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Culp, A. M., Culp, R. E., Hechtner-Galvin, T., Howell, C. S., Saathoff-Wells, T., & Marr, P. (2004). First-time mothers in home visitation services utilizing child development specialists. Infant Mental Health Journal, 25(1), 1-15. doi:10.1002/imhj.10086.

Model(s) Reviewed: Oklahoma’s Community-Based Family Resource and Support (CBFRS) Program
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
Moderate Non-experimental comparison group design Not applicable Established on socioeconomic status and race/ethnicity Not applicable None
Notes:

footnote140

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

Equivalence on socioeconomic status and race/ethnicity was established for the sample included in the 12-month follow up. Equivalence was not established for the 6-month follow up, so that sample receives a low rating. No outcomes were measured at baseline. Only those for which it was not possible to measure at baseline, such as subsequent pregnancy, receive a moderate rating; all others receive a low rating.

Study characteristics
Study participants Researchers recruited 355 primiparous women from county health departments at or before the 28th week of gestation. Those living in 5 of 12 participating counties received the CBFRS intervention, whereas those living in 7 comparison counties were assigned to the comparison group. Authors collected data from the mothers at baseline and when infants were 6 and 12 months old. At 6 months, 248 mothers participated in data collection, and 263 participated at 12 months. Among those remaining in the study at the 12-month assessment, less than a third in each study group was a minority, and approximately 6 in 10 were enrolled in Medicaid at baseline. Average education in the two study groups was less than 12 years, and mothers were slightly younger than 20 years old, on average, at the time of their child’s birth. This study used the same sample as Culp et al. (2007).
Setting The study was conducted in 12 rural counties in Oklahoma.
Intervention services Mothers in the CBFRS condition were visited weekly during the first month after enrollment, and then biweekly for the remainder of their pregnancy. After the babies were born, the mothers were visited weekly for the first three months; biweekly from 3 to 21 months; and monthly from 21 to 26 months. The curriculum had three foci: teaching about child development and parenting, teaching about child and maternal health, and modeling parenting skills. Although the curriculum was based on a set manual, the one-hour home visits were flexible in that the mothers selected topics of their interest within each of the three foci. Home visitors provided feedback to the health department about services delivered and unmet needs.
Comparison conditions Comparison group members received the same number of home visits from facilitators, which included discussions about new infant skills during the previous week and infant development and assessment. Facilitators provided mothers with answers to and handouts about their questions on infant skill development.
Staff characteristics and training Home visitors were women with bachelor’s or master’s degrees in child development (80 percent) or were attending college and had a minimum of five years’ experience working with families (20 percent). All received more than 40 hours of preservice training and received ongoing training and weekly supervision.
Funding sources Funding for the study was provided by the Office of Child Abuse Prevention, Oklahoma State Department of Health, Oklahoma City, OK.
Author affiliation P. Marr, a study author, was associated with the Oklahoma State Department of Health, which provided funding for the evaluation and may have developed the program.

Findings details

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 Acceptance
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 6.56 Adjusted mean = 5.95 Mean difference = 0.61 Study reported = 0.44 Statistically significant, p < 0.01
Moderate Home safety
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 38.10 Adjusted mean = 36.90 Mean difference = 1.20 Study reported = 0.46 Statistically significant, p < 0.01
Moderate Involvement
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 5.13 Adjusted mean = 5.14 Mean difference = -0.01 HomeVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Moderate Learning materials
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 8.17 Adjusted mean = 8.45 Mean difference = -0.28 HomeVEE calculated = -0.22 Not statistically significant, p ≥ 0.05
Moderate Organization
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 5.59 Adjusted mean = 5.44 Mean difference = 0.15 Study reported = 0.18 Not statistically significant, p ≥ 0.05
Moderate Responsivity
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 10.50 Adjusted mean = 10.30 Mean difference = 0.20 HomeVEE calculated = 0.17 Not statistically significant, p ≥ 0.05
Moderate Variety
FavorableUnfavorable or ambiguousNo Effect
Oklahoma 12 months 263 caregivers Adjusted mean = 3.70 Adjusted mean = 3.61 Mean difference = 0.09 HomeVEE calculated = 0.07 Not statistically significant, p ≥ 0.05

Outcome measure summary

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

Home Observation for Measurement of the Environment scores

The Home Observation for Measurement of the Environment inventory (0-3) assesses parent-child interactions. The authors examined all six subscales: acceptance, involvement, learning materials, organization, responsitivity, and variety. Observational assessment

Interrater reliability was 94%

Home safety

The Massachusetts Safety Checklist assesses the safety of the home in kitchen, bathroom, and child areas as well as safety practices. Home assessment

Not reported by author