Green, B. L., Tarte, J. M., Harrison, P. M., Nygren, M., & Sanders, M. B. (2014). Results from a randomized trial of the Healthy Families Oregon accredited statewide program: Early program impacts on parenting. Children and Youth Services Review, 44, 288-298.
Model(s) Reviewed:
Healthy Families America (HFA)®
| 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 | Low | Not established on race; not established on SES; not established on outcome measures assessable at baseline | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
In 2020, HomVEE updated this review to move the measure of the Protective Factors Survey (PFS) - Family Functioning Subscalefrom the Maternal Health domain to the Positive Parenting Practices because ACF determined that, with no overall score available for the PFS assessment, outcomes should belong in the domain that is most relevant to their subscale, and that the family functioning and resiliency outcomes belong in Positive Parenting Practices.
One outcome, duration of breastfeeding, rates low because it has high attrition and authors do not establish baseline equivalence on race or SES. On the outcomes with low attrition, summarized in the above table, the study rates moderate because the design did not statistically control for outcome measures that were assessable at baseline.
| Study participants | Mothers selected to participate in the study were screened by program staff using standard Healthy Families Oregon Program (HFO) screening procedures. Mothers were study-eligible if they were first-time mothers, were pregnant or had an infant up to 3 months old, and did not have medically fragile infants or children at risk of removal from the home, and if either the mother or the family was at risk according to HFO's screener assessment (the New Baby Questionnaire). Eligible, interested, and consenting mothers were randomly assigned in this randomized controlled trial to an HFO program or a control group (n=2,664). Researchers collected survey data at the children's first birthday on a random subsample of 1,604 participants (802 HFO, 802 control) out of the initially randomized 2,664 mothers. Mothers with survey data (803 in total) were analyzed, and their characteristics are as follows: 62 percent were white, 24 percent were Hispanic, and 14 percent were another race/ethnicity. Over one-fourth (28 percent) had less than a high school diploma or GED, and nearly one third (32 percent) reported that both parents were unemployed. One-fifth (20 percent) were depressed. |
|---|---|
| Setting | This study included seven Healthy Families Oregon sites, four of which were primarily urban and three of which were rural. |
| Intervention services | The Healthy Families Oregon program enrolled first-time parents with two or more risk factors according to the program screener, the New Baby Questionnaire. Families enrolled during pregnancy or up to 90 days after the child's birth and received up to 3 years of home visiting services. |
| Comparison conditions | Families assigned to the comparison condition received a standard resource and referral packet. |
| 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). • Maternal depression (present based on screening) |
| Funding sources | The grant (#90CA1782) was funded by the U.S. Department of Health and Human Services' Children's Bureau. |
| Author affiliation | None of the study authors are developers of the model. The lead author is from the Center for Improvement of Child and Family Services at the Graduate School of Social Work at Portland State University. Other authors are from NPC Research. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Study Registration:
Clinicaltrials.gov Identifier: None 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 | Baby received developmental screening in first year of life | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 762 mothers | Adjusted proportion = 0.94 | Adjusted proportion = 0.87 | OR = 0.41 | Not available | Statistically significant, p = 0.00 | |
| Moderate | Child ever breastfed - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 752 mothers | Adjusted proportion = 0.91 | Adjusted proportion = 0.91 | OR = 0.91 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Parent ever told that child was not on track developmentally - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 762 mothers | Adjusted proportion = 0.05 | Adjusted proportion = 0.09 | OR = 1.46 | Not available | Not statistically significant, p = 0.08 | Negative value is favorable to the intervention.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | CDC Pregnancy Risk Assessment Monitoring System (PRAMS) measure of maternal depression- full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 2.17 | Adjusted mean = 2.22 | Mean difference = -0.05 | HomVEE calculated = -0.06 | Not statistically significant, p ≥ 0.05 | Negative value is favorable to the intervention.
|
| Moderate | Parenting Stress Index - Short Form (PSI) - General Distress subscale score - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 1.78 | Adjusted mean = 1.86 | Mean difference = -0.08 | HomVEE calculated = -0.11 | Not statistically significant, p ≥ 0.05 | Negative value is favorable to the intervention.
|
| Moderate | Parenting Stress Index - Short Form (PSI) - Parenting Stress subscale score - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 2.02 | Adjusted mean = 2.14 | Mean difference = -0.12 | HomVEE calculated = -0.14 | Not statistically significant, p = 0.07 | Negative value is favorable to the intervention.
|
| Moderate | Parenting Stress Index - Short Form (PSI) Total Score | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 1.90 | Adjusted mean = 2.00 | Mean difference = -0.10 | HomVEE calculated = -0.14 | Not statistically significant, p = 0.06 | Negative value is favorable to the intervention.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Adult Adolescent Parenting Inventory Corporal Punishment Subscale (AAPI-CP) Score - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 763 mothers | Adjusted mean = 1.89 | Adjusted mean = 1.97 | Mean difference = -0.08 | HomVEE calculated = -0.10 | Not statistically significant, p ≥ 0.05 | Negative value is favorable to the intervention.
|
| Moderate | Number of times in last month parent read to child - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 4.74 | Adjusted mean = 4.43 | Mean difference = 0.31 | HomVEE calculated = 0.26 | Statistically significant, p = 0.00 | |
| Moderate | Parent-Child Activities Scale (PCAS) score - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 4.84 | Adjusted mean = 4.73 | Mean difference = 0.11 | HomVEE calculated = 0.15 | Statistically significant, p = 0.02 | |
| Moderate | Protective Factors Survey (PFS) - Family Functioning Subscale - full sample | FavorableUnfavorable or ambiguousNo Effect |
HF Oregon 2010-2012 | Child's 1st birthday | 764 mothers | Adjusted mean = 4.16 | Adjusted mean = 4.15 | Mean difference = 0.01 | HomVEE calculated = 0.01 | Not statistically significant, p ≥ 0.05 |