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Anisfeld, E., Sandy, J., & Guterman, N. B. (2004). Best Beginnings: A randomized controlled trial of a paraprofessional home visiting program: Technical report. Report to the Smith Richardson Foundation and New York State Office of Children and Family Services. New York: Columbia University School of Social Work.

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WWHV014499

Anisfeld, E., Sandy, J., & Guterman, N. B. (2004). Best Beginnings: A randomized controlled trial of a paraprofessional home visiting program: Executive summary. Report to the Smith Richardson Foundation and New York State Office of Children and Family Services. New York: Columbia University School of Social Work.
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)
Moderate Randomized controlled trial High Established on race/ethnicity, SES, and feasible outcomes. Statistical controls for feasible baseline outcomes included. Yes for some outcomes None Not assessed in manuscripts reviewed before 2021
Notes:

footnote82

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

Moderate rating applies to outcomes where the analytic sample size is at least 90 percent as large as the sample used to demonstrate baseline equivalence. Other outcomes receive a low rating. The moderate rating applies to the following outcomes: Increase in mother’s highest grade completed (baseline to 24 months); receipt of public assistance (up to 24 months postpartum); number of pediatric emergency room visits (up to 36 months of age); ASQ communication, gross motor, fine motor, social, and composite score (6 months); perceived social support (6, 12, and 24 months); service referrals (up to 24 months postpartum) for daycare/babysitting, English as a second language, job skills/search, pediatric primary care, AFDC or food stamps, housing assistance, Medicaid, immigration services, GED prep, early intervention program, family planning, food pantry, counseling, adult primary care, child health plus, WIC, parenting education or training, and domestic violence services.

Study characteristics
Study participants Women who were pregnant or had an infant under 2 months old and who lived in two eligible census tracts were screened using a checklist for risk factors for child abuse and neglect. Women who were deemed at risk were further screened using the Kempe Family Screening Inventory (FSI). Consenting women (n = 672) who received a score of 25 or higher on the FSI were assigned to the program group (n = 329) or the comparison group (n = 343). From November 1994 to November 1995, all women in one tract were assigned to the program group and participants from the other tract were enrolled in the comparison group. If Family Assessment Workers determined during the course of screening that a member of the family was affected by substance use, the family was provided additional Best Beginnings services (regardless of program or comparison group membership). Starting in November 1995, women were randomly assigned to the program group or comparison group within their census tract. Of the women who were randomly assigned, 535 were enrolled in Best Beginnings (273 in the program group, and 262 in the comparison group). Among participating women, 89.9% were born outside the United States and 88.3% were of Dominican ethnicity. On average at baseline, mothers were 26.3 years of age, 19.1% were employed, and 61.4% were receiving public assistance.
Setting Eligible women were recruited from one of two contiguous census tracts in Washington Heights, New York. Most women were receiving health care from the New York Presbyterian Hospital (NYPH) Ambulatory Care Network Corporation (ACNC).
Intervention services Families in the program group received home visits modeled after Healthy Families New York, but modified to meet specific goals. Goals for the visits included (1) assessing family strengths and needs and connecting the families with needed services, (2) improving maternal psychosocial functioning and life course, (3) improving parent-child interactions, and (4) promoting child growth and development.
Comparison conditions Participants in the comparison group received 1-2 home visits every six months until the child was age 5, and were provided with educational materials and information about community services. Assessment, screening and referrals for needed services were provided.
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).
Subgroups are not listed for manuscripts reviewed before 2021.
Staff characteristics and training Home visits were conducted by paraprofessionals who were fluent in Spanish. Staff were trained by HFA or the Healthy Families New York training team and protocols for service delivery were reinforced at staff meetings.
Funding sources New York State Office of Children and Family Services; the U.S. Department of Health and Human Services Children’s Bureau Abandoned Infants Assistance Program; and the Smith Richardson Foundation.
Author affiliation None of the study authors are developers of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

