Manuscript Details

Lee, H., Crowne S., Estarziau M., Kranker K., Michalopoulos C., Warren A., Mijanovich T., Filene J. H., Duggan A., and Knox V. (2019). The Effects of Home Visiting on Prenatal Health, Birth Outcomes, and Health Care Use in the First Year of Life, Final Implementation and Impact Findings from the Mother and Infant Home Visiting Program Evaluation-Strong Start (OPRE Report, 2019-08). [Study 2-HFA contrast]. Washington, DC, Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov/sites/default/files/documents/opre/mihope_stron…

High rating
Study reviewed under: Handbook of Procedures and Standards, Version 2
Study design characteristics contributing to rating
Design Attrition Baseline equivalence Confounding factors? Valid, reliable measures?
Randomized controlled trial Low

Not assessed for randomized controlled trials with low attrition

No

Yes

Notes from the review of this manuscript

The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) included two evidence-based home visiting models; this review focuses on Healthy Families America (HFA). Findings in the manuscript that are pooled across various home visiting models are ineligible for review because HomVEE only reviews findings that isolate the effects of a specific model. Information on sample sizes, further information about findings, and information necessary to demonstrate equivalence of the intervention and comparison groups is based on correspondence with the authors.

Child Health
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
Admitted to neonatal intensive care unit (%) Birth High
Not statistically significant, p= 0.44 1036 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Any emergency department visits (%) 12 months old High
Not statistically significant, p= 0.96 1036 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Any nonbirth hospitalizations (%) 12 months old High
Not statistically significant, p= 0.16 1036 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Average number of well-child office visits 12 months old High
Not statistically significant, p= 0.39 1036 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Infant was breastfed at hospital discharge (%) Birth High
Not statistically significant, p= 0.32 807 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Low birth weight (< 2,500 grams) (%) Birth High
Not statistically significant, p= 0.51 935 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Preterm birth (< 37 weeks) (%) Birth High
Not statistically significant, p= 0.68 935 infants HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Maternal Health
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
Any smoking during third trimester (%) Birth High
Not statistically significant, p= 0.31 848 mothers HFA vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant

This study included participants with the following characteristics at enrollment:

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.

Black or African American
28%
Hispanic or Latino
33%
White
30%
Unknown
9%

Maternal Education

Less than a high school diploma
36%
High school diploma or GED
38%
Unknown
26%

Other Characteristics

Enrollment in means-tested programs
88%

This study included participants from the following locations:

  • California
  • Georgia
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Massachusetts
  • Michigan
  • Nevada
  • New Jersey
  • New York
  • North Carolina
  • Pennsylvania
  • South Carolina
  • Tennessee
  • Washington
  • Wisconsin
Study Participants

The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) is a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program for families enrolled in Medicaid or the Children’s Health Insurance Program. MIHOPE-Strong Start study participants were recruited from local programs that primarily served Medicaid beneficiaries from 2012 to 2015. Participants were eligible for the MIHOPE-Strong Start evaluation if they were no more than 32 weeks pregnant, were age 15 or older, spoke English or Spanish proficiently, and met the relevant eligibility criteria for the local home visiting model. A total of 1,028 participants were recruited for the study through Healthy Families America (HFA) programs and randomly assigned to either the HFA home visiting intervention group (569 participants) or the comparison condition (459 participants). Up to 848 participants recruited for the study through HFA programs were included in the analyses: 466 in HFA and 382 in the comparison group. Similarly, up to 1,036 children of these participants were included in the analyses: 575 in HFA and 461 in the comparison group. Outcomes were measured at childbirth and when children were 12 months old. For MIHOPE-Strong Start participants recruited through HFA programs, 18 percent of women were of Mexican origin, 15 percent were another Hispanic ethnicity, 30 percent were White, 28 percent were Black, and 9 percent were another race. Thirty-six percent had less than a high school diploma at study entry. At enrollment, the average age of participants recruited through HFA programs was 24.

Setting

The study took place in 17 states: California, Georgia, Illinois, Indiana, Iowa, Kansas, Massachusetts, Michigan, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Washington, and Wisconsin. The evaluation selected 37 local program affiliates that operated Healthy Families America (HFA) and met program eligibility criteria.

Intervention condition
Comparison Conditions

Women assigned to the comparison group were not eligible to receive Healthy Families America (HFA) services. They received information about other appropriate services in their local community.

Subgroups examined

There were no subgroups reported in this manuscript.

Author Affiliation

Authors are affiliated with MDRC and subcontractors James Bell Associates, Johns Hopkins University, Mathematica, and New York University. HomVEE is not aware of any relationship between the authors and the home visiting model developer or distributor.

Funding Sources

This research was supported by the Administration for Children and Families, funded by the U.S. Department of Health and Human Services under a competitive award, Contract No. HHS-HHSP23320095644WC.