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Koniak-Griffin, D., Verzemnieks, I. L., Anderson, N. L., Brecht, M. L., Lesser, J., Kim, S., et al. (2003). Nurse visitation for adolescent mothers: Two-year infant health and maternal outcomes. Nursing Research, 52(2), 127–136.

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
Moderate Randomized controlled trial High Established on race/ethnicity, SES, and baseline outcomes. None None Not assessed in manuscripts reviewed before 2021
Study characteristics
Study participants Participants were recruited via referrals to a county public health department and assigned randomly to either the intervention or the comparison group. Initially 144 mothers were randomly assigned, 75 to the treatment group and 69 to the comparison group (information obtained from authors). At the two-year follow-up, 101 adolescent mothers participated in the study, 56 in the intervention group and 45 in the comparison group. Most were poor, unmarried, and expecting their first child. Mothers ranged in age from 14 to 19 years old at intake (26 weeks or less gestation). Sixty-two percent of the mothers were Latina, 13 percent were African American, and 18 percent were white. Participants were followed from pregnancy through two years postpartum. Note: This is a follow-up to Koniak-Griffin et al. (1999, 2000, 2002).
Setting The study was conducted in San Bernardino County, California, a large, ethnically diverse county adjacent to Los Angeles.
Intervention services The intervention included a combination of home visits and motherhood preparation classes, both conducted by specially trained public health nurses. The intervention began in mid-pregnancy and continued through the first year of the infant’s life. Participants received approximately 17 home visits by a public health nurse. Each visit lasted between two and two and a half hours. In addition, participants attended four “Preparation for Motherhood” classes lasting six hours each. In addition, The intervention covered five main content areas: (1) health, (2) sexuality and family planning, (3) life skills, (4) maternal role, and (5) social support systems.
Comparison conditions Comparison group members received traditional public health nursing services, consisting of three home visits: one at intake, one for prenatal care, and one for postpartum/well-baby care information.
Subgroups examined This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report).
Subgroups are not listed for manuscripts reviewed before 2021.
Staff characteristics and training The public health nurses in this study had a minimum education level of a bachelor’s degree in nursing. They received special training and used written protocols as guides in implementing the intervention and the traditional public health nursing services.
Funding sources National Institutes of Nursing Research (NINR), Grants R0-1 NR02325 and NR02325-S1, and the Office of Research on Women’s Health, Grant NR02325-S2. Financial support for the second author was also provided by the NINR (5-T32-NR7077).
Author affiliation The authors are developers of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

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
Moderate Number of episodes of hospitalizations
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Number of episodes = 19.00 Number of episodes = 36.00 Difference = -17.00 Not available Statistically significant, p =0.002

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

Moderate Percentage never using the ER for child’s health problems
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Percentage = 0.36 Mean % = 0.11 Mean difference = 0.25 HomeVEE calculated = 0.92 Statistically significant, p =0.004

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

Moderate Percentage of children hospitalized
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Percentage = 0.21 Mean % = 0.36 Mean difference = -0.15 HomeVEE calculated = -0.45 Statistical significance not reported
Moderate Percentage using both ER and hospital
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Percentage = 0.21 Mean % = 0.36 Mean difference = -0.15 HomeVEE calculated = -0.45 Statistical significance not reported
Moderate Total number of ER visits
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

Moderate Total number of days for nonbirth-related infant hospitalizations
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Number of days = 143.00 Number of days = 211.00 Difference = -68.00 Not available Statistically significant, p < 0.001

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

Moderate Number of episodes of hospitalization per hospitalized child
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, hospitalized children Two years postpartum 28 children Mean = 1.58 Mean = 2.19 Mean difference = -0.61 HomeVEE calculated = -0.14 Statistical significance not reported
Moderate Percentage of children adequately immunized
FavorableUnfavorable or ambiguousNo Effect
San Bernardion sample Two years postpartum 101 mothers Percentage = 0.77 Mean % = 0.87 Mean difference = -0.10 HomeVEE calculated = -0.42 Not statistically significant, p > 0.5

footnote105

Submitted by user on Fri, 03/15/2019 - 14:29

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p = 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques, such as regression models or analyses of variance (ANOVA), to determine statistical significance.

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 External social competence
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Mean = 82.96 Mean = 82.57 Mean difference = 0.39 HomeVEE calculated = 0.06 Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

Moderate Internal social competence
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Mean = 71.86 Mean = 69.56 Mean difference = 2.30 HomeVEE calculated = 0.29 Not statistically significant, p =0.057

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

footnote108

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using repeated-measures ANOVA.

