Manuscript Detail

Wagner, M., & Spiker, D. (2001). Experiences and outcomes for children and families: Multisite Parents as Teachers evaluation. Menlo Park, CA: SRI International. http://www.sri.com/policy/cehs/publications/humanpub/patfinal.pdf.

Model(s) Reviewed: Parents as Teachers (PAT)®
Additional sources:
Wagner, M. (2001). The multisite evaluation of the Parents as Teachers home visiting program. Menlo Park, CA: SRI International.
Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
Moderate Randomized controlled trial High Established on race/ethnicity, SES, and mother’s mental health. None None Not assessed in manuscripts reviewed before 2021
Notes:

In 2020, HomVEE updated this review in two ways. First, HomVEE moved the finding "child treated for injury in the past year" from the Child Health domain to the Reductions in Child Maltreatment domain because the review initially misclassified it. HomVEE places findings related to medical care for injury and ingestions in the Reductions in Child Maltreatment domain. Second, HomVEE moved the finding "child was covered by health insurance" from the Child Health domain to the Family Economic Self-Sufficiency domain  because ACF determined that health insurance coverage belongs in that domain. 

Study characteristics
Study participants The sample presented here includes 667 mothers with children who were assessed at 1 and 2 years of age. Across three sites, families with a child up to 8 months of age were recruited for enrollment in the Parents as Teachers (PAT) program. At the time of enrollment, mothers had an average education level of just over 12 years. Most study participants were African American (58%) or white (29%). The majority of households enrolled had an annual income of less than $15,000 (60%). Twenty-nine percent of children in the sample had two married parents.
Setting Three local PAT programs participated in the evaluation: the first was located in an Eastern Seaboard rural community, the second was located in a mid-size Southern city, and the third was located in a large Western city.
Intervention services Families enrolled in PAT received monthly home visits and other program services for as long as they remained in the program, up to the child’s third birthday. Among those families enrolled in PAT , 44% participated and remained in the program through the child’s second birthday (68% at Site 1, 35% at Site 2, and 31% at Site 3).
Comparison conditions The comparison families received only the services that were normally available in the community and that they sought of their own accord. In addition, they received age-appropriate toys at regular quarterly intervals, which were used as a means of tracking their locations.
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).

• Household income (less than $15,000 annually or $15,000 or more)

Funding sources National Institute of Early Childhood Development and Education of the Office of Educational Research and Improvement, U.S. Department of Education; the Smith Richardson Foundation; the Robert Wood Johnson Foundation; and the Carnegie Corporation of New York.
Author affiliation None of the study authors are developers of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

Child development and school readiness
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate DPII average months differential: cognitive development
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 children Mean = 2.20 Mean = 2.40 Mean difference = -0.20 Study reported = -0.04 Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: communication development
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 children Mean = 4.90 Mean = 4.50 Mean difference = 0.40 Study reported = 0.08 Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: physical development
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 children Mean = 2.90 Mean = 3.00 Mean difference = -0.10 Study reported = -0.01 Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: self-help development
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 children Mean = 6.10 Mean = 6.00 Mean difference = 0.10 Study reported = 0.02 Not statistically significant, p ≥ 0.05
Moderate DPII average months differential: social development
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 children Mean = 4.90 Mean = 4.90 Mean difference = 0.00 Study reported = -0.01 Not statistically significant, p ≥ 0.05
Moderate ASBI score
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 259 children Mean = 72.30 Mean = 70.80 Mean difference = 1.50 Study reported = 0.21 Not statistically significant, p ≥ 0.05
Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Child saw doctor for well-child care in past 6 months
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2 year 265 children % = 91.40 % = 94.80 = -3.40 Study reported = -0.14 Not statistically significant, p ≥ 0.05
Submitted by user on

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p ≤ 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques to determine statistical significance, such as regression models or analyses of variance (ANOVA).

Moderate Child was fully immunized
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2 year 265 children % = 26.30 % = 19.00 = 7.30 Study reported = 0.17 Not statistically significant, p ≥ 0.05
Moderate Child went to the emergency room
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2 year 265 children % = 38.50 % = 50.60 = -12.10 Study reported = -0.24 Not statistically significant, p ≥ 0.05
Submitted by user on

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p ≤ 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques to determine statistical significance, such as regression models or analyses of variance (ANOVA).

