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Lutenbacher, M., Dietrich, M. S., & Elkins, T. (2016). Evaluation of the Maternal Infant Health Outreach Worker (MIHOW) model in a sample of Hispanic women: A collaborative project between Catholic Charities and Vanderbilt University School of Nursing. Report submitted to the Home Visiting Evidence of Effectiveness (HomVEE) Review.

Model(s) Reviewed: Maternal Infant Health Outreach Worker (MIHOW)®
Manuscript Screening Details
Screening Decision Screening Conclusion
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; established on SES; established on outcomes None None
Notes:

footnote376

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

Outcome ratings vary by comparison and whether the outcome was assessable at baseline. Comparisons with low attrition rate high if the outcomes were not assessable at baseline or if measures of the outcomes were equivalent at baseline. Comparisons with low attrition rate moderate if measures of the outcomes were assessable at baseline but equivalence was not demonstrated. Comparisons with high attrition rate moderate if measures of the outcomes were not assessable at baseline and low if they were assessable at baseline but equivalence was not demonstrated. Information on baseline equivalence for race and ethnicity and socioeconomic status was based on correspondence with the author.

Study Characteristics
Study Participants Pregnant Hispanic women older than 18 were recruited to participate in the study and then randomly assigned to MIHOW (94 women) or the comparison condition (94 women). At enrollment, participants were 29.6 years old, on average, and predominantly from Mexico (64.9 percent). Ten percent were employed full-time and an additional 16.5 percent were employed part-time. Fifty-six percent of participants had never been married.
Setting The study was conducted in the urban Davidson County, Tennessee.
Intervention Services Trained outreach workers conducted monthly home visits until children reached six months. Home visits lasted about one hour and consisted of parenting support, education, and linkages to medical and social services. MIHOW also provided participants with the opportunity to participate in social and educational groups. Participants received printed materials about maternal and child health and development.
Comparison Conditions The minimal intervention group received printed materials about maternal and child health and development at the 35th week of pregnancy and 2 weeks, 2 months, and 6 months postpartum.
Staff Characteristics and Training Health outreach workers were community members who completed 40 hours of training, shadowed an experienced outreach worker, and received feedback from a supervisor. Outreach workers also received monthly in-service trainings and attended both regional trainings and an annual conference.
Funding Sources The evaluation was funded through the Affordable Care Act Maternal, Infant, and Early Childhood Home Visiting Program D89MC23542.
Author Affiliation The authors are affiliated with the Vanderbilt School of Nursing, which developed the MIHOW model and partnered in implementation.
Study Registration:
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings Details

Outcome Domain: Maternal Health
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type Notes
High Always receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.97 Unadjusted proportion = 0.67 Mean difference = 0.29 HomeVEE calculated = 1.60 Statistically significant, p = 0.00 Secondary

footnote388

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Always receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.89 Unadjusted proportion = 0.67 Mean difference = 0.22 HomeVEE calculated = 0.82 Statistically significant, p = 0.00 Secondary

footnote388

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Always receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.96 Unadjusted proportion = 0.43 Mean difference = 0.53 HomeVEE calculated = 2.04 Statistically significant, p = 0.00 Secondary

footnote388

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Average number of prenatal visits during pregnancy
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials Not reported 177 Unadjusted mean = 9.00 Unadjusted mean = 9.20 Mean difference = -0.20 HomeVEE calculated = -0.09 Not statistically significant, p = 0.48 Secondary

footnote386

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

Statistical significance is based on the authors&rsquo; analysis using an independent t-test.

High Median Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted median = 0.00 Unadjusted median = 5.00 Median difference = -5.00 Not available Not reported Secondary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

High Median Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted median = 0.00 Unadjusted median = 3.00 Median difference = -3.00 Not available Not reported Secondary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

High Median Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted median = 0.00 Unadjusted median = 0.00 Median difference = 0.00 Not available Not reported Secondary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

High Median Parenting Stress Index (PSI) total stress score
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted median = 74.00 Unadjusted median = 77.00 Median difference = -3.00 Not available Statistically significant, p = <0.001 Primary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

High Median Parenting Stress Index (PSI) total stress score
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted median = 74.00 Unadjusted median = 76.00 Median difference = -2.00 Not available Statistically significant, p = 0.00 Primary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

High Median Parenting Stress Index (PSI) total stress score
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted median = 74.00 Unadjusted median = 76.00 Median difference = -2.00 Not available Statistically significant, p = 0.00 Primary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

High Never receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p = 1.00 Secondary

footnote389

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Never receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.01 Unadjusted proportion = 0.00 Mean difference = 0.01 HomeVEE calculated = 5.62 Statistically significant, p = 0.00 Secondary

footnote389

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Never receive social and emotional help needed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p = 1.00 Secondary

footnote389

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of social and emotional support that included seven possible responses. Authors analyzed all seven responses collectively using a mixed effect linear model; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Moderate Median score on the Edinburgh Postpartum Depression Scale (EPDS)
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials Prenatal, at 35 weeks 172 Unadjusted median = 0.00 Unadjusted median = 4.00 Median difference = -4.00 Not available Not reported Secondary

footnote387

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

Statistical significance is based on the authors&rsquo; analysis using a mixed effect linear model. Negative effect is favorable to the intervention.

