgh Postpartum Depression Scale (EPDS)

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted median = 0.00 Unadjusted median = 0.00 Median difference = 0.00 Study reported = -0.76

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen’s D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted median = 74.00 Unadjusted median = 76.00 Median difference = -2.00 Study reported = -0.46

Statistically significant, p= 0.00

Author-reported effect size was calculated with Cohen’s D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

177 mothers Unadjusted median = 74.00 Unadjusted median = 76.00 Median difference = -2.00 Study reported = -0.45

Statistically significant, p= 0.00

Author-reported effect size was calculated with Cohen’s D.

Parenting Stress Index 4 (PSI): Total stress score

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted median = 74.00 Unadjusted median = 77.00 Median difference = -3.00 Study reported = -0.72

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen’s D.

Findings rated moderate

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Had a postpartum checkup

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted proportion = 0.91 Unadjusted proportion = 0.94 Difference = -0.03 Study reported = 0.23

Not statistically significant, p= 0.56

Author-reported effect size was calculated with Cohen's D.

Had a postpartum checkup

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted proportion = 1.00 Unadjusted proportion = 0.96 Difference = 0.04 Study reported = 0.41

Not statistically significant, p= 0.09

Author-reported effect size was calculated with Cohen's D.

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Child health

Findings rated high

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Child given other liquids by 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.01 Unadjusted proportion = 0.06 Difference = -0.05 HomVEE calculated = -1.03

Not statistically significant, p = 0.13

Child given other liquids by 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted proportion = 0.90 Unadjusted proportion = 0.91 Difference = -0.01 HomVEE calculated = -0.05

Not statistically significant, p = 0.87

Child given solid food by 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted proportion = 0.91 Unadjusted proportion = 0.92 Difference = -0.01 HomVEE calculated = -0.06

Not statistically significant, p = 0.86

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Child given solid food by 9 months postpartum

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted proportion = 1.00 Unadjusted proportion = 0.98 Difference = 0.02 HomVEE calculated = 1.80

Not statistically significant, p= 0.23

Currently breastfeeding at 9 months postpartum

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted proportion = 0.43 Unadjusted proportion = 0.25 Difference = 0.18 Study reported = 0.46

Statistically significant, p= 0.04

Author-reported effect size was calculated with Cohen's D.

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Breastfeeding at 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted proportion = 0.50 Unadjusted proportion = 0.49 Difference = 0.01 HomVEE calculated = 0.01

Not statistically significant, p = 0.94

Ever breastfed the child

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

177 mothers Unadjusted proportion = 0.86 Unadjusted proportion = 0.83 Difference = 0.03 Study reported = 0.13

Not statistically significant, p= 0.57

Author-reported effect size was calculated with Cohen’s D.

Median number of weeks of exclusive breastfeeding

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted median = 1.40 Unadjusted median = 0.30 Median difference = 1.10 Study reported = 0.04

Statistically significant, p= 0.01

Author-reported effect size was calculated with Cohen’s D.

Never breastfed exclusively

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.56 Unadjusted proportion = 0.79 Difference = -0.24 HomVEE calculated = -0.67

Statistically significant, p < .05

Never breastfed the child

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted proportion = 0.14 Unadjusted proportion = 0.18 Difference = -0.03 HomVEE calculated = -0.14

Not statistically significant, p = 0.56

Still exclusive breastfeeding 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.02 Unadjusted proportion = 0.01 Difference = 0.01 HomVEE calculated = 0.40

Not statistically significant, p >= .05

Stopped breastfeeding by 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted proportion = 0.16 Unadjusted proportion = 0.09 Difference = 0.06 HomVEE calculated = 0.35

Not statistically significant, p = 0.23

Stopped breastfeeding by 2 weeks postpartum

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted proportion = 0.02 Unadjusted proportion = 0.02 Difference = 0.00 HomVEE calculated = -0.04

Not statistically significant, p = 0.95

Stopped breastfeeding by 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted proportion = 0.18 Unadjusted proportion = 0.21 Difference = -0.03 HomVEE calculated = -0.13