Moderate Repeat pregnancy rate
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Two years postpartum 101 mothers Percentage = 0.32 Mean % = 0.47 Mean difference = -0.15 HomeVEE calculated = -0.38 Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate NCAST child’s score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample Two years postpartum 90 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

Moderate NCAST mother’s score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample Two years postpartum 90 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

Moderate NCAST total score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample Two years postpartum 90 mothers Mean = 51.67 Mean = 52.61 Mean difference = -0.94 HomeVEE calculated = -0.22 Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

Moderate HOME
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, HOME sample Two years postpartum 99 mothers Mean = 38.07 Mean = 38.80 Mean difference = -0.73 HomeVEE calculated = -0.16 Not statistically significant, p > 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

Outcome measure summary

Child health
Outcome measure Description of measure Data collection method Properties of measure

Number of episodes of hospitalization per hospitalized child

Count of the number of episodes of hospitalization per hospitalized child during the first 24 months of the child’s life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Number of episodes of hospitalizations

Count of the number of episodes of hospitalization during the first 24 months of the child’s life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Percentage never using the ER for child’s health problems

Percentage of mothers that had not used emergency room services for their child’s health during the first 24 months of the child’s life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Percentage of children adequately immunized

Percentage of children that had received four or more doses of diphtheria–tetanus–pertussis vaccine, three or more doses of poliovirus vaccine, and one or more doses of measles–containing vaccine were received by 24 months of age, as recommended by the Centers for Disease Control and Prevention (CDC) Review of medical records orimmunization cards

Not applicable

Percentage of children hospitalized

Percentage of children that had been hospitalized during the first 24 months of the child’s life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Percentage using both ER and hospital

Percentage of mothers that had had used both emergency room and hospital services for their child’s health during the first 24 months of the child’s life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Total number of ER visits

The total number of child ER visits during the first 24 months of life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Total number of days for nonbirth-related infant hospitalizations

Count of the total number of days of nonbirth–related child hospitalization during the first 24 months of life Parent/caregiver report confirmed by review of medical records for 80% of hospitalizations and 61% of ER episodes.

Not applicable

Maternal health
Outcome measure Description of measure Data collection method Properties of measure

External social competence

Socialcompetence measureswerecomposites derivedfrom (1)the Rosenberg Self–Esteem Inventory.(2)Pearlin’sSenseofMastery Scale. (3)the Centerfor EpidemiologicalStudies DepressionScale,(4) thePerceived StressScale;(5)the Community Life SkillsScale(CLSS), and (6)the SocialSkills Inventory (SSI). Factor analysis was used to develop two conceptual factors representing Internal and external social competence. Composite measures were formed by first standardizing each measure to a 0–100 scale with higher numbers representing higher skills, then averaging the relevant translated scores. Parent/caregiver report

Not reported by author

Internal social competence

Socialcompetence measureswerecomposites derivedfrom (1)the Rosenberg Self–Esteem Inventory,(2)Pearlin’sSenseofMastery Scale, (3)the Centerfor EpidemiologicalStudies DepressionScale,(4) thePerceived StressScale,(5)the Community Life SkillsScale(CLSS), and (6)the SocialSkills Inventory (SSI). Factor analysis was used to develop two conceptual factors representing Internal and external social competence. Composite measures were formed by first standardizing each measure to a 0–100 scale with higher numbers representing higher skills, then averaging the relevant translated scores. Parent/caregiver report

Not reported by author

Repeat pregnancy rate

Percentage of mothers that experienced a repeat pregnancy Parent/caregiver report

Not applicable

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

NCAST child’s score

The Nursing Child Assessment Teaching Scale (NCAST) is a 73–item binary scale that measures maternal and child contributions to dyadic interactive quality.

Coding of videotaped parent-child interaction during structured play episodes

Cronbach’s α = 0.71

NCAST mother’s score

The Nursing Child Assessment Teaching Scale (NCAST) is a 73–item binary scale that measures maternal and child contributions to dyadic interactive quality.

Coding of videotaped parent-child interaction during structured play episodes

Cronbach’s α = 0.77

NCAST total score

The Nursing Child Assessment Teaching Scale (NCAST) is a 73–item binary scale that measures maternal and child contributions to dyadic interactive quality.

Coding of videotaped parent-child interaction during structured play episodes

Cronbach’s α = 0.80

Home Observation for Measurement of the Environment (HOME)

The 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 report and observational assessment

Cronbach’s α = 0.71