Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT)

MODEL
EFFECTIVENESS

Evidence-based model

MIECHV eligible

13
Manuscripts

Released in 2002 through 2025

7
Manuscripts

Impact studies rated high or moderate quality

Services intended at ages
0-6 months
7-11 months
12-23 months
24-35 months
Favorable results from well-designed research
Child development and school readiness
Child health
Positive parenting practices

Skip to:  

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) model was designed to prevent rapid infant weight gain and childhood obesity. The model encouraged mothers to notice and respond promptly and appropriately to their child’s cues.

INSIGHT served first-time mothers and their infants from birth until age 30 months. Mothers who participated in the model received four home visits in the child’s first year. Between ages 12 and 30 months, mothers and infants had two clinic visits and two telephone contacts. Mothers received guidance on responsive feeding, sharing feeding responsibilities with other caregivers, and making healthy dietary choices to prevent obesity. They also received guidance on supporting healthy sleep habits, active social play, and fussiness, including strategies to soothe the child.

Where to find out more

Effectiveness

This model meets criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.

Does not meet criteria for an evidence-based home visiting model for Native communities.

Extent of Evidence

For more information about manuscripts, search the research database.

For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.

13
Manuscripts

Released in 2002 through 2025

9
Manuscripts

Eligible for review

7
Manuscripts

Impact studies rated high or moderate quality

When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

Summary of Findings

To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.

Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.

No effect:
Findings are not statistically significant.

Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.

Ambiguous findings are excluded from this table. An ambiguous finding is a statistically significant impact on an outcome measure in a direction that is not clearly beneficial for or potentially harmful to children and/or parents.

Outcomes Manuscripts Favorable Findings No Effects Findings Unfavorable Findings
Child Development and School Readiness View 3 Manuscripts 6 11 0
Child Health View 3 Manuscripts 6 33 0
Family Economic Self-Sufficiency Not measured - - -
Linkages and Referrals Not measured - - -
Maternal Health Not measured - - -
Positive Parenting Practices View 2 Manuscripts 15 38 2
Reductions In Child Maltreatment Not measured - - -
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured - - -

Research Characteristics

Well-designed impact studies about this model included participants with the following characteristics. The evidence for effectiveness for the model may include additional studies that did not report this participant information.

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

American Indian or Alaska Native
<1%
Asian
3%
Black or African American
5%
Hispanic or Latino
6%
Native Hawaiian or Pacific Islander
<1%
White
90%
Some other race
1%
Two or more races
<1%
Unknown
1%

Maternal Education

High school diploma or GED
1%
Some college or Associate's degree
21%
Bachelor's degree or higher
66%
Unknown
11%

Other Characteristics

This data is only reported if known for at least 50 percent of participants in well-designed impact studies of the model.

Native population
<1%

Well-designed impact studies about this model were conducted in the following locations:

  • Pennsylvania

Implementation

In this section:

Overview

Theoretical approach, intended population, and targeted outcomes.

Skip to section

Support Availability

Skip to section

Service Delivery

Model services, adaptions and enhancements, model intensity and length.

Skip to section

Requirements

Staffing and organizational requirements.

Skip to section

Overview

Theoretical approach

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) model was implemented from 2012 to 2017 to prevent rapid infant weight gain and childhood obesity. The model was based on research on responsive parenting—meaning that caregivers respond appropriately to an infant’s emotional and physical cues. INSIGHT emphasized responsive feeding, teaching caregivers to respond to an infant’s hunger and fullness signals. This approach promoted eating in response to physical needs and may have helped children develop self-regulation around food.

Intended population

INSIGHT served first-time mothers and their infants from birth until age 30 months.

Intended outcomes

The model was designed to prevent obesity in children at age 36 months by promoting developmentally appropriate and timely responses to a child’s cues and needs. Specifically, INSIGHT was designed to meet the following objectives: 

  • Help mothers use responsive feeding practices 
  • Reduce mothers’ use of food to soothe infants, and encourage them to use other soothing strategies for fussy infants 
  • Help mothers make healthy dietary choices for their children 
  • Decrease the amount of time infants spend fussing or crying 
  • Help infants sleep longer and wake up at night less often 
  • Reduce infants’ screen time
  • Increase the amount of time mothers and children spend in interactive play 
  • Improve mothers’ confidence in their parenting skills and satisfaction with their role as a parent 
  • Improve long term outcomes, such as increasing children’s physical activity, sleep, and self-regulation as they enter middle school.