Moderate Percentage reporting having received prenatal care
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials Not reported 172 Unadjusted mean = 0.99 Unadjusted mean = 0.99 Mean difference = 0.00 HomeVEE calculated = 0.05 Not statistically significant, p = 0.96 Secondary

footnote390

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

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

Outcome Domain: Child Health
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type Notes
High Breastfeeding exclusively
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 176 Unadjusted proportion = 0.02 Unadjusted proportion = 0.01 Mean difference = 0.01 HomeVEE calculated = 0.37 Statistically significant, p = 0.01 Secondary

footnote379

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Child given cereal
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.15 Unadjusted proportion = 0.17 Mean difference = -0.02 HomeVEE calculated = -0.08 Not statistically significant, p = 0.60 Secondary
High Child given other food
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.02 Unadjusted proportion = 0.01 Mean difference = 0.01 HomeVEE calculated = 0.37 Statistically significant, p = 0.01 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child given other food
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.91 Unadjusted proportion = 0.92 Mean difference = -0.01 HomeVEE calculated = -0.06 Not statistically significant, p = 0.68 Secondary
High Child given other liquid
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.01 Unadjusted proportion = 0.06 Mean difference = -0.05 HomeVEE calculated = -1.03 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child given other liquid
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.90 Unadjusted proportion = 0.91 Mean difference = -0.01 HomeVEE calculated = -0.05 Not statistically significant, p = 0.74 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Ever breastfed child
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 177 Unadjusted proportion = 0.86 Unadjusted proportion = 0.83 Mean difference = 0.03 HomeVEE calculated = 0.14 Not statistically significant, p = 0.57 Secondary
High Median duration of exclusive breastfeeding, in weeks
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 175 Unadjusted median = 1.40 Unadjusted median = 0.30 Median difference = 1.10 Not available Statistically significant, p = 0.01 Secondary

footnote382

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

Statistical significance is based on the authors&rsquo; analysis using a Mann-Whitney test.

High Median number of weeks to first food
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 163 Unadjusted median = 21.00 Unadjusted median = 20.00 Median difference = 1.00 Not available Not statistically significant, p = 0.20 Secondary

footnote382

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

Statistical significance is based on the authors&rsquo; analysis using a Mann-Whitney test.

High Median number of weeks to first other liquid
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 161 Unadjusted median = 20.00 Unadjusted median = 20.00 Median difference = 0.00 Not available Statistically significant, p < 0.001 Secondary

footnote382

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

Statistical significance is based on the authors&rsquo; analysis using a Mann-Whitney test.

High Median score on the breastfeeding self-efficacy scale (BSES)
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 121 Unadjusted median = 62.00 Unadjusted median = 51.00 Median difference = 11.00 Not available Not reported Primary
High Never breastfed
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 175 Unadjusted proportion = 0.14 Unadjusted proportion = 0.18 Mean difference = -0.03 HomeVEE calculated = -0.14 Not statistically significant, p = 0.34 Secondary

footnote378

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Never breastfed exclusively
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 176 Unadjusted proportion = 0.56 Unadjusted proportion = 0.79 Mean difference = -0.24 HomeVEE calculated = -0.67 Statistically significant, p = 0.00 Secondary

footnote380

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative veffect size is favorable to the intervention.

High Still breastfeeding
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 175 Unadjusted proportion = 0.50 Unadjusted proportion = 0.49 Mean difference = 0.01 HomeVEE calculated = 0.01 Not statistically significant, p = 0.92 Secondary

footnote377

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Stopped breastfeeding
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 175 Unadjusted proportion = 0.02 Unadjusted proportion = 0.02 Mean difference = 0.00 HomeVEE calculated = -0.05 Not statistically significant, p = 0.72 Secondary

footnote378

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Stopped breastfeeding
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 175 Unadjusted proportion = 0.16 Unadjusted proportion = 0.09 Mean difference = 0.06 HomeVEE calculated = 0.35 Statistically significant, p = 0.02 Secondary

