Manuscript Details

Source

Peer reviewed?
No

Michalopoulos, C., Faucetta, K., Hill, C. J., Portilla, X., Burrell, L., Lee, H., Duggan, A., & Knox, V. (2019). Impacts on family outcomes of evidence-based early childhood home visiting: Results from the Mother and Infant Home Visiting Program Evaluation (OPRE Report 2019-07). [Study 3-NFP contrast]. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation. https://www.acf.hhs.gov/sites/default/files/documents/opre/mihope_impac….

Rating
High
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, and funded by the U.S. Department of Health and Human Services under a competitive award, Contract No. HHS-HHSP23320095644WC.

Study Design

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

The Mother and Infant Home Visiting Program Evaluation (MIHOPE) included four evidence-based home visiting models; this review focuses on the Nurse-Family Partnership and the findings in Michalopoulos et al. 2019. HomVEE has reviewed additional analyses from the MIHOPE evaluation in Knox & Michalopoulos, 2023. Findings in the manuscript that were pooled across various home visiting models were ineligible for review because HomVEE only reviews findings that isolate the effects of a specific model. Findings from the manuscript about quality of the home environment, receptive language skills, and child maltreatment outcomes related to physical assault or psychological aggression received a rating of indeterminate because HomVEE could not assess whether the measures were reliable according to HomVEE standards. Information on sample sizes and reliability and validity of measures is based on correspondence with the authors.

Study Participants

The Mother and Infant Home Visiting Program Evaluation (MIHOPE) is a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIHOPE study participants were recruited from 2012 to 2015. Participants were eligible for the MIHOPE evaluation if they were pregnant or had children younger than 6 months old, were age 15 or older at enrollment, spoke English or Spanish proficiently, and met the relevant eligibility criteria for the local home visiting model. A total of 1,235 participants were recruited for the study through Nurse-Family Partnership (NFP) programs were randomly assigned to either the NFP home visiting intervention group (615 participants) or the comparison condition (620 participants). Up to 911 participants recruited for the study through NFP programs were included in the analyses: 455 in NFP and 456 in the comparison group. Similarly, up to 1,113 children of these participants were included in the analyses: 554 in NFP and 559 in the comparison group. Outcomes were measured when children were 15 months old. For the MIHOPE participants recruited through NFP programs, 30 percent of participants were of Mexican origin, 18 percent were another Hispanic ethnicity, 17 percent were White, 24 percent were Black, and 10 percent were another race. Forty-one percent did not have a high school diploma at study entry. At enrollment, the average age of participants recruited through NFP programs was 21.

Setting

The study took place in 12 states: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. The evaluation selected 22 local program affiliates that operated Nurse-Family Partnership and met program eligibility criteria.

Home Visiting Services

As described in this manuscript, the Nurse-Family Partnership (NFP) intervention consists of activities designed to help participants obtain prenatal care, improve their diets, reduce their use of harmful substances, provide responsible and competent care for their children, plan future pregnancies, continue their education, and find work. The content and delivery of NFP vary, with flexibility of the visit, content, and frequency based on families’ strengths, risks, and needs. Participants enroll in NFP when they are no more than 28 weeks pregnant.  NFP participants in this evaluation enrolled before the end of the 28th week of pregnancy and were offered weekly visits during critical periods (for example, shortly after birth). Participants were offered NFP services through the child’s second birthday.

Comparison Conditions

Participants assigned to the comparison group were not eligible to receive Nurse-Family Partnership services. They received information about other appropriate services in their local community.

Were any subgroups examined?
No
Subgroups examined

There were no subgroups reported in this manuscript.

Findings that rate moderate or high in this manuscript

Maternal health
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description

New pregnancy after study entry, % (fixed effect random slope analysis)

15 months old

High

Not statistically significant, p= 0.97

903 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

New pregnancy after study entry, % (restricted maximum likelihood analysis)

15 months old

High

Not statistically significant, p= 0.98

903 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

New pregnancy after study entry, % (split-sample analysis)

15 months old

High 0.09

Not statistically significant, p= 0.40

903 mothers

NFP vs. Resource referral RCT (MIHOPE), 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
Family economic self-sufficiency
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description

Receiving education or training, % (fixed effect random slope analysis)

15 months old

High

Not statistically significant, p= 0.08

909 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Health insurance coverage for the child, % (fixed effect random slope analysis)

15 months old

High

Not statistically significant, p= 0.58

1113 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Receiving education or training, % (restricted maximum likelihood analysis)

15 months old

High

Not statistically significant, p= 0.15

909 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Health insurance coverage for the child, % (restricted maximum likelihood analysis)

15 months old

High

Not statistically significant, p= 0.65

1113 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Receiving education or training, % (split-sample analysis)

15 months old

High -0.12

Not statistically significant, p= 0.18

909 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Health insurance coverage for the child, % (split-sample analysis)

15 months old

High -0.17

Not statistically significant, p= 0.40

1113 children

NFP vs. Resource referral RCT (MIHOPE), 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
Positive parenting practices
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description

Three-Bag Task composite score of parental supportiveness (fixed effect random slope analysis)

15 months old

High 0.08

Not statistically significant, p= 0.40

723 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Three-Bag Task composite score of parental supportiveness (restricted maximum likelihood analysis)

15 months old

High 0.08

Not statistically significant, p= 0.41

723 mothers

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Three-Bag Task composite score of parental supportiveness (split-sample analysis)

15 months old

High 0.14

Statistically significant, p= 0.04

723 mothers

NFP vs. Resource referral RCT (MIHOPE), 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
Child health
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description

Number of Medicaid-paid well-child visits (fixed effect random slope analysis)

15 months old

High

Not statistically significant, p= 0.43

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Number of Medicaid-paid child emergency department visits (fixed effect random slope analysis)

15 months old

High

Statistically significant, p= 0.02

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Number of Medicaid-paid well-child visits (restricted maximum likelihood analysis)

15 months old

High

Not statistically significant, p= 0.45

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Number of Medicaid-paid child emergency department visits (restricted maximum likelihood analysis)

15 months old

High

Statistically significant, p= 0.03

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Number of Medicaid-paid well-child visits (split-sample analysis)

15 months old

High

Not statistically significant, p= 0.10

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Number of Medicaid-paid child emergency department visits (split-sample analysis)

15 months old

High

Statistically significant, p= 0.01

895 children

NFP vs. Resource referral RCT (MIHOPE), 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
Reductions in child maltreatment
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description

Any Medicaid-paid health care encounter for injury or ingestion, % (fixed effect random slope analysis)

15 months old

High

Not statistically significant, p= 0.42

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Any Medicaid-paid health care encounter for injury or ingestion, % (restricted maximum likelihood analysis)

15 months old

High

Not statistically significant, p= 0.35

895 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Any Medicaid-paid health care encounter for injury or ingestion, % (split-sample analysis)

15 months old

High -0.10

Not statistically significant, p= 0.29

895 children

NFP vs. Resource referral RCT (MIHOPE), 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
Child development and school readiness
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description

Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (fixed effect random slope analysis)

15 months old

High -0.12

Not statistically significant, p= 0.11

929 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (restricted maximum likelihood analysis)

15 months old

High -0.12

Not statistically significant, p= 0.16

929 children

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (split-sample analysis)

15 months old

High 0.02

Not statistically significant, p= 0.69

929 children

NFP vs. Resource referral RCT (MIHOPE), 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
23.90%
Hispanic or Latino
48.40%
White
17.30%
Unknown
10.40%

Maternal Education

Less than a high school diploma
41.40%
Unknown
58.60%

Other Characteristics

Enrollment in means-tested programs
57.50%