Sadler, L. S., Slade, A., Close, N., Webb, D. L., Simpson, T., Fennie, K., & Mayes, L. C. (2013). Minding the Baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home-visiting program. Infant Mental Health Journal, 34(5), 391-405.
Model(s) Reviewed:
Minding the Baby® Home Visiting (MTB-HV)
Additional sources:
Sadler, L. S., Slade, A., Close, N., & Mayes, L. (2011). Minding the Baby: A mentalization-based parenting program for young families. (Presentation slides).
| 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 and SES | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
In 2020, HomVEE updated this review to remove the Child abuse/maltreatment: Open cases with CPS-24 months finding 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.
In 2018, HomVEE updated this review to move measures of attachment from the Positive Parenting Practices domain to the Child Development and School Readiness domain because they assess child behavior.
| Study participants | The authors used a cluster-randomized trial to test the effects of Minding the Baby®. First-time mothers who attended group prenatal care sessions at the Fair Haven Community Health Center were recruited to participate; all participants who met inclusion criteria were invited into the study and assigned to the condition to which their prenatal group had been randomly assigned. Inclusion criteria for the mother were (a) English oral and comprehension fluency; (b) 14 to 25 years of age; (c) having a first child; (d) no active heroin or cocaine use (already a criteria for participating in group prenatal care); (e) no diagnoses of a psychotic disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition; and (f) no major or terminal chronic condition (AIDS, cancer, and so on; already an eligibility criteria for group prenatal care participation). One-hundred and thirty-nine families met criteria and were assigned to the program or control group based on the random assignment status of their prenatal care group (72 treatment and 67 control). Among eligible mothers, 30 declined the invitation to participate (9 treatment and 21 control). After some additional attrition, 60 (treatment) and 45 (control) mothers participated in data collection at baseline. However, the authors also note further attrition at later data collection points; 44 treatment group mothers completed 12- and 24-month data collection, and approximately 34 and 31 control group mothers, respectively, completed data collection at these time points. Mothers were followed for approximately 27 months in total, including the time before the child's birth. Overall, the study sample of mothers was 28 percent black, 62 percent Latina, and 10 percent of another race/ethnicity. |
|---|---|
| Setting | New Haven, Connecticut |
| Intervention services | Home visitor teams conducted home visits to enhance parental reflective functioning and the development of secure attachment of the infant. Home visitors conducted a prenatal assessment of the mothers’ reflective functioning capacity. The home visitors also addressed maternal physical and mental health as well as infant mental health clinical care. Home visiting began in pregnancy and occurred weekly until the child’s first birthday, and then biweekly until the child’s second birthday. |
| Comparison conditions | Mothers in the control group received routine health care (prenatal visits, well-woman care, and well-baby care) as dictated by clinical guidelines. Families also received monthly information sheets about child rearing and health, and birthday and holiday cards. |
| 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 age (less than 20 years) • Maternal education (less than high school education) • Mother has low reflective functioning (yes or no) |
| Funding sources | National Institutes of Health, the Irving B. Harris Foundation, the FAR Fund, the Annie E. Casey Foundation, the Pritzker Early Childhood Foundation, the Seedlings Foundation, the Edlow Family, and the Schneider Family |
| Author affiliation | Dr. Lois Sadler is a developer of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Study Registration:
Clinicaltrials.gov Identifier: NCT01458145
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 | Strange Situation Procedure - Disorganized attachment | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 71 mothers | Mean % = 27.00 | Mean = 43.00 | Mean difference = -16.00 | HomVEE calculated = -0.30 | p = 0.49 | |
| Moderate | Strange Situation Procedure - Secure attachment | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 71 mothers | Mean % = 64.40 | Mean = 48.40 | Mean difference = 16.00 | HomVEE calculated = 0.39 | p = 0.28 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Immunizations - up-to-date - 12 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 78 mothers | Not reported | Not reported | Not reported | Not available | p < 0.05 | |
| Moderate | Immunizations - up-to-date - 24 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Not reported | Not reported | Not reported | Not available | 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 | Brief Symptom Inventory (BSI) - Anxiety subscale - 12 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 78 mothers | Mean = 48.10 | Mean = 45.80 | Mean difference = 2.30 | HomVEE calculated = 0.23 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Depression subscale - 12 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 78 mothers | Mean = 48.50 | Mean = 46.70 | Mean difference = 1.80 | HomVEE calculated = 0.20 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Global Severity Index (GSI) - 12 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 78 mothers | Mean = 48.40 | Mean = 47.30 | Mean difference = 1.10 | HomVEE calculated = 0.10 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Somatization subscale - 12 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 78 mothers | Mean = 50.60 | Mean = 52.90 | Mean difference = -2.30 | HomVEE calculated = -0.20 | p > 0.05 | |
| Moderate | Center for Epidemiological Studies Depression Scale (CES-D) - 12 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 12 months | 12 months | 78 mothers | Mean = 13.40 | Mean = 11.30 | Mean difference = 2.10 | HomVEE calculated = 0.21 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Anxiety subscale - 24 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean = 47.10 | Mean = 45.40 | Mean difference = 1.70 | HomVEE calculated = 0.20 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Depression subscale - 24 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean = 48.60 | Mean = 46.50 | Mean difference = 2.10 | HomVEE calculated = 0.23 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Global Severity Index (GSI) - 24 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean = 48.10 | Mean = 46.90 | Mean difference = 1.20 | HomVEE calculated = 0.12 | p > 0.05 | |
| Moderate | Brief Symptom Inventory (BSI) - Somatization subscale - 24 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean = 51.10 | Mean = 51.00 | Mean difference = 0.10 | HomVEE calculated = 0.01 | p > 0.05 | |
| Moderate | Center for Epidemiological Studies Depression Scale (CES-D) - 24 months | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean = 12.80 | Mean = 10.80 | Mean difference = 2.00 | HomVEE calculated = 0.20 | p > 0.05 | |
| Moderate | Rapid subsequent childbearing - birth of second child within 24 months of the index birth | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean % = 1.60 | Mean = 15.00 | Mean difference = -13.40 | HomVEE calculated = -1.42 | p = 0.019 | |
| Moderate | Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) Scale - response of Disrupted Communication | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 4 months | 4 months | 76 mothers | Mean % = 60.50 | Mean = 73.00 | Mean difference = -12.50 | HomVEE calculated = -0.35 | p = 0.2 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Parent Development Interview - maternal reflexive functioning | FavorableUnfavorable or ambiguousNo Effect |
Minding the Baby pilot - 24 months | 24 months | 75 mothers | Mean = 3.60 | Mean = 3.70 | Mean difference = -0.10 | HomVEE calculated = -0.09 | p = 0.38 |