Manuscript Detail | Home Visiting Evidence of Effectiveness

Kirkland, K., & Mitchell-Herzfeld, S. (2012). Evaluating the effectiveness of home visiting services in promoting children’s adjustment in school: Final report to the Pew Center on the States. Rensselaer, NY: New York State Office of Children and Family Services, Bureau of Evaluation and Research.

Model(s) Reviewed: Healthy Families America (HFA)^®

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 and SES. Baseline equivalence on outcomes not feasible.	None	None	Not assessed in manuscripts reviewed before 2021

Study characteristics
Study participants	Community agencies, including prenatal care providers and hospitals, screened expectant parents and parents with an infant younger than 3 months of age who lived in high-risk target areas and who were considered to be at risk for child abuse or neglect. Women were selected for the study following the same screening and assessment procedures used to determine eligibility for Healthy Families New York (HFNY). Family assessment workers (FAWs) obtained informed consent from women before the administration of a well-established risk assessment tool. In total 1,254 mothers were randomly assigned (intervention, n = 621; control, n = 633), and 1,173 mothers (intervention, n = 579; control, n = 594) completed baseline interviews. This study reported on the Year 7 follow-up for this study sample, with the authors matching Grade 1 school records when possible for study children whose mothers provided consent for the record collection. This results in an analysis sample size of 577 children (intervention, n = 288; control, n = 289). In this analysis sample, 36 percent of the mothers were white, non-Latina; 46 percent were African American, non-Latina; and 16 percent were Latina. Fifty-six percent of the study children were the first child for mothers in the study; 47 percent of mothers had a high school diploma or equivalent, and 28 percent were receiving cash assistance at random assignment. The authors’ estimation of annual earnings for mothers in the analysis sample was $5,173.
Setting	This study took place in three sites within the HFNY home visiting program.
Intervention services	HFNY, which is based on the Healthy Families America (HFA) model, was established as a strengths-based, intensive home visitation program with the explicit goals of (1) promoting positive parenting skills and parent-child interaction; (2) preventing child abuse and neglect; (3) supporting optimal prenatal care, and child health and development; and (4) improving parents’ self-sufficiency.Families are provided intensive home visitation services bi-weekly during the prenatal period, weekly until the child is at least 6 months old, and periodically thereafter based on the needs of the family until the child begins school or Head Start. Home visits typically emphasize content that is appropriate to the particular service level on which the family is currently assigned. For example, visits on the prenatal level focus on promoting adequate prenatal care and providing information regarding fetal development, as well as preparing the family for childbirth and providing instruction on the care and safety of a newborn. Postnatal visits focus primarily on promoting positive parent-child interactions, educating parents about child growth and development, and enhancing family functioning and self-sufficiency.HFNY programs determine the most appropriate curricula to use during home visits based on the specific needs and characteristics of individual families. At all stages, home visitors provide support, education, information, and activities designed to promote healthy parenting behaviors and child growth, including proper nutrition, age-appropriate behaviors, and positive discipline strategies. Home visitors also help mothers access health care and other services as needed; identify and address issues regarding positive family functioning; and discuss child care, education, training, and employment options.
Comparison conditions	The control group was given information on and received referrals to appropriate services other than home visiting.
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.
Funding sources	The Pew Charitable Trusts, The Pew Center on the States, Grant #2010-0588.
Author affiliation	None of the study authors are developers of this model.
Peer reviewed	Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

Child development and school readiness
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Moderate	Days absent	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 16.36	= 15.28	Mean difference = 1.08	HomVEE calculated = 1.37	Not statistically significant, p ≥ 0.05	footnote163 Submitted by user on Fri, 03/15/2019 - 14:29 Positive value is favorable to the comparison group.
Moderate	Doing poorly academically	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.30	= 0.33	Mean difference = -0.03	HomVEE calculated = -0.07	Not statistically significant, p ≥ 0.05	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	Doing poorly academically - Any of the 3 behaviors that promote learning	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.15	= 0.16	Mean difference = -0.01	HomVEE calculated = -0.03	Not statistically significant, p ≥ 0.05	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	Doing poorly academically - Reading or Math	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.21	= 0.25	Mean difference = -0.04	HomVEE calculated = -0.14	Not statistically significant, p ≥ 0.05	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	Excelling academically	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.26	= 0.20	Mean difference = 0.06	HomVEE calculated = 0.19	Not statistically significant, p ≥ 0.05
Moderate	Excelling academically - All 3 behaviors that promote learning	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.13	= 0.08	Mean difference = 0.05	HomVEE calculated = 0.36	Statistically significant, p < 0.05
Moderate	Excelling academically - Reading and Math	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.16	= 0.16	Mean difference = 0.00	HomVEE calculated = 0.01	Not statistically significant, p ≥ 0.05
Moderate	Retained in first grade	FavorableUnfavorable or ambiguousNo Effect	Healthy Families New York (HFNY) RCT, Year 7	1st grade	577 mother/child dyads	= 0.04	= 0.07	Mean difference = -0.04	HomVEE calculated = -0.44	Statistically significant, p < 0.05	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.