Study Detail

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Chazan-Cohen, R., Raikes, H. H., & Vogel, C. (2013). V. Program subgroups: Patterns of impacts for home-based, center-based, and mixed-approach programs. Monographs of the Society for Research in Child Development, 78(1), 93-109.

Model(s) Reviewed: Early Head Start–Home-Based Option (EHS-HBO)
Study Screening Details
Screening Decision Screening Conclusion
Study Passes Screens Eligible for review
Study Design Details
Rating Design Attrition Baseline Equivalence Reassignment Confounding Factors
High Randomized controlled trial Low Established on race/ethnicity and SES; established on some relevant outcomes. None None
Notes:

In 2020, HomVEE updated the details of this review in the Reductions in Child Maltreatment domain in two ways. First, HomVEE removed the child witnessed violence finding from the Reductions in Child Maltreatment domain because it does not assess where (in the home or elsewhere) the child witnessed that violence and is therefore ineligible for review in this domain. Second, HomVEE moved measures of percent spanked last week from the Reductions in Child Maltreatment domain to the Positive Parenting Practices domain because ACF determined that nonviolent discipline and corporal punishment outcomes belong in the Positive Parenting Practices domain, unless those outcome are assessed using the Conflict Tactics Scale-Parent/Child.

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Although the authors do not control for baseline measures of outcomes, the following outcomes rate high: child outcomes, which were not assessable at baseline, and parent employment and income outcomes, which were equivalent at baseline. Two outcomes rate moderate because the authors do not establish baseline equivalence: "parent depression" and "someone in household had alcohol/drug problem in past year." This review reports only those outcomes not previously reported in Love et al. (2001, 2002). Note that this manuscript reports both ITT and TOT estimates, but only ITT estimates are reported here.

Study Characteristics
Study Participants This study relies on data from a randomized controlled trial of 17 Early Head Start (EHS) programs that began in 1995. Seven of the programs served clients through a home-based option (though other clients in other EHS options also received home visits) and are the focus of this report (EHS-HBO). The study randomly assigned 1,385 families, who applied to those seven programs, either to receive home-based EHS or a comparison condition. This study included outcomes reported for the 5-year-old follow-up (other years of follow-up are reported in separate studies). For this follow-up, 927 parents (479 in EHS-HBO and 448 in the comparison group) provided data for parent interviews.
Setting The study was conducted in 17 EHS programs throughout the United States, including seven programs with home-based options, which are the focus of this report. Four programs were located in urban areas and three programs were located in rural areas. The seven programs represented a mix of implementation timing; one early implementer had all EHS-HBO elements in place by 1997, and three later implementers had all elements in place by 1999; three programs did not have all elements in place by 1999. The early-implementing program had fully implemented both child and family development services early and continued to have those services in place in 1999.
Home Visiting Services EHS-HBO services are intended to be delivered to families via weekly home visits. Seventy percent of families in these programs received weekly visits during at least one of the first two follow-up periods, and 26 percent received such services throughout both periods. Over the first two years, families in the home-based option received an average of 71 visits. Typical home visits were at least one hour long. Topics for home visits included child growth and development, child play activities, housing issues, and parent-child communication.
Comparison Conditions Control group families could not receive EHS-HBO services, but could receive other services available in their community.
Staff Characteristics and Training Not specified.
Funding Sources Administration for Children and Families (ACF), the Child Outcomes Research and Evaluation team (CORE) within ACF’s Office of Planning, Research and Evaluation (OPRE), and the Head Start Bureau in the Administration on Children, Youth and Families (ACYF).
Author Affiliation None of the study authors are developers of this model.
Study Registration:

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

Study Effects Details

Outcome domain: Maternal Health Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Moderate Parent depression
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = -0.08 Not statistically significant, p > 0.05 Secondary

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Negative value favors the intervention.

Moderate Someone in household had alcohol/drug problem in past year
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = -0.04 Not statistically significant, p > 0.05 Secondary

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Negative value favors the intervention.

Outcome domain: Child Development and School Readiness Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
High CBCL Aggressive behavior
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = -0.09 Not statistically significant, p > 0.05 Primary

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Negative value favors the intervention.

High FACES positive approaches to learning
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.18 Statistically significant, p < 0.01 Secondary
High FACES Social Behavior Problems
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = -0.13 Statistically significant, p < 0.05 Secondary

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Negative value favors the intervention.

High Child has an individualized education plan
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = -0.02 Not statistically significant, p > 0.05 Secondary

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Negative value favors the intervention.

High Engagement during play
FavorableUnfavorableNo Effect
Home-based program approach Age 5 829 Not reported Not reported Not Reported Study reported = 0.04 Not statistically significant, p > 0.05 Primary
High English receptive vocabulary (PPVT)
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = 0.05 Not statistically significant, p > 0.05 Primary
High Leiter attention sustained
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = 0.09 Not statistically significant, p > 0.05 Primary
High Negativity toward parent during play
FavorableUnfavorableNo Effect
Home-based program approach Age 5 829 Not reported Not reported Not Reported Study reported = -0.01 Not statistically significant, p > 0.05 Primary

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Negative value favors the intervention.

High Observed attention
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = 0.07 Not statistically significant, p > 0.05 Primary
High Observed Leiter emotion regulation
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = 0.02 Not statistically significant, p > 0.05 Primary
High Speech problems
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = -0.10 Not statistically significant, p > 0.05 Secondary

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Negative value favors the intervention.

