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Maternal Health

In Brief

Overview

Improving maternal health is a goal of some home visiting models in the HomVEE review. To achieve this goal, models provide mothers with health information and guidance during pregnancy and after the child’s birth. Some also link mothers to prenatal and postpartum health care providers. In addition, some programs link mothers to treatment facilities for mental health and substance issues, or may directly provide preventive mental health intervention or other services that promote their psychological well-being.

Measurement Considerations

Maternal health involves both the mother’s health status (during or after pregnancy), including mental and behavioral health, stress, and health-related habits such as nutrition and sexual health, and measures of social support and other protective factors. Primary outcome measures in this domain include health care service receipt outcomes extracted from medical records and standardized parent self-report measures. Secondary outcome measures include parent self-reports that are not standardized.

Review of Studies

The HomVEE review examined the research on 50 home visiting models with studies published between 1979 and 2018. (More information is available on literature search and prioritizing models for review.) Of the 27 models with high- or moderate-quality studies that measured outcomes in this domain, 8 had favorable effects on primary outcome measures, and 14 had favorable effects on secondary outcome measures.

Summary of Findings

The effects shown in the research are grouped into four categories: (1) favorable, (2) no effect, (3) unfavorable or ambiguous, and (4) not measured. Results for models that do not have studies with a high or moderate rating are listed as “not applicable.” For more information on these categories please read Describing Effects. Only results from studies that meet the standards for the high or moderate ratings are considered below. This table includes links to more information on the model’s effectiveness, implementation, and details on outcomes in this domain.

Effects Shown in Research — Maternal Health Domain

Summary of findings across models for the maternal health outcome domain
Model Meets HHS Criteria Favorable impacts found tag Outcome measures For more information

Attachment and Biobehavioral Catch-Up (ABC) Intervention
Meets HHS criteria?
Yes
 Child development and school readiness, Child health, Positive parenting practices
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Child First
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Linkages and referrals, Maternal health, Reductions in child maltreatment
Outcome measures
Primary:
Favorable: 10
No effect: 12
Unfavorable or ambiguous: 0
Secondary:
Favorable: 1
No effect: 3
Unfavorable or ambiguous: 0
For more information

Child Parent Enrichment Project (CPEP)
Meets HHS criteria?
No
 In at least one domain, Child development and school readiness, Maternal health
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 1
No effect: 6
Unfavorable or ambiguous: 0
For more information

Childhood Asthma Prevention Study (CAPS)
Meets HHS criteria?
No
 In at least one domain, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0
For more information

Computer-Assisted Motivational Intervention (CAMI)
Meets HHS criteria?
No
 In at least one domain, Maternal health
Outcome measures
Primary:
Favorable: 1
No effect: 1
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
For more information

Early Head Start–Home-Based Option (EHS-HBO)
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Family economic self-sufficiency, Linkages and referrals, Maternal health, Positive parenting practices, Reductions in child maltreatment
Outcome measures
Primary:
Favorable: 0
No effect: 9
Unfavorable or ambiguous: 0
Secondary:
Favorable: 5
No effect: 8
Unfavorable or ambiguous: 1
For more information

Early Intervention Program for Adolescent Mothers

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
Yes
 In at least one domain, Child health, Family economic self-sufficiency
Outcome measures
Primary:
Favorable: 0
No effect: 10
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 9
Unfavorable or ambiguous: 1
For more information

Early Start (New Zealand)
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Child health, Positive parenting practices, Reductions in child maltreatment
Outcome measures
Primary:
Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 3
Unfavorable or ambiguous: 0
For more information

Early Steps to School Success™—Home Visiting
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Even Start-Home Visiting (Birth to Age 5)

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
No
 Not applicable - no studies met criteria to be reviewed
Outcome measures
Not applicable
For more information

Family Check-Up® For Children
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 7
No effect: 2
Unfavorable or ambiguous: 0
For more information

Family Connections (Birth to Age 5)
Meets HHS criteria?
No
 Not applicable - no studies met criteria to be reviewed
Outcome measures
Not applicable
For more information

Family Connects
Meets HHS criteria?
Yes
 Child health, Linkages and referrals, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 1
No effect: 2
Unfavorable or ambiguous: 0
For more information

Family Spirit®
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 2
No effect: 17
Unfavorable or ambiguous: 0
Secondary:
Favorable: 3
No effect: 30
Unfavorable or ambiguous: 0
For more information

Following Baby Back Home (FBBH)
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Health Access Nurturing Development Services (HANDS) Program
Meets HHS criteria?
Yes
 Child health, Family economic self-sufficiency, Maternal health, Reductions in child maltreatment
Outcome measures
Primary:
Favorable: 7
No effect: 1
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
For more information

HealthConnect One's® Community-Based Doula Program
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Healthy Beginnings
Meets HHS criteria?
Yes
 Child development and school readiness, Child health, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 3
No effect: 6
Unfavorable or ambiguous: 0
For more information

Healthy Families America (HFA)®
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Child health, Family economic self-sufficiency, Linkages and referrals, Maternal health, Positive parenting practices, Reductions in child maltreatment, Reductions in juvenile delinquency, family violence, and crime
Outcome measures
Primary:
Favorable: 0
No effect: 10
Unfavorable or ambiguous: 0
Secondary:
Favorable: 4
No effect: 66
Unfavorable or ambiguous: 0
For more information

Healthy Start-Home Visiting

HHS has determined that Healthy Start is not eligible for review by HomVEE because it is a federal grant program and not a home visiting model. Information on Healthy Start has been removed from the website.

