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Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., et al. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110(3), 486.

Model(s) Reviewed: Nurse-Family Partnership (NFP)®
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 High for some outcomes for families with nurse home visitors, low for other outcomes in the study. Established for race/ethnicity and household income. None None
Notes:

footnote5

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

Information on sample sizes for this study was received through communication with the authors. HomVEE previously rated 24-month outcomes for nurse home visitors Moderate due to high attrition. Upon further examination, HomVEE noted that the outcomes had low attrition, and therefore they rate High.

footnote18

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

Subgroup findings have been replicated in at least two different samples. Other subgroup findings are excluded from this report. For the NFP model, the low psychological resource subgroup findings were used in the Memphis and Denver samples. The categorization for this subgroup differed somewhat across the two samples. Although both samples created a scale using intelligence, mental health, and mastery, only the Memphis sample also used a measure of self-efficacy in the scale. The authors indicated that self-efficacy was dropped in the Denver study because the measure was time-consuming to administer and did not appreciably improve the predictive power of the scale (this information was received through communication with the author).

footnote157

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

This study received a mixed rating. All of the outcomes comparing paraprofessional-visited mothers versus the control condition for the main sample rate high. Outcomes for the low resources subgroup, for both the nurse-visited and paraprofessional-visited versus control comparisons, rate high. In addition, outcomes for the main sample for the nurse-visited versus control comparison at the 21-month follow-up rate high. Due to high attrition, the nurse-visited versus control comparison for the other follow-ups rate moderate.

Study characteristics
Study participants Women were recruited through 21 antepartum clinics that served low-income pregnant women. Recruitment focused on women who had no previous live births and either qualified for Medicaid or had no private health insurance. From March 1994 through June 1995, 1,178 women were invited to participate and 735 consented and were randomly assigned to one of three conditions: a control group, nurse home visiting, and paraprofessional home visiting. Randomization was conducted within strata based on maternal race (Hispanic, white, black, American Indian, or Asian), maternal gestational age (less than 32 weeks, 32 weeks or more), and geographic region. This study measures the sample when the children were 6 months to 2 years old. The study sample at the 24-month parent interview included 630 women, 194 in the nurse home visiting program group, 213 in the paraprofessional home visiting program group, and 223 in the comparison group.
Setting Denver, Colorado metropolitan area
Intervention services The study included two program groups: one serviced by paraprofessionals and one serviced by nurses. Women assigned to both groups received developmental screening and referral services for their children and home visits during pregnancy and infancy (until the child was 2 years old). Both groups had the same goals: (1) to improve women’s health-related behavior, (2) to support parents in providing competent care, and (3) to encourage planning future pregnancies and promote education and employment. Paraprofessionals conducted 6.3 home visits on average during pregnancy and 16 visits during infancy. Nurses conducted 6.5 home visits on average during pregnancy and 21 visits during infancy.
Comparison conditions Women in the comparison group received developmental screening and referral services for their children at 6, 12, 15, 21, and 24 months.
Staff characteristics and training Paraprofessionals were required to have a high school education. Although those with college preparation in the “helping” professions were excluded, preference was given to paraprofessionals who had worked in human services. Nurse home visitors were required to have a BSN degree and experience in community or maternal and child health nursing. Both the nurse and paraprofessional home visitors received one month of training prior to working with families. Nurses and paraprofessionals had caseloads of similar size (approximately 25 families), but paraprofessionals had 2 supervisors for 10 visitors, compared to 1 supervisor for 10 nurse home visitors.
Funding sources The Colorado Trust (93059); a contract with Abt Associates (105–94-1925) under a grant from the Administration for Children and Families (HHS); and a Senior Research Scientist Award to David Olds from the National Institute of Mental Health (K05-MH01382).
Author affiliation David L. Olds, a study author, is a developer of this model.

Findings details

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
High CBCL
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 24-month follow-up 136 children Adjusted mean = 48.13 Adjusted mean = 49.25 Mean difference = -1.12 Not available Not statistically significant,
p > 0.05
High BSID (mental development delay)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 24-month follow-up 136 children = 0.10 = 0.19 OR = 0.48 HomeVEE calculated = -0.12 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High BSID (mental development index)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 24-month follow-up 136 children Adjusted mean = 90.18 Adjusted mean = 86.20 Mean difference = 3.98 Not available Statistically significant,
p ≤ 0.05

footnote26

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

The confidence interval includes 0, but according to the study, the result is statistically significant (α = 0.05).

