Study Detail

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Barth, R. P. (1991). An experimental evaluation of in-home child abuse prevention services. Child Abuse and Neglect: The International Journal, 15(4), 363-75.

Model(s) Reviewed: Child Parent Enrichment Project (CPEP)
Additional Sources:

WWHV014689

Barth, R. P., Hacking, S., & Ash, J. R. (1988). Preventing child abuse: An experimental evaluation of the Child Parent Enrichment Project. Journal of Primary Prevention, 8(4), 201-217.
Study Screening Details
Screening Decision Screening Conclusion
Study passes screens Study Passes Screens
Study Design Details
Rating Design Attrition Baseline Equivalence Reassignment Confounding Factors
Moderate Randomized controlled trial Not applicable Established on race and socioeconomic status Yes None
Notes:

footnote149

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

Mothers in the <abbr title="Child Parent Enrichment Project">CPEP</abbr> group who refused services or received fewer than five home visits were reassigned to the control group. Thus, we treat the study as a quasi-experimental design for purposes of the review, and an evaluation of attrition does not apply. The moderate rating applies to outcomes that were not assessable at baseline (health habits during pregnancy, child health, child development, and reductions in child maltreatment); those outcomes that could be measured at baseline (parent well-being and parent support) but were not controlled in the analysis receive a low rating.

Study Characteristics
Study Participants Expectant mothers deemed at-risk for child abuse were referred to the study team by service providers in public health, education, and social services. Eligible mothers who expressed interest in the program were randomly assigned to either CPEP or a no-treatment control group. Random assignment occurred before the formal initial assessment interview by the CPEP team. Mothers in the CPEP group who refused services or received fewer than five home visits were reassigned to the control group. The analysis sample for the study included 97 mothers in the CPEP group and 94 mothers in the control group. The ethnic composition of the combined groups was 45 percent Caucasian, 17 percent African American, 31 percent Hispanic, and 7 percent of other or multiple races. Four in 10 mothers in the sample were on Aid to Families with Dependent Children, and 70 percent had incomes of less than $10,000. On average, mothers were 5.7 months pregnant when they began the program; 56 percent had at least one additional child at enrollment.
Setting The study was conducted in Contra Costa County, California.
Home Visiting Services CPEP clients received on average 11 home visits over the course of the six-month study, with a range of 5 to 20 visits. Paraprofessionals, known as parenting consultants, administered the intervention. Home visits were centered around task lists created by mothers in conjunction with the parenting consultant. Tasks might be completed by the mother alone, the parenting consultant alone, or together. Examples of tasks include visiting prenatal care or obtaining transportation.
Comparison Conditions Control group mothers received referrals to appropriate social and health services identified by the two-hour assessment interview.
Staff Characteristics and Training Parenting consultants were paraprofessionals working at service agencies in the community. They received more than 100 hours of training in topics such as child abuse (including reporting) and perinatal development.
Funding Sources Department of Health and Human Services, Office of Human Development Services, Administration on Children, Youth, and Families, Grants 90-CA-0988 and 90-PJ-000101. Bio-Medical Research Support Grant, Grant 2-507-RR07006. National Institute of Health, Division of Research, State of California Office of Child Abuse Prevention, Grant CB 33015-AI.
Author Affiliation Richard Barth, the study author, developed CPEP and was involved in program implementation.

Study Effects Details

Outcome domain: Maternal Health Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Moderate Discomfort (birth outcome)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 1.31 Unadjusted mean = 1.36 Mean difference = -0.05 HomeVEE calculated = -0.14 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Moderate Eat bad
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 8.12 Unadjusted mean = 8.28 Mean difference = -0.16 HomeVEE calculated = -0.06 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Moderate Eat right
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 6.21 Unadjusted mean = 6.10 Mean difference = 0.11 HomeVEE calculated = 0.04 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Moderate Hospital stay
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 8.41 Unadjusted mean = 9.80 Mean difference = -1.39 HomeVEE calculated = -0.33 Statistically significant, p = 0.02 Secondary

footnote150

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

High score equals unfavorable.

