Lutenbacher, M., Dietrich, M. S., & Elkins, T. (2016). Evaluation of the Maternal Infant Health Outreach Worker (MIHOW) program model in a sample of Hispanic women: A collaborative project between Catholic Charities and Vanderbilt University School of Nursing. Report submitted to the Home Visiting Evidence of Effectiveness (HomVEE) Review.
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 2 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No | No |
Yes, details reported below for findings on valid, reliable outcomes that otherwise rate at least moderate |
The manuscript includes many findings that were duplicates of those in Lutenbacher et al. (2018), a peer-reviewed journal article. All duplicated findings were reviewed under Lutenbacher et al. (2018) rather than this unpublished manuscript.
The finding on "other liquids given" at two weeks postpartum receives a low rating because it is a high attrition finding, and baseline equivalence was not demonstrated on a socioeconomic status indicator for the analytic sample. Information to demonstrate baseline equivalence was based on correspondence with the authors. The finding on "food given" at two weeks postpartum is ineligible for review per guidance of subject matter experts.
| Study participants | Pregnant Hispanic women older than 18 were recruited to participate in the study through word of mouth, agency referrals, and distributing flyers in locations with a high concentration of Hispanic individuals. A total of 188 participants were randomly assigned to either the Maternal Infant Health Outreach Worker (MIHOW) intervention (94 women) or the comparison group (94 women). The average age of the study participants was 30, and about two-thirds of the participants were from Mexico. When the study began, 10 percent were employed full time, and 16 percent were employed part time. Most (about 80 percent) did not have a high school diploma, and more than half (about 56 percent) had never been married. |
|---|---|
| Setting | The study was conducted in Davidson County, an urban area of Tennessee. |
| Intervention services | The MIHOW intervention sends health outreach workers to provide one-on-one services to pregnant women. The health outreach workers form relationships with the expectant parents and provide support, parenting education, and referrals through monthly hourlong home visits and group activities. Health outreach workers worked with parents to demonstrate positive parenting practices, and provided information about children's development, health, and nutrition. The program services typically last until the child is 36 months old, but services in this study ended when the child reached the age of 6 months due to funding constraints. Despite the reduced length of service, there were no adaptations to the content or intensity of the intervention. Intervention participants also received the educational materials sent to those in the comparison group. |
| Comparison conditions | Pregnant women assigned to the comparison group were given educational materials about maternal and child health and development during the 35th week of pregnancy and when the infant was 2 weeks, 2 months, and 6 months old. These materials were also provided to the intervention group. |
| 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). There were no subgroups reported in this manuscript. |
| Funding sources | This research was supported by Award Number D89MC23542 from the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. |
| Author affiliation | The authors are affiliated with the Vanderbilt School of Nursing, which developed the MIHOW intervention and supports its implementation. |
| Peer reviewed | No |
Clinicaltrials.gov Identifier: None found. SocialScienceRegistry.org Identifier: None found. Registry of Efficacy and Effectiveness Studies Identifier: None found. Study registration was assessed by HomVEE for Clinicaltrials.gov beginning with the 2014 review, and for other registries beginning with the 2021 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Child given other liquids by 2 months postpartum |
FavorableUnfavorable or ambiguousNo Effect |
MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
2 months postpartum |
176 mothers | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.06 | Difference = -0.05 | HomVEE calculated = -1.03 | Not statistically significant, p = 0.13 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
| High | Child given other liquids by 6 months postpartum |
FavorableUnfavorable or ambiguousNo Effect |
MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
6 months postpartum |
178 mothers | Unadjusted proportion = 0.90 | Unadjusted proportion = 0.91 | Difference = -0.01 | HomVEE calculated = -0.05 | Not statistically significant, p = 0.87 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
| High | Child given solid food by 6 months postpartum |
FavorableUnfavorable or ambiguousNo Effect |
MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
6 months postpartum |
178 mothers | Unadjusted proportion = 0.91 | Unadjusted proportion = 0.92 | Difference = -0.01 | HomVEE calculated = -0.06 | Not statistically significant, p = 0.86 |
Statistical significance is based on HomVEE calculations. |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Average number of prenatal visits during pregnancy |
FavorableUnfavorable or ambiguousNo Effect |
MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
Prenatal period |
177 mothers | Unadjusted mean = 9.00 | Unadjusted mean = 9.20 | Mean difference = -0.20 | HomVEE calculated = -0.09 | Not statistically significant, p= 0.48 |