High PLS-3 (language delay)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 21-month follow-up 142 children = 0.07 = 0.18 OR = 0.32 HomeVEE calculated = -0.65 Statistically significant,
p ≤ 0.05
High PLS-3 (language development)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 21-month follow-up 142 children Adjusted mean = 101.52 Adjusted mean = 96.85 Mean difference = 4.67 Not available Statistically significant,
p ≤ 0.05
High Infant low vitality: anger stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 6-month follow-up 138 children = 0.13 = 0.32 OR = 0.33 HomeVEE calculated = -0.31 Statistically significant,
p ≤ 0.05
High Infant low vitality: joy stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 6-month follow-up 138 children = 0.24 = 0.40 OR = 0.46 HomeVEE calculated = -0.45 Statistically significant,
p ≤ 0.05
High Infant vulnerability: fear stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 6-month follow-up 138 children = 0.12 = 0.21 OR = 0.51 HomeVEE calculated = -0.34 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High Irritable temperament
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Nurse home visitors and comparison (Denver) 6-month follow-up 138 children Adjusted mean = 2.88 Adjusted mean = 2.92 Mean difference = -0.04 Not available Not statistically significant,
p > 0.05
High CBCL
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 24-month follow-up 163 children Adjusted mean = 48.79 Adjusted mean = 49.25 Mean difference = -0.46 Not available Not statistically significant,
p > 0.05
High BSID (Mental development delay)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 24-month follow-up 163 children = 0.19 = 0.19 OR = 0.97 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High BSID (Mental development index)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 24-month follow-up 163 children Adjusted mean = 88.54 Adjusted mean = 86.20 Mean difference = 2.33 Not available Not statistically significant,
p > 0.05
High PLS-3 (language delay)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 21-month follow-up 163 children = 0.13 = 0.18 OR = 0.66 HomeVEE calculated = -0.23 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High PLS-3 (language development)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 21-month follow-up 163 children Adjusted mean = 97.83 Adjusted mean = 96.85 Mean difference = 0.98 Not available Not statistically significant,
p > 0.05
High Infant low vitality: anger stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 6-month follow-up 158 children = 0.22 = 0.32 OR = 0.63 HomeVEE calculated = -0.31 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High Infant low vitality: joy stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 6-month follow-up 158 children = 0.30 = 0.40 OR = 0.64 HomeVEE calculated = -0.27 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High Infant vulnerability: fear stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 6-month follow-up 158 children = 0.17 = 0.21 OR = 0.77 HomeVEE calculated = -0.16 Not statistically significant,
p > 0.05

footnote23

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

Authors report results are not statistically significant, although this appears to be inconsistent with the confidence interval.

High Irritable temperament
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources — Paraprofessional home visitors and comparison (Denver) 6-month follow-up 158 children Adjusted mean = 2.95 Adjusted mean = 2.92 Mean difference = 0.02 Not available HomVEE = > 0.05
High PLS-3 (language delay)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 21 months 406 children % (adjusted) = 6.00 Adjusted mean % = 12.00 OR = 0.48 HomeVEE calculated = -0.45 Statistically significant,
p ≤ 0.05
High PLS-3 (language delay)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 21 months 406 children % (adjusted) = 6.00 Adjusted mean % = 12.00 OR = 0.48 HomeVEE calculated = -0.45 Statistically significant,
p ≤ 0.05
High PLS-3 (language development)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 21 months 406 children Adjusted mean = 101.22 Adjusted mean = 99.49 Mean difference = 1.73 Not available Not statistically significant,
p > 0.05
High PLS-3 (language development)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 21 months 406 children Adjusted mean = 101.22 Adjusted mean = 99.49 Mean difference = 1.73 Not available Not statistically significant, p ≥ 0.05
High CBCL
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 392 children Adjusted mean = 45.49 Adjusted mean = 45.26 Mean difference = 0.23 Not available Not statistically significant,
p > 0.05
High BSID (mental development delay)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 392 children % (adjusted) = 14.00 Adjusted mean % = 13.00 OR = 1.07 Not available Not statistically significant,
p > 0.05
High BSID (Mental Developmental Index)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 392 children Adjusted mean = 89.45 Adjusted mean = 89.38 Mean difference = 0.07 Not available Not statistically significant,
p > 0.05
High PLS-3 (language delay)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 21 months 420 children % (adjusted) = 11.00 Adjusted mean % = 12.00 OR = 0.90 HomeVEE calculated = -0.06 Not statistically significant,
p > 0.05
High PLS-3 (language development)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 21 months 420 children Adjusted mean = 99.89 Adjusted mean = 99.49 Mean difference = 0.40 Not available Not statistically significant,
p > 0.05
High Irritable temperament (video coding)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 6 months 377 children Adjusted mean = 2.83 Adjusted mean = 2.84 Mean difference = -0.01 Not available Not statistically significant,
p > 0.05
High Low vitality: anger stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 6 months 377 children % (adjusted) = 26.00 Adjusted mean % = 28.00 OR = 0.89 HomeVEE calculated = -0.06 Not statistically significant,
p > 0.05
High Low vitality: joy stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 6 months 377 children % (adjusted) = 31.00 Adjusted mean % = 34.00 OR = 0.88 HomeVEE calculated = -0.08 Not statistically significant,
p > 0.05
High Vulnerable: fear stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 6 months 377 children % (adjusted) = 18.00 Adjusted mean % = 25.00 OR = 0.67 HomeVEE calculated = -0.25 Not statistically significant,
p > 0.05
Moderate CBCL (Behavior problems score)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 372 children Adjusted mean = 43.71 Adjusted mean = 45.26 Mean difference = -1.56 Not available Not statistically significant,
p > 0.05
Moderate BSID MDI
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 372 children Adjusted mean = 90.13 Adjusted mean = 89.38 Mean difference = 0.75 Not available Not statistically significant,
p > 0.05
Moderate BSID, MDI: Mental development delay
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 372 children %, (adjusted) = 11.00 Adjusted mean % = 13.00 OR = 0.83 HomeVEE calculated = -0.12 Not statistically significant,
p > 0.05