 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Healthy Steps (National Evaluation 1996 Protocol)

This report focuses on Healthy Steps as implemented in the 1996 evaluation. HHS has determined that home visiting is not the primary service delivery strategy and the model does not meet current requirements for MIECHV program implementation.
Meets HHS criteria?
Yes
 In at least one domain, Child health, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 10
Unfavorable or ambiguous: 1
For more information

Home Instruction for Parents of Preschool Youngsters (HIPPY)®
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Positive parenting practices
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Home-Start
Meets HHS criteria?
No
 No favorable effects found
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 4
Unfavorable or ambiguous: 0
For more information

HOMEBUILDERS (Birth to Age 5)®
Meets HHS criteria?
No
 Not applicable - no studies met criteria to be reviewed
Outcome measures
Not applicable
For more information

Maternal Early Childhood Sustained Home-Visiting Program (MECSH)
Meets HHS criteria?
Yes
 Child health, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 6
Unfavorable or ambiguous: 0
Secondary:
Favorable: 1
No effect: 9
Unfavorable or ambiguous: 0
For more information

Maternal Infant Health Outreach Worker (MIHOW)®
Meets HHS criteria?
No
 Child health, Linkages and referrals, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 3
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 3
No effect: 8
Unfavorable or ambiguous: 1
For more information

Maternal Infant Health Program (MIHP)
Meets HHS criteria?
Yes
 Child health, Maternal health
Outcome measures
Primary:
Favorable: 2
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 1
No effect: 0
Unfavorable or ambiguous: 0
For more information

Minding the Baby®
Meets HHS criteria?
Yes
 In at least one domain, Child health, Maternal health
Outcome measures
Primary:
Favorable: 1
No effect: 1
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 10
Unfavorable or ambiguous: 0
For more information

MOM Program
Meets HHS criteria?
No
 Linkages and referrals
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 4
Unfavorable or ambiguous: 0
For more information

Mothers’ Advocates in the Community (MOSAIC)
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

North Carolina Baby Love Maternal Outreach Workers Program

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Nurse-Family Partnership (NFP)®
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Child health, Family economic self-sufficiency, Maternal health, Positive parenting practices, Reductions in child maltreatment, Reductions in juvenile delinquency, family violence, and crime
Outcome measures
Primary:
Favorable: 8
No effect: 18
Unfavorable or ambiguous: 0
Secondary:
Favorable: 21
No effect: 81
Unfavorable or ambiguous: 0
For more information

Nurses for Newborns®
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Nurturing Parenting Programs (Birth to Age 5)
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Oklahoma’s Community-Based Family Resource and Support (CBFRS) Program

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
Yes
 In at least one domain, Maternal health, Positive parenting practices
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 3
No effect: 0
Unfavorable or ambiguous: 0
For more information

Parent-Child Assistance Program (P-CAP)
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

ParentChild+® Core Model
Meets HHS criteria?
No
 Child development and school readiness, Positive parenting practices
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Parents as Teachers (PAT)®
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Family economic self-sufficiency, Positive parenting practices, Reductions in child maltreatment
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 3
Unfavorable or ambiguous: 0
For more information

Philani Outreach Programme
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Play and Learning Strategies (PALS)

Entries in this row combine information across all versions of PALS except for PALS Infant. Some other versions of PALS have at least one high- or moderate-quality impact study, but no version of the model other than PALS Infant meets HHS criteria for an evidence-based home visiting model.
Meets HHS criteria?
No
 Child development and school readiness, Positive parenting practices
Outcome measures
Not applicable
For more information

Play and Learning Strategies (PALS) Infant
Meets HHS criteria?
Yes
 In at least one domain, Child development and school readiness, Positive parenting practices
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Pride in Parenting (PIP)

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Promoting First Relationships®—Home Visiting Option
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
No
 No favorable effects found
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0
For more information

Resource Mothers Program

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
No
 Not applicable
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Resources, Education, and Care in the Home (REACH)
Meets HHS criteria?
No
 In at least one domain, Child health
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

REST Routine

Implementation support is not currently available for the model as reviewed.
Meets HHS criteria?
No
 In at least one domain, Child health
Outcome measures
Primary:
Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
For more information

SafeCare®

Entries in this row combine information across all versions of SafeCare except for SafeCare Augmented. The main version of SafeCare has no high- or moderate-quality impact studies. Some other versions of SafeCare have at least one such study, but no version of the model other than SafeCare Augmented meets HHS criteria for an evidence-based home visiting model. Planned Activities Training (a SafeCare module) and Cellular Phone Enhanced Planned Activities Training (a SafeCare module with an add-on) show evidence of effectiveness.
Meets HHS criteria?
No
 In at least one domain, Child development and school readiness, Maternal health, Positive parenting practices
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

SafeCare Augmented
Meets HHS criteria?
Yes
 In at least one domain, Family economic self-sufficiency, Linkages and referrals, Maternal health, Reductions in child maltreatment, Reductions in juvenile delinquency, family violence, and crime
Outcome measures
Primary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
For more information

Seattle-King County Healthy Homes Project
Meets HHS criteria?
No
 Not applicable - no studies met criteria to be reviewed
Outcome measures
Not applicable
For more information

Triple P - Positive Parenting Program®—Variants suitable for home visiting

No Triple P intervention is exclusively delivered in the home with families with children from birth through age 5. This profile is based on (1) studies of programs that provided Triple P services in the home to families with children from birth through age 5, and (2) developer input on the Triple P interventions suitable for delivery in the home with families with children from birth through age 5.
Meets HHS criteria?
No
 Child development and school readiness
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information

Video-Feedback Intervention to Promote Positive Parenting-Sensitive Discipline® (VIPP-SD)
Meets HHS criteria?
No
 Positive parenting practices
Outcome measures
Not measured in high- or moderate-rated outcomes
For more information