footnote129
High rating applies to most outcomes. Medical record outcomes receive a low rating because of high attrition and failure to demonstrate baseline equivalence.
Screening decision | Screening conclusion |
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Passes screens | Eligible for review |
Rating | Design | Attrition | Baseline equivalence | Reassignment | Confounding factors |
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High | Randomized controlled trial | Low | Not applicable | None | None |
High rating applies to most outcomes. Medical record outcomes receive a low rating because of high attrition and failure to demonstrate baseline equivalence.
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 baseline, the study groups were split among European Americans (22 percent treatment, 21 percent control), African American (23 percent treatment, 22 percent control), U.S.-born Hispanic (33 percent treatment, 31 percent control) and foreign-born Hispanic (22 percent treatment, 20 percent control). Approximately half of each group had incomes less than $12,000 per year. Participants were followed for one year after baseline data were collected. |
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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. |
Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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High | Cotinine level | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 130 children | = 0.66 | = 0.56 | Mean difference = 0.10 | HomeVEE calculated = 0.25 | Not statistically significant, p = 0.28 | footnote127Cotinine level outcome based on logistic regression model. Outcome from logrnormal regression model had high attrition and is not included in this report. |
High | Functional Severity Score | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 150 children | Mean = 1.03 | Mean = 1.04 | Mean difference = -0.01 | Not available | Not Statistically significant, p = 0.60 |
Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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High | Caregiver quality of life score | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 143 parents | Mean = 6.47 | Mean = 6.34 | Mean difference = 0.13 | Not available | Not statistically significant, p = 0.72 |
Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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High | HOME score | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 137 parents | Mean = 36.66 | Mean = 36.64 | Mean difference = 0.02 | Not available | Not statistically significant, p = 0.94 | |
High | Asthma knowledge score | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 150 parents | Mean = 5.20 | Mean = 4.84 | Mean difference = 0.36 | Not available | Statistically significant, p = 0.04 | |
High | Cat dander | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 140 parents | = 0.33 | = 0.26 | Mean difference = 0.07 | HomeVEE calculated = 0.20 | Not statistically significant, p = 0.25 | |
High | Cockroach allergen | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 140 parents | = 0.01 | = 0.13 | Mean difference = -0.12 | HomeVEE calculated = -1.62 | Statistically significant, p = 0.03 | |
High | Collaborative relationship score | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 146 parents | Mean = 6.13 | Mean = 5.81 | Mean difference = 0.33 | Not available | Statistically significant, p = 0.04 | |
High | Dog dander | FavorableUnfavorable or ambiguousNo Effect |
Denver, Colorado sample | 12 months | 141 parents | = 0.13 | = 0.24 | Mean difference = -0.11 | HomeVEE calculated = -0.45 | Not statistically significant, p = -.07 |
Outcome measure | Description of measure | Data collection method | Properties of measure |
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Cotinine level |
The authors measured cotinine levels to detect environmental tobacco smoke exposure. The measure indicates the percentage of infants in whom cotinine levels, a metabolite of nicotine, were greater than 5 nanograms of cotinine per gram of creatinine. | Infant urine samples | Not applicable |
Functional Severity Score |
Incidence and severity of infant respiratory symptoms over the past six months. | Parent/caregiver report | Not applicable |
Outcome measure | Description of measure | Data collection method | Properties of measure |
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Caregiver quality of life score |
The Pediatric Asthma Caregiver's Quality of Life scale assesses the effects of a child's illness on the parent. The term "asthma" was replaced with words describing symptoms of wheezing illness. Items were coded on a 7-point scale. | Parent/caregiver report | Not reported by author |
Outcome measure | Description of measure | Data collection method | Properties of measure |
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HOME score |
The Home Observation for Measurement of the Environment inventory (0-3 years) assesses parent-child interactions. | Observational assessment | Interrater reliability was 93.2% |
Cat dander |
Percentage of homes in which the presence of cat dander was higher than the standard cut-off levels. | House dust collection | Not applicable |
Cockroach allergen |
Percentage of homes in which the presence of cockroach allergen was higher than the standard cut-off levels. | House dust collection | Not applicable |
Dog dander |
Percentage of homes in which the presence of dog dander was higher than the standard cut-off levels. | House dust collection | Not applicable |
Family Asthma Management System Scale--asthma knowledge and collaborative relationship subscales |
The scale was adapted to assesses the caregiver's illness management practices with a wheezing infant. The authors used the asthma knowledge and collaborative relationship with medical care provider subscales. Items were coded on a 9-point scale. | Parent/caregiver report | Interrater reliability ranged from 0.82-0.96 for the asthma knowledge subscale and from 0.79-0.96 for the collaborative relationship subscale |