Manuscript Detail

View Revisions

Carta, J. J., Lefever, J. B., Bigelow, K., Borkowski, J., & Warren, S. F. (2013). Randomized trial of a cellular-phone enhanced home visitation parenting intervention. Pediatrics, 132(2), S167–S173.

Model(s) Reviewed: SafeCare/Cellular Phone Enhanced Planned Activities Training Module , SafeCare/Planned Activities Training Module
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, socioeconomic status, and baseline outcomes None None
Study characteristics
Study participants Mothers with a child age 3.5 to 4.5 years old were recruited from community health, early education, and social service agencies serving low-income families in metropolitan South Bend, Indiana, and metropolitan Kansas City, Missouri. Eligible mothers had at least one of the following risk factors for child maltreatment: age younger than 18 years at first child’s birth, having less than a high school diploma or equivalent, receiving financial assistance, or meeting the income eligibility requirement for Head Start or the Special Supplemental Program for Women, Infants, and Children (WIC). The study included two intervention groups; one received Planned Activities Training, a module of SafeCare; the other received Cellular Phone Enhanced Planned Activities Training, which provided mothers with a cellular phone to receive contacts from staff in addition to normal Planned Activities Training services. The authors compared both Planned Activities Training and Cellular Phone Enhanced Planned Activities Training with the control group, as well as the two intervention conditions with each other. In total, 371 mothers were randomly assigned (Planned Activities Training, n= 142; Cellular Phone Enhanced Planned Activities Training, n = 113; control, n = 116). The authors used multiple imputation to account for missing values. Mothers self-identified as belonging to the following ethnic groups: 46% Hispanic; 33% African-American, 17% European American; and 4% mixed race or other. Estimated annual mean family earnings were $18,608 (SD = 15,835).
Setting This study took place in metropolitan South Bend, Indiana and Kansas City, Missouri.
Intervention services Planned Activities Training is the parent training module of SafeCare. In the present study, mothers received services during five home visiting sessions, focusing on responsive parenting strategies with skills such as engaging in positive interactions, establishing rules and limits, and providing feedback. The cellular phone add-on of Cellular Phone Enhanced Planned Activities Training was used to promote client engagement and to provide encouragement and skill reinforcement via text messages and phone calls.
Comparison conditions The control group received no additional services during the study. Members of the control group were placed on the program wait list and were offered services at the conclusion of the study.
Staff characteristics and training Planned Activities Training and Cellular Phone Enhanced Planned Activities Training services were delivered by a “family coach,” a research staff member with at least a bachelor’s degree.
Funding sources Supported by Cooperative Agreement U49 CE 001070-0 from the Violence Prevention Branch of the U.S. Centers for Disease Control and Prevention; and co-sponsored by the CDC Foundation, the Doris Duke Charitable Foundation, the Health Care Foundation of Greater Kansas City, the AT&T Foundation, and the Sprint 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
High Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Adaptive Behaviors
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 229 mothers Adjusted mean = 53.59 Adjusted mean = 48.28 Mean difference = 2.95 Study reported = 0.29 Statistically significant, p ≤ 0.05
High Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Externalizing Behaviors
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 229 mothers Adjusted mean = 47.73 Adjusted mean = 49.85 Mean difference = -2.17 HomeVEE calculated = -0.21 Not statistically significant, p ≥ 0.05
High Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Internalizing Behaviors
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 229 mothers Adjusted mean = 48.48 Adjusted mean = 49.21 Mean difference = -2.27 HomeVEE calculated = -0.07 Not statistically significant, p ≥ 0.05
High Child Behavior Rating Scale (CBRS)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 229 mothers Adjusted mean = 4.45 Adjusted mean = 4.23 Mean difference = 0.27 Study reported = 0.43 Statistically significant, p ≤ 0.001
High Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Adaptive Behaviors
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 258 mothers Adjusted mean = 50.27 Adjusted mean = 48.28 Mean difference = 0.77 HomeVEE calculated = 0.18 Not statistically significant, p ≥ 0.05
High Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Externalizing Behaviors
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 258 mothers Adjusted mean = 48.96 Adjusted mean = 49.85 Mean difference = -1.44 HomeVEE calculated = -0.09 Not statistically significant, p ≥ 0.05
High Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Internalizing Behaviors
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 258 mothers Adjusted mean = 50.60 Adjusted mean = 49.21 Mean difference = -0.55 HomeVEE calculated = 0.13 Not statistically significant, p ≥ 0.05
High Child Behavior Rating Scale (CBRS)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 258 mothers Adjusted mean = 4.33 Adjusted mean = 4.23 Mean difference = 0.18 Study reported = 0.29 Statistically significant, 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
High Beck Depression Inventory-II (BDI-II)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 221 mothers Adjusted mean = 6.12 Adjusted mean = 8.25 Mean difference = -2.52 Study reported = 0.31 Statistically significant, p ≤ 0.05

footnote162

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

Negative value is favorable to the intervention.

High Beck Depression Inventory-II (BDI-II)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control Posttest 224 mothers Adjusted mean = 7.52 Adjusted mean = 8.70 Mean difference = -1.59 HomeVEE calculated = -0.17 Not statistically significant, p ≥ 0.05
High Mild to severe depression
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control Posttest 224 mothers Not available Not available Not Reported Not available Statistically significant, p = 0.05

footnote162

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

Negative value is favorable to the intervention.

High Mild to severe depression
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 221 mothers Not available Not available Not Reported Not available Statistically significant, p = 0.04

footnote162

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

Negative value is favorable to the intervention.

