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Lefever, J. E. B., Bigelow, K. M., Carta, J. J., Borkowski, J. G., Grandfield, E., McCune, L., Irvin, D. W., & Warren, S. F. (2017). Long-term impact of a cell phone-enhanced parenting intervention. Child Maltreatment, 22(4): 305–315.

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
High Randomized controlled trial Low Established on race/ethnicity and SES; not established on baseline measures of the outcomes None None Not assessed in manuscripts reviewed before 2021
Notes:

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All outcomes in the comparison of Planned Activities Training vs. control rated high. All outcomes in the comparison of Cellular Phone Enhanced Planned Activities Training vs. control rated moderate because baseline equivalence on race/ethnicity was not established. Information on baseline equivalence for race/ethnicity and socioeconomic status was based on correspondence with the author. All analytical models controlled for baseline measures of the outcome variables. Outcomes assessed at the 6-month follow-up are reported in Carta et al. (2013) and not included in the review of this study. Lefever et al. (2017) reports comparisons of Planned Activities Training vs. Cellular Phone Enhanced Planned Activities Training, but these are not eligible for review because they isolate the effect of a cellular add-on to a SafeCare module. Note that the study uses “Parent Child Interactions (PCI)” instead of “Planned Activities Training” and “cellular phone-supported version (PCI-C)” instead of “Cellular Phone Enhanced Planned Activities Training.” The authors note that the <abbr title="Parent-Child Interactions">PCI</abbr> intervention was labeled "Planned Activities Training" in other publications. In this review and others, <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr> continues to use “Planned Activities Training” and “Cellular Phone Enhanced Planned Activities Training” to remain consistent in reporting findings for SafeCare and related studies.

Study characteristics
Study participants Participants were 371 mother-child dyads recruited through health and social services agencies serving low-income families. Eligible mothers had a preschool–aged child and at least one risk factor: less than 18 years of age at child’s birth, less than a high school diploma, receiving financial assistance, or meeting income eligibility for WIC or Head Start. After consent was obtained, dyads were randomized to one of two arms of the home visiting intervention, or to the control group. Mothers in the Planned Activities Training group received the Planned Activities Training module of SafeCare (but were not enrolled in SafeCare more broadly), while mothers in the second arm of the intervention (Cellular Phone Enhanced Planned Activities Training) received the Planned Activities Training module of SafeCare with the aid of a cell phone for receiving texts and calls from their case manager (but were not enrolled in SafeCare more broadly). A total of 371 mother-child dyads were randomized: 142 into the Planned Activities Training group, 113 into the Cellular Phone Enhanced Planned Activities Training group, and 116 into the control group. Mother-child dyads were analyzed at 12 months on aspects of positive parenting, child development, and maternal depression. At baseline, average maternal age was 28.9 years, while average child age was 4.6 years. Maternal race/ethnicity was as follows: 46 percent Hispanic; 33 percent African-American; 17 percent White, non-Hispanic; and 4 percent mixed race or Asian. Families’ average annual income was $18,608.
Setting Participants were recruited through health and social services agencies in South Bend, Indiana; Kansas City, Kansas; and Kansas City, Missouri.
Intervention services Planned Activities Training is the parent training module of SafeCare. This study had two treatment arms. Mothers in the Planned Activities Training group received approximately five Planned Activities Training sessions, twice weekly, while mothers in the Cellular Phone Enhanced Planned Activities Training group received the same but with the aid of a cell phone, where they received frequent texts and check-in calls from their family coach with encouragements and reminders. In each of these arms, mothers selected two or three daily routines with their children for which they received coaching. On those routines, and more generally, home visiting staff provided coaching, observation, and feedback to promote positive parent-child interactions in daily activities.
Comparison conditions Families assigned to the wait-list control condition received no home visiting services for one year. They were eligible to receive services after completing the 12-month follow-up.
Subgroups examined This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report).

• Maternal depression (present based on screening)

Funding sources The research and evaluation was supported by Cooperative Agreement U49 CE 001070-0 from the Violence Prevention Branch of the U.S. Centers for Disease Control and Prevention. Additional funding was received from the CDC Foundation, the Doris Duke Charitable Foundation, the Health Care Foundation of Greater Kansas City, the AT&T Foundation, and the Spring Foundation.
Author affiliation The corresponding author is affiliated with the William J. Shaw Center for Children and Families, University of Notre Dame; co-authors are affiliated with the Juniper Gardens Children’s Project, University of Kansas.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.
Study Registration:

Clinicaltrials.gov Identifier: NCT01294475. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings that rate moderate or high

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 Child adaptive skills: Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS), Adaptive Skills subscale, PCI (Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI (Planned Activities Training) vs. Control 12 months 258 mother/child dyads Not applicable Not applicable Not reported Study reported = -0.15 Not statistically significant, p = 0.37

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

High Child cooperative behavior: Child Behavior Rating Scale (CBRS), PCI (Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI (Planned Activities Training) vs. Control 12 months 258 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.28 Not statistically significant, p = 0.06

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

High Child externalizing behaviors: Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS), Externalizing subscale, PCI (Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI (Planned Activities Training) vs. Control 12 months 258 mother/child dyads Not applicable Not applicable Not reported Not available Not statistically significant, p = 0.57

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

Moderate Child adaptive skills: Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS), Adaptive Skills subscale, PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control 12 months 229 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.09 Not statistically significant, p = 0.59

footnote300

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

Moderate Child cooperative behavior: Child Behavior Rating Scale (CBRS), PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control 12 months 229 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.38 Statistically significant, p = 0.04

footnote300

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

Moderate Child externalizing behaviors: Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS), Externalizing subscale, PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control 12 months 229 mother/child dyads Not applicable Not applicable Not reported Not available Statistically significant, p = 0.00

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

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 PCI (Planned Activities Training) skills: Positive Behavior Support (PCI skills checklist), PCI (Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI (Planned Activities Training) vs. Control 12 months 258 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.37 Statistically significant, p = 0.01

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

High Parenting: Keys to Interactive Parenting Scale (KIPS), PCI (Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI (Planned Activities Training) vs. Control 12 months 258 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.58 Statistically significant, p < 0.001

footnote300

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

Moderate PCI (Planned Activities Training) skills: Positive Behavior Support (PCI skills checklist), PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control 12 months 229 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.68 Statistically significant, p < 0.001

footnote300

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.

Moderate Parenting: Keys to Interactive Parenting Scale (KIPS), PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control, 12 months
FavorableUnfavorable or ambiguousNo Effect
PCI-C (Cellular Phone Enhanced Planned Activities Training) vs. Control 12 months 229 mother/child dyads Not applicable Not applicable Not reported Study reported = 0.35 Statistically significant, p = 0.00

footnote300

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Authors used linear regression models to estimate the impact, and reported a coefficient, standard error, effect size, and p-value.