Fergusson, D. M., Horwood, L. J., Grant, H., & Ridder, E. M. (2005). Early start evaluation report. Christchurch, NZ: Early Start Project Ltd.
Model(s) Reviewed:
Early Start (New Zealand)
Additional sources:
Fergusson, D. M., Grant, H., Horwood, L. J., & Ridder, E. M. (2005). Randomized trial of the Early Start program of home visitation. Pediatrics, 116(6), e803-e809.
| 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 | High | Established on race/ethnicity, SES, and outcomes | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
All findings from the peer-reviewed journal article that is cited as an additional source were included in the review of the Early start evaluation report. Both manuscripts report an intersecting set of findings, while the Early start evaluation report contains additional findings not included in the peer-reviewed article. Several maternal outcomes describing employment, hardship factors, contraceptive use, and stressful life events received a low rating because they were assessable at baseline but were not assessed.
In 2020, HomVEE updated this review in three ways. First, HomVEE removed mother's partnership status/family structure findings from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE. Second, HomVEE removed the finding "percent parental report of agency contact for abuse/neglect" from the Reductions in Child Maltreatment domain because some cases measured may be unsubstantiated. In this domain, HomVEE reviews only outcomes focused on substantiated cases of abuse and neglect. Finally, HomVEE clarified that the direction for the finding on duration of attendance for early childhood education is ambiguous, rather than favorable.
| Study participants | Nurses screened all families in the Christchurch area who had new infants. Screening included an 11-point assessment of family stress and an evaluation of the client's need for Early Start services. A total of 588 families were determined to be eligible and 443 families agreed to participate. Those 443 families were then randomly assigned to either the treatment or comparison group. The analysis sample consisted of 184 families in the treatment group and 207 in the comparison group. Approximately one quarter of the analysis sample was Māori, and weekly income in both the Early Start and comparison groups averaged about $340 per week (according to information provided by the authors). Results are reported as of the 36-month follow-up (certain outcomes have fewer than 391 respondents at this follow-up). |
|---|---|
| Setting | The study was conducted in Christchurch, New Zealand. |
| Intervention services | Trained family support workers engaged in home visits to encourage positive family change in the following areas: child health, maternal well-being, parenting skills, family economic functioning, and crisis management. The services were tailored to each family’s particular circumstances. Initially, families received two hours of contact with a home visitor per week. Some families in crisis received more contact. The intensity of services decreased as families made progress. Once families became self-reliant, they received a home visit every three months. |
| Comparison conditions | Comparison participants were not offered any services beyond what is typically available to families in the Christchurch, NZ area. |
| 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). • Race/ethnicity (Māori or Non-Māori) • Parity (primiparous or multiparous) • Maternal age (less than 20 years or 20 or older) • Family disadvantage (low or high) |
| Funding sources | Major funders are The Department of Child, Youth, and Family, Ministry of Health, Canterbury District Health Board, Christchurch City Council, Trustbank Community Trust and Health Research Council of New Zealand. Hyman Marks Trust, Mayor’s Welfare Fund, McKenzie Trust, Telecom New Zealand and UMC Ltd. provided other financial and non-financial support. |
| Author affiliation | David M. Fergusson, a study author, is a board member of Early Start. Hildegard Grant, another study author, is the general manager of the program. |
| 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 | Early childhood education, duration of attendance (months) | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | Unadjusted mean = 16.40 | Unadjusted mean = 13.60 | Mean difference = 2.80 | Study reported = 0.22 | Statistically significant, p < 0.05 | |
| Moderate | Ever attended early childhood education | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | % = 90.80 | % = 84.50 | = 6.30 | Study reported = 0.19 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Infant-Toddler Social and Emotional Assessment (ITSEA), Total behavior score | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | Unadjusted mean = 9.87 | Unadjusted mean = 10.11 | Mean difference = -0.24 | Study reported = 0.24 | Statistically significant, p < 0.05 | High score equals unfavorable.
|
| Moderate | Infant-Toddler Social and Emotional Assessment (ITSEA), Total externalizing score | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | Unadjusted mean = 9.90 | Unadjusted mean = 10.09 | Mean difference = -0.19 | Study reported = 0.19 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Infant-Toddler Social and Emotional Assessment (ITSEA), Total internalizing score | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | Unadjusted mean = 9.86 | Unadjusted mean = 10.12 | Mean difference = -0.26 | Study reported = 0.26 | Statistically significant, p < 0.05 | High score equals unfavorable.