High Parenting Stress Index-Short Form (PSI-SF)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control Posttest 229 mothers Adjusted mean = 68.91 Adjusted mean = 73.33 Mean difference = -5.61 Study reported = 0.27 Statistically significant, p ≤ 0.05

footnote162

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

Negative value is favorable to the intervention.

High Beck Depression Inventory-II (BDI-II)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control Posttest 251 mothers Adjusted mean = 7.88 Adjusted mean = 8.70 Mean difference = -1.27 HomeVEE calculated = 0.11 Not statistically significant, p ≥ 0.05
High Beck Depression Inventory-II (BDI-II)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 249 mothers Adjusted mean = 8.37 Adjusted mean = 8.25 Mean difference = -0.50 HomeVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
High Mild to severe depression
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control Posttest 251 mothers Percentage = 0.05 Not available Not Reported Not available Not statistically significant, p ≥ 0.05
High Mild to severe depression
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 249 mothers Not available Not available Not Reported Not available Not statistically significant, p ≥ 0.05
High Parenting Stress Index-Short Form (PSI-SF)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control Posttest 258 mothers Adjusted mean = 72.30 Adjusted mean = 73.33 Mean difference = -2.78 HomeVEE calculated = -0.05 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
High Keys to Interactive Parenting Scale (KIPS)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control Posttest 229 mothers Adjusted mean = 3.99 Adjusted mean = 3.48 Mean difference = 0.51 Study reported = 0.78 Statistically significant, p ≤ 0.01
High Keys to Interactive Parenting Scale (KIPS)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 229 mothers Adjusted mean = 3.83 Adjusted mean = 3.54 Mean difference = 0.30 Study reported = 0.46 Statistically significant, p ≤ 0.01
High Positive Behavior Support (Planned Activities Training Checklist)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control Posttest 229 mothers Adjusted mean = 0.55 Adjusted mean = 0.37 Mean difference = 0.18 Study reported = 1.13 Statistically significant, p ≤ 0.01
High Positive Behavior Support (Planned Activities Training Checklist)
FavorableUnfavorable or ambiguousNo Effect
Cellular Phone Enhanced Planned Activities Training vs. Control 6 months 229 mothers Adjusted mean = 0.47 Adjusted mean = 0.38 Mean difference = 0.09 Study reported = 0.56 Statistically significant, p ≤ 0.01
High Keys to Interactive Parenting Scale (KIPS)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control Posttest 258 mothers Adjusted mean = 3.97 Adjusted mean = 3.48 Mean difference = 0.40 Study reported = 0.62 Statistically significant, p ≤ 0.01
High Keys to Interactive Parenting Scale (KIPS)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 258 mothers Adjusted mean = 3.82 Adjusted mean = 3.54 Mean difference = 0.22 Study reported = 0.34 Statistically significant, p ≤ 0.05
High Positive Behavior Support (Planned Activities Training Checklist)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control Posttest 258 mothers Adjusted mean = 0.51 Adjusted mean = 0.37 Mean difference = 0.13 Study reported = 0.81 Statistically significant, p ≤ 0.01
High Positive Behavior Support (Planned Activities Training Checklist)
FavorableUnfavorable or ambiguousNo Effect
Planned Activities Training vs. Control 6 months 258 mothers Adjusted mean = 0.45 Adjusted mean = 0.38 Mean difference = 0.07 Study reported = 0.44 Statistically significant, p ≤ 0.05

Outcome measure summary

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

Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Adaptive Behaviors

Mean score on the BASC-2-PRS, adaptive behaviors

Parent/caregiver report

Internal consistency reliability for the age of interest ranged from 0.85 to 0.93; test-retest reliability ranged from 0.81 to 0.86.

Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Externalizing Behaviors

Mean score on the BASC-2-PRS, externalizing behaviors

Parent/caregiver report

Internal consistency reliability for the age of interest ranged from 0.85 to 0.93; test-retest reliability ranged from 0.81 to 0.86.

Behavior Assessment Scale for Children-2-Parent Report Scale (BASC-2-PRS) - Internalizing Behaviors

Mean score on the BASC-2-PRS, internalizing behaviors

Parent/caregiver report

Internal consistency reliability for the age of interest ranged from 0.85 to 0.93; test-retest reliability ranged from 0.81 to 0.86.

Child Behavior Rating Scale (CBRS)

Mean CBRS score; CBRS was a 5-point scale used to rate five dimensions of children’s positive engagement and responsiveness during parent-child interactions.

Child assessment

Internal consistency = 0.81

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

Beck Depression Inventory-II (BDI-II)

Mean score on BDI-II; BDI-II was used to assess depressive mood and somatic complaints.

Parent/caregiver report

internal consistency coefficients ranged from 0.92 to 0.93

Mild to severe depression

Percentage of mothers exhibiting mild to severe depression on the BDI-II

Parent/caregiver report

internal consistency coefficients ranged from 0.92 to 0.93

Parenting Stress Index-Short Form (PSI-SF)

PSI -SF14 was used to assess maternal parenting stress.

Parent/caregiver report

Internal consistencies were very good to excellent

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

Keys to Interactive Parenting Scale (KIPS)

Mean score on KIPS; KIPS rated the quality of interactions between mothers and the target children. Parenting behaviors were rated on a 5-point scale along 12 dimensions.

Observational assessment

Interrater reliability coefficients ranged from 0.90 to 0.96 and the items have a high internal consistency reliability (a = 0.89).

Positive Behavior Support (Planned Activities Training Checklist)

Mean percentage of parenting strategies properly employed, as measured by the Planned Activities Training Checklist

Observational assessment

Not reported by authors