Maternal Infant Health Outreach Worker (MIHOW)®

Last updated: June 2018

Effects Shown in Research & Outcome Measure Details

Summary of Findings

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.

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Positive Parenting Practices

Outcomes 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 Outcome Type Notes
Child always co-sleeps
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.01 Unadjusted proportion = 0.20 Mean difference = -0.19 HomeVEE calculated = -1.87 Statistically significant, p = 0.00 Secondary

footnote384

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Child always co-sleeps
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.24 Mean difference = -0.24 HomeVEE calculated = -7.65 Statistically significant, p = 0.00 Secondary

footnote384

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Child always co-sleeps
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.01 Unadjusted proportion = 0.18 Mean difference = -0.17 HomeVEE calculated = -1.82 Statistically significant, p = 0.00 Secondary

footnote384

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Child never co-sleeps
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.87 Unadjusted proportion = 0.28 Mean difference = 0.59 HomeVEE calculated = 1.70 Statistically significant, p = 0.00 Secondary

footnote385

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Child never co-sleeps
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.81 Unadjusted proportion = 0.33 Mean difference = 0.49 HomeVEE calculated = 1.33 Statistically significant, p = 0.00 Secondary

footnote385

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Child never co-sleeps
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.86 Unadjusted proportion = 0.32 Mean difference = 0.54 HomeVEE calculated = 1.53 Statistically significant, p = 0.00 Secondary

footnote385

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Child sleeps on back
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.98 Unadjusted proportion = 0.66 Mean difference = 0.32 HomeVEE calculated = 1.88 Statistically significant, p = 0.00 Secondary
Child sleeps on back
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.99 Unadjusted proportion = 0.66 Mean difference = 0.33 HomeVEE calculated = 2.31 Statistically significant, p = 0.00 Secondary
Child sleeps on back
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.98 Unadjusted proportion = 0.75 Mean difference = 0.23 HomeVEE calculated = 1.64 Statistically significant, p = 0.00 Secondary
Child sleeps on side
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.02 Unadjusted proportion = 0.33 Mean difference = -0.30 HomeVEE calculated = -1.85 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child sleeps on side
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.01 Unadjusted proportion = 0.34 Mean difference = -0.33 HomeVEE calculated = -2.31 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child sleeps on side
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.02 Unadjusted proportion = 0.24 Mean difference = -0.22 HomeVEE calculated = -1.60 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child sleeps on stomach
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.01 Mean difference = -0.01 HomeVEE calculated = -5.68 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child sleeps on stomach
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p = 1.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child sleeps on stomach
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.01 Mean difference = -0.01 HomeVEE calculated = -5.62 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Median Home Observation for Measurement of the Environment (HOME) Inventory Score
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 27.00 Unadjusted median = 19.00 Median difference = 8.00 Not available Statistically significant, p = 0.00 Primary
Median Home Observation for Measurement of the Environment (HOME) Inventory Score
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 21.00 Unadjusted median = 15.00 Median difference = 6.00 Not available Statistically significant, p = 0.00 Primary
Median Home Observation for Measurement of the Environment (HOME) Inventory Score
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 40.00 Unadjusted median = 33.00 Median difference = 7.00 Not available Statistically significant, p = 0.00 Primary
Median number of days during prior week reading to child
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 5.00 Unadjusted median = 0.00 Median difference = 5.00 Not available Statistically significant, p = 0.00 Secondary
Median number of days during prior week singing or telling stories to child
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 6.00 Unadjusted median = 5.00 Median difference = 1.00 Not available Statistically significant, p = 0.00 Secondary
Reads stories at least three times per week
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.92 Unadjusted proportion = 0.37 Mean difference = 0.55 HomeVEE calculated = 1.81 Statistically significant, p = 0.00 Secondary
Reads stories at least three times per week
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.97 Unadjusted proportion = 0.26 Mean difference = 0.71 HomeVEE calculated = 2.68 Statistically significant, p = 0.00 Secondary
Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Child always co-sleeps

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Child never co-sleeps

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Child sleeps on back

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Child sleeps on side

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Child sleeps on stomach

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

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

The HOME Inventory Score measures the stimulation available in the child's home environment. Direct observation

Cronbach’s alpha equal or greater than .90 for total scores.