footnote2

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

Statistical significance reported on authors’ calculations of the odds ratio.

Moderate Infant low vitality: anger stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 6 months 363 children %, (adjusted) = 19.00 Adjusted mean % = 28.00 OR = 0.62 HomeVEE calculated = -0.31 Not statistically significant,
p > 0.05

footnote2

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

Statistical significance reported on authors’ calculations of the odds ratio.

Moderate Infant low vitality: joy stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 6 months 363 children %, (adjusted) = 26.00 Adjusted mean % = 34.00 OR = 0.68 HomeVEE calculated = -0.23 Not statistically significant,
p > 0.05

footnote2

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

Statistical significance reported on authors’ calculations of the odds ratio.

Moderate Infant vulnerability: fear stimuli (video coding)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 6 months 363 children % (adjusted) = 16.00 Adjusted mean % = 25.00 OR = 0.57 HomeVEE calculated = -0.34 Statistically significant,
p ≤ 0.05

footnote2

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

Statistical significance reported on authors’ calculations of the odds ratio.

Moderate Irritable temperament
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 6 months 363 children Adjusted mean = 2.80 Adjusted mean = 2.84 Mean difference = -0.04 Not available Not statistically significant,
p > 0.05
Family economic self-sufficiency
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Educational achievement (years)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 21 months 427 mothers Adjusted mean = 11.51 Adjusted mean = 11.51 Mean difference = 0.00 Not available Not statistically significant,
p ≥ 0.05
High Educational achievement (years)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 21 months 440 mothers Adjusted mean = 11.62 Adjusted mean = 11.51 Mean difference = 0.11 Not available Not statistically significant,
p ≥ 0.05
High Months employed (1–12 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 12 months 425 mothers Adjusted mean = 4.21 Adjusted mean = 3.97 Mean difference = 0.24 Not available Not statistically significant,
p ≥ 0.05
High Months employed (13–24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 439 mothers Adjusted mean = 6.14 Adjusted mean = 5.73 Mean difference = 0.41 Not available Not statistically significant,
p ≥ 0.05
High Months on AFDC (1–12 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 12 months 425 mothers Adjusted mean = 2.60 Adjusted mean = 2.35 Mean difference = 0.25 Not available Not statistically significant,
p ≥ 0.05
High Months on AFDC (13–24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 439 mothers Adjusted mean = 2.31 Adjusted mean = 1.92 Mean difference = 0.39 Not available Not statistically significant,
p ≥ 0.05
Moderate Months employed (1–12 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 12 months 406 mothers Adjusted mean = 4.35 Adjusted mean = 3.97 Mean difference = 0.38 Not available Not statistically significant,
p ≥ 0.05
Moderate Months employed (13–24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 419 mothers Adjusted mean = 6.87 Adjusted mean = 5.73 Mean difference = 1.14 Not available Statistically significant,
p ≤ 0.05
Moderate Months on AFDC (1–12 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 12 months 406 mothers Adjusted mean = 2.31 Adjusted mean = 2.35 Mean difference = -0.04 Not available Not statistically significant,
p ≥ 0.05
Moderate Months on AFDC (13–24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 419 mothers Adjusted mean = 1.95 Adjusted mean = 1.92 Mean difference = 0.03 Not available Not statistically significant,
p ≥ 0.05
Maternal health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Subsequent birth (24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 436 mothers % (adjusted) = 12.00 Adjusted mean % = 19.00 OR = 0.58 HomeVEE calculated = -0.33 Statistically significant,
p ≤ 0.05
High Subsequent pregnancy (24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 24 months 436 mothers % (adjusted) = 29.00 Adjusted mean % = 41.00 OR = 0.60 HomeVEE calculated = -0.32 Statistically significant,
p ≤ 0.05
High Subsequent birth (24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 417 mothers % (adjusted) = 13.00 Adjusted mean % = 19.00 OR = 0.63 HomeVEE calculated = -0.27 Not statistically significant, p > 0.05