Not statistically significant, p = 0.57

Stopped breastfeeding exclusively by 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.19 Unadjusted proportion = 0.08 Difference = 0.11 HomVEE calculated = 0.59

Statistically significant, p < .05

Stopped breastfeeding exclusively by 2 weeks postpartum

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.23 Unadjusted proportion = 0.12 Difference = 0.12 HomVEE calculated = 0.51

Statistically significant, p < .05

Findings rated moderate

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Breastfeeding initiated (ever breastfed the child)

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

113 mothers Unadjusted proportion = 0.97 Unadjusted proportion = 0.89 Difference = 0.08 Study reported = 0.30

Not statistically significant, p= 0.11

Author-reported effect size was calculated with Cohen's D.

Child given solid food by 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

112 mothers Unadjusted proportion = 0.02 Unadjusted proportion = 0.08 Difference = -0.06 Study reported = -0.85

Not statistically significant, p= 0.12

Author-reported effect size was calculated with Cohen's D.

Child given solid food by 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

111 mothers Unadjusted proportion = 0.95 Unadjusted proportion = 0.93 Difference = 0.02 Study reported = 0.22

Not statistically significant, p= 0.61

Author-reported effect size was calculated with Cohen's D.

Currently breastfeeding at 12 months postpartum

FavorableUnfavorable or ambiguousNo Effect

12 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted proportion = 0.37 Unadjusted proportion = 0.13 Difference = 0.24 Study reported = 0.74

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Currently breastfeeding at 15 months postpartum

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted proportion = 0.11 Unadjusted proportion = 0.02 Difference = 0.09 HomVEE calculated = 1.09

Not statistically significant, p= 0.05

Currently breastfeeding at 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

113 mothers Unadjusted proportion = 0.71 Unadjusted proportion = 0.61 Difference = 0.10 Study reported = 0.25

Not statistically significant, p= 0.26

Author-reported effect size was calculated with Cohen's D.

Currently breastfeeding at 2 weeks postpartum

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

106 mothers Unadjusted proportion = 0.84 Unadjusted proportion = 0.82 Difference = 0.03 Study reported = 0.10

Not statistically significant, p= 0.73

Author-reported effect size was calculated with Cohen's D.

Currently breastfeeding at 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

111 mothers Unadjusted proportion = 0.52 Unadjusted proportion = 0.34 Difference = 0.18 Study reported = 0.40

Not statistically significant, p= 0.06

Author-reported effect size was calculated with Cohen's D.

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Positive parenting practices

Findings rated high

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Child sleeps on back at 9 months postpartum

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted proportion = 0.80 Unadjusted proportion = 0.60 Difference = 0.20 Study reported = 0.54

Statistically significant, p= 0.02

Author-reported effect size was calculated with Cohen's D.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted median = 43.00 Unadjusted median = 40.00 Median difference = 3.00 Study reported = 1.53

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week reading to child

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted median = 4.50 Days Unadjusted median = 1.00 Days Median difference = 3.50 Study reported = 1.29

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Parenting Sense of Competence (PSOC) score

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

107 mothers Unadjusted mean = 67.10 Unadjusted mean = 64.70 Mean difference = 2.40 Study reported = 0.41

Statistically significant, p = 0.03

Author-reported effect size was calculated with Cohen's D.

Parenting Sense of Competence (PSOC) score

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

107 mothers Unadjusted mean = 68.80 Unadjusted mean = 65.80 Mean difference = 3.00 Study reported = 0.47

Statistically significant, p = 0.02

Author-reported effect size was calculated with Cohen's D.

