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Green, B., Sanders, M. B., & Tarte, J. M. (2018). Effects of home visiting program implementation on preventive health care access and utilization: Results from a randomized trial of Healthy Families Oregon. Advance online publication. Prevention Science. https://doi.org/10.1007/s11121-018-0964-8

Model(s) Reviewed: Healthy Families America (HFA)®
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
High Randomized controlled trial Low Established on race/ethnicity and SES; outcomes not feasible to assess at baseline None None
Notes:

Information on baseline equivalence and additional details about the study enrollment and context came from Green et al. (2017). Models controlled for the Healthy Families Oregon (HFO) program site, caregivers race and ethnicity, and total number of risk factors related to child maltreatment at baseline (as defined in the New Baby Questionnaire [NBQ]).

Study characteristics
Study participants Families were eligible to participate if they were first-time parents and considered to be at high risk for child maltreatment based on the NBQ. The questionnaire defined high risk as having two or more risk factors on the NBQ; for example, being a teenage parent, having symptoms of depression, or having less than a high school education. The program screened a total of 8,520 parents using the NBQ and found 4,646 eligible. The final sample consisted of 2,727 parents (others declined participation, could not be located, or received a study wavier allowing them to bypass random assignment). The program randomly assigned a total of 1,438 parents to the HFO program and 1,289 to the comparison group. At enrollment, 61.6 percent of parents (99.5 percent of whom were mothers) identified as White, 26.9 percent as Hispanic, 2.3 percent as Asian/Pacific Islander, and 6.5 percent as multiracial. About one-third (32.3 percent) had less than a high school education.
Setting The study took place in seven Healthy Families Oregon program sites, three of which served primarily rural communities and four of which served mixed urban and rural communities.
Intervention services Healthy Families Oregon is an accredited state home-visiting program that uses the Healthy Families America program model. Families enroll prenatally or up to 90 days after birth and receive home visiting services through the children’s third birthday. Families receive weekly individualized home visits for at least six months that typically focus on child development and positive parent–child interactions. Families also receive case management services that identify their needs and link them to relevant services. Intervention take-up was low; of those assigned to the home-visiting group, only 44 percent received at least one home visit.
Comparison conditions Families assigned to the comparison group were not eligible to receive home-visiting services through the HFO program.
Staff characteristics and training Not specified.
Funding sources The study was funded by the U.S. Department of Health and Human Services, Children's Bureau (grant no. 90CA1782).
Author affiliation None of the study authors are developers of the program model.
Study Registration:

Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

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
High

Percentage of children ever enrolled in Oregon Health Plan

FavorableUnfavorable or ambiguousNo Effect

Oregon, 2010-2012, full sample

2 years

2,707 children Percent = 0.83 Percent = 0.83 Odds ratio = 1.01 HomeVEE calculated = 0.01

Not statistically significant, p= 0.93

Effect size based on study OR

Submitted by barbara on Fri, 04/12/2019 - 18:55

HomVEE calculated the effect size based on the study-reported odds ratio.

High

Total number of days enrolled in Oregon Health Plan (children)

FavorableUnfavorable or ambiguousNo Effect

Oregon, 2010-2012, full sample

2 years

2,707 children Days = 519.20 Days = 524.80 Mean difference = -5.60 HomeVEE calculated = -0.02

Not statistically significant, p= 0.61

Moderate

Percentage of parents ever enrolled in Oregon Health Plan

FavorableUnfavorable or ambiguousNo Effect

Oregon, 2010-2012, full sample

2 years

2,707 parents Percent = 0.84 Percent = 0.84 Odds ratio = 1.03 HomeVEE calculated = 0.02

Not statistically significant, p= 0.77

Effect size based on study OR

Submitted by barbara on Fri, 04/12/2019 - 18:55

HomVEE calculated the effect size based on the study-reported odds ratio.

Moderate

Total number of days enrolled in Oregon Health Plan (parents)

FavorableUnfavorable or ambiguousNo Effect

Oregon, 2010-2012, full sample

2 years

2,707 parents Days = 381.40 Days = 380.10 Mean difference = 1.30 HomeVEE calculated = 0.00

Not statistically significant, p= 0.62

Outcome measure summary

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

Percentage of children ever enrolled in Oregon Health Plan

Percent of children ever enrolled in Oregon Health Plan (OHP)

Administrative data

Not reported by author

Total number of days enrolled in Oregon Health Plan (children)

Total number of days enrolled in Oregon Health Plan (OHP) for children

Administrative data

Not reported by author

Percentage of parents ever enrolled in Oregon Health Plan

Percent of parents ever enrolled in Oregon Health Plan (OHP)

Administrative data

Not reported by author

Total number of days enrolled in Oregon Health Plan (parents)

Total number of days enrolled in Oregon Health Plan (OHP) for parent

Administrative data

Not reported by author