Green, B., Sanders, M. B., & Tarte, J. M. (2018). Effects of home visiting program implementation on preventive health care access and utilization: Results from a randomized trial of Healthy Families Oregon. Advance online publication. Prevention Science. https://doi.org/10.1007/s11121-018-0964-8
| 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) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Established on race/ethnicity and SES; outcomes not feasible to assess at baseline | None | None | Not assessed in manuscripts reviewed before 2021 |
Information on baseline equivalence and additional details about the study enrollment and context came from Green et al. (2017). Models controlled for the Healthy Families Oregon (HFO) program site, caregiver’s race and ethnicity, and total number of risk factors related to child maltreatment at baseline (as defined in the New Baby Questionnaire [NBQ]).
| Study participants | Families were eligible to participate if they were first-time parents and considered to be at high risk for child maltreatment based on the NBQ. The questionnaire defined high risk as having two or more risk factors on the NBQ; for example, being a teenage parent, having symptoms of depression, or having less than a high school education. The program screened a total of 8,520 parents using the NBQ and found 4,646 eligible. The final sample consisted of 2,727 parents (others declined participation, could not be located, or received a study wavier allowing them to bypass random assignment). The program randomly assigned a total of 1,438 parents to the HFO program and 1,289 to the comparison group. At enrollment, 61.6 percent of parents (99.5 percent of whom were mothers) identified as White, 26.9 percent as Hispanic, 2.3 percent as Asian/Pacific Islander, and 6.5 percent as multiracial. About one-third (32.3 percent) had less than a high school education. |
|---|---|
| Setting | The study took place in seven Healthy Families Oregon program sites, three of which served primarily rural communities and four of which served mixed urban and rural communities. |
| Intervention services | Healthy Families Oregon is an accredited state home-visiting program that uses the Healthy Families America program model. Families enroll prenatally or up to 90 days after birth and receive home visiting services through the children’s third birthday. Families receive weekly individualized home visits for at least six months that typically focus on child development and positive parent–child interactions. Families also receive case management services that identify their needs and link them to relevant services. Intervention take-up was low; of those assigned to the home-visiting group, only 44 percent received at least one home visit. |
| Comparison conditions | Families assigned to the comparison group were not eligible to receive home-visiting services through the HFO program. |
| 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). • Public benefit receipt (family had Oregon Health Plan coverage) |
| Funding sources | The study was funded by the U.S. Department of Health and Human Services, Children's Bureau (grant no. 90CA1782). |
| Author affiliation | None of the study authors are developers of the program model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 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 | Percentage of children ever enrolled in Oregon Health Plan |
FavorableUnfavorable or ambiguousNo Effect |
Oregon, 2010-2012, full sample |
2 years |
2,707 children | Percent = 0.83 | Percent = 0.83 | Odds ratio = 1.01 | HomVEE calculated = 0.01 | Not statistically significant, p= 0.93 |
HomVEE calculated the effect size based on the study-reported odds ratio. |
| High | Total number of days enrolled in Oregon Health Plan (children) |
FavorableUnfavorable or ambiguousNo Effect |
Oregon, 2010-2012, full sample |
2 years |
2,707 children | Days = 519.20 | Days = 524.80 | Mean difference = -5.60 | HomVEE calculated = -0.02 | Not statistically significant, p= 0.61 |
|
| Moderate | Percentage of parents ever enrolled in Oregon Health Plan |
FavorableUnfavorable or ambiguousNo Effect |
Oregon, 2010-2012, full sample |
2 years |
2,707 parents | Percent = 0.84 | Percent = 0.84 | Odds ratio = 1.03 | HomVEE calculated = 0.02 | Not statistically significant, p= 0.77 |
HomVEE calculated the effect size based on the study-reported odds ratio. |
| Moderate | Total number of days enrolled in Oregon Health Plan (parents) |
FavorableUnfavorable or ambiguousNo Effect |
Oregon, 2010-2012, full sample |
2 years |
2,707 parents | Days = 381.40 | Days = 380.10 | Mean difference = 1.30 | HomVEE calculated = 0.00 | Not statistically significant, p= 0.62 |