Parenting Sense of Competence (PSOC) score

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

107 mothers Unadjusted mean = 73.20 Unadjusted mean = 65.30 Mean difference = 7.90 Study reported = 0.98

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

9 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted proportion = 0.93 Unadjusted proportion = 0.43 Difference = 0.50 Study reported = 1.56

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Child sleeps on back at 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.98 Unadjusted proportion = 0.66 Difference = 0.31 HomVEE calculated = 1.88

Statistically significant, p = 0.00

Child sleeps on back at 2 weeks postpartum

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

177 mothers Unadjusted proportion = 0.99 Unadjusted proportion = 0.66 Difference = 0.33 HomVEE calculated = 2.32

Statistically significant, p = 0.00

Child sleeps on back at 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted proportion = 0.98 Unadjusted proportion = 0.75 Difference = 0.23 HomVEE calculated = 1.64

Statistically significant, p = 0.00

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

175 mothers Unadjusted median = 27.00 Unadjusted median = 19.00 Median difference = 8.00 Not reported

Statistically significant, p <.001

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

177 mothers Unadjusted median = 21.00 Unadjusted median = 15.00 Median difference = 6.00 Not reported

Statistically significant, p <.001

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted median = 40.00 Unadjusted median = 33.00 Median difference = 7.00 Not reported

Statistically significant, p <.001

Median number of days during prior week reading to child

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted median = 5.00 Days Unadjusted median = 0.00 Days Median difference = 5.00 Not reported

Statistically significant, p <.001

Median number of days during prior week singing or telling stories to child

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted median = 6.00 Days Unadjusted median = 5.00 Days Median difference = 1.00 Not reported

Statistically significant, p <.001

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.92 Unadjusted proportion = 0.37 Difference = 0.55 HomVEE calculated = 1.82

Statistically significant, p = 0.00

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

176 mothers Unadjusted proportion = 0.97 Unadjusted proportion = 0.26 Difference = 0.71 HomVEE calculated = 2.69

Statistically significant, p = 0.00

Findings rated moderate

Maternal Infant Health Outreach Worker (MIHOW)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Child sleeps on back at 2 months postpartum

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

113 mothers Unadjusted proportion = 0.98 Unadjusted proportion = 0.85 Difference = 0.13 Study reported = 1.27

Statistically significant, p= 0.01

Author-reported effect size was calculated with Cohen's D.

Child sleeps on back at 2 weeks postpartum

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

113 mothers Unadjusted proportion = 0.93 Unadjusted proportion = 0.93 Difference = 0.01 Study reported = 0.19

Not statistically significant, p= 0.63

Author-reported effect size was calculated with Cohen's D.

Child sleeps on back at 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

111 mothers Unadjusted proportion = 0.83 Unadjusted proportion = 0.72 Difference = 0.11 Study reported = 0.35

Not statistically significant, p= 0.16

Author-reported effect size was calculated with Cohen's D.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

12 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted median = 43.00 Unadjusted median = 38.00 Median difference = 5.00 Study reported = 1.74

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted median = 44.00 Unadjusted median = 35.00 Median difference = 9.00 Study reported = 1.78

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted median = 30.00 Unadjusted median = 29.00 Median difference = 1.00 Study reported = 0.47

Statistically significant, p= 0.01

Author-reported effect size was calculated with Cohen's D.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

105 mothers Unadjusted median = 23.00 Unadjusted median = 23.00 Median difference = 0.00 Study reported = 0.11

Not statistically significant, p= 0.52

Author-reported effect size was calculated with Cohen's D.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted median = 43.00 Unadjusted median = 40.00 Median difference = 3.00 Study reported = 1.44

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week reading to child

FavorableUnfavorable or ambiguousNo Effect

12 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted median = 6.00 Days Unadjusted median = 3.00 Days Median difference = 3.00 Study reported = 1.85

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week reading to child

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted median = 7.00 Days Unadjusted median = 3.00 Days Median difference = 4.00 Study reported = 1.79

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week reading to child

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

113 mothers Unadjusted median = 1.00 Days Unadjusted median = 0.00 Days Median difference = 1.00 Study reported = 0.30

Not statistically significant, p= 0.09

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week reading to child

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

111 mothers Unadjusted median = 4.00 Days Unadjusted median = 1.00 Days Median difference = 3.00 Study reported = 0.66

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week singing or telling stories to child

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

113 mothers Unadjusted median = 5.00 Days Unadjusted median = 5.00 Days Median difference = 0.00 Study reported = 0.08

Not statistically significant, p= 0.67

Author-reported effect size was calculated with Cohen's D.