footnote3

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

Authors report the difference in this outcome to be statistically significant, p < 0.10, which is greater than the acceptable alpha for this review (&alpha; = 0.05).

High Subsequent pregnancy (24 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 417 mothers % (adjusted) = 33.00 Adjusted mean % = 41.00 OR = 0.70 HomeVEE calculated = -0.21 Not statistically significant, p > 0.05

footnote3

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

Authors report the difference in this outcome to be statistically significant, p < 0.10, which is greater than the acceptable alpha for this review (&alpha; = 0.05).

High Use of emergency services
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 36 weeks (prenatal) 344 mothers % (adjusted) = 9.00 Adjusted mean % = 9.00 OR = 1.01 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
High Use of preventative services
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 36 weeks (prenatal) 344 mothers Adjusted mean = 0.67 Adjusted mean = 0.69 Mean difference = -0.02 Not available Not statistically significant,
p > 0.05
Moderate Use of emergency services
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 36 weeks (prenatal) 353 mothers % (adjusted) = 6.00 Adjusted mean % = 9.00 OR = 0.64 HomeVEE calculated = -0.27 Not statistically significant,
p > 0.05
Moderate Use of preventative services
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) 36 weeks (prenatal) 353 mothers Adjusted mean = 0.80 Adjusted mean = 0.69 Mean difference = 0.11 HomeVEE calculated = 0.09 Not statistically significant,
p > 0.05
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
High HOME environment score
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 21 months 420 mothers Adjusted mean = 37.40 Adjusted mean = 37.10 Mean difference = 0.30 Not available Not statistically significant,
p > 0.05
High Mother-infant responsive interaction
FavorableUnfavorable or ambiguousNo Effect
Paraprofessional home visitor and comparison (Denver) 24 months 392 mothers Adjusted mean = 100.15 Adjusted mean = 98.99 Mean difference = 1.16 Not available Not statistically significant, p ≥ 0.05
Moderate HOME environment score
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) Unknown 406 mothers Adjusted mean = 37.79 Adjusted mean = 37.10 Mean difference = 0.69 Not available Not statistically significant,
p > 0.05

footnote3

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

Authors report the difference in this outcome to be statistically significant, p < 0.10, which is greater than the acceptable alpha for this review (&alpha; = 0.05).

Moderate Mother-infant responsive interaction
FavorableUnfavorable or ambiguousNo Effect
Nurse home visitor and comparison (Denver) Unknown 372 mothers Adjusted mean = 100.31 Adjusted mean = 98.99 Mean difference = 1.32 Not available Statistically significant,
p ≤ 0.05

footnote17

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

The study indicates home environments were rated at 12 and 21 months, however, only one result is presented in the article and the timing is not labeled.

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

CBCL

The CBCL is a questionnaire that assesses behavioral problems in young children.

Child assessment

Not reported by author

BSID: Mental development delay and Mental Development Index

The MDI of the BSID assesses the cognitive functioning of young children. For mental development delay, children with MDI scores <77 were classified as delayed. For mental development, the MDI scores were analyzed as continuous.

Child assessment

Not reported by author

PLS-3 (language delay and language development)

The PLS-3 is used to assess expressive and receptive language skills in young children. To examine language delay, scores < 85 were considered delayed. For language development, the outcome was analyzed as continuous.