High Woodcock Johnson Applied Problems
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = 0.08 Not statistically significant, p > 0.05 Primary
High Woodcock Johnson Letter-Word identification (English)
FavorableUnfavorableNo Effect
Home-based program approach Age 5 802 Not reported Not reported Not Reported Study reported = 0.03 Not statistically significant, p > 0.05 Primary
Outcome domain: Positive Parenting Practices Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
High HOME Language and Literacy
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.16 Statistically significant, p < 0.05 Primary
High Children's books (26 or more)
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.14 Statistically significant, p < 0.05 Secondary
High Parent supportiveness during play
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.04 Not statistically significant, p > 0.05 Secondary
High Percent reading daily
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.15 Statistically significant, p < 0.05 Secondary
High Percent spanked last week
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = -0.06 Not statistically significant, p > 0.05 Secondary

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Negative value favors the intervention.

High Teaching activities
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.15 Statistically significant, p < 0.05 Secondary
Outcome domain: Family Economic Self-Sufficiency Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
High Parent employed
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.00 Not statistically significant, p > 0.05 Secondary
High Parent income (dollars)
FavorableUnfavorableNo Effect
Home-based program approach Age 5 927 Not reported Not reported Not Reported Study reported = 0.16 Statistically significant, p < 0.05 Secondary

Study Outcome Measure Summary

Outcome Domain: Maternal Health Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
Moderate

Parent depression

The Composite International Diagnostic Interview (CIDI) measured depression. Parent survey

Internal consistency= 0.88

Secondary
Moderate

Someone in household had alcohol/drug problem in past year

Parent survey response. Parent survey

Not reported by author

Secondary
Outcome Domain: Child Development and School Readiness Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
High

CBCL Aggressive behavior

The Child Behavior Checklist is a questionnaire that assesses behavioral problems in young children. Parent survey

Internal consistency= 0.89

Primary
High

FACES positive approaches to learning

Subscales from Family and Child Experiences Survey (FACES) assessed child social-emotional functioning, social skills, and positive approaches to learning. Parent survey

Internal consistency= 0.64

Secondary
High

FACES Social Behavior Problems

Subscales from Family and Child Experiences Survey (FACES) assessed child social-emotional functioning, social skills, and positive approaches to learning. Parent survey

Internal consistency= 0.76

Secondary
High

Child has an individualized education plan

Percent of parents who report that their child has an individualized education plan. Parent survey

Not reported by author

Secondary
High

Engagement during play

Assessment of parent-child semistructured play evaluated children’s engagement with parent and negativity toward parents. The free play tasks and coding scheme used were adapted from the National Institute of Child Health and Development (NICHD) Study of Early Child Care. Videotape observation

Intercoder reliability= 96%

Primary
High

English receptive vocabulary (PPVT)

The Peabody Picture Vocabulary Test (PPVT)-III assesses receptive vocabulary for Standard American English in young children. Child assessment

Internal consistency= 0.96

Primary
High

Leiter attention sustained

The Leiter-R Sustained Attention test assesses skills in memory or attention in children. Child assessment

Internal consistency= 0.75

Primary
High

Negativity toward parent during play

The child’s behavior during a play task was coded. Child engagement with parent was measured as the extent to which the child interacted with the parent and communicated positive feelings. Child negativity toward parent measured displays of anger, rejection, or a negative reaction to parent’s behavior. Child sustained attention with objects was measured as the duration of the child’s focus on an object or set of objects. Videotape observation

Intercoder reliability= 99%

Primary
High

Observed attention

The Leiter-R Sustained Attention test assesses skills in memory or attention in children. Child assessment

Internal consistency= 0.93

Primary
High

Observed Leiter emotion regulation

The Leiter-R Sustained Attention test assesses skills in memory or attention in children. Child assessment

Internal consistency= 0.93

Primary
High

Speech problems

Parent survey response. Parent survey

Not reported by author

Secondary
High

Woodcock Johnson Applied Problems

The Woodcock-Johnson-Revised Test (WJ-R) assesses scholastic ability and intelligence in children. The Applied Problems subscale measures symbolic representation, counting, and simple addition and subtraction. Child assessment

Internal consistency= 0.91

Primary
High

Woodcock Johnson Letter-Word identification (English)

The Woodcock-Johnson-Revised Test (WJ-R) assesses scholastic ability and intelligence in children. The Letter-Word Identification subscale measures recognition of letters and words. Child assessment

Internal consistency= 0.84

Primary
Outcome Domain: Positive Parenting Practices Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
High

HOME Language and Literacy

The Home Observation for Measurement of the Environment (HOME) scale is a 45-item measure that assesses parenting practices and the child's home environment, including physical structure, play materials, and amount of stimulation. Parent/caregiver interview and observational assessment

Not reported by author

Primary
High

Children's books (26 or more)

Percentage of parents who provided 26 or more children’s books in the home. Parent survey

Not reported by author

Secondary
High

Parent supportiveness during play

Parent behavior during play was coded. Parent behaviors reported include parental support (a composite of sensitivity, positive regard, and cognitive stimulation) and parent negative regard. Videotaped observation

Intercoder agreement= 94%

Secondary
High

Percent reading daily

Percentage of parents who read to their child daily. Parent survey

Not reported by author

Secondary
High

Percent spanked last week

Percentage of parents who spanked their child in the prior week.

Parent survey

Not reported by author

Secondary
High

Teaching activities

Percentage of parents who engaged in eight or more teaching activities with their child. Parent survey

Not reported by author

Secondary
Outcome Domain: Family Economic Self-Sufficiency Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
High

Parent employed

Parents responded to the question "How much time in the past 6 months have you held a job or jobs in which you worked at least 20 hr per week?" (Answers were on a 5-point scale from 1-never to 5= all of the time.) Parent survey

Not reported by author

Secondary
High

Parent income (dollars)

Parents provided monthly income. Parent survey

Not reported by author

Secondary