| Screening decision | Screening conclusion |
|---|---|
| Passes screens | Eligible for review |
| Rating | Design | Attrition | Baseline equivalence | Reassignment | Confounding factors |
|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | Low | Established on race/ethnicity; not established on SES; outcome measures not assessable at baseline | No | None |
Equivalence on race/ethnicity established using data from Dodge, K.A., Goodman, W.B., Murphy, R.A., O'Donnell, K., Sato, J. & Guptill, S. (2013). "Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting." American Journal of Public Health, published online ahead of print. Both articles used the same sample.
| Study participants | Among 4,777 residential births from July 1, 2009, through December 31, 2010, the authors randomly selected one family with a birth on each even day to receive Durham Connects, and one family with a birth on each odd day to be followed as the control group. If those selected did not consent to be studied, the authors replaced them with a randomly selected family from the same birth date with the same race/ethnicity. Among the 664 families enrolled in the study, 531 participated in follow-up data collection. Participating families were approximately one-quarter non-Hispanic white, 40 percent black, one-quarter Hispanic, and 9 percent were another race or ethnicity. Mothers were about 28 years old on average. Control group babies had slightly worse birth outcomes (on average) than control group babies. Eight percent of control group babies had a birth complication, whereas only 4 percent of Durham Connects babies had a birth complication (a statistically significant difference, p less than 0.05). |
|---|---|
| Setting | Durham, North Carolina |
| Intervention services | Durham Connects' services consist of a total of four to seven contacts: a contact at the birthing hospital, one to three nurse home visits when infants are age 3 to 12 weeks, one or two nurse contacts with a community service provider, and a telephone or in-person follow-up contact one month later. |
| Comparison conditions | Families in the comparison condition could receive other services in their community, but were not eligible to receive Durham Connects services. |
| Staff characteristics and training | Nurses deliver Durham Connects according to manualized procedures. An independent expert accompanied the nurses to observe adherence to the intervention protocol at a random selection of 7 percent of home visits. |
| Funding sources | The Duke Endowment, the Pew Center on the States, NIH Grants K05DA15226, P30DA023026, and HD069981 |
| Author affiliation | The authors are affiliated with the Center for Child and Family Policy at Duke University, which sponsors Durham Connects. |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | No. of emergency department visits, birth to 12 months (hospital records) | FavorableUnfavorable or ambiguousNo Effect |
Interviewed subsample, 7/2009-12/2010 births | birth to 12 months | 531 families | Unadjusted mean = 0.68 | Unadjusted mean = 0.83 | Mean difference = -0.15 | Not available | Not statistically significant, p = 0.22 |
|
| Moderate | No. of overnights in hospital, birth to 12 months (hospital records) | FavorableUnfavorable or ambiguousNo Effect |
Interviewed subsample, 7/2009-12/2010 births | birth to 12 months | 531 families | Unadjusted mean = 0.11 | Unadjusted mean = 0.74 | Mean difference = -0.63 | Study reported = 0.27 | Statistically significant, p<0.001 | |
| Moderate | No. of total emergency medical care episodes, 6 to 12 months (hospital records) | FavorableUnfavorable or ambiguousNo Effect |
Interviewed subsample, 7/2009-12/2010 births | 6 to 12 months | 531 families | Unadjusted mean = 0.36 | Unadjusted mean = 0.52 | Mean difference = -0.16 | Study reported = 0.14 | Statistically significant, p = 0.03 |
|
| Moderate | No. of total emergency medical care episodes, birth to 12 months (hospital records) | FavorableUnfavorable or ambiguousNo Effect |
Interviewed subsample, 7/2009-12/2010 births | birth to 12 months | 531 families | Unadjusted mean = 0.78 | Unadjusted mean = 1.57 | Mean difference = -0.79 | Study reported = 0.28 | Statistically significant, p<0.001 |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
No. of emergency department visits, birth to 12 months (hospital records) |
Number of ED visits since initial hospital discharge | Hospital records | Not applicable |
No. of emergency department visits, birth to 12 months (hospital records) |
Number of ED visits since initial hospital discharge | Hospital records | Not applicable |
No. of emergency department visits, birth to 12 months (hospital records) |
Number of ED visits since initial hospital discharge | Hospital records | Not applicable |
No. of overnights in hospital, birth to 12 months (hospital records) |
Number of hospital overnights, excluding overnights for birth-related medical care | Hospital records | Not applicable |