Primary

Median number of days during prior week reading to child

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

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

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Reads stories at least three times per week

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
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Linkages and Referrals

Outcomes 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 Outcome Type
Referred to resources
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 1.00 Unadjusted proportion = 0.28 Mean difference = 0.72 HomeVEE calculated = 8.92 Statistically significant, p = 0.00 Secondary
Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Referred to resources

Question developed for the MIHOW Program Mother report

Not reported by author

Secondary
View Revisions

Maternal Health

Outcomes 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 Outcome Type Notes
Always receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.89 Unadjusted proportion = 0.67 Mean difference = 0.22 HomeVEE calculated = 0.82 Statistically significant, p = 0.00 Secondary

footnote388

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Always receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.97 Unadjusted proportion = 0.67 Mean difference = 0.29 HomeVEE calculated = 1.60 Statistically significant, p = 0.00 Secondary

footnote388

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Always receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.96 Unadjusted proportion = 0.43 Mean difference = 0.53 HomeVEE calculated = 2.04 Statistically significant, p = 0.00 Secondary

footnote388

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Average number of prenatal visits during pregnancy
FavorableUnfavorable or ambiguousNo Effect
Not reported Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted mean = 9.00 Unadjusted mean = 9.20 Mean difference = -0.20 HomeVEE calculated = -0.09 Not statistically significant, p = 0.48 Secondary

footnote386

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using an independent t-test.

Median Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 0.00 Unadjusted median = 3.00 Median difference = -3.00 Not available Not reported Secondary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Median Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 0.00 Unadjusted median = 5.00 Median difference = -5.00 Not available Not reported Secondary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Median Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 0.00 Unadjusted median = 0.00 Median difference = 0.00 Not available Not reported Secondary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Median Parenting Stress Index (PSI) total stress score
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 74.00 Unadjusted median = 76.00 Median difference = -2.00 Not available Statistically significant, p = 0.00 Primary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Median Parenting Stress Index (PSI) total stress score
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 74.00 Unadjusted median = 76.00 Median difference = -2.00 Not available Statistically significant, p = 0.00 Primary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Median Parenting Stress Index (PSI) total stress score
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 74.00 Unadjusted median = 77.00 Median difference = -3.00 Not available Statistically significant, p = <0.001 Primary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Never receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.01 Unadjusted proportion = 0.00 Mean difference = 0.01 HomeVEE calculated = 5.62 Statistically significant, p = 0.00 Secondary

footnote389

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Never receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p = 1.00 Secondary

footnote389

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Never receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p = 1.00 Secondary

footnote389

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Always receive social and emotional help needed

Mothers were asked how often they received the social and emotional support needed, with response options being Always, Usually, Sometimes, Rarely, Never, Don't Know, or to refuse to respond. Mother report

Not reported by author

Secondary

Average number of prenatal visits during pregnancy

Question developed for the MIHOW Program Mother report

Not reported by author

Secondary

Median Parenting Stress Index (PSI) total stress score

The PSI measures parental distress, parent-child dysfunction interaction, and difficult child. Mother report

Cronbach's alpha of 0.88-0.89

Primary

Median score on the Edinburgh Postpartum Depression Scale (EPDS)

The EPDS measures depressive symptoms using a 10-question structured interview guide. Mother report

Cronbach's alpha of 0.87-0.88

Secondary

Never receive social and emotional help needed

Mothers were asked how often they received the social and emotional support needed, with response options being Always, Usually, Sometimes, Rarely, Never, Don't Know, or to refuse to respond. Mother report

Not reported by author

Secondary

Outcomes 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 Outcome Type Notes
Median score on the Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
Prenatal, at 35 weeks Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 0.00 Unadjusted median = 4.00 Median difference = -4.00 Not available Not reported Secondary

footnote387

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Percentage reporting having received prenatal care
FavorableUnfavorable or ambiguousNo Effect
Not reported Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted mean = 0.99 Unadjusted mean = 0.99 Mean difference = 0.00 HomeVEE calculated = 0.05 Not statistically significant, p = 0.96 Secondary

footnote390

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors’ analysis using a chi-square test of independence.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Median score on the Edinburgh Postpartum Depression Scale (EPDS)