Family economic self-sufficiency
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Child covered by health insurance
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2 year 265 children % = 79.80 % = 84.80 = -4.60 Study reported = -0.13 Not statistically significant, p ≥ 0.05
Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate AAPI average child maltreatment precursor scale (range = 6 to 24)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 267 mothers Mean = 18.30 Mean = 18.30 Mean difference = 0.00 Study reported = 0.01 Not statistically significant, p ≥ 0.05
Moderate AAPI average child maltreatment precursor scale (range = 6 to 24)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean = 19.10 Mean = 19.10 Mean difference = 0.00 Study reported = 0.02 Not statistically significant, p ≥ 0.05
Moderate HOME acceptance of child’s behavior subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 6.00 Mean = 5.70 Mean difference = 0.30 Study reported = 0.22 Not statistically significant, p ≥ 0.05
Moderate HOME acceptance of child’s behavior subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 6.00 Mean = 6.20 Mean difference = -0.20 Study reported = -0.12 Not statistically significant, p ≥ 0.05
Moderate HOME appropriate play materials subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 7.90 Mean = 7.40 Mean difference = 0.30 Study reported = 0.26 Not statistically significant, p ≥ 0.05
Moderate HOME involvement with child subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 4.10 Mean = 4.10 Mean difference = 0.00 Study reported = -0.01 Not statistically significant, p ≥ 0.05
Moderate HOME involvement with child subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 5.00 Mean = 4.90 Mean difference = 0.10 Study reported = 0.02 Not statistically significant, p ≥ 0.05
Moderate HOME opportunities for stimulation subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 3.40 Mean = 3.40 Mean difference = 0.00 Study reported = -0.02 Not statistically significant, p ≥ 0.05
Moderate HOME opportunities for stimulation subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 3.70 Mean = 3.50 Mean difference = 0.20 Study reported = 0.20 Not statistically significant, p ≥ 0.05
Moderate HOME organization of the environment subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 5.30 Mean = 5.30 Mean difference = 0.00 Study reported = 0.03 Not statistically significant, p ≥ 0.05
Moderate HOME appropriate play materials subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 6.80 Mean = 6.70 Mean difference = 0.10 Study reported = 0.06 Not statistically significant, p ≥ 0.05
Moderate HOME organization of the environment subscale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 5.70 Mean = 5.60 Mean difference = 0.10 Study reported = 0.17 Not statistically significant, p ≥ 0.05
Moderate HOME parental responsivity subcale
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 9.40 Mean = 9.30 Mean difference = 0.10 Study reported = 0.09 Not statistically significant, p ≥ 0.05
Moderate HOME subscale related to language- and literacy-promoting behaviors (range = 0 to 8)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 5.50 Mean = 5.30 Mean difference = 0.20 Study reported = 0.08 Not statistically significant, p ≥ 0.05
Moderate HOME subscale related to language- and literacy-promoting behaviors (range = 0 to 8)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 mothers Mean = 6.50 Mean = 6.10 Mean difference = 0.40 Study reported = 0.31 Not statistically significant, p ≥ 0.05
Moderate HOME subscale: parental responsivity
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 8.50 Mean = 8.50 Mean difference = 0.00 Study reported = -0.02 Not statistically significant, p ≥ 0.05
Moderate HOME total scale (range = 0 to 45)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 34.10 Mean = 34.20 Mean difference = -0.10 Study reported = -0.01 Not statistically significant,
p = 0.93
Moderate HOME total scale (range = 0 to 45)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 37.70 Mean = 36.40 Mean difference = 1.30 Study reported = 0.22 Not statistically significant, p ≥ 0.05
Moderate NCAST, total scale score
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 254 mothers Mean = 52.60 Mean = 52.90 Mean difference = -0.30 Study reported = -0.09 Not statistically significant,
p = 0.41
Moderate PSOC parenting efficacy subscale (range = 8 to 32)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean = 28.60 Mean = 28.80 Mean difference = -0.20 Study reported = -0.10 Not statistically significant, p ≥ 0.05
Moderate PSOC parenting efficacy subscale (range = 8 to 32)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 267 mothers Mean = 28.70 Mean = 28.70 Mean difference = 0.00 Study reported = 0.01 Not statistically significant, p ≥ 0.05
Moderate PSOC satisfaction subscale (range = 9 to 36)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean = 25.90 Mean = 26.80 Mean difference = -0.90 Study reported = -0.20 Not statistically significant, p ≥ 0.05
Moderate PSOC satisfaction subscale (range = 9 to 36)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 267 mothers Mean = 25.50 Mean = 25.70 Mean difference = -0.20 Study reported = -0.05 Not statistically significant, p ≥ 0.05
Moderate PSOC total scale (range = 17 to 68)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 267 mothers Mean = 54.20 Mean = 54.40 Mean difference = -0.20 Study reported = -0.04 Not statistically significant, p ≥ 0.05
Moderate PSOC total scale (range = 17 to 68)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean = 54.40 Mean = 55.60 Mean difference = -1.20 Study reported = -0.20 Not statistically significant, p ≥ 0.05
Moderate Language literacy numeracy promotion scale (range = 6 to 24)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 mothers Mean = 20.00 Mean = 19.70 Mean difference = 0.30 Study reported = 0.09 Not statistically significant, p ≥ 0.05
Moderate Language literacy numeracy promotion scale (range = 6 to 24)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 19.00 Mean = 18.50 Mean difference = 0.50 Study reported = 0.12 Not statistically significant, p ≥ 0.05
Moderate Parent Observation Scale (range 1 to 4; 4 = more observant)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 267 mothers Mean = 3.80 Mean = 3.80 Mean difference = 0.00 Study reported = 0.01 Not statistically significant, p ≥ 0.05
