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Sadler, L. S., Slade, A., Close, N., Webb, D. L., Simpson, T., Fennie, K., & Mayes, L. C. (2013). Minding the Baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home-visiting program. Infant Mental Health Journal, 34(5), 391-405.

Additional sources:

WWHV027983

Sadler, L. S., Slade, A., Close, N., & Mayes, L. (2011). Minding the Baby: A mentalization-based parenting program for young families. (Presentation slides).
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 and SES None None Not assessed in manuscripts reviewed before 2021
Notes:

In 2020, HomVEE updated this review to remove the Child abuse/maltreatment: Open cases with CPS-24 months finding from the Reductions in Child Maltreatment domain because some cases measured may be unsubstantiated. In this domain, HomVEE reviews only outcomes focused on substantiated cases of abuse and neglect.

footnote299

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

In 2018, HomVEE updated this review to move measures of attachment from the Positive Parenting Practices domain to the Child Development and School Readiness domain because they assess child behavior.

Study characteristics
Study participants The authors used a cluster-randomized trial to test the effects of Minding the Baby®. First-time mothers who attended group prenatal care sessions at the Fair Haven Community Health Center were recruited to participate; all participants who met inclusion criteria were invited into the study and assigned to the condition to which their prenatal group had been randomly assigned. Inclusion criteria for the mother were (a) English oral and comprehension fluency; (b) 14 to 25 years of age; (c) having a first child; (d) no active heroin or cocaine use (already a criteria for participating in group prenatal care); (e) no diagnoses of a psychotic disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition; and (f) no major or terminal chronic condition (AIDS, cancer, and so on; already an eligibility criteria for group prenatal care participation). One-hundred and thirty-nine families met criteria and were assigned to the program or control group based on the random assignment status of their prenatal care group (72 treatment and 67 control). Among eligible mothers, 30 declined the invitation to participate (9 treatment and 21 control). After some additional attrition, 60 (treatment) and 45 (control) mothers participated in data collection at baseline. However, the authors also note further attrition at later data collection points; 44 treatment group mothers completed 12- and 24-month data collection, and approximately 34 and 31 control group mothers, respectively, completed data collection at these time points. Mothers were followed for approximately 27 months in total, including the time before the child's birth. Overall, the study sample of mothers was 28 percent black, 62 percent Latina, and 10 percent of another race/ethnicity.
Setting New Haven, Connecticut
Intervention services Home visitor teams conducted home visits to enhance parental reflective functioning and the development of secure attachment of the infant. Home visitors conducted a prenatal assessment of the mothers’ reflective functioning capacity. The home visitors also addressed maternal physical and mental health as well as infant mental health clinical care. Home visiting began in pregnancy and occurred weekly until the child’s first birthday, and then biweekly until the child’s second birthday.
Comparison conditions Mothers in the control group received routine health care (prenatal visits, well-woman care, and well-baby care) as dictated by clinical guidelines. Families also received monthly information sheets about child rearing and health, and birthday and holiday cards.
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 visiting teams consisted of a pediatric nurse practitioner and a clinical social worker.
Funding sources National Institutes of Health, the Irving B. Harris Foundation, the FAR Fund, the Annie E. Casey Foundation, the Pritzker Early Childhood Foundation, the Seedlings Foundation, the Edlow Family, and the Schneider Family
Author affiliation Dr. Lois Sadler is a developer of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.
Study Registration:

