Manuscript Detail | Home Visiting Evidence of Effectiveness

Klinnert, M. D., Liu, A. H., Pearson, M. R., Tong, S., Strand, M, Luckow, A., & Robinson, J. L. (2007). Outcome of a randomized multifaceted intervention with low-income families of wheezing infants. Archives of Pediatrics & Adolescent Medicine, 161(8), 783-790.

Model(s) Reviewed: Childhood Asthma Prevention Study (CAPS)

Manuscript screening details
Screening decision	Screening conclusion
Passes screens	Eligible for review

Study design details
Rating	Design	Attrition	Baseline equivalence	Reassignment	Confounding factors
High	Randomized controlled trial	Low	Not applicable	None	None

Notes:

footnote130

High rating applies to oral corticosteroid and emergency department visit outcomes. All other outcomes receive a low rating because of high attrition and failure to demonstrate baseline equivalence.

Study characteristics
Study participants	Participants (infants and their families) were recruited from local hospitals and clinics in the Denver, Colorado, area and assigned randomly to either the intervention or the comparison group. Initially 181 infants were randomly assigned, 90 to the treatment group and 91 to the comparison group. At the four-year-old follow-up that is the focus of the paper, 72 children remained in the intervention group and 77 in the control group. This follow-up sample included European Americans (21 percent treatment, 21 percent control), African American (22 percent treatment, 25 percent control), U.S.-born Hispanic (35 percent treatment, 29 percent control) and foreign-born Hispanic (22 percent treatment, 22 percent control). Approximately half of each group had incomes less than $12,000 per year.
Setting	The study was conducted in Denver, Colorado.
Intervention services	The intervention included home visits conducted by specially trained nurses. The intervention began when infants were from 9 to 24 months old and continued for 12 months. Participants received approximately 15 visits (or telephone calls) by a public health nurse. Each visit lasted an average of 53 minutes.
Comparison conditions	Comparison group members received an educational video at the baseline interview that described risk factors for developing asthma and actions that caregivers can take to mediate the risks.
Staff characteristics and training	The nurses in this study had bachelor’s of science degrees in nursing and had experience in community outreach.
Funding sources	National Institute of Allergy and Infectious Diseases; National Institute of Health/National Center for Research Resources.
Author affiliation	Mary D. Klinnert, a study author, is a developer of this model.

Findings details

Child health
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
High	Emergency Department Visits	FavorableUnfavorable or ambiguousNo Effect	Denver, CO sample	Between 24 and 34 months	144 children	Unadjusted mean 18. 6 = 18.60	Unadjusted mean = 24.30	OR = 0.85	HomeVEE calculated = 0.01	Not statistically significant, p = .72
High	Oral corticosteroid use	FavorableUnfavorable or ambiguousNo Effect	Denver, CO sample	Between 24 and 34 months	144 children	Unadjusted mean 18. 6 = 18.60	Unadjusted mean = 24.30	OR = 0.69	HomeVEE calculated = 0.01	Not statistically significant, p = .44

Outcome measure summary

Child health
Outcome measure	Description of measure	Data collection method	Properties of measure
Emergency Department Visits	Percentage of child emergency department visits between three and four years of age	Review of medical records	Not applicable
Oral corticosteroid use	Percentage of children who had a course of oral corticosteroids during the previous year.	Review of medical records	Not applicable