Child assessment

Not reported by author

Irritable temperament

No description provided by author.

Videotaped observation

Not reported by author

Vulnerable: fear stimuli (video coding), Low vitality: joy stimuli (video coding), Low vitality: anger stimuli (video coding)

Children’s emotional reactivity and looking at mother were videotaped and coded separately for their responses to stimuli designed to elicit fear, joy, and anger. The reactivity and looking-at-mother dimensions were dichotomized at the mean and cross-classified. Vulnerable infants exhibited high reactivity and low looking at mother in response to fear stimuli. Low vitality infants exhibited low reactivity and low looking at mother in response to joy and anger stimuli. High vitality infants exhibited high reactivity and frequent looking at mother in response to stimuli.

Videotaped observation

Not reported by author

CBCL

The CBCL is a questionnaire that assesses behavioral problems in young children. Child assessment

Not reported by author

BSID: Mental development delay BSID: MDI

The MDI of the BSID assesses the cognitive functioning of young children. For mental development delay, children with MDI scores <77 were classified as delayed. For mental development, the MDI scores were analyzed as continuous. Child assessment

Not reported by author

Vulnerable: fear stimuli (video coding)Low vitality: joy stimuli (video coding)Low vitality: anger stimuli (video coding)

Children’s emotional reactivity and looking at mother were videotaped and coded separately for their responses to stimuli designed to elicit fear, joy, and anger. The reactivity and looking-at-mother dimensions were dichotomized at the mean and cross-classified. Vulnerable infants exhibited high reactivity and low looking at mother in response to fear stimuli. Low vitality infants exhibited low reactivity and low looking at mother in response to joy and anger stimuli. High vitality infants exhibited high reactivity and frequent looking at mother in response to stimuli. Videotaped observation

Not reported by author

Irritable temperament

No description provided Videotaped observation

Not reported by author

Family economic self-sufficiency
Outcome measure Description of measure Data collection method Properties of measure

Educational achievement

The highest year of school the mother had completed

Parent/caregiver report

Not applicable

Months employed

Counts of the number of months the mother was employed. The outcome was measured for the periods of 1 to 12 months postpartum and 13 to 24 months postpartum.

Parent/caregiver report

Not applicable

Months on AFDC

Counts of the number of months the mother received AFDC. The outcome was measured for the periods of 1 to 12 months postpartum and 13 to 24 months postpartum.

Parent/caregiver report

Not applicable

Months employed

Counts of the number of months the mother was employed Parent/caregiver report

Not applicable

Months on AFDC

Counts of the number of months the mother received AFDC Parent/caregiver report

Not applicable

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

Subsequent births

The number of subsequent births experienced by the mother

Parent/caregiver report

Not applicable

Subsequent pregnancy

The number of subsequent pregnancies experienced by the mother

Parent/caregiver report

Not applicable

Use of emergency services

A summary variable of the families’ use of emergency services, including emergency housing and emergency food banks

Parent/caregiver report

Not applicable

Use of preventative services

A summary variable of the families’ use of ancillary preventative services, including mental health, legal aid, drug/alcohol treatment, childbirth classes, rent and utility assistance, education, and employment

Parent/caregiver report

Not applicable

Use of emergency services

A summary variable of the families’ use of emergency services, including emergency housing and emergency food banks Parent/caregiver report

Not applicable

Use of preventative services

A summary variable of the families’ use of ancillary preventative services, including mental health, legal aid, drug/alcohol treatment, childbirth classes, rent and utility assistance, education, and employment Parent/caregiver report

Not applicable

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

HOME: Environment score

The HOME assesses parenting practices and aspects of the home environment

Parent/caregiver interview and observational assessment

Not reported by author

Mother-infant responsive interaction

Subscale scores were factor analyzed and identified a single internally consistent principal component, responsive interaction, which was standardized to a mean of 100 and a standard deviation of 10. The outcome was measured at the 24th month of the child’s life.

Parent/caregiver-infant interaction was videotaped either in the laboratory or at home

Not reported by author

HOME: Total score

The HOME assesses parenting practices and aspects of the home environment. Parent/caregiver interview and observational assessment

Not reported by author

Mother-infant responsive interaction

Subscale scores were factor analyzed and identified a single internally consistent principal component, responsive interaction, which was standardized to a mean of 100 and a standard deviation of 10. The outcome was measured at the 24th month of the child’s life. Parent/caregiver-infant interaction was videotaped either in the laboratory or at home

Not reported by author