Moderate Pregnancy problems
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 1.49 Unadjusted mean = 1.36 Mean difference = 0.13 HomeVEE calculated = 0.12 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Moderate Prenatal care
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 9.90 Unadjusted mean = 9.73 Mean difference = 0.17 HomeVEE calculated = 0.05 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Moderate Worries (birth outcome)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 25.04 Unadjusted mean = 24.19 Mean difference = 0.85 HomeVEE calculated = 0.12 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Outcome domain: Child Health Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Moderate Baby care (child welfare)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 7.43 Unadjusted mean = 7.09 Mean difference = 0.34 HomeVEE calculated = 0.09 Not statistically significant, p > 0.05 Secondary
Moderate Birthweight (grams)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean 3,396 = 3396.00 Unadjusted mean = 3255.00 Mean difference = 141.00 HomeVEE calculated = 0.21 Not statistically significant, p > 0.05 Secondary
Moderate Emergency (child welfare)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 1.44 Unadjusted mean = 1.44 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Moderate Health (child welfare)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 5.62 Unadjusted mean = 5.43 Mean difference = 0.19 HomeVEE calculated = 0.06 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Outcome domain: Child Development and School Readiness Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Moderate Activity (ITQ subscale)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 48.05 Unadjusted mean = 50.19 Mean difference = -2.13 HomeVEE calculated = -0.23 Not statistically significant, p > 0.05 Primary

footnote150

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

High score equals unfavorable.

Moderate Distractibility (ITQ subscale)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 24.11 Unadjusted mean = 24.59 Mean difference = -0.48 HomeVEE calculated = -0.07 Not statistically significant, p > 0.05 Primary

footnote150

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

High score equals unfavorable.

Moderate Mood (ITQ subscale)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 22.05 Unadjusted mean = 23.91 Mean difference = -1.86 HomeVEE calculated = -0.39 Statistically significant, p = 0.01 Primary

footnote150

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

High score equals unfavorable.

Outcome domain: Reductions in Child Maltreatment Outcome Effects
Rating Outcome Measure Effect Sample Timing of Follow-up Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Moderate Need care (child welfare)
FavorableUnfavorableNo Effect
Reassigned sample 6 months 191 mothers Unadjusted mean = 2.08 Unadjusted mean = 2.06 Mean difference = 0.02 HomeVEE calculated = 0.07 Not statistically significant, p > 0.05 Secondary

footnote150

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

High score equals unfavorable.

Study Outcome Measure Summary

Outcome Domain: Maternal Health Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
Moderate

Discomfort (birth outcome)

The difference between mother's expected discomfort during pregnancy and labor and what she actually experienced. Parent/caregiver report

Not applicable

Secondary
Moderate

Eat bad

The frequency with which mothers ingested unhealthy items such as tobacco, alcoholic or caffeinated drinks, chips, and nonprescription drugs during pregnancy. Parent/caregiver report

Not applicable

Secondary
Moderate

Eat right

The frequency with which mothers followed a healthy diet during pregnancy. Parent/caregiver report

Not applicable

Secondary
Moderate

Hospital stay

The number of days the mother and her newborn were in the hospital around the time of delivery. Parent/caregiver report

Not applicable

Secondary
Moderate

Pregnancy problems

The number of events that occurred during delivery such as drug treatment, use of forceps, episiotomy, cesarean section, induced labor, and breech delivery. Parent/caregiver report

Not applicable

Secondary
Moderate

Prenatal care

The number of prenatal visits mothers had during their second and third trimesters. Parent/caregiver report

Not applicable

Secondary
Moderate

Worries (birth outcome)

The worries scale assesses a mother's level of concern regarding being able to care for her newborns. The scale addresses issues such as feeding and caring for a sick child, and paying bills. Items were coded on a 4-point scale. Parent/caregiver report

Not applicable

Secondary
Outcome Domain: Child Health Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
Moderate

Baby care (child welfare)

The number of doctors visits for well baby care and vaccinations. Parent/caregiver report

Not applicable

Secondary
Moderate

Birthweight (grams)

The infant’s reported birth weight in grams. Parent/caregiver report

Not applicable

Secondary
Moderate

Emergency (child welfare)

The number of times an infant was taken to the emergency department. Parent/caregiver report

Not applicable

Secondary
Moderate

Need care (child welfare)

The number of mothers whose child was removed from her care by a police office or social worker or was cared for by a neighbor as a result of the mother's neglect. Parent/caregiver report

Not applicable

Secondary
Outcome Domain: Child Development and School Readiness Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
Moderate

Infant Temperament Questionnaire (ITQ)

The Infant Temperament Questionnaire assesses a child's temperament. The researchers examined the following three subscales: level of activity, mood, and distractibility.

Parent/caregiver report

Not reported by author

Primary
Outcome Domain: Reductions in Child Maltreatment Outcome Measures
Rating Outcome Measure Description of measure Data collection method Properties of measure Outcome Type
Moderate

Health (child welfare)

The rating from minor to serious of eight common medical conditions (e.g., virus, rash, diarrhea) that the infant experienced. Parent/caregiver report

Not applicable

Secondary