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Green, B. L., Tarte, J. M., Harrison, P. M., Nygren, M., & Sanders, M. B. (2014). Results from a randomized trial of the Healthy Families Oregon accredited statewide program: Early program impacts on parenting. Children and Youth Services Review, 44, 288-298.

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 Low Not established on race; not established on SES; not established on outcome measures assessable at baseline None None Not assessed in manuscripts reviewed before 2021
Notes:

In 2020, HomVEE updated this review to move the measure of the Protective Factors Survey (PFS) - Family Functioning Subscalefrom the Maternal Health domain to the Positive Parenting Practices because ACF determined that, with no overall score available for the PFS assessment, outcomes should belong in the domain that is most relevant to their subscale, and that the family functioning and resiliency outcomes belong in Positive Parenting Practices. 

footnote225

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

One outcome, duration of breastfeeding, rates low because it has high attrition and authors do not establish baseline equivalence on race or SES. On the outcomes with low attrition, summarized in the above table, the study rates moderate because the design did not statistically control for outcome measures that were assessable at baseline.

Study characteristics
Study participants Mothers selected to participate in the study were screened by program staff using standard Healthy Families Oregon Program (HFO) screening procedures. Mothers were study-eligible if they were first-time mothers, were pregnant or had an infant up to 3 months old, and did not have medically fragile infants or children at risk of removal from the home, and if either the mother or the family was at risk according to HFO's screener assessment (the New Baby Questionnaire). Eligible, interested, and consenting mothers were randomly assigned in this randomized controlled trial to an HFO program or a control group (n=2,664). Researchers collected survey data at the children's first birthday on a random subsample of 1,604 participants (802 HFO, 802 control) out of the initially randomized 2,664 mothers. Mothers with survey data (803 in total) were analyzed, and their characteristics are as follows: 62 percent were white, 24 percent were Hispanic, and 14 percent were another race/ethnicity. Over one-fourth (28 percent) had less than a high school diploma or GED, and nearly one third (32 percent) reported that both parents were unemployed. One-fifth (20 percent) were depressed.
Setting This study included seven Healthy Families Oregon sites, four of which were primarily urban and three of which were rural.
Intervention services The Healthy Families Oregon program enrolled first-time parents with two or more risk factors according to the program screener, the New Baby Questionnaire. Families enrolled during pregnancy or up to 90 days after the child's birth and received up to 3 years of home visiting services.
Comparison conditions Families assigned to the comparison condition received a standard resource and referral packet.
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 Not specified.
Funding sources The grant (#90CA1782) was funded by the U.S. Department of Health and Human Services' Children's Bureau.
Author affiliation None of the study authors are developers of the model. The lead author is from the Center for Improvement of Child and Family Services at the Graduate School of Social Work at Portland State University. Other authors are from NPC Research.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.
Study Registration:

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

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 Baby received developmental screening in first year of life
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 762 mothers Adjusted proportion = 0.94 Adjusted proportion = 0.87 OR = 0.41 Not available Statistically significant, p = 0.00
Moderate Child ever breastfed - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 752 mothers Adjusted proportion = 0.91 Adjusted proportion = 0.91 OR = 0.91 Not available Not statistically significant, p ≥ 0.05
Moderate Parent ever told that child was not on track developmentally - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 762 mothers Adjusted proportion = 0.05 Adjusted proportion = 0.09 OR = 1.46 Not available Not statistically significant, p = 0.08

footnote162

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

Negative value is favorable to the intervention.

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 CDC Pregnancy Risk Assessment Monitoring System (PRAMS) measure of maternal depression- full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 2.17 Adjusted mean = 2.22 Mean difference = -0.05 HomeVEE calculated = -0.06 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 Parenting Stress Index - Short Form (PSI) - General Distress subscale score - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 1.78 Adjusted mean = 1.86 Mean difference = -0.08 HomeVEE calculated = -0.11 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 Parenting Stress Index - Short Form (PSI) - Parenting Stress subscale score - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 2.02 Adjusted mean = 2.14 Mean difference = -0.12 HomeVEE calculated = -0.14 Not statistically significant, p = 0.07

footnote162

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

Negative value is favorable to the intervention.

