Williams, C. M., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2014). Maternal health improvement by HANDS home visiting program (Unpublished manuscript). University of Kentucky Department of Obstetrics and Gynecology, Lexington, KY.
Model(s) Reviewed:
Health Access Nurturing Development Services (HANDS) Program
Additional sources:
Williams, C., Cprek, S., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2017). Kentucky Health Access Nurturing Development Services home visiting program improves maternal and child health. Maternal & Child Health Journal, 21(5), 1166–1174. https://doi.org/10.1007/s10995-016-2215-6
| 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 | Non-experimental comparison group design | Not applicable | Established on race; established on SES. Outcome measures were not assessable at baseline. | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
The findings in the unpublished manuscript are also in the peer reviewed journal article cited as an additional source.
| Study participants | This study examined 4,506 mother–infant pairs. Among these, 2,253 were HANDS participants and 2,253 were in a comparison group. All study participants were first-time parents, had at least two risk factors, and were either pregnant or had a child who was age 3 months or younger. Risk factors included unemployment, isolation, history of substance abuse, unstable housing, limited parental education, domestic violence, poor prenatal care, and maternal depression. Study participants were 88 percent white, non-Hispanic; 9 percent black, non-Hispanic; 2 percent Hispanic; and 1 percent some other race. Most (78 percent) study participants had Medicaid coverage at the time of referral to HANDS, and 33 percent of the mothers had less than 12 years of education. |
|---|---|
| Setting | Kentucky (statewide) |
| Intervention services | Women could enroll in HANDS during pregnancy or until the infant was 3 months old. Home visiting services continued until the child's second birthday. Home visiting services included education and development of parenting skills, linking families to medical homes, assisting families to meet basic needs, and direct service delivery for the mother and child. |
| Comparison conditions | Mother–infant pairs in the comparison groups were selected from the group of mothers referred to HANDS. Mothers in the comparison condition completed a screening tool and were found to be eligible for home visits, but chose not to participate and did not receive any home visits. |
| 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 | Kentucky Department for Public Health, funded through MIECHV grants D89MC23538 and X02MC27402. |
| Author affiliation | Two of the authors are affiliated with the University of Kentucky Department of Obstetrics and Gynecology and four with the Kentucky Department for Public Health. The Kentucky Department for Public Health developed the HANDS model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Study Registration:
Clinicaltrials.gov Identifier: Not found. Study registration was assessed by HomVEE beginning with the 2014 review.
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 | Breastfeeding (proportion) | FavorableUnfavorable or ambiguousNo Effect |
Kentucky 2011-2012 matched | Birth | 4,506 mothers | Unadjusted mean = 0.55 | Unadjusted mean = 0.57 | OR = 0.91 | HomVEE calculated = -0.06 | Not statistically significant, p = 0.15 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Maternal receipt of WIC (proportion) | FavorableUnfavorable or ambiguousNo Effect |
Kentucky 2011-2012 matched | Birth | 4,506 mothers | Unadjusted mean = 0.92 | Unadjusted mean = 0.88 | OR = 1.57 | HomVEE calculated = 0.27 | Statistically significant, p = 0.00 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Adequate prenatal care (proportion) | FavorableUnfavorable or ambiguousNo Effect |
Kentucky 2011-2012 matched | Birth | 4,506 mothers | Unadjusted mean = 0.74 | Unadjusted mean = 0.71 | OR = 1.14 | HomVEE calculated = 0.08 | Statistically significant, p = 0.05 | |
| Moderate | Maternal complications during delivery (proportion) | FavorableUnfavorable or ambiguousNo Effect |
Kentucky 2011-2012 matched | Birth | 4,506 mothers | Unadjusted mean = 0.02 | Unadjusted mean = 0.03 | OR = 0.60 | HomVEE calculated = -0.31 | Statistically significant, p = 0.01 | Negative effect is favorable.
|
| Moderate | Maternal weight gain during pregnancy (pounds) | FavorableUnfavorable or ambiguousNo Effect |
Kentucky 2011-2012 matched | Birth | 4,506 mothers | Not reported | Not reported | Mean difference = -1.20 | Not available | Statistically significant, p = 0.05 | |
| Moderate | Pregnancy-induced hypertension (proportion) | FavorableUnfavorable or ambiguousNo Effect |
Kentucky 2011-2012 matched | Birth | 4,506 mothers | Unadjusted mean = 0.09 | Unadjusted mean = 0.18 | OR = 0.51 | HomVEE calculated = -0.41 | Statistically significant, p = 0.00 | Negative effect is favorable.
|