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Wagner, M., Cameto, R., & Gerlach-Downie, S. (1996). Intervention in support of adolescent parents and their children: A final report on the Teen Parents as Teachers Demonstration. Menlo Park, CA: SRI International.

Model(s) Reviewed: Parents as Teachers (PAT)®
Additional sources:

WWHV017041

Wagner, M. & Clayton, S. (1999). The Parents as Teachers program: Results from two demonstrations. The Future of Children, 9(1), 91-115.
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
Moderate Randomized controlled trial High Established on race/ethnicity, and SES. Lack of equivalence on baseline contraceptive use and experience with infants. Yes None
Notes:

In 2020, HomVEE updated this review to remove four findings related mother's partnership status/family structure and two about the teen mother being the only adult in the household from the Family Economic Self-Sufficiency domain because ACF determined that these outcomes are ineligible for review by HomVEE.

footnote66

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

Although some effect sizes are included in the study tables, HomVEE was unable to determine if they pertain to the one-year or two-year results and excluded the study-reported effect sizes from this table.

Study characteristics
Study participants Four sites in California recruited 717 teens to participate in the study. Teens were eligible if they (1) were less than 19 years of age, and (2) were pregnant or had babies younger than 6 months. Teens were randomly assigned to four conditions: (1) PAT , (2) case management, (3) PAT plus case management, or (4) control group. The HomVEE report focuses on the comparison between PAT and the control group. At enrollment, over half of the mothers were Latina (56%), 20% were African American, 21% were white, and the remainder were classified as “other” race/ethnicity. The average age was 16.7 years, and approximately 30% had dropped out of high school. Follow-ups were conducted around the time of the child’s 1- and 2-year birthdays.
Setting The study was conducted in four sites: Los Angeles, San Bernardino, San Diego, and Santa Barbara. The sponsoring agencies at the sites included three youth-serving organizations and one partnership between a local YWCA and the county health department.
Intervention services Families enrolled in PAT received monthly home visits and group meetings for as long as they remained in the program, up to the child’s second birthday. During the home visits, parent educators provided lessons using the PAT curriculum. Families received 10 visits on average over the two-year period. The study indicates that the PAT services began to “blend” with the case management services, even though this was designed to be a separate condition in the study. For example, some parent educators addressed family planning and postponing subsequent pregnancies, which was a focus of case management, but not part of the PAT curriculum.
Comparison conditions The comparison families received only the services that were normally available in the community and that they sought of their own accord. In addition, they received age-appropriate toys at regular quarterly intervals, which were used as a means of tracking their locations.
Staff characteristics and training Parent educators were trained in weeklong sessions held at authorized training sites.
Funding sources Office of Child Abuse Prevention in the California Department of Social Services; Center for the Future of Children of the David and Lucile Packard Foundation; and the Stuart Foundation.
Author affiliation None of the study 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 DPII average months differential: cognitive development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 196 children Mean = 2.60 Mean = 2.20 Mean difference = 0.40 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: cognitive development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 children Mean = 3.90 Mean = 3.60 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: communication development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 196 children Mean = 3.50 Mean = 3.20 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: communication development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 children Mean = 2.60 Mean = 2.30 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: physical development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 196 children Mean = 5.60 Mean = 5.60 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: physical development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 children Mean = 3.60 Mean = 3.80 Mean difference = -0.20 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: self-help
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 196 children Mean = 9.00 Mean = 9.40 Mean difference = -0.40 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: self-help
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 children Mean = 2.70 Mean = 2.60 Mean difference = 0.10 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: social development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 196 children Mean = 7.80 Mean = 6.80 Mean difference = 1.00 Not available Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: social development
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 children Mean = 6.10 Mean = 6.60 Mean difference = -0.50 Not available Not statistically significant, p ≥ 0.05
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 Child had a regular source of medical care
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 192 children % = 90.30 % = 92.90 = -2.60 HomeVEE calculated = -0.21 Not statistically significant, p ≥ 0.05
Moderate Child had a regular source of medical care
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 232 children % = 92.00 % = 94.10 = -2.10 HomeVEE calculated = -0.20 Not statistically significant, p ≥ 0.05
Moderate Child saw a doctor for well-baby care in past 6 months
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 232 children % = 97.40 % = 95.80 = 1.60 HomeVEE calculated = 0.30 Not statistically significant, p ≥ 0.05

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 Child saw a doctor for well-baby care in past 6 months
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 194 children % = 87.10 % = 92.10 = -5.00 HomeVEE calculated = -0.33 Not statistically significant, p ≥ 0.05

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).

