Barth, R. P. (1991). An experimental evaluation of in-home child abuse prevention services. Child Abuse and Neglect: The International Journal, 15(4), 363-75.
Model(s) Reviewed:
Child Parent Enrichment Project (CPEP)
Additional sources:
Barth, R. P., Hacking, S., & Ash, J. R. (1988). Preventing child abuse: An experimental evaluation of the Child Parent Enrichment Project. Journal of Primary Prevention, 8(4), 201-217.
| 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 | Not applicable | Established on race and socioeconomic status | Yes | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
Mothers in the CPEP group who refused services or received fewer than five home visits were reassigned to the control group. Thus, we treat the study as a quasi-experimental design for purposes of the review, and an evaluation of attrition does not apply. The moderate rating applies to outcomes that were not assessable at baseline (health habits during pregnancy, child health, child development, and reductions in child maltreatment); those outcomes that could be measured at baseline (parent well-being and parent support) but were not controlled in the analysis receive a low rating.
| Study participants | Expectant mothers deemed at-risk for child abuse were referred to the study team by service providers in public health, education, and social services. Eligible mothers who expressed interest in the program were randomly assigned to either CPEP or a no-treatment control group. Random assignment occurred before the formal initial assessment interview by the CPEP team. Mothers in the CPEP group who refused services or received fewer than five home visits were reassigned to the control group. The analysis sample for the study included 97 mothers in the CPEP group and 94 mothers in the control group. The ethnic composition of the combined groups was 45 percent Caucasian, 17 percent African American, 31 percent Hispanic, and 7 percent of other or multiple races. Four in 10 mothers in the sample were on Aid to Families with Dependent Children, and 70 percent had incomes of less than $10,000. On average, mothers were 5.7 months pregnant when they began the program; 56 percent had at least one additional child at enrollment. |
|---|---|
| Setting | The study was conducted in Contra Costa County, California. |
| Intervention services | CPEP clients received on average 11 home visits over the course of the six-month study, with a range of 5 to 20 visits. Paraprofessionals, known as parenting consultants, administered the intervention. Home visits were centered around task lists created by mothers in conjunction with the parenting consultant. Tasks might be completed by the mother alone, the parenting consultant alone, or together. Examples of tasks include visiting prenatal care or obtaining transportation. |
| Comparison conditions | Control group mothers received referrals to appropriate social and health services identified by the two-hour assessment interview. |
| 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 | Department of Health and Human Services, Office of Human Development Services, Administration on Children, Youth, and Families, Grants 90-CA-0988 and 90-PJ-000101. Bio-Medical Research Support Grant, Grant 2-507-RR07006. National Institute of Health, Division of Research, State of California Office of Child Abuse Prevention, Grant CB 33015-AI. |
| Author affiliation | Richard Barth, the study author, developed CPEP and was involved in program implementation. |
| 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 | Activity (ITQ subscale) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 48.05 | Unadjusted mean = 50.19 | Mean difference = -2.13 | HomVEE calculated = -0.23 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Distractibility (ITQ subscale) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 24.11 | Unadjusted mean = 24.59 | Mean difference = -0.48 | HomVEE calculated = -0.07 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Mood (ITQ subscale) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 22.05 | Unadjusted mean = 23.91 | Mean difference = -1.86 | HomVEE calculated = -0.39 | Statistically significant, p = 0.01 | High score equals unfavorable.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Baby care (child welfare) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 7.43 | Unadjusted mean = 7.09 | Mean difference = 0.34 | HomVEE calculated = 0.09 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Birthweight (grams) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 3396.00 | Unadjusted mean = 3255.00 | Mean difference = 141.00 | HomVEE calculated = 0.21 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Emergency (child welfare) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 1.44 | Unadjusted mean = 1.44 | Mean difference = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Health (child welfare) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 5.62 | Unadjusted mean = 5.43 | Mean difference = 0.19 | HomVEE calculated = 0.06 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Discomfort (birth outcome) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 1.31 | Unadjusted mean = 1.36 | Mean difference = -0.05 | HomVEE calculated = -0.14 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Eat bad | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 8.12 | Unadjusted mean = 8.28 | Mean difference = -0.16 | HomVEE calculated = -0.06 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Eat right | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 6.21 | Unadjusted mean = 6.10 | Mean difference = 0.11 | HomVEE calculated = 0.04 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Hospital stay | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 8.41 | Unadjusted mean = 9.80 | Mean difference = -1.39 | HomVEE calculated = -0.33 | Statistically significant, p = 0.02 | High score equals unfavorable.
|
| Moderate | Pregnancy problems | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 1.49 | Unadjusted mean = 1.36 | Mean difference = 0.13 | HomVEE calculated = 0.12 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Prenatal care | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 9.90 | Unadjusted mean = 9.73 | Mean difference = 0.17 | HomVEE calculated = 0.05 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Worries (birth outcome) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 25.04 | Unadjusted mean = 24.19 | Mean difference = 0.85 | HomVEE calculated = 0.12 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Need care (child welfare) | FavorableUnfavorable or ambiguousNo Effect |
Reassigned sample | 6 months | 191 mothers | Unadjusted mean = 2.08 | Unadjusted mean = 2.06 | Mean difference = 0.02 | HomVEE calculated = 0.07 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|