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Barnes-Boyd, C., Norr, K. F., & Nacion, K. W. (1996). Evaluation of an interagency home visiting program to reduce postneonatal mortality in disadvantaged communities. Public Health Nursing, 13(3), 201-208.

Model(s) Reviewed: Resources, Education, and Care in the Home (REACH)
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 NA Established on race/ethnicity and SES. Baseline equivalence on outcomes not feasible. NA For morbidity outcomes (neonatal and at 12 months), the REACH group was assessed by a nurse at home and the comparison group was assessed by a nurse in a clinic. Because a nurse collected the data in both settings, this was judged as not being a threat to the study’s internal validity.
Study characteristics
Study participants Researchers recruited 1,269 infants who were healthy at birth and had high socioeconomic risk factors from target communities. At intake, 79 percent of the infants were African American and 18 percent were Hispanic. More than one-third of infants had mothers aged 19 or younger, and more than one-third had mothers with less than a high school education.
Setting Chicago, Illinois
Intervention services Services included at least five home visits in the first year of life (at 2 weeks, 6-8 weeks, and 4, 8, and 12 months), and more as necessary. Timing of the home visits was designed to coincide with the child’s developmental changes and a greater likelihood of illness. Home visitors were registered nurses who coordinated the family’s care with participating agencies, made referrals, and provided individual counseling. The focus of the visits was health education and screening. Retention in the program (through 12 months) was 57.5 percent.
Comparison conditions The study included three comparison groups, which were used for different outcomes. The comparison group for the infant mortality outcome included infants residing in REACH target communities (but not participating in REACH) over a four-year span. The comparison group for the neonatal morbidity outcomes was 334 mothers and infants evaluated at 7-15 days postpartum for a study of early discharge conducted just before the REACH study began. For morbidity at 12 months, the comparison group was recruited from a pediatric clinic and was made up of 83 infants who lived either in REACH target communities or in other neighborhoods with high infant mortality rates.
Staff characteristics and training Registered nurses
Funding sources Special Project of Regional and National Significance Grant by the Office of Maternal and Child Health of the Department of Health and Human Services (MCJ 173851) and the University of Illinois Hospital.
Author affiliation The authors are developers 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
Moderate Pass rate on Denver Developmental Screening Test
FavorableUnfavorable or ambiguousNo Effect
REACH and Comparison Group III 12 months 372 infants Passed = 1.00 Passed = 0.00 Not Reported Not available Not available
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 Postneonatal Mortality Rate
FavorableUnfavorable or ambiguousNo Effect
REACH and Comparison Group I 12 months 1,775 infants 4.7 per 1,000 = 4.70 5.2 to 10.9 per 1,000 = 8.05 Not Reported Not available Not available
Moderate Incidence of preventable health problems
FavorableUnfavorable or ambiguousNo Effect
REACH and Comparison Group II 7 to 15 days after birth 531 infants % had no problems = 75.00 % had no problems = 55.00 = 25.00 Not available Not statistically significant, p ≥ 0.05
Moderate Number of illnesses in first year of life
FavorableUnfavorable or ambiguousNo Effect
REACH and Comparison Group III 12 months 372 infants % had no illnesses = 46.00 % had no illnesses = 6.00 = 40.00 Not available Statistically significant, p < 0.05
Moderate One or more physical problems at 12-month visit
FavorableUnfavorable or ambiguousNo Effect
REACH and Comparison Group III 12 months 327 infants % = 25.00 % = 29.00 = -4.00 HomeVEE calculated = -0.12 Not statistically significant, p ≥ 0.05

Outcome measure summary

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

Pass rate on Denver Developmental Screening Test

The Denver Developmental Screening Test assesses cognitive and behavioral problems in children. The authors report the percentage of children that passed the assessment. Direct child assessment

Not applicable

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

Incidence of preventable health problems

Measures the incidence of preventable health problems, including upper and lower respiratory infections, eye infections, thrush, diarrhea, cord infections, skin rashes or infections, and injuries. Child physical examination 7-15 days after birth

Not applicable

Number of illnesses in first year of life

Provides a count of the total illnesses recalled by the mother during the child’s first year of life Parent/caregiver report

Not applicable

One or more physical problems at 12-month visit

Measures the percentage of children with one or more physical problems at the 12–month visit. Common problems included skin infections or rashes and upper respiratory infections. Child physical examination

Not applicable

Postneonatal Mortality Rate

Percentage of newborns dying between 28 and 364 days of age. Review of medical records

Not applicable