Manuscript Detail | Home Visiting Evidence of Effectiveness

McKelvey, L., Schiffman, R. F., Brophy-Herb, H. E., Bocknek, E. L., Fitzgerald, H. E., Reischl, T. M., Hawver, S., & DeLuca, M. C. (2015). Examining long-term effects of an infant mental health home-based Early Head Start Program on family strengths and resilience. Infant Mental Health Journal, 36(4), 353-365.

Model(s) Reviewed: IMH-HB EHS

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

Study design details
Rating	Design	Attrition	Baseline equivalence	Reassignment	Confounding factors
Moderate	Randomized controlled trial	Low	Not established on race; established on SES; not established on outcome measures assessable at baseline.	None	None

Study characteristics
Study participants	This study used data from one of 17 sites that were part of a national randomized controlled trial (the Early Head Start Research and Evaluation Project). This site, called the Pathways Project, implemented an infant mental health home-based services (IMH-HB) version of Early Head Start. The site randomly assigned 98 families to the treatment condition and 98 to the control condition. The analysis sample included 152 families who participated in three waves of data collection when the child was 3, 5, and 7 years old. The median household income at baseline data collection was $7,714 [1998 dollars], and approximately half (45 percent) of parents had less than a high school degree. The majority of parents were Caucasian (75 percent), 17 percent were African American, and the remainder (8 percent) identified as another race/ethnicity.
Setting	The study examined outcomes for participants in Jackson, Michigan. Jackson was one of 17 sites that participated in a larger study of Early Head Start.
Intervention services	Families enrolled in the program participated for an average of 21 months with an average of 71 completed home visits. The home visits included activities focused on the child, the family, and staff-family relationship building.
Comparison conditions	Families in the comparison condition were not enrolled in Early Head Start but could access similar services in their communities, including home visiting services. Seventy percent of families in the comparison condition accessed home visiting services, including those provided by Medicaid enhanced prenatal care programs.
Staff characteristics and training	The program was staffed with 10 registered social workers with expertise in child development, families, and family development issues.
Funding sources	90YF0010: Pathways Project: Research into Directions for Family Health and Service Use, from the Administration on Children, Youth, and Families, Department of Health and Human Services, Rachel F. Schiffman, Ph.D., R.N., Principal Investigator, Michigan State University.
Author affiliation	The authors are members of the Early Head Start Research Consortium, and the research is part of an independent research conducted by Michigan State University.

Study Registration:

Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

Maternal health
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Moderate	Pearlin Mastery, age 7	FavorableUnfavorable or ambiguousNo Effect	0	Age 7	152	Not reported	Not reported	Not Reported	Not available	Statistically significant, p<0.05	footnote237 Submitted by user on Fri, 03/15/2019 - 14:29 IMH-HB <abbr title="Early Head Start">EHS</abbr> group showed higher levels of perceived mastery. P-value reported by the author was based on an F-test of repeated measure analysis.
Moderate	PSI: parent-child dysfunctional interaction	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3 and 7)	152	Not reported	Not reported	Not Reported	Not available	Not statistically significant, p ≥ 0.05
Moderate	PSI: parental distress	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3 and 7)	152	Not reported	Not reported	Not Reported	Not available	Not statistically significant, p ≥ 0.05
Moderate	F-COPES: cognitive reframing	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Not statistically significant, p >0.10
Moderate	F-COPES: seeking support from family and friends	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Not statistically significant, p >0.10
Moderate	F-COPES: seeking support from neighbors	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Statistically significant, p<0.05	footnote234 Submitted by user on Fri, 03/15/2019 - 14:29 Comparison group was more likely to seek neighbor support. P-value reported by the author was based on an F-test of repeated measure analysis.
Moderate	F-COPES: seeking support from service providers	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Not statistically significant, p >0.10
Moderate	F-COPES: spiritual coping	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Not statistically significant, p > 0.10
Moderate	McMaster FAD: healthy functioning	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Statistically significant, p<0.01	footnote235 Submitted by user on Fri, 03/15/2019 - 14:29 IMH-HB <abbr title="Early Head Start">EHS</abbr> group had higher scores on healthy functioning. P-value reported by the author was based on an F-test of repeated measure analysis.
Moderate	McMaster FAD: unhealthy functioning	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Statistically significant, p<0.01	footnote236 Submitted by user on Fri, 03/15/2019 - 14:29 IMH-HB <abbr title="Early Head Start">EHS</abbr> group had lower scores on unhealthy functioning. P-value reported by the author was based on an F-test of repeated measure analysis.
Moderate	PES: attitudes	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Statistically significant, p<0.01	footnote232 Submitted by user on Fri, 03/15/2019 - 14:29 IMH-HB <abbr title="Early Head Start">EHS</abbr> group had higher levels of empowerment based on reported attitudes. P-value reported by the author was based on an F-test of repeated measure analysis.
Moderate	PES: skills & knowledge	FavorableUnfavorable or ambiguousNo Effect	Full sample	Pooled (ages 3, 5, and 7)	152	Not reported	Not reported	Not Reported	Not available	Statistically significant, p<0.01	footnote233 Submitted by user on Fri, 03/15/2019 - 14:29 IMH-HB <abbr title="Early Head Start">EHS</abbr> group had higher levels of empowerment based on reported knowledge and skills. P-value reported by the author was based on an F-test of repeated measure analysis.