The EPDS measures depressive symptoms using a 10-question structured interview guide. Mother report

Cronbach’s alpha of 0.87-0.88

Secondary

Percentage reporting having received prenatal care

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
View Revisions

Child Health

Outcomes 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 Outcome Type Notes
Breastfeeding exclusively
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.02 Unadjusted proportion = 0.01 Mean difference = 0.01 HomeVEE calculated = 0.37 Statistically significant, p = 0.01 Secondary

footnote379

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Child given cereal
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.15 Unadjusted proportion = 0.17 Mean difference = -0.02 HomeVEE calculated = -0.08 Not statistically significant, p = 0.60 Secondary
Child given other food
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.02 Unadjusted proportion = 0.01 Mean difference = 0.01 HomeVEE calculated = 0.37 Statistically significant, p = 0.01 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child given other food
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.91 Unadjusted proportion = 0.92 Mean difference = -0.01 HomeVEE calculated = -0.06 Not statistically significant, p = 0.68 Secondary
Child given other liquid
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.01 Unadjusted proportion = 0.06 Mean difference = -0.05 HomeVEE calculated = -1.03 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Child given other liquid
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.90 Unadjusted proportion = 0.91 Mean difference = -0.01 HomeVEE calculated = -0.05 Not statistically significant, p = 0.74 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Ever breastfed child
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.86 Unadjusted proportion = 0.83 Mean difference = 0.03 HomeVEE calculated = 0.14 Not statistically significant, p = 0.57 Secondary
Median duration of exclusive breastfeeding, in weeks
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 1.40 Unadjusted median = 0.30 Median difference = 1.10 Not available Statistically significant, p = 0.01 Secondary

footnote382

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a Mann-Whitney test.

Median number of weeks to first food
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 21.00 Unadjusted median = 20.00 Median difference = 1.00 Not available Not statistically significant, p = 0.20 Secondary

footnote382

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a Mann-Whitney test.

Median number of weeks to first other liquid
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 20.00 Unadjusted median = 20.00 Median difference = 0.00 Not available Statistically significant, p < 0.001 Secondary

footnote382

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the authors&rsquo; analysis using a Mann-Whitney test.

Median score on the breastfeeding self-efficacy scale (BSES)
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted median = 62.00 Unadjusted median = 51.00 Median difference = 11.00 Not available Not reported Primary
Never breastfed
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.14 Unadjusted proportion = 0.18 Mean difference = -0.03 HomeVEE calculated = -0.14 Not statistically significant, p = 0.34 Secondary

footnote378

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Never breastfed exclusively
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.56 Unadjusted proportion = 0.79 Mean difference = -0.24 HomeVEE calculated = -0.67 Statistically significant, p = 0.00 Secondary

footnote380

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative veffect size is favorable to the intervention.

Still breastfeeding
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.50 Unadjusted proportion = 0.49 Mean difference = 0.01 HomeVEE calculated = 0.01 Not statistically significant, p = 0.92 Secondary

footnote377

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

Stopped breastfeeding
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.16 Unadjusted proportion = 0.09 Mean difference = 0.06 HomeVEE calculated = 0.35 Statistically significant, p = 0.02 Secondary

footnote378

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Stopped breastfeeding
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.02 Unadjusted proportion = 0.02 Mean difference = 0.00 HomeVEE calculated = -0.05 Not statistically significant, p = 0.72 Secondary

footnote378

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Stopped breastfeeding
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.18 Unadjusted proportion = 0.21 Mean difference = -0.03 HomeVEE calculated = -0.13 Not statistically significant, p = 0.39 Secondary

footnote378

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Stopped breastfeeding exclusively
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.19 Unadjusted proportion = 0.08 Mean difference = 0.11 HomeVEE calculated = 0.59 Statistically significant, p = 0.00 Secondary

footnote381

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Stopped breastfeeding exclusively
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.23 Unadjusted proportion = 0.12 Mean difference = 0.12 HomeVEE calculated = 0.51 Statistically significant, p = 0.00 Secondary

footnote381

Submitted by user on Fri, 03/15/2019 - 14:29

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Breastfeeding exclusively

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Child given cereal

Question from the Infant Feeding Practices Study II Mother report

Not reported by author

Secondary

Child given other food

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Child given other liquid

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Ever breastfed the child

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Median duration of exclusive breastfeeding, in weeks