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 ASQ Communication score
FavorableUnfavorable or ambiguousNo Effect
Program group children not affected by substance abuse,
NY Best Beginnings trial
6 months 359 children Mean = 55.70 Mean = 55.30 Mean difference = 0.40 HomeVEE calculated = 0.07 Statistical significance not reported
Moderate ASQ Composite score
FavorableUnfavorable or ambiguousNo Effect
Program group children not affected by substance abuse,
NY Best Beginnings trial
6 months 359 children Mean = 54.80 Mean = 54.00 Mean difference = 0.80 HomeVEE calculated = 0.15 Statistical significance not reported
Moderate ASQ Fine Motor score
FavorableUnfavorable or ambiguousNo Effect
Program group children not affected by substance abuse,
NY Best Beginnings trial
6 months 359 children Mean = 55.10 Mean = 54.20 Mean difference = 0.90 HomeVEE calculated = 0.12 Statistical significance not reported
Moderate ASQ Gross Motor score
FavorableUnfavorable or ambiguousNo Effect
Program group children not affected by substance abuse,
NY Best Beginnings trial
6 months 359 children Mean = 52.90 Mean = 51.80 Mean difference = 1.10 HomeVEE calculated = 0.12 Statistical significance not reported
Moderate ASQ Social score
FavorableUnfavorable or ambiguousNo Effect
Program group children not affected by substance abuse,
NY Best Beginnings trial
6 months 359 children Mean = 53.70 Mean = 54.20 Mean difference = -0.50 HomeVEE calculated = -0.06 Statistical significance not reported
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 Number of pediatric emergency department visits
FavorableUnfavorable or ambiguousNo Effect
Program group children not affected by substance abuse,
NY Best Beginnings trial
36 months 271 children Not available Not available Beta = 0.12 Not available 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
Moderate Increased education by year or more since baseline
FavorableUnfavorable or ambiguousNo Effect
Program group families not affected by substance abuse,
NY Best Beginnings trial
24 months 512 families % = 18.40 % = 7.40 OR = 2.50 HomeVEE calculated = 0.63 Statistically significant,
p < 0.05
Moderate Receipt of public assistance
FavorableUnfavorable or ambiguousNo Effect
Program group families not affected by substance abuse,
NY Best Beginnings trial
24 months 512 families Not available Not available Beta = 0.02 Not available Not statistically significant, p ≥ 0.05

footnote62

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

Study reports results using a standardized partial regression coefficient.

Linkages and referrals
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Referral to AFDC or food stamps
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 33.00 % = 26.00 = 7.00 HomeVEE calculated = 0.20 Not statistically significant,
p > 0.10
Moderate Referral to GED prep
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 29.00 % = 26.00 = -7.00 HomeVEE calculated = 0.09 Not statistically significant,
p > 0.10
Moderate Referral to WIC
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 19.00 % = 12.00 = 7.00 HomeVEE calculated = 0.33 Not statistically significant,
p > 0.10

footnote61

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

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p ≤ 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques to determine statistical significance, such as regression models or analyses of variance (ANOVA).

Moderate Referral to adult primary care
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 20.00 % = 17.00 = 3.00 HomeVEE calculated = 0.12 Not statistically significant,
p > 0.10
Moderate Referral to child health plus
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 18.00 % = 16.00 = 2.00 HomeVEE calculated = 0.09 Not statistically significant,
p > 0.10
Moderate Referral to counseling
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 28.00 % = 21.00 = 7.00 HomeVEE calculated = 0.23 Not statistically significant,
p > 0.10
Moderate Referral to daycare/babysitting
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 52.00 % = 50.00 = 2.00 HomeVEE calculated = 0.05 Not statistically significant,
p > 0.10
Moderate Referral to domestic violence services
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 10.00 % = 5.00 = 5.00 HomeVEE calculated = 0.45 Not statistically significant, p > 0.10

footnote61

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

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p ≤ 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques to determine statistical significance, such as regression models or analyses of variance (ANOVA).

