Manuscript Detail | Home Visiting Evidence of Effectiveness

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.

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	Not applicable	Established on race and socioeconomic status	Yes	None	Not assessed in manuscripts reviewed before 2021

Notes:

footnote149

Mothers in the CPEP 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.
Intervention 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.
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.
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.
Peer reviewed	Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

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	Activity (ITQ subscale)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 48.05	Unadjusted mean = 50.19	Mean difference = -2.13	HomVEE calculated = -0.23	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Distractibility (ITQ subscale)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 24.11	Unadjusted mean = 24.59	Mean difference = -0.48	HomVEE calculated = -0.07	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Mood (ITQ subscale)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 22.05	Unadjusted mean = 23.91	Mean difference = -1.86	HomVEE calculated = -0.39	Statistically significant, p = 0.01	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.

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	Baby care (child welfare)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 7.43	Unadjusted mean = 7.09	Mean difference = 0.34	HomVEE calculated = 0.09	Not statistically significant, p ≥ 0.05
Moderate	Birthweight (grams)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 3396.00	Unadjusted mean = 3255.00	Mean difference = 141.00	HomVEE calculated = 0.21	Not statistically significant, p ≥ 0.05
Moderate	Emergency (child welfare)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 1.44	Unadjusted mean = 1.44	Mean difference = 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Health (child welfare)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 5.62	Unadjusted mean = 5.43	Mean difference = 0.19	HomVEE calculated = 0.06	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.

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	Discomfort (birth outcome)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 1.31	Unadjusted mean = 1.36	Mean difference = -0.05	HomVEE calculated = -0.14	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Eat bad	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 8.12	Unadjusted mean = 8.28	Mean difference = -0.16	HomVEE calculated = -0.06	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Eat right	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 6.21	Unadjusted mean = 6.10	Mean difference = 0.11	HomVEE calculated = 0.04	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Hospital stay	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 8.41	Unadjusted mean = 9.80	Mean difference = -1.39	HomVEE calculated = -0.33	Statistically significant, p = 0.02	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Pregnancy problems	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 1.49	Unadjusted mean = 1.36	Mean difference = 0.13	HomVEE calculated = 0.12	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Prenatal care	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 9.90	Unadjusted mean = 9.73	Mean difference = 0.17	HomVEE calculated = 0.05	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.
Moderate	Worries (birth outcome)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 25.04	Unadjusted mean = 24.19	Mean difference = 0.85	HomVEE calculated = 0.12	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.

Reductions in child maltreatment
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Moderate	Need care (child welfare)	FavorableUnfavorable or ambiguousNo Effect	Reassigned sample	6 months	191 mothers	Unadjusted mean = 2.08	Unadjusted mean = 2.06	Mean difference = 0.02	HomVEE calculated = 0.07	Not statistically significant, p ≥ 0.05	footnote150 Submitted by user on Fri, 03/15/2019 - 14:29 High score equals unfavorable.