footnote378

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Stopped breastfeeding
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 175 Unadjusted proportion = 0.18 Unadjusted proportion = 0.21 Mean difference = -0.03 HomeVEE calculated = -0.13 Not statistically significant, p = 0.39 Secondary

footnote378

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of breastfeeding practices that included five possible responses. Authors analyzed all five responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Stopped breastfeeding exclusively
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 176 Unadjusted proportion = 0.23 Unadjusted proportion = 0.12 Mean difference = 0.12 HomeVEE calculated = 0.51 Statistically significant, p = 0.00 Secondary

footnote381

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Stopped breastfeeding exclusively
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.19 Unadjusted proportion = 0.08 Mean difference = 0.11 HomeVEE calculated = 0.59 Statistically significant, p = 0.00 Secondary

footnote381

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on duration of exclusive breastfeeding that included four possible responses. Authors analyzed all four responses collectively using a Mann-Whitney test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

Moderate Child given other liquid
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 176 Unadjusted proportion = 0.00 Unadjusted proportion = 0.04 Mean difference = -0.04 HomeVEE calculated = -6.34 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

Outcome Domain: Positive Parenting Practices
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type Notes
High Child always co-sleeps
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.01 Unadjusted proportion = 0.18 Mean difference = -0.17 HomeVEE calculated = -1.82 Statistically significant, p = 0.00 Secondary

footnote384

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Child always co-sleeps
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.00 Unadjusted proportion = 0.24 Mean difference = -0.24 HomeVEE calculated = -7.65 Statistically significant, p = 0.00 Secondary

footnote384

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Child always co-sleeps
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.01 Unadjusted proportion = 0.20 Mean difference = -0.19 HomeVEE calculated = -1.87 Statistically significant, p = 0.00 Secondary

footnote384

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response. Negative effect size is favorable to the intervention.

High Child never co-sleeps
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.86 Unadjusted proportion = 0.32 Mean difference = 0.54 HomeVEE calculated = 1.53 Statistically significant, p = 0.00 Secondary

footnote385

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Child never co-sleeps
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.81 Unadjusted proportion = 0.33 Mean difference = 0.49 HomeVEE calculated = 1.33 Statistically significant, p = 0.00 Secondary

footnote385

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Child never co-sleeps
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.87 Unadjusted proportion = 0.28 Mean difference = 0.59 HomeVEE calculated = 1.70 Statistically significant, p = 0.00 Secondary

footnote385

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

Proportions indicate the percentages of women who selected this response to a closed-ended question on frequency of cosleeping that included five possible responses. Authors analyzed all five responses collectively using a likelihood chi-square test; we report a <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated effect size and p-value associated with the individual response.

High Child sleeps on back
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.99 Unadjusted proportion = 0.66 Mean difference = 0.33 HomeVEE calculated = 2.31 Statistically significant, p = 0.00 Secondary
High Child sleeps on back
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.98 Unadjusted proportion = 0.66 Mean difference = 0.32 HomeVEE calculated = 1.88 Statistically significant, p = 0.00 Secondary
High Child sleeps on back
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.98 Unadjusted proportion = 0.75 Mean difference = 0.23 HomeVEE calculated = 1.64 Statistically significant, p = 0.00 Secondary
High Child sleeps on side
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.02 Unadjusted proportion = 0.33 Mean difference = -0.30 HomeVEE calculated = -1.85 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child sleeps on side
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.02 Unadjusted proportion = 0.24 Mean difference = -0.22 HomeVEE calculated = -1.60 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child sleeps on side
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.01 Unadjusted proportion = 0.34 Mean difference = -0.33 HomeVEE calculated = -2.31 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child sleeps on stomach
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.00 Unadjusted proportion = 0.01 Mean difference = -0.01 HomeVEE calculated = -5.68 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child sleeps on stomach
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 0.00 Unadjusted proportion = 0.01 Mean difference = -0.01 HomeVEE calculated = -5.62 Statistically significant, p = 0.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Child sleeps on stomach
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p = 1.00 Secondary

footnote383

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

Negative effect size is favorable to the intervention.