Highlights

Populations intended
Families with low-income
Services intended at ages
0-6 months
7-11 months
12-23 months
24-35 months

Support Availability

Implementation support availability

INSIGHT was tested with a prospective, randomized controlled trial led by researchers from Penn State College of Medicine and Penn State College of Health and Human Development. The information in this profile reflects how the model was implemented during the trial. 

Support for implementing the model may be available upon request to the model developers.

Highlights

Locations where model has been implemented
Within the U.S.

Service Delivery

Model services

INSIGHT was a model designed to help mothers understand and respond to their child’s needs in the early stages of development. The model focused on helping caregivers recognize their child’s cues and respond to their child’s needs across four behavioral states: (1) drowsy, (2) sleeping, (3) fussy, and (4) alert (interactive play and feeding). 

Families received materials and coaching early in the program, followed by a series of home visits, clinic visits, and phone contacts from birth through early childhood. Through these interactions, home visitors provided guidance on feeding, sleep, emotional regulation, and play. Home visitors taught caregivers how to read growth patterns and encouraged them to use consistent routines, respond to hunger and fullness cues, promote healthy sleep habits, and engage in developmentally appropriate play. 

Home visitors delivered a structured, age-appropriate curriculum that relied on facilitator guides and handouts to ensure consistent implementation across visits.

Model intensity and length

Home visiting requirements: 

INSIGHT included four home visits during the child’s first year, at the ages of about 3 to 4 weeks, 16 weeks, 28 weeks, and 40 weeks. Home visits typically lasted 60 minutes. 

Additional requirements: 

In addition to home visits, mothers participated in two clinic visits when the child was 12 months old and 24 months old. These visits typically lasted 30 minutes. Mothers also participated in two telephone contacts when the child was age 18 months and age 30 months, which typically lasted about 20 minutes. 

Service duration: 

The model provided services from the child’s birth until age 30 months.

Tailored services and enhanced models

As part of the Early Intervention to Promote the Cardiovascular Health of Mothers and Children (ENRICH) consortium trial, researchers are testing a modified version of INSIGHT’s content that can be added to other home visiting models to promote cardiovascular health. 

HomVEE has not reviewed research about ENRICH. For more information, please contact the model developer.

Implementation with Indigenous peoples and communities

The model was not implemented with Native communities.

Highlights

Maximum program duration
More than one year up to three years
Visit frequency
Visit frequency varies
Delivery method supported
Supports hybrid in-person and virtual service delivery

Requirements

Staffing requirements

Education and supervisory requirements:

Staff education and experience. Nurses implemented the model under the supervision of the model development team, whose members held at least master’s degrees.

Supervision. Supervisors monitored nurses’ fidelity to the model. Ongoing supervision used multiple modalities, including:

  • Real-time answers to questions 
  • Recording visits (with participant consent) to assess fidelity to the model 
  • Reviewing participant surveys to ensure content was delivered as intended 
  • Providing and reviewing nurse checklists for delivering the content 

Training and professional development 

Pre-service training. The model development team provided in-person training for the nurses. Please contact the model developer for additional information about the pre-service training requirement. 

Ongoing professional development. Please contact the model developer for additional information about the ongoing professional development requirement.

Organizational requirements

The model development team does not have recommendations or requirements regarding the types or characteristics of organizations that can implement the intervention.

Home visitors were required to meet a set of ongoing fidelity guidelines. Please contact the model developer for additional information about these guidelines.

Highlights

Minimum education requirement
Associate’s degree
Professional certification required for home visitors
Yes

HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer. HomVEE reserves the right to edit the profile for clarity and consistency. The description of the implementation of the model here may differ from how the model was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.