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Median number of weeks to first food

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Median number of weeks to first other liquid

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Median score on the breastfeeding self-efficacy scale (BSES)

The BSES Short Form uses a 5-point scale on 14 questions to assess a mother's confidence breastfeeding her child. Mother report

Cronbach’s alpha of 0.93–0.95

Primary

Never breastfed

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Never breastfed exclusively

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Still breastfeeding

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary

Stopped breastfeeding

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Stopped breastfeeding exclusively

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary

Outcomes 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 Outcome Type Notes
Child given other liquid
FavorableUnfavorable or ambiguousNo Effect
2 weeks postpartum Davidson County, Tennessee, MIHOW vs. Educational Materials Unadjusted proportion = 0.00 Unadjusted proportion = 0.04 Mean difference = -0.04 HomeVEE calculated = -6.34 Statistically significant, p = 0.00 Secondary

footnote383

Submitted by user on Fri, 03/15/2019 - 14:29

Negative effect size is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Child given other liquid

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
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Model Overview

Theoretical Model

MIHOW is flexible and tailored to the needs of the sponsoring agency and community. It is community-based, has a community-development focus, and is strengths-based. The model emphasizes that outreach workers and program participants are equal members of the community and have mutual investment in one another.

MIHOW is based on systems theory, which views human behavior as the collective impact of multiple interrelated systems. To understand and assist individual program participants, MIHOW considers how participants are affected by families, organizations, societies, and other systems in which the participants are involved. Outreach workers assess all the systems at work in individuals’ lives and then strive to strengthen those systems to help participants meet their goals. The outreach worker helps to bolster the individual system, advocates for participants within larger systems, and supports participants’ efforts to positively affect the systems in which they are involved. By training mothers within a community to serve as outreach workers, MIHOW aims to generate broader system change in the community.

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Model Components

The core components of MIHOW are (1) home visits, (2) case management and advocacy, (3) parent education, (4) role modeling for positive parent-child interaction, (5) health and developmental screening, (6) information and referral, and (7) peer support groups.

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Target Population

MIHOW targets underserved communities, but does not have eligibility requirements for participants. The intervention primarily serves low-income, stressed, and isolated families with children from birth to age 3—families with the highest risk for poor birth outcomes.

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Where to Find Out More

Tonya Elkins
MIHOW Director
Vanderbilt University School of Nursing
1400 18th Ave. South, A-1
Nashville, TN 37212
Phone: (615) 343-4513
Fax: (615) 343-0325
Email: tonya.j.elkins@vanderbilt.edu
Website: https://www.mihow.org//

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In Brief

Evidence of Model Effectiveness

This model does not meet 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 or for tribal populations because the findings from high- or moderate-rated effectiveness studies of the model do not meet all required criteria.

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Model Description

The Maternal Infant Health Outreach Worker (MIHOW) Program targets underserved communities and primarily serves low-income, stressed, and isolated families with children from birth to age 3. The model is designed to improve child and maternal health, increase use of linkages and referrals, and build positive parenting skills. MIHOW employs parents from the local community as home visitors and role models who educate families about nutrition, health, children’s development, and positive parenting practices. The home visitors also provide links to medical and social services. For more information, please read the Model Overview.

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Extent of Evidence

Results of Research and Review
Number of studies
Eligible for review
6
Rated high
1
Rated moderate
0
Rated low
4
Additional source1
1

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

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Summary of Findings

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.

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Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study?
Yes
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?
Yes
Favorable impacts on full sample?
Yes
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1
No
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1
No

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

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