Moderate Parent Observation Scale (range 1 to 4; 4 = more observant)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 340 mothers Mean = 3.70 Mean = 3.80 Mean difference = -0.10 Study reported = -0.21 Not statistically significant, p ≥ 0.05
Moderate Parent reads books with child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 261 mothers Mean = 3.20 Mean = 3.20 Mean difference = 0.00 Study reported = 0.05 Not statistically significant, p ≥ 0.05
Moderate Parent reads books with child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 327 mothers Mean = 3.00 Mean = 3.00 Mean difference = 0.00 Study reported = 0.07 Not statistically significant, p ≥ 0.05
Moderate Parent talks to/asks child questions during reading
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 261 mothers Mean = 3.60 Mean = 3.60 Mean difference = 0.00 Study reported = -0.04 Not statistically significant, p ≥ 0.05
Moderate Parent talks to/asks child questions during reading
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 327 mothers Mean = 3.30 Mean = 3.10 Mean difference = 0.20 Study reported = 0.20 Not statistically significant, p ≥ 0.05
Moderate Parent tell stories sings with child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 mothers Mean = 3.40 Mean = 3.20 Mean difference = 0.20 Study reported = 0.19 Not statistically significant, p ≥ 0.05
Moderate Parent tell stories sings with child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 3.40 Mean = 3.50 Mean difference = -0.10 Study reported = -0.02 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge all items (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 268 mothers Mean % = 77.70 Mean % = 75.90 Mean difference = 1.80 Study reported = 0.14 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge all items (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean % = 78.80 Mean % = 80.00 Mean difference = -0.20 Study reported = -0.20 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge child care and safety (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 268 mothers Mean % = 74.30 Mean % = 74.60 Mean difference = -0.30 Study reported = -0.01 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge child care and safety (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean % = 84.00 Mean % = 85.50 Mean difference = -1.50 Study reported = -0.09 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge discipline (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 268 mothers Mean % = 75.40 Mean % = 75.80 Mean difference = -0.40 Study reported = -0.02 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge discipline (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean % = 84.80 Mean % = 85.20 Mean difference = -0.40 Study reported = -0.02 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge emotional development (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 268 mothers Mean % = 79.80 Mean % = 75.10 Mean difference = 4.70 Study reported = 0.24 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge emotional development (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean % = 75.50 Mean % = 77.90 Mean difference = -2.40 Study reported = -0.12 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge general child development (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean % = 82.40 Mean % = 80.30 Mean difference = 2.10 Study reported = 0.14 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge general child development (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 268 mothers Mean % = 74.00 Mean % = 71.90 Mean difference = 2.10 Study reported = 0.13 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge language/cognitive development (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 344 mothers Mean % = 70.70 Mean % = 73.90 Mean difference = -3.20 Study reported = -0.20 Not statistically significant, p ≥ 0.05
Moderate Parental knowledge language/cognitive development (percentage answered correctly)
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 268 mothers Mean % = 79.90 Mean % = 78.70 Mean difference = 1.20 Study reported = 0.07 Not statistically significant, p ≥ 0.05
Moderate While doing everyday things parent counts things or uses numbers with child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 mothers Mean = 3.40 Mean = 3.40 Mean difference = 0.00 Study reported = 0.04 Not statistically significant, p ≥ 0.05
Moderate While doing everyday things parent counts things or uses numbers with child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 3.10 Mean = 3.20 Mean difference = -0.10 Study reported = -0.10 Not statistically significant, p ≥ 0.05
Moderate While doing everyday things parent reads aloud to child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 2.80 Mean = 2.60 Mean difference = 0.20 Study reported = 0.13 Not statistically significant, p ≥ 0.05
Moderate While doing everyday things parent reads aloud to child
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 mothers Mean = 3.10 Mean = 2.90 Mean difference = 0.20 Study reported = 0.20 Not statistically significant, p ≥ 0.05
Moderate While doing everyday things parent talks to/asks child questions
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 1-year assessment 343 mothers Mean = 3.30 Mean = 3.20 Mean difference = 0.10 Study reported = 0.09 Not statistically significant, p ≥ 0.05
Moderate While doing everyday things parent talks to/asks child questions
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2-year assessment 266 mothers Mean = 3.30 Mean = 3.40 Mean difference = -0.10 Study reported = -0.09 Not statistically significant, p ≥ 0.05
Reductions in child maltreatment
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Child treated for injury in the past year
FavorableUnfavorable or ambiguousNo Effect
Three-site sample 2 year 265 children % = 5.50 % = 11.00 = -5.50 Study reported = -0.20 Not statistically significant, p ≥ 0.05
Submitted by user on

In contrast to the study-reported results, HomVEE calculations showed this difference to be statistically significant (p ≤ 0.05). The HomVEE tests of statistical significance are based on the HomVEE calculated effect sizes, whereas authors may have used other techniques to determine statistical significance, such as regression models or analyses of variance (ANOVA).