footnote150
High score equals unfavorable.
Model effectiveness research report last updated: 2023
Early Start aims to create a collaborative, problem-solving partnership between the home visitor and family to maximize child health, increase child and family well-being, build strengths, and eliminate deficiencies. Early Start recognizes that child well-being can occur only through the more general health and well-being of the family, although the target child is treated as the primary focus of services.
Early Start was designed for at-risk families in the general population. However, the developers took steps to make the model relevant to the Māori, an indigenous population of New Zealand. During the development phase, the Early Start team consulted with Māori representatives on the design of the program. The developers established an Early Start board, half of whose members were Māori, to oversee implementation of the program and to foster an organizational culture that was respectful and sensitive to the needs and perspectives of Māori families. The Māori board members provided a Māori cultural training to all Early Start staff and Māori home visitors were hired to work with Māori families. These efforts aimed to create a model that can be delivered to both Māori and non-Māori families in a culturally responsive way.
Early Start provides services through home visitation and offers aspects of two established curricula that are incorporated into home visits and tailored to a family’s needs and situation. The two curricula the program uses are:
Families are offered several additional services as needs are identified during the program:
Early Start also offers the full Incredible Years Toddler Parenting Program, a group-based program that is run twice a year for referred Early Start families.
Early Start was designed to serve a general population of at-risk families with newborn children up to age 5. The developers took steps to make the model culturally responsive to the Māori, an indigenous population of New Zealand.
Early Start uses a three-stage eligibility determination process. First, Early Start administers a short risk assessment containing items on maternal age, extent of family support, whether the pregnancy was planned or unplanned, substance abuse, family violence, and child abuse and neglect. Any family with two or more risk factors continues to the next stage of the process. Second, families enroll in Early Start for a one-month assessment period to become acquainted with the program and so Early Start can learn about the family. During this time, families engage in an in-depth needs assessment based on a series of conversation topics. Third, families who consent to participate then are fully enrolled in the program for longer-term services based on their risk factors.
Postal Address:
P.O. Box 21013
Edgeware,
Christchurch 8143
New Zealand
Street Address:
354 Armagh St
Linwood,
Christchurch 8011
New Zealand
Phone: +64 3365 9087
Fax: +64 3365 9237
Email: reception@earlystart.co.nz
Web: www.earlystart.co.nz
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Number of home safety features | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | Unadjusted mean = 5.20 | Unadjusted mean = 4.90 | Mean difference = 0.30 | Study reported = 0.17 | Not statistically significant, p ≥ 0.05 | |
Number of visits made to family doctor in past 36 months | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | Unadjusted mean = 23.50 | Unadjusted mean = 20.70 | = 2.80 | Study reported = 0.24 | Statistically significant, p < 0.05 | |
Percent attended hospital for any other reason | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 382 children | % = 68.40 | % = 74.20 | = -9.80 | Study reported = 0.13 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Percent breastfed for six months or more | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | % = 31.30 | % = 34.10 | = -2.80 | Study reported = -0.05 | Not statistically significant, p ≥ 0.05 | |
Percent of children up to date with immunizations | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | % = 92.50 | % = 91.90 | = 0.60 | Study reported = 0.24 | Not statistically significant, p ≥ 0.05 | |
Percent of children up to date with well-child checks | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | % = 41.90 | % = 30.10 | = 11.80 | Study reported = 0.24 | Statistically significant, p < 0.05 | |
Percent with dental service | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | % = 72.30 | % = 62.80 | = 9.50 | Study reported = 0.20 | Statistically significant, p < 0.05 |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Early childhood education, duration of attendance (months) | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | Unadjusted mean = 16.40 | Unadjusted mean = 13.60 | Mean difference = 2.80 | Study reported = 0.22 | Statistically significant, p < 0.05 | |
Ever attended early childhood education | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | % = 90.80 | % = 84.50 | = 6.30 | Study reported = 0.19 | Not statistically significant, p ≥ 0.05 | |
Infant-Toddler Social and Emotional Assessment (ITSEA), Total behavior score | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | Unadjusted mean = 9.87 | Unadjusted mean = 10.11 | Mean difference = -0.24 | Study reported = 0.24 | Statistically significant, p < 0.05 | footnote150High score equals unfavorable. |
Infant-Toddler Social and Emotional Assessment (ITSEA), Total externalizing score | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | Unadjusted mean = 9.90 | Unadjusted mean = 10.09 | Mean difference = -0.19 | Study reported = 0.19 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Infant-Toddler Social and Emotional Assessment (ITSEA), Total internalizing score | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | Unadjusted mean = 9.86 | Unadjusted mean = 10.12 | Mean difference = -0.26 | Study reported = 0.26 | Statistically significant, p < 0.05 | footnote150High score equals unfavorable. |
Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Performance IQ score | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 367 children | Unadjusted mean = 98.10 | Unadjusted mean = 96.80 | Mean difference = 1.30 | Study reported = 0.08 | Not statistically significant, p ≥ 0.05 | |
Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Total IQ | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 367 children | Unadjusted mean = 97.70 | Unadjusted mean = 96.50 | Mean difference = 1.20 | Study reported = 0.07 | Not statistically significant, p ≥ 0.05 | |
Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Verbal IQ score | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 367 children | Unadjusted mean = 97.70 | Unadjusted mean = 97.00 | Mean difference = 0.70 | Study reported = 0.04 | Not statistically significant, p ≥ 0.05 |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Attended hospital for accident/injury or accidental poisoning | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 382 children | % = 17.50 | % = 26.30 | = -8.80 | Study reported = 0.22 | Statistically significant, p < 0.05 | footnote150High score equals unfavorable. |
Parent-Child Conflict Tactics Scale (CTSPC), Physical assault by any parent | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | % = 4.40 | % = 11.70 | = -7.30 | Study reported = 0.26 | Statistically significant, p < 0.05 | footnote150High score equals unfavorable. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
---|---|---|---|---|---|---|---|---|---|
Non-punitive attitudes (adapted from Child Rearing Practices Report and Adult-Adolescent Parenting Inventory) | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | Unadjusted mean = 10.12 | Unadjusted mean = 9.90 | Mean difference = 0.22 | Study reported = 0.22 | Statistically significant, p < 0.05 |
Percent smoke-free home/smoke-free area | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 children | % = 80.80 | % = 81.60 | = -0.80 | Study reported = -0.02 | Not statistically significant, p ≥ 0.05 |
Positive parenting attitude (adapted from Child Rearing Practices Report and Adult-Adolescent Parenting Inventory) | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | Unadjusted mean = 10.14 | Unadjusted mean = 9.88 | Mean difference = 0.26 | Study reported = 0.26 | Statistically significant, p < 0.05 |
Total parenting score (adapted from Child Rearing Practices Report and Adult-Adolescent Parenting Inventory) | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 391 children | Unadjusted mean = 10.14 | Unadjusted mean = 9.87 | Mean difference = 0.27 | Study reported = 0.27 | Statistically significant, p < 0.05 |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Percent any family/social relationship problem | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | % = 81.30 | % = 82.90 | = -1.60 | Study reported = 0.04 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Percent ever pregnant to 36 months | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 mothers | % = 42.90 | % = 47.60 | = -4.70 | Study reported = 0.09 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Percent major depression | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 mothers | % = 36.00 | % = 37.10 | = -1.10 | Study reported = 0.02 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Percent mother smoked cigarettes | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 mothers | % = 73.10 | % = 68.90 | = 4.20 | Study reported = -0.09 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Percent substance use problems | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 mothers | % = 38.50 | % = 33.00 | = 5.50 | Study reported = -0.11 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Mean amount of debt | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | Unadjusted mean = 3582.00 | Unadjusted mean = 3380.00 | Mean difference = 202.00 | Study reported = -0.04 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Mean family income per week | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | Unadjusted mean = 454.00 | Unadjusted mean = 443.00 | Mean difference = 11.00 | Study reported = 0.08 | Not statistically significant, p ≥ 0.05 | |
Percent income inadequate/very inadequate | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | % = 41.80 | % = 37.40 | = 4.40 | Study reported = -0.09 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Percent welfare dependent | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | % = 89.60 | % = 86.40 | = 3.20 | Study reported = -0.10 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Mother assaulted by any partner | FavorableUnfavorable or ambiguousNo Effect |
36 months | Christchurch sample | 388 families | % = 26.40 | % = 22.30 | = -4.10 | Study reported = -0.10 | Not statistically significant, p ≥ 0.05 | footnote150High score equals unfavorable. |
Title | General population | Tribal population | Domains with favorable effects |
---|---|---|---|
Early Start (New Zealand) | Meets HHS criteria | Does not meet HHS criteria for tribal population because the findings from high- or moderate-rated effectiveness studies of the model in tribal populations do not meet all required criteria. |
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Early Start is a home visiting program designed to improve child health, reduce child abuse, improve parenting skills, support parental physical and mental health, encourage family economic well-being, and encourage stable, positive partner relationships. Early Start was designed for at-risk families in the general population, and the developers took steps to make the model culturally responsive to the Māori, an indigenous population of New Zealand. Early Start serves families with newborns and children up to age 5.
Home visitors deliver services at varying levels of intensity depending on the family’s needs. Families with the highest needs receive up to three hours of home visits and indirect contact per week (level 1); families with moderate needs receive up to three hours of home visiting every two weeks (level 2); families with lower needs receive up to one hour of home visiting monthly (level 3); and "graduate" families receive up to one hour of contact every three months (level 4). Home visitors in consultation with their supervisors determine when a family is ready to progress to the next level.
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.