Moderate Parenting Stress Index - Short Form (PSI) Total Score
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 1.90 Adjusted mean = 2.00 Mean difference = -0.10 HomeVEE calculated = -0.14 Not statistically significant, p = 0.06

footnote162

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

Negative value is favorable to the intervention.

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 Adult Adolescent Parenting Inventory Corporal Punishment Subscale (AAPI-CP) Score - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 763 mothers Adjusted mean = 1.89 Adjusted mean = 1.97 Mean difference = -0.08 HomeVEE calculated = -0.10 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 Number of times in last month parent read to child - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 4.74 Adjusted mean = 4.43 Mean difference = 0.31 HomeVEE calculated = 0.26 Statistically significant, p = 0.00
Moderate Parent-Child Activities Scale (PCAS) score - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 4.84 Adjusted mean = 4.73 Mean difference = 0.11 HomeVEE calculated = 0.15 Statistically significant, p = 0.02
Moderate Protective Factors Survey (PFS) - Family Functioning Subscale - full sample
FavorableUnfavorable or ambiguousNo Effect
HF Oregon 2010-2012 Child's 1st birthday 764 mothers Adjusted mean = 4.16 Adjusted mean = 4.15 Mean difference = 0.01 HomeVEE calculated = 0.01 Not statistically significant, p ≥ 0.05

Outcome measure summary

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

Baby received developmental screening in first year of life

This survey item asks whether the baby received a developmental screening in first year of life. Parent/caregiver report

Not reported by author

Child ever breastfed - full sample

This survey item asks whether the child was ever breastfed. Parent/caregiver report

Not reported by author

Parent ever told that child was not on track developmentally - full sample

This survey item asks whether the parent was ever told that the child was not on track developmentally. Parent/caregiver report

Not reported by author

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

CDC Pregnancy Risk Assessment Monitoring System (PRAMS) measure of maternal depression- full sample

CDC Pregnancy Risk Assessment Monitoring System (PRAMS) is a 3-item measure of maternal depression. Parent/caregiver report

Not reported by author

Parenting Stress Index - Short Form (PSI) - General Distress subscale score - full sample

The Parenting Stress Index-Short Form General Distress subscale. Parent/caregiver report

Crohnbach's alpha = .715

Parenting Stress Index - Short Form (PSI) - Parenting Stress subscale score - full sample

The Parenting Stress Index-Short Form Parental Distress subscale measures the level of distress parents feel in their role because of personal factors. Parent/caregiver report

Crohnbach's alpha = .638

Parenting Stress Index - Short Form (PSI) Total Score

The Parenting Stress Index-Short Form assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. Parent/caregiver report

Crohnbach's alpha = .794

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

Adult Adolescent Parenting Inventory Corporal Punishment Subscale (AAPI-CP) Score - full sample

The Adult Adolescent Parenting Inventory-Corporal Punishment Subscale assesses parenting and childrearing attitudes on discipline. Parent/caregiver report

Crohnbach's alpha = .77

Number of times in last month parent read to child - full sample

This survey item asks for the number of times in the last month that the parent read to child. Parent/caregiver report

Not reported by author

Parent-Child Activities Scale (PCAS) score - full sample

The Parent-Child Activities Scale assesses the frequency with which the parent engaged in several activities with the child that can stimulate cognitive and language development, including reading or telling stories, dancing, singing, and playing outside together. Parent/caregiver report

Crohnbach's alpha = .678

Protective Factors Survey (PFS) - Family Functioning Subscale - full sample

The Protective Factors Survey (PFS) - Family Functioning Subscale assesses whether a family has adaptive skills and strategies to persevere in times of crisis.

Parent/caregiver report

Crohnbach's alpha = .845