High Median Home Observation for Measurement of the Environment (HOME) Inventory Score
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted median = 40.00 Unadjusted median = 33.00 Median difference = 7.00 Not available Statistically significant, p = 0.00 Primary
High Median Home Observation for Measurement of the Environment (HOME) Inventory Score
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 177 Unadjusted median = 21.00 Unadjusted median = 15.00 Median difference = 6.00 Not available Statistically significant, p = 0.00 Primary
High Median Home Observation for Measurement of the Environment (HOME) Inventory Score
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 175 Unadjusted median = 27.00 Unadjusted median = 19.00 Median difference = 8.00 Not available Statistically significant, p = 0.00 Primary
High Median number of days during prior week reading to child
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 176 Unadjusted median = 5.00 Unadjusted median = 0.00 Median difference = 5.00 Not available Statistically significant, p = 0.00 Secondary
High Median number of days during prior week singing or telling stories to child
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 weeks postpartum 176 Unadjusted median = 6.00 Unadjusted median = 5.00 Median difference = 1.00 Not available Statistically significant, p = 0.00 Secondary
High Reads stories at least three times per week
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 2 months postpartum 176 Unadjusted proportion = 0.92 Unadjusted proportion = 0.37 Mean difference = 0.55 HomeVEE calculated = 1.81 Statistically significant, p = 0.00 Secondary
High Reads stories at least three times per week
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 176 Unadjusted proportion = 0.97 Unadjusted proportion = 0.26 Mean difference = 0.71 HomeVEE calculated = 2.68 Statistically significant, p = 0.00 Secondary
Outcome Domain: Linkages and Referrals
Rating Outcome Measure Effect Sample Timing of Follow-Up Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type
Moderate Referred to resources
FavorableUnfavorable or ambiguousNo Effect
Davidson County, Tennessee, MIHOW vs. Educational Materials 6 months postpartum 178 Unadjusted proportion = 1.00 Unadjusted proportion = 0.28 Mean difference = 0.72 HomeVEE calculated = 8.92 Statistically significant, p = 0.00 Secondary

Outcome Measure Summary

Outcome Domain: Maternal Health
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
High

Always receive social and emotional help needed

Mothers were asked how often they received the social and emotional support needed, with response options being Always, Usually, Sometimes, Rarely, Never, Don't Know, or to refuse to respond. Mother report

Not reported by author

Secondary
High

Average number of prenatal visits during pregnancy

Question developed for the MIHOW Program Mother report

Not reported by author

Secondary
High

Median Parenting Stress Index (PSI) total stress score

The PSI measures parental distress, parent-child dysfunction interaction, and difficult child. Mother report

Cronbach's alpha of 0.88-0.89

Primary
High

Median score on the Edinburgh Postpartum Depression Scale (EPDS)

The EPDS measures depressive symptoms using a 10-question structured interview guide. Mother report

Cronbach's alpha of 0.87-0.88

Secondary
High

Never receive social and emotional help needed

Mothers were asked how often they received the social and emotional support needed, with response options being Always, Usually, Sometimes, Rarely, Never, Don't Know, or to refuse to respond. Mother report

Not reported by author

Secondary
Moderate

Median score on the Edinburgh Postpartum Depression Scale (EPDS)

The EPDS measures depressive symptoms using a 10-question structured interview guide. Mother report

Cronbach’s alpha of 0.87-0.88

Secondary
Moderate

Percentage reporting having received prenatal care

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
Outcome Domain: Child Health
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
High

Breastfeeding exclusively

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Child given cereal

Question from the Infant Feeding Practices Study II Mother report

Not reported by author

Secondary
High

Child given other food

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Child given other liquid

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Ever breastfed the child

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Median duration of exclusive breastfeeding, in weeks

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Median number of weeks to first food

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Median number of weeks to first other liquid

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Median score on the breastfeeding self-efficacy scale (BSES)

The BSES Short Form uses a 5-point scale on 14 questions to assess a mother's confidence breastfeeding her child. Mother report

Cronbach’s alpha of 0.93–0.95

Primary
High

Never breastfed

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Never breastfed exclusively

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Still breastfeeding

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Stopped breastfeeding

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Stopped breastfeeding exclusively

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
Moderate

Child given other liquid

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
Outcome Domain: Positive Parenting Practices
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
High

Child always co-sleeps

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Child never co-sleeps

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Child sleeps on back

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Child sleeps on side

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Child sleeps on stomach

Question from the Perinatal Risk Assessment Monitory System Survey Mother report

Not reported by author

Secondary
High

Median Home Observation for Measurement of the Environment (HOME) Inventory Score

The HOME Inventory Score measures the stimulation available in the child's home environment. Direct observation

Cronbach’s alpha equal or greater than .90 for total scores.

Primary
High

Median number of days during prior week reading to child

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Median number of days during prior week singing or telling stories to child

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
High

Reads stories at least three times per week

Question from the National Survey of Children’s Health Mother report

Not reported by author

Secondary
Outcome Domain: Linkages and Referrals
Rating Outcome Measure Description of Measure Data Collection Method Properties of Measure Outcome Type Link to delete Content
Moderate

Referred to resources

Question developed for the MIHOW Program Mother report

Not reported by author

Secondary