Moderate Referral to early intervention program
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 28.00 % = 24.00 = 4.00 HomeVEE calculated = 0.13 Not statistically significant,
p > 0.10
Moderate Referral to English as a Second Language
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 44.00 % = 36.00 = 8.00 HomeVEE calculated = 0.20 Not statistically significant,
p > 0.10
Moderate Referral to family planning
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 25.00 % = 10.00 = 15.00 HomeVEE calculated = 0.67 Statistically significant,
p < 0.01
Moderate Referral to food pantry
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 25.00 % = 19.00 = 6.00 HomeVEE calculated = 0.21 Not statistically significant,
p > 0.10
Moderate Referral to housing assistance
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 33.00 = 37.00 = -4.00 HomeVEE calculated = -0.11 Not statistically significant,
p > 0.10
Moderate Referral to immigration services
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 30.00 % = 23.00 = 7.00 HomeVEE calculated = 0.22 Not statistically significant,
p > 0.10
Moderate Referral to job skills/search
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 43.00 % = 39.00 = 4.00 HomeVEE calculated = 0.10 Not statistically significant,
p > 0.10
Moderate Referral to Medicaid
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 30.00 % = 36.00 = -6.00 HomeVEE calculated = -0.16 Not statistically significant,
p > 0.10
Moderate Referral to parenting education or training
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 14.00 % = 31.00 = -17.00 HomeVEE calculated = -0.62 Statistically significant,
p < 0.001
Moderate Referral to pediatric primary care
FavorableUnfavorable or ambiguousNo Effect
Full sample 24 months postpartum 289 families % = 41.00 % = 32.00 = 9.00 HomeVEE calculated = 0.24 Not statistically significant,
p > 0.10

footnote61

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

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p ≤ 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques to determine statistical significance, such as regression models or analyses of variance (ANOVA).

Maternal health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Perceived social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
Program group members not affected by substance abuse,
NY Best Beginnings trial
6 months 354 mothers Mean = 6.20 Mean = 7.20 Mean difference = -1.00 HomeVEE calculated = -0.31 Statistical significance not reported
Moderate Perceived social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
Program group members not affected by substance abuse,
NY Best Beginnings trial
24 months 274 mothers Mean = 6.20 Mean = 6.60 Mean difference = -0.40 HomeVEE calculated = -0.12 Statistical significance not reported
Moderate Perceived social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
Program group members not affected by substance abuse,
NY Best Beginnings trial
12 months 325 mothers Mean = 6.50 Mean = 6.60 Mean difference = -0.10 HomeVEE calculated = -0.03 Statistical significance not reported

Outcome measure summary

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

ASQ:

  • Communication score
  • Gross Motor score
  • Fine Motor score
  • Social score
  • Composite score
The ASQ assesses the status of development in young children. The researchers examined subscales related to communication, motor development, and social practices. Parent/caregiver report

Not reported by author

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

Number of pediatric emergency department visits

Number of pediatric emergency department visits between birth and age 36 months Parent/caregiver report

Not applicable

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

Receipt of public assistance

Percentage of households receiving public assistance Parent/caregiver report

Not applicable

Linkages and referrals
Outcome measure Description of measure Data collection method Properties of measure

Referral to AFDC or food stamps

Percentage of families with one or more service referrals for AFDC or food stamps Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to GED prep

Percentage of families with one or more service referrals for GED prep Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to WIC

Percentage of families with one or more service referrals for WIC Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to adult primary care

Percentage of families with one or more service referrals for adult primary care Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to child health plus

Percentage of families with one or more service referrals for child health plus Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to counseling

Percentage of families with one or more service referrals for counseling Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to daycare/babysitting

Percentage of families with one or more service referrals for daycare/babysitting Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to domestic violence services

Percentage of families with one or more service referrals for domestic violence services Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to early intervention program

Percentage of families with one or more service referrals for early intervention program Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to English as a Second Language

Percentage of families with one or more service referrals for English as a Second Language Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to family planning

Percentage of families with one or more service referrals for family planning Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to food pantry

Percentage of families with one or more service referrals for food pantry Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to housing assistance

Percentage of families with one or more service referrals for housing assistance Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to immigration services

Percentage of families with one or more service referrals for immigration services Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to job skills/search

Percentage of families with one or more service referrals for job skills/search Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to Medicaid

Percentage of families with one or more service referrals for Medicaid Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to parenting education or training

Percentage of families with one or more service referrals for parenting education or training Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

Referral to pediatric primary care

Percentage of families with one or more service referrals for pediatric primary care Review of Service Referral Forms completed by home visitors at the time of referral

Not applicable

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

MSSI: Perceived Social Support

The MSSI assesses caregiver social support with regard to the division of household tasks and responsibilities for child rearing, access to transportation, interaction with other adults, and community involvement. The researchers analyzed the 3-item Perceived Social Support subscale, with possible scores ranging from 0 to 13. Parent/caregiver report

Not reported by author