Study Detail

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Keefe, M. R., Karlsen, K. A., Lobo, M. L., Kotzer, A. M., & Dudley, W. N. (2006). Reducing parenting stress in families with irritable infants. Nursing Research, 55(3), 198-205.

Model(s) Reviewed: REST Routine
Study Screening Details
Screening Decision Screening Conclusion
Study Passes Screens Study Passes Screens
Study Design Details
Rating Design Attrition Baseline Equivalence Reassignment Confounding Factors
High Randomized controlled trial Low Not applicable None None


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

Keefe, M. R., Lobo, M., Froese-Fretz, A., Kotzer, A. M., Barbosa, G., & Dudley, W. (2006) and Keefe M. R., Karlsen, K. A., Lobo, M. L., Kotzer, A. M., & Dudley, W. N. (2006) used the same sample.


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

High rating applies to treatment versus control comparison. Comparisons of these groups with the post-test-only group receive a low rating because of failure to establish baseline equivalence on socioeconomic status for that group.

Study Characteristics
Study Participants Participants (infants and their parents) were either referred by their pediatrician or nurse or recruited through local advertisements. Infants were all full-term, healthy, low-risk births between the ages of 2 and 6 weeks and lived within a 2-hour radius of the metropolitan area. Researchers randomly assigned 137 infants and their caregivers: 71 to the treatment group and 66 to the comparison group. A third group of 48 infants and their caregivers were assigned to receive limited exposure to treatment and comprised a post-test-only group. These 48 infants exceeded the authors’ 2- to 6-week age cutoff and could not be included in the randomization. Baseline equivalence on socioeconomic status could not be established on this group and their results are excluded from the HomVEE review. Participants were followed for 8 weeks.
Setting The study was conducted in Charleston, South Carolina, and Denver, Colorado.
Home Visiting Services The intervention included four home visits conducted by specially trained pediatric nurse specialists. The intervention consisted of four home visits that occurred weekly after baseline data were collected. Each home visit lasted approximately one hour and included infant behavior assessments and demonstrations. The intervention had two components: the first was activities to help colicky infants and the second component assisted parents. The principles guiding infant interventions were: (1) regulation, (2) entrainment, (3) structure, and (4) touch. The parent component covered four main content areas: (1) reassurance, (2) empathy, (3) support, and (4) time-out.
Comparison Conditions Comparison group members received a standard well-child care for a four-week period.
Staff Characteristics and Training The pediatric nurses in this study had a minimum education level of a master’s degree in nursing. They received special training and used written protocols as guides in implementing the intervention.
Funding Sources National Institutes of Nursing Research, Grants R0-1 NR04661.
Author Affiliation Maureen R. Keefe, a study author, is a developer of this model.

Study Effects Details

Outcome domain: Maternal Health Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
High Parenting Stress Index-Short Form
FavorableUnfavorableNo Effect
Full sample 4 weeks 121 mother/child dyads <abbr title"not reported">NR</abbr> <abbr title"not reported">NR</abbr> Repeated Measures = 2.30 HomeVEE calculated = 0.27 Not statistically significant, p > 0.05 Primary

Study Outcome Measure Summary

Outcome Domain: Maternal Health Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type

Parenting Stress Index-Short Form

The Parenting Stress Index (PSI)-Short Form assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. The PSI includes three domains (Parent Distress, Difficult Child, and Parent–Child Dysfunctional) and items are rated on a 5-point scale from strongly disagree to strongly agree . Parent/caregiver report

For a subsample of participants, Cronbach’s α = 0.92 (total scale) Cronbach’s α = 0.83 to 0.88 (across subscales)