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 Receiving AFDC at assessment
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 234 mothers % = 50.40 % = 58.00 = -7.60 HomeVEE calculated = -0.19 Not statistically significant, p ≥ 0.05
Moderate Receiving AFDC at assessment
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 192 mothers % = 61.30 % = 54.60 = 6.70 HomeVEE calculated = 0.17 Not statistically significant, p ≥ 0.05
Moderate Working or in job training
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 234 mothers % = 16.50 % = 18.50 = -2.00 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Moderate Working or in job training
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 194 mothers % = 26.60 % = 29.00 = -2.40 HomeVEE calculated = -0.07 Not statistically significant, p ≥ 0.05
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 HOME appropriate play materials subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 7.60 Mean = 7.20 Mean difference = 0.40 Not available Statistically significant,
p < 0.05
Moderate HOME appropriate play materials subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 7.60 Mean = 8.00 Mean difference = -0.40 Not available Statistically significant,
p < 0.05
Moderate HOME involvement with child subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 4.70 Mean = 4.90 Mean difference = -0.20 Not available Not statistically significant, p ≥ 0.05
Moderate HOME involvement with child subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 5.00 Mean = 4.70 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Moderate HOME opportunities for stimulation subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 4.00 Mean = 3.70 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Moderate HOME opportunities for stimulation subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 3.50 Mean = 3.40 Mean difference = 0.10 Not available Not statistically significant, p ≥ 0.05
Moderate HOME organization of the environment subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 5.70 Mean = 5.70 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Moderate HOME organization of the environment subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 5.60 Mean = 5.60 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Moderate HOME acceptance of child’s behavior subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 6.30 Mean = 6.30 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Moderate HOME acceptance of child’s behavior subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 6.10 Mean = 6.00 Mean difference = 0.10 Not available Not statistically significant, p ≥ 0.05
Moderate HOME parental responsivity subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 9.80 Mean = 9.90 Mean difference = -0.10 Not available Not statistically significant, p ≥ 0.05
Moderate HOME parental responsivity subscale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 9.90 Mean = 9.40 Mean difference = 0.50 Not available Statistically significant,
p < 0.05
Moderate HOME total scale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 2 year 195 mothers Mean = 38.00 Mean = 38.50 Mean difference = -0.50 Not available Not statistically significant, p ≥ 0.05
Moderate HOME total scale
FavorableUnfavorable or ambiguousNo Effect
Teen mothers sample 1 year 236 mothers Mean = 37.60 Mean = 36.20 Mean difference = 1.40 Not available Statistically significant,
p < 0.05

Outcome measure summary

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

DPII:

  • Physical Development Scale
  • Cognitive Development Scale
  • Communication Development Scale
  • Self-Help Development Scale
  • Social Development Scale
The subscales of the DPII assess the physical, communication, self-help, social, and cognitive development of young children. The scores were presented as the difference in months between a child’s chronological age and the age that corresponds to the skill level assessed. Child assessment

Not reported by author

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

Child had a regular source of medical care

Percentage of children who had a regular source of medical care Parent/caregiver report

Not applicable

Child saw a doctor for well-baby care in past 6 months

Percentage of children who had seen a doctor for well-child care during the past 6 months Parent/caregiver report

Not applicable

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

Receiving AFDC at assessment

Percentage of households that received AFDC Parent/caregiver report

Not applicable

Working or in job training

Percentage of mothers who were working or in job training Parent/caregiver report

Not applicable

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

HOME:

  • Total score
  • Parental responsivity subscale
  • Acceptance of child’s behavior subscale
  • Appropriate play materials subscale
  • Organization of the environment subscale
  • Involvement with child subscale
  • Opportunities for stimulation subscale
The HOME assesses parenting practices and aspects of the home environment. The researchers examined the total score, as well as subscales related to parental responsivity, acceptance of child's behavior, provision of appropriate play materials, organization of the child’s environment, parental involvement with children, and the opportunities provided for daily stimulation. Parent/caregiver interview and observational assessment

Not reported by author