Kemp, L., Harris, E., McMahon, C., Matthey, S., Vimpani, G., Anderson, T., Schmied, V., Aslam, H., & Zapart, S. (2011). Child and family outcomes of a long-term nurse home visitation programme: A randomised controlled trial. Archives of Disease in Childhood, 96, 533-540.
Model(s) Reviewed:
Maternal Early Childhood Sustained Home-Visiting Program (MECSH)
| 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 | Equivalent on SES, information on race/ethnicity not available | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
Moderate rating applies to outcomes (birthweight and preterm birth) measured at the one-month post partum follow-up, which had low attrition. Outcomes measured after one month postpartum had high attrition. Because of missing data on race and ethnicity, baseline equivalence could not be established and all other outcomes receive a low rating.
| Study participants | Pregnant women were eligible to participate if they did not require the use of an interpreter and reported at least one risk factor for poor maternal or child outcomes during routine psychosocial and domestic violence screenings conducted by midwives in a local hospital. After consenting to participate in the study, 208 eligible mothers were randomly assigned to the program (MECSH) or comparison group before baseline data were collected, assigning 111 to MECSH and 97 to the comparison group. There were no significant differences between the two groups on age, marital status, educational attainment, source of income, or number of risk factors. The study did not report baseline information on race or ethnicity, so equivalence could not be established on this factor. Participants were followed for 24 months. |
|---|---|
| Setting | The study was conducted in a socioeconomically disadvantaged suburb of Sydney, Australia. |
| Intervention services | Women in the intervention group received an average of 16.3 visits (range 0–52), each of 60 to 90 minutes duration, by a child health nurse. Visits began, on average, at 26 weeks gestation and continued up to the child’s second birthday. Home visits included information and activities to encourage child development and linkages to community activities (such as parenting groups). |
| Comparison conditions | Women in both study conditions received usual antenatal midwifery, obstetric, and birthing services. Comparison group women were expected to receive a home visit by a child health nurse within two weeks of giving birth, in accordance with standard practice in New South Wales. |
| 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 | The trial was funded by the Australian Research Council (LP0560285), Sydney South West Area Health Service, the New South Wales (NSW) Department of Community Services, and the NSW Department of Health. |
| Author affiliation | Lynn Kemp, a study author, is a developer 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 | Breastfeeding duration (weeks) | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 12 months | 139 children | Mean = 16.12 | Mean = 8.24 | Mean difference = 7.88 | HomVEE calculated = 0.52 | Statistically significant, p = 0.002 | |
| Moderate | Gastroenteritis | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 166 children | % = 58.00 | % = 60.00 | OR = 1.10 | HomVEE calculated = -0.05 | Not Statistically significant, p = 0.76 | |
| Moderate | Immunization up to date | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 166 children | % = 100.00 | % = 100.00 | Not reported | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Low birth weight (< 2500 g) | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 1 month | 201 mothers | % = 7.00 | % = 2.00 | OR = 3.22 | HomVEE calculated = 0.79 | Not Statistically significant, p = 0.15 | |
| Moderate | Preterm (< 37 weeks) | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 1 month | 203 mothers | % = 10.00 | % = 6.00 | OR = 1.69 | HomVEE calculated = 0.33 | Not Statistically significant, p = 0.32 | |
| Moderate | Respiratory infection | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 166 children | % = 33.00 | % = 31.00 | OR = 0.90 | HomVEE calculated = 0.06 | Not Statistically significant, p = 0.76 | |
| Moderate | Transition to solids (weeks) | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 12 months | 162 children | Mean = 21.74 | Mean = 23.06 | Mean difference = -1.32 | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Family functioning | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 1.83 | Mean = 1.77 | Mean difference = 0.06 | Not available | Not Statistically significant, p = 0.21 | |
| Moderate | Maternal depression | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 7.34 | Mean = 7.07 | Mean difference = 0.30 | Not available | Not Statistically significant, p = 0.55 | |
| Moderate | Maternal experience of being a mother | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 12 months | 138 mothers | Mean = 30.05 | Mean = 29.83 | Mean difference = 0.22 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Maternal general health | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 2.42 | Mean = 2.50 | Mean difference = -0.08 | Not available | Not Statistically significant, p = 0.33 | |
| Moderate | Maternal mental health | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 51.60 | Mean = 51.33 | Mean difference = 0.28 | Not available | Not Statistically significant, p = 0.69 | |
| Moderate | Maternal physical health | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 48.34 | Mean = 48.23 | Mean difference = 0.11 | Not available | Not Statistically significant, p = 0.84 | |
| Moderate | Maternal social support | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 20.11 | Mean = 20.45 | Mean difference = -0.34 | Not available | Not Statistically significant, p = 0.26 | |
| Moderate | Mother never smoked | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | % = 62.00 | % = 68.00 | OR = 1.30 | HomVEE calculated = 0.00 | Not Statistically significant, p = 0.38 | |
| Moderate | Stressful life events | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | Mean = 3.07 | Mean = 3.06 | Mean difference = 0.01 | Not available | Not Statistically significant, p = 0.98 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Home Observation for Measurement of the Environment (HOME), Avoidance of restriction and punishment | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 174 mothers | Mean = 5.75 | Mean = 5.50 | Mean difference = 0.25 | Not available | Not Statistically significant, p = 0.18 | |
| Moderate | Home Observation for Measurement of the Environment (HOME), Maternal involvement with child | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 174 mothers | Mean = 3.24 | Mean = 3.19 | Mean difference = 0.05 | Not available | Not Statistically significant, p = 0.76 | |
| Moderate | Home Observation for Measurement of the Environment (HOME), Organization of environment | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 174 mothers | Mean = 4.92 | Mean = 4.84 | Mean difference = 0.09 | Not available | Not Statistically significant, p = 0.43 | |
| Moderate | Home Observation for Measurement of the Environment (HOME), Provision of appropriate play materials | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 174 mothers | Mean = 6.90 | Mean = 6.68 | Mean difference = 0.23 | Not available | Not Statistically significant, p = 0.21 | |
| Moderate | Home Observation for Measurement of the Environment (HOME), Responsivity | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 174 mothers | Mean = 9.35 | Mean = 8.88 | Mean difference = 0.47 | Study reported = 0.26 | Statistically significant, p = 0.02 | |
| Moderate | Home Observation for Measurement of the Environment (HOME), Variety in daily stimulation | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 174 mothers | Mean = 3.75 | Mean = 3.67 | Mean difference = 0.08 | Not available | Not Statistically significant, p = 0.49 | |
| Moderate | Household always smoke free | FavorableUnfavorable or ambiguousNo Effect |
Sydney sample | 24 months | 208 mothers | % = 35.00 | % = 35.00 | OR = 1.00 | HomVEE calculated = 0.00 | Not Statistically significant, p = 0.99 |