Koniak-Griffin, D., Verzemnieks, I. L., Anderson, N. L., Brecht, M. L., Lesser, J., Kim, S., et al. (2003). Nurse visitation for adolescent mothers: Two-year infant health and maternal outcomes. Nursing Research, 52(2), 127–136.
Model(s) Reviewed:
Early Intervention Program for Adolescent Mothers
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | High | Established on race/ethnicity, SES, and baseline outcomes. | None | None | Not assessed in manuscripts reviewed before 2021 |
| Study participants | Participants were recruited via referrals to a county public health department and assigned randomly to either the intervention or the comparison group. Initially 144 mothers were randomly assigned, 75 to the treatment group and 69 to the comparison group (information obtained from authors). At the two-year follow-up, 101 adolescent mothers participated in the study, 56 in the intervention group and 45 in the comparison group. Most were poor, unmarried, and expecting their first child. Mothers ranged in age from 14 to 19 years old at intake (26 weeks or less gestation). Sixty-two percent of the mothers were Latina, 13 percent were African American, and 18 percent were white. Participants were followed from pregnancy through two years postpartum. Note: This is a follow-up to Koniak-Griffin et al. (1999, 2000, 2002). |
|---|---|
| Setting | The study was conducted in San Bernardino County, California, a large, ethnically diverse county adjacent to Los Angeles. |
| Intervention services | The intervention included a combination of home visits and motherhood preparation classes, both conducted by specially trained public health nurses. The intervention began in mid-pregnancy and continued through the first year of the infant’s life. Participants received approximately 17 home visits by a public health nurse. Each visit lasted between two and two and a half hours. In addition, participants attended four “Preparation for Motherhood” classes lasting six hours each. In addition, The intervention covered five main content areas: (1) health, (2) sexuality and family planning, (3) life skills, (4) maternal role, and (5) social support systems. |
| Comparison conditions | Comparison group members received traditional public health nursing services, consisting of three home visits: one at intake, one for prenatal care, and one for postpartum/well-baby care information. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). Subgroups are not listed for manuscripts reviewed before 2021. |
| Funding sources | National Institutes of Nursing Research (NINR), Grants R0-1 NR02325 and NR02325-S1, and the Office of Research on Women’s Health, Grant NR02325-S2. Financial support for the second author was also provided by the NINR (5-T32-NR7077). |
| Author affiliation | The authors are developers of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Number of episodes of hospitalizations | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Number of episodes = 19.00 | Number of episodes = 36.00 | Difference = -17.00 | Not available | Statistically significant, p =0.002 | Statistical significance is based on the results of the authors’ analysis using a chi-square test.
|
| Moderate | Percentage never using the ER for child’s health problems | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Percentage = 0.36 | Mean % = 0.11 | Mean difference = 0.25 | HomVEE calculated = 0.92 | Statistically significant, p =0.004 | Statistical significance is based on the results of the authors’ analysis using a chi-square test.
|
| Moderate | Percentage of children hospitalized | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Percentage = 0.21 | Mean % = 0.36 | Mean difference = -0.15 | HomVEE calculated = -0.45 | Statistical significance not reported | |
| Moderate | Percentage using both ER and hospital | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Percentage = 0.21 | Mean % = 0.36 | Mean difference = -0.15 | HomVEE calculated = -0.45 | Statistical significance not reported | |
| Moderate | Total number of ER visits | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Not available | Not available | Not reported | Not available | Not statistically significant, p ≥ 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
|
| Moderate | Total number of days for nonbirth-related infant hospitalizations | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Number of days = 143.00 | Number of days = 211.00 | Difference = -68.00 | Not available | Statistically significant, p < 0.001 | Statistical significance is based on the results of the authors’ analysis using a chi-square test.
|
| Moderate | Number of episodes of hospitalization per hospitalized child | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample, hospitalized children | Two years postpartum | 28 children | Mean = 1.58 | Mean = 2.19 | Mean difference = -0.61 | HomVEE calculated = -0.14 | Statistical significance not reported | |
| Moderate | Percentage of children adequately immunized | FavorableUnfavorable or ambiguousNo Effect |
San Bernardion sample | Two years postpartum | 101 mothers | Percentage = 0.77 | Mean % = 0.87 | Mean difference = -0.10 | HomVEE calculated = -0.42 | Not statistically significant, p > 0.5 | In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p = 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques, such as regression models or analyses of variance (ANOVA), to determine statistical significance. |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | External social competence | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Mean = 82.96 | Mean = 82.57 | Mean difference = 0.39 | HomVEE calculated = 0.06 | Not statistically significant, p ≥ 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
Information on outcomes was received through communication with the authors.
|
| Moderate | Internal social competence | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Mean = 71.86 | Mean = 69.56 | Mean difference = 2.30 | HomVEE calculated = 0.29 | Not statistically significant, p =0.057 | Information on outcomes was received through communication with the authors.
Statistical significance is based on the results of the authors’ analysis using repeated-measures ANOVA.
|
| Moderate | Repeat pregnancy rate | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample | Two years postpartum | 101 mothers | Percentage = 0.32 | Mean % = 0.47 | Mean difference = -0.15 | HomVEE calculated = -0.38 | Not statistically significant, p ≥ 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | NCAST child’s score | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample, NCAST sample | Two years postpartum | 90 mothers | Not available | Not available | Not reported | Not available | Not statistically significant, p ≥ 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
|
| Moderate | NCAST mother’s score | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample, NCAST sample | Two years postpartum | 90 mothers | Not available | Not available | Not reported | Not available | Not statistically significant, p ≥ 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
|
| Moderate | NCAST total score | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample, NCAST sample | Two years postpartum | 90 mothers | Mean = 51.67 | Mean = 52.61 | Mean difference = -0.94 | HomVEE calculated = -0.22 | Not statistically significant, p ≥ 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
Information on outcomes was received through communication with the authors.
|
| Moderate | HOME | FavorableUnfavorable or ambiguousNo Effect |
San Bernardino sample, HOME sample | Two years postpartum | 99 mothers | Mean = 38.07 | Mean = 38.80 | Mean difference = -0.73 | HomVEE calculated = -0.16 | Not statistically significant, p > 0.05 | Authors report whether the groups are significantly different or not, but do not report actual p-values.
Information on outcomes was received through communication with the authors.
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