Clinicaltrials.gov Identifier: NCT01458145

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 Strange Situation Procedure - Disorganized attachment
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 71 mothers Mean % = 27.00 Mean = 43.00 Mean difference = -16.00 HomeVEE calculated = -0.30 p = 0.49
Moderate Strange Situation Procedure - Secure attachment
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 71 mothers Mean % = 64.40 Mean = 48.40 Mean difference = 16.00 HomeVEE calculated = 0.39 p = 0.28
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 Immunizations - up-to-date - 12 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 78 mothers Not reported Not reported Not reported Not available p < 0.05
Moderate Immunizations - up-to-date - 24 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Not reported Not reported Not reported Not available p > 0.05
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 BriefSymptom Inventory (BSI) - Anxiety subscale - 12 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 78 mothers Mean = 48.10 Mean = 45.80 Mean difference = 2.30 HomeVEE calculated = 0.23 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Depression subscale - 12 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 78 mothers Mean = 48.50 Mean = 46.70 Mean difference = 1.80 HomeVEE calculated = 0.20 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Global Severity Index (GSI) - 12 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 78 mothers Mean = 48.40 Mean = 47.30 Mean difference = 1.10 HomeVEE calculated = 0.10 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Somatization subscale - 12 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 78 mothers Mean = 50.60 Mean = 52.90 Mean difference = -2.30 HomeVEE calculated = -0.20 p > 0.05
Moderate Center for Epidemiological Studies Depression Scale (CES-D) - 12 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 12 months 12 months 78 mothers Mean = 13.40 Mean = 11.30 Mean difference = 2.10 HomeVEE calculated = 0.21 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Anxiety subscale - 24 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean = 47.10 Mean = 45.40 Mean difference = 1.70 HomeVEE calculated = 0.20 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Depression subscale - 24 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean = 48.60 Mean = 46.50 Mean difference = 2.10 HomeVEE calculated = 0.23 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Global Severity Index (GSI) - 24 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean = 48.10 Mean = 46.90 Mean difference = 1.20 HomeVEE calculated = 0.12 p > 0.05
Moderate BriefSymptom Inventory (BSI) - Somatization subscale - 24 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean = 51.10 Mean = 51.00 Mean difference = 0.10 HomeVEE calculated = 0.01 p > 0.05
Moderate Center for Epidemiological Studies Depression Scale (CES-D) - 24 months
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean = 12.80 Mean = 10.80 Mean difference = 2.00 HomeVEE calculated = 0.20 p > 0.05
Moderate Rapid subsequent childbearing - birth of second child within 24 months of the index birth
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean % = 1.60 Mean = 15.00 Mean difference = -13.40 HomeVEE calculated = -1.42 p = 0.019
Moderate Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) Scale - response of Disrupted Communication
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 4 months 4 months 76 mothers Mean % = 60.50 Mean = 73.00 Mean difference = -12.50 HomeVEE calculated = -0.35 p = 0.2
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 Parent Development Interview - maternal reflexive functioning
FavorableUnfavorable or ambiguousNo Effect
Minding the Baby pilot - 24 months 24 months 75 mothers Mean = 3.60 Mean = 3.70 Mean difference = -0.10 HomeVEE calculated = -0.09 p = 0.38

Outcome measure summary

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

Immunizations - up-to-date - 12 months

Whether the child's immunizations were up to date Infant's pediatric health record and mother report

Not applicable

Immunizations - up-to-date - 24 months

Whether the child's immunizations were up to date Infant's pediatric health record and mother report

Not applicable

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

Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) Scale - response of Disrupted Communication

Videotaped interactions between mother and infant when babies were 4 months old were coded on a 7 point scale, ranging from 1 (high normal) to 7 (disrupted communication with few or no ameliorating behaviors) Videotape

Not provided

BriefSymptom Inventory (BSI) - Anxiety subscale - 12 months

Anxiety subscale of the BSI Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Anxiety subscale - 24 months

Anxiety subscale of the BSI Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Depression subscale - 12 months

Depression subscale of the BSI Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Depression subscale - 24 months

Depression subscale of the BSI Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Global Severity Index (GSI) - 12 months

A widely-used 18-item measure of psychopathology that yields an index to indicate the severity of symptoms experienced in the prior two weeks. Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Global Severity Index (GSI) - 24 months

A widely-used 18-item measure of psychopathology that yields an index to indicate the severity of symptoms experienced in the prior two weeks. Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Somatization subscale - 12 months

Somatization subscale of the BSI Maternal self report

α = 0.90 in for overall BSI

BriefSymptom Inventory (BSI) - Somatization subscale - 24 months

Somatization subscale of the BSI Maternal self report

α = 0.90 in for overall BSI

Center for Epidemiological Studies Depression Scale (CES-D) - 12 months

20 items selected from other depression scales, to describe six major symptom areas of depression. Mother report

α = 0.89 in a sample of urban adolescents and adolescent mothers

Center for Epidemiological Studies Depression Scale (CES-D) - 24 months

20 items selected from other depression scales, to describe six major symptom areas of depression. Mother report

α = 0.89 in a sample of urban adolescents and adolescent mothers

Rapid subsequent childbearing - birth of second child within 24 months of the index birth

Indicates whether the mother had a repeat birth within 24 months Mother report and health center record review

Not applicable

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

Parent Development Interview - maternal reflexive functioning

22-item clinical interview to assess a woman's emotional experience of pregnancy and the nature of her developing relationship with her baby. Videotape

Not provided

Strange Situation Procedure - Disorganized attachment

30-minute laboratory separation procedure to assess child's attachment to his or her caregiver; results in classification of child as secure, avoidant, disorganized, or resistant. Videotape

Not provided

Strange Situation Procedure - Secure attachment

30-minute laboratory separation procedure to assess child's attachment to his or her caregiver; results in classification of child as secure, avoidant, disorganized, or resistant. Videotape

Not provided