Outcome measure summary

Maternal health
Outcome measure	Description of measure	Data collection method	Properties of measure
PSI: parent-child dysfunctional interaction	This subscale from the PSI measures parents’ perception of parent-child interaction not meeting the parent's expectations.	Parent/caregiver report	The parent-child dysfunctional interaction subscale had Cronbach's alphas of .79 and .78 for the study sample at ages 3 and 7, respectively.
PSI: parental distress	This subscale from the PSI measures the level of distress parents feel in their role because of personal factors.	Parent/caregiver report	The authors report that the parental distress subscale was associated with stress associated with parenting demands and with depressive symptomatology. The subscale had Cronbach's alphas of .83 and .82 for the study sample at ages 3 and 7, respectively.
F-COPES: cognitive reframing	The F-COPES measures behaviors and attitudes that families use to respond to problems.	Parent/caregiver report	The reframing subscale had Cronbach's alphas of .72, .68, and .68 for the study sample at ages 3, 5, and 7, respectively.
F-COPES: seeking support from family and friends	The F-COPES measures behaviors and attitudes that families use to respond to problems.	Parent/caregiver report	The seeking support from family and friends subscale had Cronbach's alphas of .81, .83, and .80 for the study sample at ages 3, 5, and 7, respectively.
F-COPES: seeking support from neighbors	The F-COPES measures behaviors and attitudes that families use to respond to problems.	Parent/caregiver report	The seeking support from neighbors subscale had Cronbach's alphas of .72, .79, and .69 for the study samples at ages 3, 5, and 7, respectively.
F-COPES: seeking support from service providers	The F-COPES measures behaviors and attitudes that families use to respond to problems.	Parent/caregiver report	The seeking support from service providers subscale had Cronbach's alphas of .60, .61, and .74 for the study sample at ages 3, 5, and 7, respectively.
F-COPES: spiritual coping	The F-COPES measures behaviors and attitudes that families use to respond to problems.	Parent/caregiver report	The spiritual coping subscale had Cronbach's alphas of .85, .82, and .85 for the study sample at ages 3, 5, and 7, respectively.
McMaster FAD: healthy functioning	The McMaster FAD healthy functioning subscale assesses emotional supportiveness between family members.	Parent/caregiver report	The healthy functioning subscale had Cronbach's alphas of .85, .76, and .86 for the study sample at ages 3, 5, and 7, respectively.
McMaster FAD: unhealthy functioning	The McMaster FAD unhealthy functioning subscale assesses lack of family cohesion.	Parent/caregiver report	The unhealthy functioning subscale had Cronbach's alphas of .78, .80, and .84 for the study sample at ages 3, 5, and 7, respectively.
Pearlin Mastery, age 7	The Pearlin Mastery Scale assesses the degree to which a person has a sense of mastery or control over their life.	Parent/caregiver report	The Pearlin Mastery Scale had a Cronbach's alpha of .69 for the study sample at age 7.
PES: attitudes	The PES measures psychological empowerment for parents of children with a disability.	Parent/caregiver report	The attitudes subscale had Cronbach's alphas of .83 and .86 for the study samples at ages 3 and 5, respectively.
PES: skills & knowledge	The PES measures psychological empowerment for parents of children with a disability.	Parent/caregiver report	The skills and knowledge subscale had a Cronbach's alpha of .77 for the study sample at both ages 3 and 5.