|
| Moderate | Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Performance IQ score | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 367 children | Unadjusted mean = 98.10 | Unadjusted mean = 96.80 | Mean difference = 1.30 | Study reported = 0.08 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Total IQ | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 367 children | Unadjusted mean = 97.70 | Unadjusted mean = 96.50 | Mean difference = 1.20 | Study reported = 0.07 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Verbal IQ score | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 367 children | Unadjusted mean = 97.70 | Unadjusted mean = 97.00 | Mean difference = 0.70 | Study reported = 0.04 | 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 | Number of home safety features | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | Unadjusted mean = 5.20 | Unadjusted mean = 4.90 | Mean difference = 0.30 | Study reported = 0.17 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Number of visits made to family doctor in past 36 months | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | Unadjusted mean = 23.50 | Unadjusted mean = 20.70 | = 2.80 | Study reported = 0.24 | Statistically significant, p < 0.05 | |
| Moderate | Percent attended hospital for any other reason | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 382 children | % = 68.40 | % = 74.20 | = -9.80 | Study reported = 0.13 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Percent breastfed for six months or more | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | % = 31.30 | % = 34.10 | = -2.80 | Study reported = -0.05 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Percent of children up to date with immunizations | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | % = 92.50 | % = 91.90 | = 0.60 | Study reported = 0.24 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Percent of children up to date with well-child checks | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | % = 41.90 | % = 30.10 | = 11.80 | Study reported = 0.24 | Statistically significant, p < 0.05 | |
| Moderate | Percent with dental service | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | % = 72.30 | % = 62.80 | = 9.50 | Study reported = 0.20 | 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 | Mean amount of debt | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | Unadjusted mean = 3582.00 | Unadjusted mean = 3380.00 | Mean difference = 202.00 | Study reported = -0.04 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Mean family income per week | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | Unadjusted mean = 454.00 | Unadjusted mean = 443.00 | Mean difference = 11.00 | Study reported = 0.08 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Percent income inadequate/very inadequate | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | % = 41.80 | % = 37.40 | = 4.40 | Study reported = -0.09 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Percent welfare dependent | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | % = 89.60 | % = 86.40 | = 3.20 | Study reported = -0.10 | 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 | Percent any family/social relationship problem | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | % = 81.30 | % = 82.90 | = -1.60 | Study reported = 0.04 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Percent ever pregnant to 36 months | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 mothers | % = 42.90 | % = 47.60 | = -4.70 | Study reported = 0.09 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Percent major depression | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 mothers | % = 36.00 | % = 37.10 | = -1.10 | Study reported = 0.02 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Percent mother smoked cigarettes | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 mothers | % = 73.10 | % = 68.90 | = 4.20 | Study reported = -0.09 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|
| Moderate | Percent substance use problems | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 mothers | % = 38.50 | % = 33.00 | = 5.50 | Study reported = -0.11 | 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 | Non-punitive attitudes (adapted from Child Rearing Practices Report and Adult-Adolescent Parenting Inventory) | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | Unadjusted mean = 10.12 | Unadjusted mean = 9.90 | Mean difference = 0.22 | Study reported = 0.22 | Statistically significant, p < 0.05 | |
| Moderate | Percent smoke-free home/smoke-free area | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 children | % = 80.80 | % = 81.60 | = -0.80 | Study reported = -0.02 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Positive parenting attitude (adapted from Child Rearing Practices Report and Adult-Adolescent Parenting Inventory) | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | Unadjusted mean = 10.14 | Unadjusted mean = 9.88 | Mean difference = 0.26 | Study reported = 0.26 | Statistically significant, p < 0.05 | |
| Moderate | Total parenting score (adapted from Child Rearing Practices Report and Adult-Adolescent Parenting Inventory) | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 391 children | Unadjusted mean = 10.14 | Unadjusted mean = 9.87 | Mean difference = 0.27 | Study reported = 0.27 | 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 | Attended hospital for accident/injury or accidental poisoning | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 382 children | % = 17.50 | % = 26.30 | = -8.80 | Study reported = 0.22 | Statistically significant, p < 0.05 | High score equals unfavorable.
|
| Moderate | Parent-Child Conflict Tactics Scale (CTSPC), Physical assault by any parent | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | % = 4.40 | % = 11.70 | = -7.30 | Study reported = 0.26 | 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 | Mother assaulted by any partner | FavorableUnfavorable or ambiguousNo Effect |
Christchurch sample | 36 months | 388 families | % = 26.40 | % = 22.30 | = -4.10 | Study reported = -0.10 | Not statistically significant, p ≥ 0.05 | High score equals unfavorable.
|