Median number of days during prior week singing or telling stories to child

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

111 mothers Unadjusted median = 5.00 Days Unadjusted median = 5.00 Days Median difference = 0.00 Study reported = 0.18

Not statistically significant, p= 0.33

Author-reported effect size was calculated with Cohen's D.

Parenting Sense of Competence (PSOC) score

FavorableUnfavorable or ambiguousNo Effect

12 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted mean = 74.80 Unadjusted mean = 63.80 Mean difference = 11.00 Study reported = 1.51

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Parenting Sense of Competence (PSOC) score

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted mean = 77.00 Unadjusted mean = 63.40 Mean difference = 13.60 Study reported = 2.02

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Parenting Sense of Competence (PSOC) score

FavorableUnfavorable or ambiguousNo Effect

2 weeks postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted mean = 65.60 Unadjusted mean = 65.00 Mean difference = 0.60 HomVEE calculated = 0.11

Not statistically significant, p= 0.55

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

12 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted proportion = 0.98 Unadjusted proportion = 0.54 Difference = 0.44 Study reported = 2.13

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

109 mothers Unadjusted proportion = 0.98 Unadjusted proportion = 0.70 Difference = 0.28 Study reported = 1.75

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

2 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

112 mothers Unadjusted proportion = 0.41 Unadjusted proportion = 0.21 Difference = 0.20 Study reported = 0.53

Statistically significant, p= 0.02

Author-reported effect size was calculated with Cohen's D.

Reads stories at least three times per week

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

108 mothers Unadjusted proportion = 0.83 Unadjusted proportion = 0.35 Difference = 0.47 Study reported = 1.18

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

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Linkages and referrals

Findings rated high

Maternal Infant Health Outreach Worker (MIHOW)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Referred to resources (prenatal)

FavorableUnfavorable or ambiguousNo Effect

35 weeks gestation

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

105 mothers Unadjusted proportion = 0.70 Unadjusted proportion = 0.14 Difference = 0.56 Study reported = 1.49

Statistically significant, p <.01

Author-reported effect size was calculated with Cohen's D.

Maternal Infant Health Outreach Worker (MIHOW)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Referred to resources at 6 months postpartum

FavorableUnfavorable or ambiguousNo Effect

6 months postpartum

MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample

178 mothers Unadjusted proportion = 1.00 Unadjusted proportion = 0.28 Difference = 0.72 HomVEE calculated = 4.77

Statistically significant, p = 0.02

Findings rated moderate

Maternal Infant Health Outreach Worker (MIHOW)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Referred to resources (postpartum)

FavorableUnfavorable or ambiguousNo Effect

15 months postpartum

MIHOW vs. MEI, Tennessee, 2018-2020, full sample

110 mothers Unadjusted proportion = 0.95 Unadjusted proportion = 0.25 Difference = 0.70 HomVEE calculated = 2.43

Statistically significant, p <.01

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In brief

Evidence of model effectiveness

Title General population Tribal population Domains with favorable effects
Maternal Infant Health Outreach Worker (MIHOW)® Yes, Meets HHS Criteria Meets HHS criteria Does not meet HHS criteria for tribal population because the model has not been evaluated with a tribal population.
  • Child health,
  • Linkages and referrals,
  • Maternal health,
  • Positive parenting practices,

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The Maternal Infant Health Outreach Worker (MIHOW) Program serves families with low incomes, who are experiencing stress and isolation. Families enroll prenatally, and receive home visits until the child is 36 months old. The model is designed to improve child and maternal health, increase use of linkages and referrals to medical and social services, and build positive parenting skills. MIHOW employs community health workers from the local area as home visitors and role models. These workers provide participants with monthly visits that last about 60 minutes each. During visits, community health workers educate families about nutrition, health, child development, and positive parenting. They also provide links to medical and social services.

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39

Results of search and review
Number of manuscripts
At least one finding was eligible for review…
6
  …and at least one finding rated high
3
  …and at least one finding rated moderate (but none rated high)
0
  …and all findings that were eligible for review rated low or indeterminate2
2
  …but manuscript is additional source3
1

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

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103

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29

Information based on comprehensive review of all high- and moderate-rated manuscripts
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across 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?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
Yes
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